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EVIDENCE for oral joint supp's?

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  • EVIDENCE for oral joint supp's?

    My vet wants me to put a 7 year-old trail horse with loose stifles on a glucosamine/chondroitin oral supplement as a "preventative" since his joints have some extra range of motion.

    Years ago, I read a study that clearly stated that all of these "joint supplements" are not absorbed by equines except as simple sugar, and are basically a very expensive "owner placebo." In spite of this, my vet is convinced they do something.

    Personally, I find the idea that ~EATING~ glucosamine and chondroitin, obtained from another species, will result in that molecule "going where it's needed" to be somewhere between simplistic and magical thinking, and though I adore this horse I am loathe to spend money on snake oil.

    Does anyone know of a reliable study that shows this stuff is actually absorbed to any measurable effect? We're talking about the oral stuff here, I'm already familiar with the effects of Legend & Adequan.

    Thanks!

  • #2
    Cosequin and Corta-Flx have both undergone clinical trials, IIRC. I would look into the data behind those two products first.

    However, I do NOT believe that anyone has ever shown any oral joint supplement is effective at *preventing* DJD. I don't think the data is even there for the injectibles like Legend or Adequan.

    Comment


    • #3
      Even the Cosequin trials are extremely sketchy, and these are considered "gold standard". Which goes to show how poor the standard is with nutraceuticals.

      You're not going to find anything convincing, I'm afraid. Absorbed, yes . . . some of it is absorbed. But getting to its intended destination intact? Not much evidence for that.

      Convictions of efficacy are much easier to come by than demonstrable benefit that is clear to dispassionate observers. This is why anecdotes are "enough" for a lot of people.
      Click here before you buy.

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      • #4
        I put my old, retired broodmare on Smartpak's Seniorflex a couple years ago because she was really getting stiff and ouchy. (and she was already out 24/7, so getting enough "natural" exercise to help her joints) It took about 2 weeks to notice an effect, but then the difference was like night and day. Horses can't lie-- either they're in pain or they're not, and she moves like she did 5 years ago, with absolutely no hint of pain. This is enough "proof" for me. So there's gotta be something that's getting into her system and helping.

        Now, all this being said... If your horse is having stifle problems, maybe you can try doing hill exercises to help strengthen the muscles surrounding the joint. Trot uphill, walk back down, repeat. I would start with about 5 minutes at first.

        Comment


        • #5
          Check out Pentosan. It is an injectable that is being used as both a preventative and a joint/tissue supplement.

          Not sure if actual studies have been done on it in other countries. It has been in use abroad for a while and is now getting popular in the US.
          "The greatness of a nation and its moral progress can be judged by the way its animals are treated." --Ghandi

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          • #6
            I read about a French (I think) study a few years ago that showed horses on a daily dose of 10,000mg of MSM had fewer inflammatory cells (agents, radicals?) in their joint fluid after a hard (they used jumping) work than those not on MSM.

            That's likely as close as you'll get to preventative joint care. MSM is cheap too.

            Comment

            • Original Poster

              #7
              Here's the thing--we're not HAVING a "problem" yet. He's just a very loosey-goosey kind of guy with remarkable range of motion all over his body--front end and spine as well as stifles. Also, he's out 24/7, eats ONLY grass and hay to hold a good weight, and by most people's standards is lightly ridden. Being a TWH, his "work" is 98% at a brisk walk over gentle terrain.

              I'm not seeing this as a Pentosan-worthy workload.

              One of the "better" joint supps. would run me around $1,400.00 per year if used daily. If there is no empirical proof that this is justified and beneficial for an ASYMPTOMATIC light-use young horse, I'd rather put that new overhang on the barn.

              That's some pretty durn expensive "pixie dust!'

              Comment


              • #8
                You're right.

                Based on your last description of your horses present and future workload I wouldn't be spending any money on a joint supplement either, at least not at this point.
                "The greatness of a nation and its moral progress can be judged by the way its animals are treated." --Ghandi

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                • #9
                  Horses can't lie-- either they're in pain or they're not
                  But osteoarthritis can certainly wax and wane in terms of symptom severity. It is one of the characteristics of the disease. Many of my patients express it very colorfully as having "another visit from Old Arthur" when their OA flares up. Which it does periodically before quieting down again.
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                  • #10
                    Another product with research on it is Actistatin. However, I still am not convinced of the COST effectiveness of oral joint supplements. My hand was pushed to Legend/Adequan by an injury and it is actually less than 1400/yr and gives good results. Not to mention pentosan.

                    Comment


                    • #11
                      Here's the one (or at least one of the ones) on Corta-Flx. Tiny sample of horses with DJD. Horse Journal also did a review of joint supplements in 1999 and saw results from Corta-Flx also, but I wasn't able to find a description of the procedures they used to evaluate it, nor a sample size.

                      If there's any data on efficacy for preventative use, I sure don't know about it.
                      "I'm not always sarcastic. Sometimes I'm asleep." - Harry Dresden

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                      • Original Poster

                        #12
                        Delta, what do you think of the Corta-Flex study above?

                        (Of course, I'm imagining it was paid for by Corta-Flex!)

                        Comment


                        • #13
                          You might find that a properly designed exercise routine by an equine physio-therapist would be more effective and if done diligently would be longer lasting.

                          I had one that entailed some cavaletti, stretching, hills, etc.
                          Proud member of People Who Hate to Kill Wildlife clique

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                          • #14
                            I thought my horse was just a little stiff and was convinced to put him on Pentosan. I had tried a few oral supplements and noticed no difference so stopped them. The Pentosan has literally given me a new horse...he has movement I never thought he had. It's only $20 a dose so a loading dose of 4 shots plus one a month is 300 a year the first year and 240 a year after that. If your vet is really pressuring you maybe try it and see it's not that expensive. If there is no difference whatsoever after a few months stop using it until you do see him getting stiff and then try different supplements to see what works for your horse. I do know of the oral supplements my cousin who is a vet (and doesn't believe in oral supplements much) says the only ones with half decent studies behind them that she would recommend are cosequin and platinum performance.

                            Comment


                            • #15
                              Originally posted by Lady Eboshi View Post
                              Delta, what do you think of the Corta-Flex study above?

                              (Of course, I'm imagining it was paid for by Corta-Flex!)
                              Too short, too few horses, the endpoints they chose are difficult to sift through, they supply very little validation of the various kinematic measurements WRT what they actually mean in terms of prognosis/function, and it appears that they put everything in a blender and plucked out things with a significant p-value to put forward as "evidence".

                              If they were hard core and wanting to REALLY put their product to the test, they would have selected 2-3 of the kinematic parameters that are STRONGLY validated as correlating with improved soundness (I'm not sure there are any that fit this description) and used a larger group of animals with a longer period of treatment, including a crossover period where the "test" horses became the "control" horses to account for the variable of "things getting better on their own". No fair using weird, unvalidated parameters as evidence of benefit just because there happens to be a p value <0.05. That's cheating.

                              In the scheme of "studies done with oral joint supplements on horses" I'd give it a 6. But most other "studies" get about a 2 or 3, so it's "better" than those. Sadly, though, when compared to good, solid, hard core studies that "6" would fall on a scale of 1-100.
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                              • Original Poster

                                #16
                                That's about what I thought you'd say. The very low numbers pretty much killed it for me as "proving" anything. I found the following article pretty enlightening:

                                http://www1.agric.gov.ab.ca/$department/deptdocs.nsf/all/hrs3236

                                What I find interesting is that all this uber-expensive stuff has been on the market since at least 1990 and NO ONE seems to have been able to satisfactorily come up with any data. You and I both know that one reason for that can be because no one really WANTS to fund research that just might prove their oh-so-profitable product to be mostly worthless. I strongly suspect that might be the case here. Actually, just read another article that talks about "3% to 4%" bioavailability with even the BEST orals, in this case Cosequin. Pretty much killed THAT idea in the cost-benefit ratio department!

                                After looking pretty closely at all the options, I've pretty much concluded I'll opt for brand-name Adequan only if I think I see a problem. In the meantime, on days he works I'll give him a dose of MSM.

                                While I have heard the "miracle" anecdotes with regard to Pentosan, I've also heard that it's unapproved, is compounded overseas by some pretty sketchy outfits, and is being used off-label and may ultimately be banned. None of that makes me want to inject it into a young, HEALTHY animal!

                                Delta, you're an eventer of long experience with a number of horses, knowledgeable and motivated about soundness. Do YOU feed your guys oral glucosamine/chondroitin preparations or other "nutraceuticals?" Would you, if they were on good pasture 24/7 and were not jumping?
                                Last edited by Lady Eboshi; Mar. 14, 2013, 08:45 PM.

                                Comment


                                • #17
                                  I do not use any nutraceuticals or supplements other than vitamins/minerals that I know my hay or soil are lacking. I do use Pentosan on one of mine, with mild hock arthritis. Dressage scores in the 20a and no longer randomly stopping at simple XC fences are the endpoints I've observed.

                                  I am reasonably comfortable with compounded drugs (Pentosan is made in the USA) and with drugs from overseas as well. But one cannot ask another individual to adopt one's own comfort level, so YMMV, as they say.
                                  Click here before you buy.

                                  Comment

                                  • Original Poster

                                    #18
                                    Many thanks, Delta, for the input. I think I'm going to just leg him up with the pole and hill work someone else suggested above (as did my vet) and see where it goes once he's fit for the year.

                                    The whole question of a horse needing "joint support" just to walk around seems a little silly to me, but for one factor; he does have a lot of laxity in his stifles, and he's a smaller guy than I've historically ridden as my primary horse--he's a dainty 14.3 and probably not more than 800 lbs. Being 150 I'm a little more aware of him carrying my weight. That said, there's not a lot of concussion involved since he's gaited. I do follow "cavalry protocol" resting his back intermittently by getting off and leading him a few minutes per hour on longer rides. He's a gallant little soul and will do anything I ask, and I'd like to still be riding him when I'm old(er) and gray(er)!

                                    Comment


                                    • #19
                                      I recently switched both of my horses from a more expensive "joint" supplement to straight MSM, and both seem to be doing just fine. MSM is significantly cheaper, even if you are paranoid like I am and will only buy the MSM manufactured in the US (which costs more than the MSM made overseas).

                                      Comment


                                      • #20
                                        Originally posted by Lady Eboshi View Post
                                        That's about what I thought you'd say. The very low numbers pretty much killed it for me as "proving" anything. I found the following article pretty enlightening:

                                        http://www1.agric.gov.ab.ca/$department/deptdocs.nsf/all/hrs3236

                                        What I find interesting is that all this uber-expensive stuff has been on the market since at least 1990 and NO ONE seems to have been able to satisfactorily come up with any data. You and I both know that one reason for that can be because no one really WANTS to fund research that just might prove their oh-so-profitable product to be mostly worthless. I strongly suspect that might be the case here. Actually, just read another article that talks about "3% to 4%" bioavailability with even the BEST orals, in this case Cosequin. Pretty much killed THAT idea in the cost-benefit ratio department!
                                        I had a long conversation with the owner of one of the better known supplement manufacturers about the lack of data. He told me that he started his career working with pigs. With them you could have a large number of genetically identical animals, feed them a supplement and then slaughter them and analyze the impact of the feed/supplement/drug. With horses, it's a lot more complicated!

                                        Of course, there is also the problem that many of these supplements may well do little to nothing and no one wants data that shows that.

                                        Anecdotally I've seen very good results with MSM, although if you feed it for a long time my vet tells me the efficacy drops off. She recommends feeding it for awhile and then giving your horse a break during seasonal down times.

                                        Way back when supplements were less ubiquitous than they are now, I did start my older horse on an oral joint supplement and was shocked by how much it helped him. Can't remember what it was called . . . this was back in the early 90s, maybe it was Flex Free? So I think to a certain extent it depends on your horse and what the problem is.

                                        I've tried many supplements since then and most of them have provided little to no improvement. I do currently feed my horse Corta-Flx and I do think he moves better on it. I will tell you for sure that it helped my dog significantly. Not exactly an apples to apples comparison, for sure, but interesting.
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