Efficacy Of Oral Joint Supplements: Which Ingredients Actually ‘Work?’

Dr. Rachel Tucker, an associate at Liphook Equine Hospital in the United Kingdom, was on a quest to determine which ingredients, if any, contained in popular equine joint supplements actually worked.

Many oral supplements claim a wide array of effects, including maintaining joint health, offering anti-inflammatory benefits, improving welfare, reducing joint stiffness and pain, and slowing osteoarthritis progression, reports The Horse.

Since most supplements are sold as food products, they are not required to conform to regulations or quality — or to have demonstrated efficacy.

Tucker considered ingredients effective if they achieved a desired response in the joint. They must also be bioavailable when administered orally, and have an appropriate formulation and concentration that matches published studies.

Chondroitin sulfate is a building block of joints; it is bioavailable and reaches synovial fluid and cartilage. It has an anti-inflammatory effect on human joint tissues and has been shown to reduce pain and swelling, as well as to prevent joint space narrowing. Equine-specific studies, however, have shown that chondroitin sulfate has no measurable effect on the horse.

Glucosamine is present in cartilage and synovial fluid; the amino monosaccharide prevents joint breakdown and acts as an anti-inflammatory. Research has shown conflicting evidence: some studies show that glucosamine has slow or no utilization in tissue, while others find that it does have an effect on pain or function.

Boswellia serrata, also called Indian frankincense, claims to be an anti-inflammatory. There have been no veterinary studies on Boswellia serrata's use, so additional investigation is needed, Tucker said. It has shown some benefit in humans who have taken it.

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Turmeric use in humans has demonstrated anti-inflammatory and antioxidant properties, but it has poor bioavailability. Only one veterinary study has been done to date, and the vets involved thought it showed significant improvement in dogs that consumed it.

While Tucker concluded that there is no concrete evidence that supplements work, they are safe to feed horses.

Read more at The Horse.

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Joint Care: Provide Support After Wounds, Infection

Viscous and transparent, synovial fluid acts as a biological lubricant within musculoskeletal mechanisms. Penetrating wounds to joints and tendon sheaths cause most infections, though pathogens carried in the bloodstream, as with foals diagnosed with joint ill, have been implicated, as has contamination at the time of intraarticular injection or surgery. Veterinarians refer to infection that sets up in any structure containing synovial fluid, namely joints, tendons, and bursas, as synovial sepsis.

Prompt diagnosis and aggressive treatment minimize damage to septic structures and often prevent career- and life-threatening consequences. To determine if infection is present, bacterial isolation through culture is the best diagnostic tool, yet low sensitivity and long laboratory turnaround time often preclude a definite diagnosis in the face of emergency situations and treatment decisions, which may include joint irrigation and surgery. Because of these limitations, researchers have sought alternative ways to quickly identify the presence of infection.

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Austrian researchers recently evaluated the presence of specific biomarkers, called antimicrobial proteins, in synovial fluid as a way to confirm infection.* These proteins are activated by the immune system in response to a pathogenic challenge, so their existence in the fluid indicates sepsis. According to the researchers, “using enzyme activity as a biomarker of synovial sepsis enables the development of a point-of-care diagnostic test, which would allow veterinarians to perform, analyze, and act on test results stall-side, in a matter of minutes.”

In the study, researchers collected synovial fluid samples from three groups of horses: healthy controls, horses with aseptic synovitis (inflammation without infection), and horses with septic synovitis. Enzyme activity assays were compared with standard synovial fluid parameters and broad-range bacterial DNA extraction.

The researchers found enzyme activities were significantly different between septic synovial samples and aseptic and control samples, leading them to believe that measurement of enzyme activities would allow for reliable, rapid diagnosis of synovial sepsis and immediate therapeutic interventions.

Joint health depends largely on conscientious management of exercise, including frequency and intensity of athletic bouts, and the provision of high-quality nutritional supplements formulated specifically for joint support. While synovial sepsis typically develops from injuries that compromise the joint capsule, it can occur following routine intraarticular injection of hyaluronic acid and corticosteroids, though the incidence of infection is uncommon.° The prophylactic use of joint supplements in high-performance horses and prospects can delay the need for joint injections, thus postponing any risk associated with invasive procedures.

*Haralambus, R., A. Florczyk, E.  Sigl, S. Gultekin, C. Vogl, S. Brandt, M. Schierer, C. Gamerith, and F. Jenner. 2021. Detection of synovial sepsis in horses using enzymes as biomarker. Equine Veterinary Journal. In press.

°Steel, C.M., R.R. Pannirselvam, and G.A. Anderson. 2013. Risk of septic arthritis after intra-articular medication: A study of 16,624 injections in Thoroughbred racehorses. Australian Veterinary Journal 91(7):268-273.

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Reprinted courtesy of Kentucky Equine Research. Visit ker.com for the latest in equine nutrition and management, and subscribe to Equinews to receive these articles directly.

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