Practitioners and supplement manufacturers alike are concerned about the quality, efficacy and safety of equine joint supplements. “The biggest problem,” says Paul Bryant Jr., DVM, of Okeechobee, Fla., Veterinary Hospital, “is that joint supplements aren’t FDA-regulated.” In treating performance horses—racing, reining, speed events and hunter/jumper—Dr. Bryant says: “It’s trial and error to find a joint supplement that works. I want to see the company’s research to make sure the product is legitimate. “The market is out of control with so many supplements available. It is hard for a veterinarian to read all the available research, and almost impossible for horse owners to read and understand before they make a choice.” Bryant prefers injectable supplements and uses Bayer Animal Health’s Legend (hyaluronate sodium), the only FDA-regulated product to treat joint dysfunction, and Luitpold Animal Health’s Adequan IM (polysulfated glycoaminoglycan). He says those two supplements “have years of research behind them, and I go with the gold standards.” He has seen research on the efficacy of glucosamine and HA, but he says quality research is provided for very few products. “Show me a double-blinded study,” he says. “I want to see valid research.” Check Ingredient List Shawn Madere, CEO of GLC Direct LLC of Paris, Ky., recommends that veterinarians understand joint supplements and their ingredients. He says most supplements use hydrochloride to stabilize gluscosamine, but it actually is the poorest absorbable form. Glucosamine sulfates have been clinically proven to provide better absorption, he says. “Consumer Labs has found fault with the majority of animal products tested in 2009,” Madere says. “Only GLC 5500 and Cosequin Optimized have received approval in the equine category to meet both label claim and test free of lead contaminates.” The non-profit National Animal Supplement Council has a seal of approval program for animal health supplements. To have products carry the NASC seal, manufacturer members provide facility audits, quality-control procedures, adverse event reporting, label guidelines and warning/caution statements. Though Madere says a vanguard group such as NASC is good for the industry, he thinks that stricter overall regulations are necessary for purity and content and that more documented research is necessary. “Independent validation and evaluation provides a less skewed view of equine joint supplements,” he says. “There is so much misinformation out there that veterinarians need to be able to rely on validated clinical evaluations. Do your homework so you know what to tell your clients. “As an industry, we need to more invest time, energy and money in safety studies before bringing products to market,” Madere says. “You cannot rely solely on existing research and basic biochemistry. Some formularies look good on paper yet have no value in real-world applications.” Formula Approach Phil Brown, DVM, of Nutri-Vet LLC says veterinarians are using more combinations of ingredients for joint support treatment. As senior vice president of marketing and regulatory affairs at Nutri-Vet, Dr. Brown wants to continue to create condition-specific products. Brown says new formulas include boswellia as an anti-inflammatory and pain modifier as well as omega-3s in glucosamine/chondroitin sulfate products. He prefers to use ecologically supported pure salmon oil. Bee pollen is added to one of Nutri-Vet’s joint supports products for overall general health. “Supplements are often helpful with unspecific lameness,” he says, “although a veterinarian should always be consulted with severe joint problems. “As alternatives to heavy-duty drugs,” Brown says, “supplements help restructure cells, but they don’t mask pain as bute does. The horse stays sore and moves less, so cells have a chance to rest and rebuild.” Manufacturing has improved and veterinary acceptance has increased in the past seven to 10 years, Brown says. The joint supplement industry’s “sloppy” labeling of years past is being replaced with product traceability and validity, he says. “Is it perfect? Probably not, but we’re getting there,” Brown says. “We’re past infancy, but we’re still in the adolescent stage of regulation development.” Material Differences Barbara E. Eves, DVM, is senior manager of scientific communications for Nutramax Laboratories Inc. of Edgewood, Md. “Our Cosequin equine line was developed after our Cosamin glucosamine/chondroitin sulfate product for humans,” she says. “Our premier product, Cosequin ASU, contains NMX1000 avocado/soybean unsaponifiables (ASU), FCHG49 glucosamine and TRH122 chondroitin sulfate along with high-purity MSM.” “The combination of glucosamine and chondroitin sulfate plus ASU has been shown to work better than glucosamine and chondroitin sulfate alone.” The quality of the raw materials is important, Dr. Eves says. “A cell culture study with chondroitin sulfate raw materials purchased from different suppliers showed they did not all inhibit expression of several mediators involved in cartilage breakdown,” she says. “Some had inconsistent effects; some had no effect at all.” Jason Watkin, CEO of Biomedica Labs of Duncan, British Columbia, says his company’s products exceed the quality standards required by law. Veterinarians use Biomedica’s Recovery EQ, developed to improve overall healing after surgery or injury and to treat joint disease and other chronic degenerative diseases, Watkin says. Recovery EQ and RecoveryEQ Extra (with hyaluronic acid) are sold to compounding labs and veterinarians primarily in Canada and the U.S. Because Recovery is manufactured in Canada, it must pass strict quality-control regulations, Watkin says. “It is tested for quality, quanity, microbe contamination, heavy metals and solvent residue,” he says. “All tests must pass or it cannot be sold. This assures no product contamination and guarantees label claims. “We guarantee that our product quality exceeds any seal of approval. It costs thousands of dollars per batch to test, and companies that are not required to do it are unlikely to volunteer.” He says the entire supplement industry would have more crediblity if quality standards were upheld: “Then everyone would have to have 1,500 mg of glucosamine if that is what the label said, instead of actually having 300 mg.” This article first appeared in the September 2009 issue of Veterinary Practice News. <HOME>
