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(207) 846-6515

ORTHOPEDICS: ARTHRITIS: OA 6. MEDICAL TREATMENTS: SUPPLEMENTS

(Nutraceuticals are nutritional supplements that have pharmaceutical - drug-level - effects. Since they are not categorized as pharmaceuticals they are not regulated as such by the FDA. There is very limited FDA oversight of the production and marketing of nutraceuticals. As a result, nutraceuticals vary widely in quality from brand to brand. 

This is not idle speculation: for example, some researchers studying nutraceuticals have analyzed glucosamine/chondroitin products obtained from grocery stores, pharmacies, health food stores and internet retailers and found that they contain little or no glucosamine/chondroitin.

Oral supplements are expensive. They also are only likely to help if they are administered every day for life. Choosing poor quality supplements can be a very costly mistake with regard to money badly spent and lack of effectiveness. 

At YVC we dispense some nutraceuticals and mention them by name in the following article because we are confident that they are of exceptionally high quality.)

A wide variety of supplements have been used for treatment and prevention of OA. We believe there are two categories of supplements worth using for all patients with OA, as well as for prevention of OA in healthy patients: Joint Protective Compounds and Fatty Acids. 

JOINT PROTECTIVE COMPOUNDS (JPCs)
JPCs are supplements that slow or prevent damage and degenerative changes in all of the tissues (cartilage, tendon, ligament, synovium, fluid) of joints. 

JPCs are available as oral and injectable products. The oral supplement that many of our clients are familiar with because they use it themselves is a combination of glucosamine and chondroitin sulfate. Evidence for the effectiveness of glucosamine/chondroitin sulfate supplements has been accumulating since the 1990s; more recently a third compound, avocado-soybean unsaponifiables (ASUs) has been shown to have similar beneficial effects, particularly when added to glucosamine/chondroitin sulfate.  We recommend and dispense the glucosamine/chondroitin sulfate/ASU product Dasuquin. 

Polysulfated glycosaminoglycans (PSGAGs) are JPCs that are given by injection instead of orally. These injections are administered under the skin or in a muscle, and not directly into the joint. They are relatively easy to do, and many of our clients that have their pets on PSGAGs give the injections at home. They are a good JPC alternative for pets that are difficult to medicate orally. Another appealing feature of PSGAGs is that they are not given daily; our typical schedule for their use is twice weekly for one month, once weekly for one month, once every other week for one month, then long-term maintenance with what the individual pet seems to respond best to, ranging from once monthly to once weekly. Adequan and Ichon are the two brands of PSGAGs that we regularly use.

PSGAGs are very similar to glucosamine/chondroitin, but different enough that some pets may respond better to one or the other, and it is our impression that some pets with OA have done particularly well when treated with both products. 

FATTY ACIDS (FISH OILS)
Fatty acids (FAs) are supplements that have anti-inflammatory effects and probably also slow the degenerative processes that occur in arthritic joints. These are the same products that have been used for years by people for heart disease and other ailments, and by pet owners for their pet’s skin problems. 

There is very good scientific evidence that using FAs at high doses provides particularly good anti-inflammatory effect for arthritis. High-dose means two to three times the dose listed on the label of most FAs marketed for pets, or a dose in the range of 25 to 50 mg of the EPA (eicosapentanoic acid) portion of the supplement. We believe the best way to provide this dose is to feed Hill’s Prescription Diet J/D as the dog’s or cat’s regular maintenance food. An alternative is the use a high quality FA supplement - we prefer Welactin and Derma-3 - at this same dose. Standard doses of fish oil - about 1/2 to 1/3 of this amount - could provide a reasonable level of effectiveness. 

Peter Smith, DVM
Yarmouth Veterinary Center
2014

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