What ‘Sup’ With Joint Supplements?
Imagine you’re walking down the aisle at your favorite big box store on a weekend, catching up on groceries and grabbing much needed supplies.
Dog food? Check.
Dental chews? Check.
Joint Supplement for dogs? Check…or so you thought.
Did you grab the nearest one with a picture of a running Labrador Retriever on it that says “Added glucosamine and chondroitin for your dog’s hips”?
It turns out that Americans spend over $25 Billion (Yes, Billion with a “B”) on supplements annually. Approximately one third of this is spent on glucosamine and chondroitin. But do we really know what ingredients are being put into most joint supplements for pets, and how do we know they even work?
Let’s look at the term “Nutraceutical”, which is a product that uses a food ingredient in a pharmacological capacity. In other words, a food ingredient is being used with the goal of achieving a therapeutic effect. Nutraceuticals are different than pharmaceuticals, which undergo testing for Bioavailability (how much does the body actually USE the product?), Efficacy (Does the product even work?), and Safety (Could the product potentially cause harm?). Nutraceuticals do not have the same rigorous testing as pharmaceuticals, which leaves room for error, lack of safety, and and risk of contamination, including heavy metals, pesticides, and pharmaceuticals. Yes, you read that right: pharmaceuticals sometimes get added so it makes the product appear to work. Yikes.
Consider this guide when choosing supplements:
When looking for the right product, watch for a seal that says “NASC”, which stands for the National Animal Supplement Council. It usually is a yellow/gold seal somewhere on the product’s label. This means it has gone through rigorous third-party testing, which is a 300+ point inspection for quality assurance, including identity of the ingredients, purity, strength, and composition.
Hold the products to a pharmaceutical standard. Ask about bioavailability, efficacy, and safety. Has the product had rigorous testing with randomized control trials (RCT) of the whole product on the species you are using it for, not just an individual ingredient? Is the dosing easy and is it palatable (will my pet even eat it?)
Thankfully there are measures in place to help guide the safest and most effective product choices for supplements, and current evidence based medicine does shed some light on the most effective (and least effective) ingredients out there. Let’s take a look at some of the most common ingredients and see how they measure up to current standards:
1) Glucosamine/Chondroitin: The overall evidence for these ingredients for dogs is actually very poor. Research has found that bioavailability (what is actually useable in the body, not what it can do in a petri dish!) is about 12% for glucosamine and 5% for chondroitin. So what does this mean for your budget? It means that the majority of your hard earned dollars are going down the drain. Be careful of products that list “added" glucosamine/chondroitin such as treats, as these are typically lower than the average amounts found in supplements. Overall it has minimal side effects and is well tolerated in most patients, so you’ll find it in most joint health products for pets. It’s advised to use it for at least two months before evaluating its effects.
2) Curcumin: Commonly referred to as Turmeric, this is a flowering plant in the ginger family that has been used for centuries for its anti-inflammatory, neuro-protective, and anti-neoplastic effects. Unfortunately, it’s bioavailability is very low (Less than 1%) which contrasts from in vitro effects (i.e. what it does in a petri dish), which may explain its popularity. Side effects can include gastrointestinal discomfort and studies have not shown favorable results to improve mobility.
3) CBD/Cannabinoids: Honestly, this should be it’s own journal post. CBD has been under a bright spotlight in the last few years, with little definitive research so far. CBD and THC are chemical constituents of hemp. THC is psychoactive and has a toxic potential for pets. CBD may have analgesic and anti-inflammatory effects, as well as appetite stimulation, anxiolytic (anti-anxiety) effects and help alleviate neuropathic pain. We do know that there are cannabinoid receptors in the body: CB-1 receptors are located in the brain, cerebellum, basal ganglia and hippocampus. CB-2 receptors are part of the immune system, gut, and parts of the musculoskeletal and cardiac systems. It is synergistic with other drugs including opioids, and it may show promising anti-neoplastic (anti-cancer) effects. Two promising studies to check out are through ElleVet Sciences and ABSC Organics. Side effects may include excessive sedation and increased hepatic (liver) values.
4) Omega 3 Fatty Acids: Omega 3 EFA’s (Essential Fatty Acids) have excellent evidence for bioavailability and efficacy for joint health. EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid) both have an anti-inflammatory effect by affecting several biochemical participants of inflammation including IL-1, IL-6, MMP, COX-2, 5-LOX, and TNF-alpha. Thankfully, there are many studies that show excellent efficacy and there are many quality products available. The best source may be through the diet, such as a therapeutic diet (Hill’s Metabolic + Mobility), while oral supplementation can increase the risk for diarrhea. Doses over 300mg/kg or higher can have an anti-platelet effect, so be aware if you are also administering an NSAID (Rimadyl or equivalent) and Adequan injections!
5) Green Lipped Mussel: This is a lipid extract from the Green Lipped Mussel, a bivalve mollusk, in New Zealand. It is rich in PUFA’s (Polyunsaturated Fatty Acids), vitamins, minerals, and amino acids. This ingredient is popular in joint supplements and studies have shown efficacy for decreased pain and swelling, as well as increased mobility and musculoskeletal scores.
6) Boswellia Serrata: You may have heard this alternatively named as “Frankincense”. It contains a resin extract called AKBA (Acetyl-11-keto-B-Boswellic Acid) that has anti-inflammatory effects by potently inhibiting 5-LOX. Canine studies have shown decreased lameness and pain, and increased Peak Vertical Force (PVF) and daily activity. Ingredient levels and concentrations vary, so ensure a product has been third-party tested.
7) Astaxanthin: Extracted from red marine algae, this is a POTENT anti-inflammatory, antioxidant, and anti-neoplastic supplement. It alleviates age-related oxidative and inflammatory damage, as well as enhances mitochondrial function. Studies have shown it has more of an effect on geriatric canine populations for this effect. In athletes (exercise-conditioned dogs), it may mitigate exercise-induced fatigue and increase exercise performance. Just how potent is its antioxidant power? It is 6,000 times more potent than Vitamin C, 800 times more potent than CoQ10, and 550 times more potent than Vitamin E.
8) Fortetropin: This supplement is derived from fertilized chicken egg-yolks that decreases myostatin levels in dogs. Increased Myostatin levels can lead to muscle atrophy, so fortetropin is used to combat this effect. A randomized control trial (RCT) performed on dogs that underwent a TPLO (a surgery of the stifle or “knee”) who took fortetropin for 12 weeks post-operatively did not show signs of muscle atrophy when serum myostatin levels were measured.
