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Old 07-17-2010, 11:40 PM
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Supplements, etc. for Arthritis/Joint Problems

Reading through the threads here, it's easy to see that joint problems (be they hip or elbow dysplasia, cruciate injuries, or just plain arthritis from advanced age) are a common source of questions. As my own young dog was recently diagnosed and treated for elbow dysplasia, I've been doing a lot of research on the Veterinary Information Network (VIN) to determine what supplements (if any) have merit for my girl who is only a year old and already has DJD (dengerative joint disease). Here's what I have come up with from VIN as far as supplements:

Some supplements have been proven to reduce inflammation. Individual supplements can be efficacious in individual dogs - not every supplement will produce profound results in every dog. Because of their very natures, the supplements listed below are extremely unlikely to have unpleasant side effects so their potential to help far outweighs their potential to harm. Collectively, they are recommended as a first line of defense in all dogs with DJD. In fact the following supplement are so benign, that most of them would be entirely appropriate to give to dogs not currently suffering from, but at increased risk of developing, DJD.

1. Glycosaminoglycans: Glycosaminoglycans are a source of cartilage-matrix molecules which are the components and precursors to cell synthesis, increase the production of synovial fluid, and neutralize the damaging effects of free radicals.

A. Adequan® injections. The label dose is twice weekly for 8 doses. Many veterinarians will continue to maintain their DJD patients with injections every 1 to 4 months (or more often in severe cases).
-Adequan® injections will reach adequate blood and tissue levels much quicker than oral products.

B. Oral Glucosamine/Chondroitin supplements. These should start at the same time as the Adequan injections. By the time the semi-weekly Adequan® injections are completed, the oral supplements have had time to achieve sufficient blood levels.
-The joint products made by Nutramax Laboratories, Inc. (Cosequin® and Dasuquin®) are the only ones that have credible efficacy data in dogs, but that does not mean that other products are not effective. You do need to be careful as many products do not actually contain the stated amounts of supplement.


2. Omega 3 Fatty Acids: Fish oil, or more specifically EPA and DHA, has been proven to decrease inflammation and is helpful in most inflammatory processes (DJD, allergies, cancer, etc.).

A. The anti-inflammatory dose of fish oil is approximately 300mg of combined EPA/DHA per 10 pounds of body weight. This is typically one 1000-1200mg fish oil capsule per 10 pounds.

B. Some fish oil supplements have been shown to contain unacceptably high levels of mercury and other contaminants. You can check the rating of a potential fish oil supplement at the following sites:
-Environmental Defense Fund: http://www.edf.org/page.cfm?tagID=16536
-International Fish Oil Standards: http://www.ifosprogram.com/IFOS/ConsumerReport.aspx

3. Antioxidants: Antioxidants neutralize the damaging effects of free radicals which can start chain reactions that damage cells.

A. A general antioxidant supplement should contain components such as bioflavonoids, vitamins E and C, selenium, zinc, and manganese which are all good antioxidants.

B. Vitamin E: This fat soluble vitamin is not only a powerful antioxidant but will also help with the absorption and utilization of fish oils.
-Natural (d-alpha) vitamin E is more efficacious than synthetic (dl-alpha).
-Large dogs should receive approximately 400 IU per day (smaller dogs, approximately 200 IU). Many general antioxidant supplements contain some vitamin E, but the amounts included are unlikely to reach the recommended level of vitamin E, so supplementary quantities can be given to achieve the desired level.

C. Vitamin C: This water soluble vitamin is another powerful antioxidant.
-Dogs naturally produce vitamin C, but given the possible benefit and the lack of potential harm, adding additional vitamin C may be prudent. Excess vitamin C will be eliminated in the urine.
-Large dogs can receive 1000mg or more per day (small dogs, 500mg); ideally split into morning and evening doses as vitamin C is quickly eliminated from the body.
-Massive doses have been known to cause loose stools so it is advisable to slowly increase vitamin C supplementation to the desired level.

D. S-adenosyl methionine (SAM-e): SAM-e has been shown to improve cartilage metabolism. It has also increases glutathione levels, especially in the liver (glutathione is a natural antioxidant).
-Denosyl® and Denamarin® are the only brands of SAM-e researched in U.S. trials for dogs and cats.
-After an induction period (perhaps one 30-day supply), it is reasonable to decrease the dose to every other day or twice weekly due to the significant cost of daily supplementation.
-An added benefit is protecting the liver from the potentially harmful effects of NSAIDs, if the DJD progresses to the point where these drugs are needed.


4. Niacinamide (aka Nicotinamide): This water soluble B vitamin has demonstrated some anti-inflammatory properties. Note that Niacinamide is not the same as Niacin.
-Large dogs should receive 500mg per day; small dogs, 250mg per day.


5. Methylsulfonylmethane (MSM): MSM is potentially anti-inflammatory. It may not help, but is extremely unlikely to harm. It is included in some glucosamine/chondroitin products.

None of the above supplements have been proven to prevent the development of DJD. Dogs are notoriously good at hiding the early signs of DJD, though, so early supplementation could potentially achieve the result of having physiologic levels of the supplements in the body when the first damage is done, long before the dog exhibits clear signs of DJD. Therefore, dogs at risk of developing DJD may potentially benefit from supplementation with oral glucosamine/chondroitin supplements (+/- MSM), fish oil (perhaps drop the dose to half the anti-inflammatory dose), and a general antioxidant supplement with supplemental vitamins E and possibly C.
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Old 07-17-2010, 11:42 PM
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Currently my girl is getting the twice weekly Adequan injections, we're about 3 weeks into the treatment. She also has started Dasuquin tablets. I did start her with an "induction" dose, but will drop down to the maintenance dose when the twice weekly Adequan is finished (the induction dose is recommended for 4-6 weeks). She gets 5 fish oil capsules every day. I also have her on Denosyl-we're going to do a month of daily pills, then we'll go to twice weekly. We're also doing one capsule twice daily of the antioxidant tablets by Vetri-Science (Cell Advance 880). I'm not doing quite the full dose they recommend (1 capsule per 20#) simply because I'm going to go broke buying all the supplements for 3 dogs! And we're doing 400 IU vitamin E every other day (the Cell Advance has 75 IU per capsule) and 500mg vitamin C twice daily. My other dogs (75# senior; 60# middle aged) are getting all the same products and doses except I'm not doing Adequan or Denosyl with them mostly due to cost.

For anyone that's interested here's *my* cost breakdown:

Adequan=$9/ml (which is one dose for 50#)
Dasuquin=$.35/tablet (one tablet daily for 60-120# maintenance)
Fish Oil=$.04/capsules (5 capsules per day)
Denosyl=$1.33/tablet (one tablet per day induction, then 2X/week)
Cell Advance=$.20/capsules (2 capsules per day)
Vitamin E=$.10/capsule (1 capsule every other day)
Vitamin C=<$.05/2 tablets (I don't really remember the cost, but it is cheap)

So average cost at maintenance (I probably should compute this...) is about $50/month or a bit less than $2 per day. This is for my ED girl. My "regular" dogs will cost about $30/month each. Dang all those things add up quick!
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Old 07-17-2010, 11:59 PM
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WONDEFUL post Sarah. My crew gets a good share of the supps you mention and it's great to have all the info in one post. Mods.. can we make this a sticky???
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Old 07-18-2010, 12:29 AM
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Great post! I'm a huge believer in Cosequin, and don't know if I'd own an adult dog not on it daily as a preventative. I like to use it in horses too, and for cosamin for me.

Milly gets cosequin, pro/pre biotics, and two types of fish oil (one a salmon - I forget the other) each day.
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Old 07-18-2010, 12:39 AM
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Great post!! I've seen Adequan work for a few dogs with great success. Seeing this post will push me to have my mom speak with her vet about using it with our 12 yr old, Casey, who had HD sx when he was a puppy!
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Old 07-18-2010, 07:15 AM
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Great post Sarah, thanks for all the info!
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Old 07-18-2010, 08:30 AM
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Great post!
I have been low,low, LOW on the fish oil....
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Old 07-18-2010, 08:39 AM
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Thank you for the great post.
I have this bookmarked.
I need to start adding a few more to Sierra's regiment.
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Old 07-18-2010, 09:06 AM
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Quote:
Originally Posted by LibertyME View Post
Great post!
I have been low,low, LOW on the fish oil....
I've been giving Copper 1 fish oil capsule a day. No wonder it didn't seem to have any effect. I'll start increasing his dose today.

Thank you for the info.

His ortho vet recommended SAM-e and said some dogs respond as well to that as rimadyl or other NSAID. I'm trying it for Copper.
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Old 07-18-2010, 10:30 AM
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Thanks so much for posting this information!! I've only been giving Merlin one fish oil capsule a day. Definitely will up the amount and add a few more supplements.

I do believe Cosequin works. I had a 13 yr old husky mix with a torn acl. He improved dramatically once I started him on it.
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