Focus on some of the more-studied and widely accepted nutraceuticals, novel treatments, and complementary therapies

Alternative medicines and dietary supplements quickly are growing in popularity among those in the equine industry as a means of treating conditions and illnesses that affect horses. Some of these therapeutic agents have been researched intensively, while others have little or no scientific evidence to support their claims of efficacy. However, consistent, anecdotal reports on their use in treating musculoskeletal conditions, pain, and behavioral issues, as well as enhancing overall well-being and performance, cannot be ignored.

Nutraceuticals and alternative therapies can be extremely beneficial in the treatment of certain conditions, but it is important to understand what a product or modality is designed to do and how it works before deciding to use it for a specific situation. Additionally, it is important to remember that each of these treatments or supplements will complement – not provide an absolute alternative to – solid feeding and training programs, good management, and sound veterinary advice.

Glucosamine and chondroitin sulfate
Arthritis is a disease that affects joint integrity, causing pain, inflammation, and eventually limited movement of the affected joint. With progression of the disease, the articula (joint) cartilage that protects the ends of bones by providing a cushion within the joint begins to degrade. Osteoarthritis is characterized by cartilage deterioration and damage to the bone. Pain and inflammation experienced by the horse are the results of bone rubbing against bone as the protective cartilage breaks down.

Treatment of arthritis typically is centered on pain relief and preventing further deterioration of existing cartilage. Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and injections of steroids into the joint are used to relieve arthritic pain, but they do nothing to promote cartilage repair or slow degeneration.

Extended use of NSAIDs has been shown to weaken the horse’s gut and increase the the risk of developing gastric ulcers, increasing the permeability of the intestinal wall. The more permeable the gut wall, the more susceptible the horse is to toxins and other trigger factors that could lead to laminitis. With this in mind, alternative treatments for joint deterioration should be taken into consideration because they may not only relieve pain but also may slow degeneration of the joint and avoid the potential intestinal damage caused by other treatments.
As an alternative or in addition to NSAIDs, glucosamine and chondroitin sulfate, substances found naturally in the body, are now commonly supplemented in the diets of horses suffering from arthritic conditions. Glucosamine is a form of amino sugar that is believed to play a role in the formation and repair of cartilage. Chondroitin sulfate is part of a large protein molecule (proteoglycan) that gives cartilage elasticity.

It once was thought that the large chondroitin sulfate molecule could be absorbed across the wall of the digestive tract, which potentially would make oral supplementation less than effective. That theory has since been disproved in several clinical studies.

Glucosamine and chondroitin sulfate, when given individually or in combination, can greatly reduce the pain experienced by the horse. Studies relating to the ability of these nutraceuticals to improve the condition of the cartilage have been conducted by Nutra-Max, resulting in strong support for its product Cosequin, which utilizes glucosamine and chondroitin sulfate. Studies have shown that not only are these elements biologically available and able to be absorbed by the horse, but when used together, overall effectiveness is much greater. When used in conjunction, glucosamine and chondroitin sulfate were better able to deter inflammatory substances that cause damage within an arthritic joint, as well as encourage production of new cartilage.

This year (2007), an eight-year clinical field study conducted by Martha Rodgers, V.M.D., formerly a clinician at Rood & Riddle Equine Hospital in Lexington, and published in the Journal of Applied Research in Veterinary Medicine, reconfirmed the usefulness of glucosamine and chondroitin sulfate in treating progressive clinical lameness from osteoarthritic conditions in the hock of competitive hunters and jumpers.

In a press release from GLC Direct, the company that manufactures GLC 5500 (the product used in the study), Rodgers said: “Distal tarsitis is a progressive disease… . It would be expected that with the increase in age and the demands of showhorse performance, all the horses would develop more pronounced pain… . In light of this, the overall drop in the number of injections required and the decrease in the injection frequency over the eight-year study period can be viewed as an even more convincing argument for the benefiical effects of long-term supplementation.”

Hyaluronic acid
Hyaluronic acid (HA) is a stiff biopolymer that is found naturally in the fluid of the joint capsule. It serves to lubricate the joint and provides anti-inflammatory action by limiting the release of damaging enzymes. Initially, HA was administered by injection directly into the affected joints, but the potential for joint infections has led many veterinarians to switch to the intramuscular route, which has the added benefit of treating numerous joints at one time.
Shock absorption is crucial to joint maintenance is crucial to joint maintenance, and the stiff nature of HA gives it the ability to cushion the joint well. Ultimately, this allows HA products to reduce arthritic pain and improve joint function.
HA can be extracted from several animal sources (rooster combs and bovine vitreous humor of the eye), but these sources also bring the risk of infection, have become popular ways to produce large quantities of HA.
Most commercially available HA products that are used to treat osteoarthritis are produced in this manner. This form of HA either is injected directly into a specific joint or in injected intravenously to treat multiple joints. HA also can be administered orally. Oral supplementation provides an effective alternative route for administering HA to arthritic joints. In this form, HA is circulated throughout the body, not only benefiting arthritic joints but also improving overall health as a result of its potent antioxidant effects.

Methylsulfonylmethane, or MSM, is an organic compound derived from dimethyl sulfoxide (DMSO) when that compound is oxidized. DMSO is a solvent commonly used topically and systematically as a treatment in horses to decrease inflammation. MSM is a naturally occurring, sulfur-containing organic compound found primarily in fresh fruits and raw vegetables – including broccoli, peppers, Brussels sprouts, onions, asparagus, and cabbage – and in every cell of the mammalian body. The highest natural concentration of MSM is found in mammal’s milk. In the body, MSM is found in significant amounts in nerve tissue, skin, hair, and joints.

MSM has been prescribed to treat a variety of illnesses in horses, including chronic muscle soreness, epiphysitis, acute laminitis, pleuritis, and recurring disorders of the digestive tract. Primarily, MSM is used to treat the pain and discomfort associated with osteoarthritis, but it has little effect on repairing damage in the joint. Also, its effects are exerted only while the supplement is being taken.

Research studies has shown that patients responded best and showed the most reduction in pain when supplemented with MSM and glucosamine in conjunction, rather than with either supplement alone.

Another emerging food supplement for horses is biologically available silicon. Silicon is an abundant element and a normal part of the equine diet because it is found in minute amounts in grain and forage. Unfortunately, many natural sources of silicon are biologically unavailable to the horse, but a highly absorbable form, monosilicic acid, exists. Recent technology has made monosilicic acid available for supplementation to horses in the United States.

Silicon plays a key role in improving bone quality, and it improves the mineralization process in the bones. Silicon acts as a regulator for uptake of calcium and phosphorus, and it directly contributes to a healthy bone cortex and a well-calcified bone matrix. Silicon also plays also plays an important role in the formation of connective tissue and collagen (bones, cartilages, ligaments, tendons, hair, skin, and hooves).

Recent field studies conducted by several veterinarians in Central Kentucky have shown excellent results radiographically when silicon if fed at a therapeutic dose for conditions such as pre-condylar fractures, sesamoiditis, decomposition of the bone (lysis) in regions of carpal bones, and soft-tissue injuries.
Many growing horses will benefit from a maintenance dose with the expectations of producing better quality bone/cartilage growth and density.

Phytotherapy is the crucial constituent of folk medicine. It has a long history and broad experience. The utilization of plants in the treatment of illness and injury is a practice that formed the base of early medicine. Hippocrates, whom we often call “the father of medicine,” used more than 200 herbs and other natural supplements for treating different diseases. Not only herbalists, but even ordinary people, knew about the curative properties of many herbs and used them for keeping and restoring normal body functions to improve health, to feel better, and to live longer.
Phytotherapy is currently gaining popularity because it offers the chance of alternative treatment for those who are not satisfied with the efficacy of modern synthetic medications or who cannot use them for some reason (about 10% of patients do not respond properly and adequately to the modern medications). Moreover, one of the most appealing qualities and advantages of phytotherapy and Chinese herbs is the low risk of adverse reaction or side effects, especially in comparison to pharmaceutical drugs.

Several synthetic medicines used to treat conditions in horses have been derived from medicinal herbs – digioxin, aspirin, reserpine, and ephedrine are some commonly used medicines derives from plants – and their mode of action and efficacy have been proven repeatedly in clinical studies.

Traditional beliefs, coupled with clinical observation, have provided the foundation for herbal prescriptions by indicating which substances will produce a certain effect. Yucca (yucca schidigera) and devil’s claw (harpagophytum procumbens) are two herbs that commonly are marketed to the equine community. Proponents claim both herbs reduce inflammation, or more specifically, inflammation resulting from arthritic conditions.

Yucca is a plant that is native to the hot, dry areas of North and Central America, most commonly Mexico, Polyphenols contained in the plant, particularly resveratrol, are the components that generate yucca’s anti-inflammatory action. These polyphenols also allow this plant to act as an antioxidant, clearing the body of free radicals. Antioxidant activity is important because the cells of the joints that produce cartilage (chondrocytes) also produce nitric oxide, a source of free radicals, as a result of the degenerative arthritic process.

Steroidal saponins may add to anti-arthritic properties of yucca because of their anti-protozoal activity and antifungal activity. It is possible that yucca could serve well as an adjunct therapy to horses suffering from equine protozoal myeloencephalitis (EPM), a degenerative neurological condition caused by protozoa in the central nervous system.

The roots of devil’s claw, a plant native to South Africa, often are used to treat the pain, fever, and inflammation of arthritis. This herb commonly is utilized as a stimulant for the digestive tract, as well. The main active ingredients in devil’s claw are harpogoside and beta-sitosterol, which are purported to possess anti-inflammatory properties and create support for joint, ligament, and tendon problems.

Some studies suggest devil’s claw may be just as effective as many conventional medications but possibly safer. In a randomized, double-blind, parallel group study conducted in France, patients received either capsules containing devil’s claw or a pharmaceutical drug. Assessment of pain of all patients indicated that those taking the herb and the drug experienced similar benefits. Both medications were shown to ease arthritic pain, but devil’s claw was shown to have a much less negative effect on the digestive tract than NSAIDs, including diacerhein, the drug used in the French study. Devil’s claw is contraindicated for use in pregnant mares because it can stimulate uterine contractions via the secretion of oxytocin from the pituitary gland.

Bovine colostrum and laminitis
All mammals produce milk for their young, but the first milk, consumed within the first few hours of birth, is extremely important to the newborn’s health. The first milk, or colostrum, contains a variety of immune-building agents necessary to initial immune strength in addition to other factors that encourage growth and overall health.

Use of bovine colostrum during the developmental phase of laminitis may help prevent the passage of bacteria (Streptococcus bovis) from the digestive tract into the bloodstream by improving the integrity of the contact between epithelial cells in the intestinal wall. These bacteria are thought to trigger the cascade of events that leads to the destruction of the laminae in the hoof during the onset of this devastating disease.

Colostrum has been used therapeutically to treat several disorders. Without knowing the exact mode of action of colostrums in stimulating immune response, it has been used as an adjunct therapy in both ill humans and animals, often with positive results.

Bovine colostrum is nutritionally well-balanced to provide all the needed elements to protect its young. Unlike the colostrum of other species, bovine colostrum can serve as a substitute for all other mammals and can be easily collected. Colostrum may be intended for young animals, but its components can be utilized to the benefit of animals at any age.

While the specific contents and levels of certain components in bovine colostrum may vary, they tend to provide high levels of growth factors and immune-strengthening factors, along with protein, amino acids, vitamins, and minerals.
Factors acting to increase immune strength are abundant in bovine colostrum and include immunoglobulins, proline-rich polypeptides, lactoferrin, lymphokines, cytokines, trypsin inhibitors, lysozyme, leucocytes, and lactalbumins.

  • Immunoglobulins are antibodies that are passively transferred through the colostrum to the newborn and are crucial to their survival. Bovine colostrum primarily contains Immunoglobulin G (IGg) and lower levels of Immunoglobulin A (IgA) and Immunoglobulin M (IgM). These antibodies present in colostrum offer protection aganist specific infectious agents, but they also have been shown to provide a general boost to the immune systems of humans and animals by counteracting toxins present in the body. They also appear to have various antibacterial and antiviral properties
  • Proline-rich polypeptides, along with cytokines and lymphokines, act as regulators for the immune system, stimulating deficient systems while slowing down those that are unnecessarily overactive
  • Lactoferrin is a protein responsible for the binding of iron and slows the growth of both bacteria and viruses
  • Trypsin inhibitors are of extreme importance for the functioning of other immune factors within the gastrointestinal tract. They prevent the breakdown of these factors in the gut and allow them to exert their maximum effect
  • Lysozyme and leucocytes assist with the strengthening of the immune system by slowing viral reproduction

Growth factors, both insulin-like growth factors (IGF-I and IGF-II) and transforming growth factors, may be found in colostrum. IGF plays a significant role in the growth of muscle, and it has been suggested that this factor may act similarly to human growth hormone. More studies are needed to provide support for this theory, but preliminary observations indicate this may be the case. Transforming growth factors, on the other hand, are utilized by the gastrointestinal tract for growth and repair of any damaged tissues. They also act as an inhibitor of acid secretion, which allows colostrum not only to repair ulceration of gastrointestinal epithelium but also to prevent further ulceration.

Emphasis on complementary
When treating horses for illness, disorders, or simply for better well-being, all forms of supplementation, therapy, and treatments should be considered. Often, it is a combination of these procedures and products that is the basis of a well-rounded, comprehensive program. In most cases, combining the beneficial effects of each component has stronger positive effect than using one modality alone.
It is important to note that none of the supplements discussed here should be considered a cure-all for any particular disease or disorder. In order to maintain a horse’s bones and joints correctly or properly deal with an arthritic situation, all aspects of the horse’s management should be considered. The appropriate exercise program along with balanced nutrition and the advice and guidance of a veterinarian will provide the comprehensive program required for excellent joint health.

By Dr. Amy M Gill, originally published in the Thoroughbred Times 2006