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60 Minutes to Healthier Joints-Free Webinar from SmartPak Equine


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sound advice from equine health experts on how to prevent bad things from happening to good joints presented free courtesy of SmartPak Equine

sound advice from equine health experts on how to prevent bad things from happening to good joints presented free courtesy of SmartPak Equine

Published in: Sports
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  • 1. 60 Minutes to Healthier Joints Lydia F. Gray, DVM, MA Medical Director/Staff Veterinarian Jessica Normand Senior Director – SmartSupplements™ October 16, 2012
  • 2. Your Presenters 2
  • 3. Agenda• Joint Anatomy & Function• What is Osteoarthritis?• Prevention & Therapy• Questions & Answers 3
  • 4. Joint Anatomy & Function1. Ligaments2. Joint capsule 13. Synovial membrane 2 34. Synovial fluid 4 5 65. Articular cartilage6. Subchondral bone 4
  • 5. Equine Joints Commonly Affected by OA1. Hock2. Fetlock3. Pastern4. Knee 1 4 2 3 5
  • 6. What is Osteoarthritis?• Progressive, permanent degeneration of articular cartilage• aka Degenerative Joint Disease (DJD) “OA is a by-product of the wear and tear and daily trauma that horses experience during heavy training.” - Dr. Rick Mitchell, Fairfield Equine Associates 6
  • 7. Osteoarthritis: Some Statistics• 60% of equine lameness problems are related to osteoarthritis, making it the most common cause of lameness in the horse.• Inflammation of the hock joints affects more than 50% of jumpers and grand prix dressage horses, and requires treatment for maintenance of peak performance. 7
  • 8. Osteoarthritis: Effects• OA is a cascading cycle of inflammation that leads to: 1. (Ligaments) 2. Joint capsule fibrosis 3. Synovial membrane thickening 4. Loss of synovial fluid 2 5. Articular cartilage erosion 3 4 6. Subchondral bone sclerosis 5 6 and Osteophytes (bone spurs) 8
  • 9. Osteoarthritis: Risk Factors• Acute trauma or sudden injury• Age• Conformation• Foot care• Footing• Workload – Frequency – Duration – Intensity 9
  • 10. Osteoarthritis: Signs of Lameness• Stiffness• Shortened stride• Uneven gaits• Reluctance to pick up, keep or change canter lead• Reluctance to stop or turn while working at speed 10
  • 11. Prevention & Therapy: Goals• Halt the cascade of inflammation• Stop or limit damage to articular tissue• Promote healing of damaged cartilage• Improve mobility• Alleviate discomfort• Extend the horse’s competitive career 11
  • 12. Methods of Prevention & Therapy• Physical therapy – Rest or controlled exercise – Ice or other cold therapy – Ceramic or other heat therapy – Compression 12
  • 13. Prevention & Therapy: Methods• Injections – Intra-articular (joint) • Steroids and/or Hyaluronic Acid • Polysulfated Glycosaminoglycans (Adequan®) – Intravenous • Hyaluronic Acid (Legend®) – Intramuscular • Polysulfated Glycosaminoglycans (Adequan®) Effects of Oral Glucosamine and Chondroitin Sulfates Supplementation on Frequency of Intra-articular Therapy of the Horse Tarsus Rodgers MR, Intern J Appl Res Vet Med 2006;4(2):155-162. 13
  • 14. Prevention & Therapy: Methods• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) – Aspirin (OTC) – Bute – Equioxx® – Surpass® (topical) 14
  • 15. Prevention & Therapy: Methods• Newer Therapies – Extracorporeal Shockwave Therapy (ESWT) – Biologics • IRAP • PRP • Stem Cell• Complementary & Alternative Therapies – Acupuncture – Chiropractic – Massage – Magnetic• Corrective shoeing• Oral joint supplements 15
  • 16. Oral Joint Supplements: Key Active Ingredients• “Mother Nature’s Big Three” – Glucosamine – Chondroitin Sulfate – Hyaluronic Acid (HA) Safety of an Oral Chondroprotective Agent in Horses Kirker-Head CA, Kirker-Head RP, Vet Ther. 2001 Fall;2(4):345-53. Double-Blind Study of the Effects of an Oral Joint Supplement in Horses with Tarsal Degenerative Joint Disease. Clayton HM, Almeida PE, Prades M, et al Proceedings. 48th Annu Conv Am Assoc Equine Pract. 2002;48:314-7. Oral Treatment With a Glucosamine-Chondroitin Sulfate Compound for Degenerative Joint Disease in Horses: 25 Cases Hanson RR, Smalley LR, Huff GK, et al, Equine Practice. 1997 Oct;19(9):16-20. 16
  • 17. “Mother Nature’s Big Three”Glucosamine is the building block of chondroitin sulfate, a specific type of glycosaminoglycan (GAG).Chondroitin Sulfate is not only the building block of the much larger molecules hyaluronic acid (HA) and proteoglycan (PG) it also inhibits the effects of various enzymes that degrade cartilage.Hyaluronic Acid (HA) is an integral component of joint cartilage and joint fluid, providing both lubrication and shock absorption. Evidence of the Oral Absorption of Chondroitin Sulfate as Determined by Total Disaccharide Content After Oral and Intravenous Administration to Horses Eddington ND, Du J, White N, Proceedings. 47th Annu Conv Am Assoc Equine Pract. 2001;47:326-8. Oral hyaluronan (HA) gel reduces post operative tarsocrural effusion in the yearling Thoroughbred. Bergin BJ, Pierce SW, Bramlage LR, Stromberg A., Equine Vet J. 2006 Jul;38(4):375-8. 17
  • 18. Oral Joint Supplements: Key Active Ingredients• Other ingredients to look for – MSM – ASU – Omega 3 Fatty Acids – Cetyl Myristoleate – Herbs • Devil’s Claw, Yucca, Boswellia, Bromelain, Curcumin, more! – Antioxidants • Vitamin C, Grape Seed Extract, Resveratrol, Superfruits, more! The effect of methylsulphonylmethane supplementation on biomarkers of oxidative stress in sport horses following jumping exercise. Marañón G, Muñoz-Escassi B, Manley W, et al, Acta Vet Scand. 2008 Nov 7;50:45. Markers of Inflammation in Arthritic Horses Fed Omega-3 Fatty Acids Manhart DR, Scott BD , Gibbs PG, et al, The Professional Animal Scientist 2009;25(2):155–160 18
  • 19. Horse in Light Work/Young Horse• Workload Definition from NRC: – 1-3 hours per week – 40% walk, 50% trot, 10% canter• Goal: – Maintain healthy joint tissue, avoid future problems• Ingredients to Look For: – Glucosamine – Also consider Chondroitin Sulfate, MSM 19
  • 20. Horse in Moderate Work• Workload Definition from NRC: – 3-5 hours/week – 30% walk, 55% trot, 10% canter, 5% low jumping, cutting/other skill work• Goal: – Support joints in day to day stress• Ingredients to Look For: – Glucosamine, Chondroitin Sulfate, MSM 20
  • 21. Horse in Heavy Work• Workload Definition from NRC: – 4-5 hours per week – 20% walk, 50% trot, 15% canter, 15% gallop, jumping/other skill work• Goal: – Provide comprehensive support for joint, tendon/ligament health, avoid discomfort and stiffness• Ingredients to Look For: – Glucosamine, Chondroitin Sulfate, MSM, HA – Tendon/Ligament Support from Silica & Collagen 21
  • 22. Horse in Very Heavy Work• Workload Definition from NRC: – 1 hour/week of speed work to 6-12 hours/week of slow work – Includes elite performance horses in intense, strenuous work• Goal: – Provide aggressive support for joint, tendon and ligament health, minimize discomfort and stiffness caused by intense training and competition• Ingredients to Look For: – Glucosamine, Chondroitin Sulfate, MSM, HA – Tendon/Ligament Support from Silica and Collagen – Antioxidants (Resveratrol, Superfruits, Grape Seed Extract) 22
  • 23. Horse in Recovery• Ingredients to Look For: – Glucosamine, Chondroitin Sulfate, MSM, Hyaluronic Acid (HA) – Tendon/Ligament Support from Silica & Collagen – Antioxidants – Herbs (Devil’s Claw, Yucca, Boswellia, Bromelain, Curcumin, more) – Omega 3 Fatty Acids – Essential Amino Acids (Lysine, Methionine, Threonine)• Goal: – Help minimize inflammation, alleviate discomfort and support the healing process 23
  • 24. Senior Horse• Ingredients to Look For: – Glucosamine, Chondroitin Sulfate, MSM, Hyaluronic Acid (HA) – Herbs (Devil’s Claw, Yucca, Boswellia, Bromelain) – Antioxidants – Probiotics & prebiotics for digestive Support• Goal: – Ease stiffness and discomfort, support joint and digestive health, provide antioxidants 24
  • 25. Active Ingredient Guidelines Chondroitin Hyaluronic Glucosamine Sulfate Acid MSM OtherYoung 4,000 mg 5,000 mg Vitamin CHorse/Horse inLight WorkHorse in 8,000 mg 1,000 mg 10,000 mg Vitamin CModerate WorkHorse in Heavy 10,000 mg 1,000 mg 100 mg 10,000 mg Vitamin C, Silica,Work CollagenHorse in Very 10,000 mg 1,000 mg 150 mg 10,000 mg Vitamin C,Heavy Work Silica, Collagen, Antioxidants, Cetylated Fatty AcidsHorse in 5,000 mg 400 mg 100 mg 12,000 mg Vitamin CRecovery Silica, Collagen, Antioxidants, Amino Acids, HerbsSenior Horse 7,000 mg 500 mg 50 mg 12,000 mg Vitamin C Pro/Prebiotics Herbs 25
  • 26. Product Selection Guidelines Horse Product RecommendationsYoung Horse/Horse in Light Work SmartFlex I Maintenance, Cosequin, Grand FlexHorse in Moderate Work SmartFlex II Support, Cosequin SP, Glucosamine XL Plus w/MSMHorse in Heavy Work SmartFlex III Resilience, Cosequin ASU, HylaSport, Grand HA SynergyHorse in Very Heavy Work SmartFlex IV Ultimate, Cosequin ASU Plus, Recovery EQ Extra StrengthHorse in Recovery SmartFlex Rehab, Recovery EQ, Recovery EQ Extra StrengthSenior Horse SmartFlex Senior, Senior Flex or Senior Flex HA Pellets, Grand Flex Senior 26
  • 27. Questions & Answers 27
  • 28. Questions1. Aside from jumping at shows is there a "safe" height we can jump frequently at home for schooling that wont wear down the horses joints too much?2. Id like to hear about joint care in warm weather vs. in cold weather. What supplements should you feed at different times of year, how should you warm your horse up, etc.?3. Assuming the horse has been on an oral supplement for several weeks, how long before it becomes effective after administering? What is the optimum time to allow before working a horse after feeding a daily supplement?4. How do you accurately evaluate the impact of joint supplements and IV/IM medications given how subtle differences can be? What would you recommend the owner looks for and what are good metrics/benchmarks to watch for?5. Are joint supplements meant to be an ongoing, lifelong basis or are they meant to be fed on an as-needed basis? 28
  • 29. Questions6. Please tell us how to use MSM effectively for our horses.7. Can you feed a Cushings-positive horse a supplement that containsglucosamine?8. I have a 16 year-old thoroughbred not on any supplements. He currently hasshoes all the way around and is used as a long stirrup 23"" hunter. He has, onoccasion, started out stiff during warm-up. Would you recommend starting asupplement? Which one?9. My horse is 7. Isnt he too young for me to be worried about his joints?10. My older mare is exhibiting stiffness when ridden. However, she has hadgastric ulcers in the past and I am concerned that ingredients in joint supplementscould affect her digestive system. Is there a specific joint supplement that isrecommended? 29
  • 30. Questions11. If you had to choose 2-3 supplements for a 12 year-old H/J that is worked 4-5times per week, what would they be?12. I currently give my 24-year-old mare Cosequin. Ive been giving it to her sinceshe was 15 not because she needed it, but so she wouldnt need it later. Is it goodfor her or not? She moves as though shes still 15. She is a Shire/Thoroughbredmix.13. Are there any scientific studies in equines to support the use of supplementswith improvements in radiographs or decreased pain ( how do you measure this ina horse)?14. From my warmblood H/J show horse to my tamed wild mustang who is a trailriding horse, why hock problems and how to prevent them? I understood why myhunter might have problems but why does a 13 year-old mustang from the wildalso have problems? 30
  • 31. Questions15. Id like to hear about joint care for senior horses that are retired and beingworked vs. joint care for senior horses that are still actively being shown andworked on a regular basis.16. I have one mare that looks smooth when I ride her and has checked out soundin a vet examination, but every so often I hear a click/pop sound in her hocks. Sheis a 7 year-old mare and she does not act lame when I hear this.17. I have a foal who went through OCD surgery at 11 months. He had two in hisleft fetlock and one on his left stifle. All are removed and his recovery wastextbook. Is there anything I should be doing now to continue to help those jointsheal and become strong?18. "Lexi" is a 10 year-old mare that has arthritis in her back legs and left front leg.She is on Adequan and Legend every month, gets supplements in SmartPaks andgets exercise every day with rest one day a week. Now shes getting stiff moreoften. Please help. 31
  • 32. Questions19. How much does proper farrier work help with joints? My vet says my horse isalot more prone to joint and suspensory damage when the farrier has not done agood job on her feet. Please comment.20. Should you give Adequan once a month or give the full loading dose twice ayear?21. Im interested in hearing about injections vs. supplements and how to workthem together. 32
  • 33. Thank you for attending our Webinar! Please visit us at SmartPak.comOr call us at 1-800-461-8898 if we can answer any further questions. ~ Your Friends at SmartPak 33