Chondroprotectors

Question 1

What are chondroprotectives?

Answer 1

Agents that retard degradation of articular cartilage and promote chondrocyte metabolism in the treatment of osteoarthritis in dogs and cats.

Question 2

Describe the legislation surrounding nutraceuticals

Answer 2

Products classified as nutraceuticals are not technically drugs, so they can be marketed without proving that they work

Question 3

List some veterinary nutraceuticals used commonly

Answer 3

Glucosamine
Chondroitin
Polysulfatedglycosaminoglycan
Avocade/soybean unsaponifables
Manganese
Vitamin E
Green lipped mussel
Essential fatty acids
Pentosan polysulphate
Hyaluron
Hyalouronic acid
Circurmin

Question 4

What is the role of glucosamine?

Answer 4

Building block for glycosaminoglycans
Make extracellular matrix (ECM) of cartilage

Question 5

Which veterinary nutraceutical is the predominant component of cartilage?

Answer 5

Chondroitin

Question 6

Which nutraceutical agent does glucosamine have a synergistic effect with?

Answer 6

Chondroitin

Question 7

What is the in vitro effect of glucosamine and chondroitin?

Answer 7

Modulating cartilage metabolism, imporvin cartilage integrity and increasing matrix synthesis.

Question 8

How is polysulphated glycosaminoglycan administered and how often is it given?

Answer 8

Intra-muscular
Every 5-7 days

Question 9

What is the main side effect of polysulphated glycosaminoglycan?

Answer 9

Inhibits coagulation

Question 10

Which species is hyaluronan/hyaluronic acid licensed in and how is it administered?

Answer 10

Horses
Intra-articular injection

Question 11

What is the purpose of hyaluronan/hyaluronic acid?

Answer 11

Improves joint fluid viscosity

Question 12

What is the trade name of pentosan polysulphate and which species is it liscenced in?

Answer 12

Cartrophen Vet
Liscenced in dogs and horses

Question 13

How often and how should pentosan polysulphate be administered?

Answer 13

Weekly injections - IM/SC

Question 14

List two side effects of pentosan polysulphate

Answer 14

Vomiting
Anti-coagulant

Question 15

List two purposes of essential fatty acids

Answer 15

Anti-inflammatory properties in vitro
Reduces cartilage degradation

Question 16

Which pathway does green lipped mussel inhibit and what effect does this have?

Answer 16

Anti inflammatory
Inhibits 5 lipoxygenase pathway

Question 17

What are the two main adverse effects of chondroprotectives?

Answer 17

Gastrointestinal
Anti-coagulant

Question 18

Discuss what the 2003 study into carprofen vs meloxicam found in dogs with osteoarthritis? List how they measured it and they type of trial conducted.

Answer 18

Double blind trial
GRF measured on a treadmill - measurements at 30 and 60 days
No differences in GRF with carprofen
Improvements with the NSAIDs

Question 19

Discuss what the 2007 study into glucosamine/chondroitin sulfate vs meloxicam found in dogs with osteoarthritis? List how they measured it and they type of trial conducted.

Answer 19

Double blind trial
5 outcome measures: lameness, mobility, pain…
Mild changes with nutraceuticals
Better improvement with NSAIDs

Question 20

Describe the evidence in dogs for the use of pentosan polysulphate.

Answer 20

Improvement in dogs with OA after SC injection
Lower levels of proteoglycans in joint fluid after oral PPS no imporvement in outcome or radiographs of dogs with CCLD
Improved recovery in dogs with CCLD seen by GRF measurements

Question 21

Describe the evidence in horses for the use of pentosan polysulphate.

Answer 21

Imporved signs of OA in horses
Reduced articular cartilage fibrillation in experimental carpal OA
IM PPS efficacious when used prophylactically prior to competition

Question 22

Describe how you should advise clients on the use of nutraceuticals

Answer 22

Some scientific evidence supporting their use
No definitive beneficial effects for animals with OA
Side effects minimal and mild if occuring
Try for 2-3 months
If no improvement consider stopping usage