Chondroprotectors Flashcards
What are chondroprotectives?
Agents that retard degradation of articular cartilage and promote chondrocyte metabolism in the treatment of osteoarthritis in dogs and cats.
Describe the legislation surrounding nutraceuticals
Products classified as nutraceuticals are not technically drugs, so they can be marketed without proving that they work
List some veterinary nutraceuticals used commonly
Glucosamine
Chondroitin
Polysulfatedglycosaminoglycan
Avocade/soybean unsaponifables
Manganese
Vitamin E
Green lipped mussel
Essential fatty acids
Pentosan polysulphate
Hyaluron
Hyalouronic acid
Circurmin
What is the role of glucosamine?
Building block for glycosaminoglycans
Make extracellular matrix (ECM) of cartilage
Which veterinary nutraceutical is the predominant component of cartilage?
Chondroitin
Which nutraceutical agent does glucosamine have a synergistic effect with?
Chondroitin
What is the in vitro effect of glucosamine and chondroitin?
Modulating cartilage metabolism, imporvin cartilage integrity and increasing matrix synthesis.
How is polysulphated glycosaminoglycan administered and how often is it given?
Intra-muscular
Every 5-7 days
What is the main side effect of polysulphated glycosaminoglycan?
Inhibits coagulation
Which species is hyaluronan/hyaluronic acid licensed in and how is it administered?
Horses
Intra-articular injection
What is the purpose of hyaluronan/hyaluronic acid?
Improves joint fluid viscosity
What is the trade name of pentosan polysulphate and which species is it liscenced in?
Cartrophen Vet
Liscenced in dogs and horses
How often and how should pentosan polysulphate be administered?
Weekly injections - IM/SC
List two side effects of pentosan polysulphate
Vomiting
Anti-coagulant
List two purposes of essential fatty acids
Anti-inflammatory properties in vitro
Reduces cartilage degradation
Which pathway does green lipped mussel inhibit and what effect does this have?
Anti inflammatory
Inhibits 5 lipoxygenase pathway
What are the two main adverse effects of chondroprotectives?
Gastrointestinal
Anti-coagulant
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.
Double blind trial
GRF measured on a treadmill - measurements at 30 and 60 days
No differences in GRF with carprofen
Improvements with the NSAIDs
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.
Double blind trial
5 outcome measures: lameness, mobility, pain…
Mild changes with nutraceuticals
Better improvement with NSAIDs
Describe the evidence in dogs for the use of pentosan polysulphate.
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
Describe the evidence in horses for the use of pentosan polysulphate.
Imporved signs of OA in horses
Reduced articular cartilage fibrillation in experimental carpal OA
IM PPS efficacious when used prophylactically prior to competition
Describe how you should advise clients on the use of nutraceuticals
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
