Lame - chondroprotectives Flashcards
What are chondroprotectives also known as?
Nutraceuticals - nutrition and pharmaceuticals
What is a chondroprotective?
An agent that stops degredation of articular cartilage
Promotes chondrocyte metabolism
Treats osteoarthritis in dogs and cats
What are some examples of chondroprotectives?
Glucosamine
Hyaluronic acid
Polysulfated glycosaminoglycan
Green lipped mussel
Vitamin E
What is the legislation surrounding nutraceuticals?
They arent technically drugs so can be marketed without proof they work
May not contain what the label says
What type of chondroprotectives are legislated?
Injectibles
What are the modes of action of chondroprotectives?
Stimulate chondrocytes
Stimulate synoviocytes
Increase synovial fluid viscosity
Inhibit enzymes
Anti-inflammatory
Anti-oxidants
Support collagen formation
What is glucosamine?
An amino monosaccharide made of glucose and glutamine
Building block for glycosaminoglycans
What does glucosamine do?
Makes up the extracellular matrix of cartilage
How is glucosamine produced commercially?
The hydrolysis of crustacean exoskeletons - found in these
What is chondroitin?
Predominant component of cartilage
Polymer of repeating disaccharide units
What is chondroitin produced from commercially?
Bovine, poultry or shark cartilage
What is the supposed mechanism of action of glucosamine and chondroitin?
Stimulates glycosaminoglycan and collagen production
Work together synergistically
Improves cartilage integrity
What is a product made up of polysulphated glycosaminoglycan from bovine cartilage?
Adequan
What animals is adequan given to? How is it given?
IM injection for horses and dogs
When disease is adequan given to treat?
Non infectious degenerative or traumatic arthritis
How often is adequan given?
Every day for 7 days
Or every week for 5 weeks
What is a concern with toxicity associated with adequan?
Similar to heparin so theoretically might inhibit coagulation
What hyaluronic acid product is licensed for horses?
Hyalovet/hyvisc
How is hyalovet administered?
Intraarticular injection
What is hyalovet meant to improve?
Joint fluid viscosity
Inhibit inflammatory enzymes
What chondroprotective drug contains pentosan polysulphate?
Cartrophen
How is cartrophen given?
Weekly injections
What animals is pentosan used in?
Dogs, horses
What are the side effects of cartrophen?
Vomiting
Anticoagulant
What are the claims that cartrophen can improve?
Stimulate chondrocytes to synthesise matrix
Anti-inflammatory
What are omega 3 fatty acids said to help with?
Reduced cartilage degredation
Anti-inflammatory properties
Treat osteoarthritis symptoms
What is green lipped mussel?
Mussel from new zealand
High omega 3 fatty acid content
What are green lipped mussels said to help with?
Anti-inflammatory
Help with arthritis - inhibits 5 lipooxygenase pathway
What are the adverse effects of chondroprotectives?
Usually mild/rare - no serious risk
GI side effects
Potentially anti-coagulant
What evidence is there from chondroprotective trials involving chondroitin?
Mild to no improvements with Chondroitin sulphate glucosamine supplements
Better improvements with NSAIDs
All double blind trials
So limited conclusive evidence for beneficial effects
What evidence of efficacy is there for pentosan?
Improvements in dogs and horses for OA
No improvement in dogs with cruciate disease
What should you say to clients about chondroprotectives?
Some scientific evidence supporting their use
No definitive beneficial effects for animals with OA
Side effects minimal/mild
Try for 2-3 months
If no improvement stop use
