Lame - chondroprotectives

Question 1

What are chondroprotectives also known as?

Answer 1

Nutraceuticals - nutrition and pharmaceuticals

Question 2

What is a chondroprotective?

Answer 2

An agent that stops degredation of articular cartilage
Promotes chondrocyte metabolism
Treats osteoarthritis in dogs and cats

Question 3

What are some examples of chondroprotectives?

Answer 3

Glucosamine
Hyaluronic acid
Polysulfated glycosaminoglycan
Green lipped mussel
Vitamin E

Question 4

What is the legislation surrounding nutraceuticals?

Answer 4

They arent technically drugs so can be marketed without proof they work
May not contain what the label says

Question 5

What type of chondroprotectives are legislated?

Answer 5

Injectibles

Question 6

What are the modes of action of chondroprotectives?

Answer 6

Stimulate chondrocytes
Stimulate synoviocytes
Increase synovial fluid viscosity
Inhibit enzymes
Anti-inflammatory
Anti-oxidants
Support collagen formation

Question 7

What is glucosamine?

Answer 7

An amino monosaccharide made of glucose and glutamine
Building block for glycosaminoglycans

Question 8

What does glucosamine do?

Answer 8

Makes up the extracellular matrix of cartilage

Question 9

How is glucosamine produced commercially?

Answer 9

The hydrolysis of crustacean exoskeletons - found in these

Question 10

What is chondroitin?

Answer 10

Predominant component of cartilage
Polymer of repeating disaccharide units

Question 11

What is chondroitin produced from commercially?

Answer 11

Bovine, poultry or shark cartilage

Question 12

What is the supposed mechanism of action of glucosamine and chondroitin?

Answer 12

Stimulates glycosaminoglycan and collagen production
Work together synergistically
Improves cartilage integrity

Question 13

What is a product made up of polysulphated glycosaminoglycan from bovine cartilage?

Answer 13

Adequan

Question 14

What animals is adequan given to? How is it given?

Answer 14

IM injection for horses and dogs

Question 15

When disease is adequan given to treat?

Answer 15

Non infectious degenerative or traumatic arthritis

Question 16

How often is adequan given?

Answer 16

Every day for 7 days
Or every week for 5 weeks

Question 17

What is a concern with toxicity associated with adequan?

Answer 17

Similar to heparin so theoretically might inhibit coagulation

Question 18

What hyaluronic acid product is licensed for horses?

Answer 18

Hyalovet/hyvisc

Question 19

How is hyalovet administered?

Answer 19

Intraarticular injection

Question 20

What is hyalovet meant to improve?

Answer 20

Joint fluid viscosity
Inhibit inflammatory enzymes

Question 21

What chondroprotective drug contains pentosan polysulphate?

Answer 21

Cartrophen

Question 22

How is cartrophen given?

Answer 22

Weekly injections

Question 23

What animals is pentosan used in?

Answer 23

Dogs, horses

Question 24

What are the side effects of cartrophen?

Answer 24

Vomiting
Anticoagulant

Question 25

What are the claims that cartrophen can improve?

Answer 25

Stimulate chondrocytes to synthesise matrix Anti-inflammatory

Question 26

What are omega 3 fatty acids said to help with?

Answer 26

Reduced cartilage degredation Anti-inflammatory properties Treat osteoarthritis symptoms

Question 27

What is green lipped mussel?

Answer 27

Mussel from new zealand High omega 3 fatty acid content

Question 28

What are green lipped mussels said to help with?

Answer 28

Anti-inflammatory Help with arthritis - inhibits 5 lipooxygenase pathway

Question 29

What are the adverse effects of chondroprotectives?

Answer 29

Usually mild/rare - no serious risk GI side effects Potentially anti-coagulant

Question 30

What evidence is there from chondroprotective trials involving chondroitin?

Answer 30

Mild to no improvements with Chondroitin sulphate glucosamine supplements Better improvements with NSAIDs All double blind trials So limited conclusive evidence for beneficial effects

Question 31

What evidence of efficacy is there for pentosan?

Answer 31

Improvements in dogs and horses for OA No improvement in dogs with cruciate disease

Question 32

What should you say to clients about chondroprotectives?

Answer 32

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