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Equine Joint Pain: A White Paper

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Horse Health:

A White Paper addressing how to prevent and relieve equine joint pain in performance and pleasure horses.

June 2016

INTRODUCTION

Signs of poor joint condition and arthritis can be found in both performance and pleasure horses. As would be expected, horse trainers, owners, and veterinarians face many conditions associated with their horses’ high impact activities, high performance levels, endurance activities, and aging joints. But poor joint condition is not limited to high performance and senior horses. Arthritic changes have also been found in young horses and horses in light work.

Osteoarthritis can happen in any horse, and early intervention is critical to reduce the onset of conditions and assist in the prevention of unnecessary wear and tear.  Quality, natural treatment and prevention is of the utmost importance, allowing trainers, owners, and veterinarians to understand what is being put in or on your horse’s body, simplify the prevention and treatment protocols, and avoid causing unwanted side effects.

PROBLEM STATEMENT

WHAT IS ARTHRITIS?

Arthritis, Osteoarthritis (OA), and Degenerative Joint Disease (DJD) are different names for the same thing. Arthritis is the progressive deterioration of articular cartilage and is one of the most common conditions that affects both performance and pleasure horses. In fact, arthritis is believed to be responsible for up to 60% of all lameness. 1

The joints most often affected by arthritis include:

  • knee
  • fetlock
  • coffin
  • hock
  • pastern (where it is often referred to as “ringbone”)

Signs of joint issues and arthritis in horses include:

  • inflammation in and around the joint
  • lameness or unevenness
  • shuffling gait
  • limping or favoring other legs
  • difficulty or discomfort when getting up from lying down
  • stiffness
  • reduced activity
  • sleeping more
  • sidebone
  • ringbone
  • navicular syndrome
  • tendonitis

WHO GETS ARTHRITIS?

A 1999 study published in the Equine Veterinary Journal 2 identified arthritic changes in a herd of wild mustangs, which led the researchers to conclude that arthritis was a natural part of the aging process in horses. In essence, this means that it’s not just horses in heavy work that are at risk -- all horses are at risk for developing arthritis, even those in light work or no work at all.

While all horses are susceptible to developing arthritis, there are some factors that can increase your horse’s risk, including consistent stress from riding, acute injury, and poor conformation. Senior horses are also more likely to show arthritic changes.

Arthritis is an unwelcome diagnosis for any horse, regardless of his discipline or occupation. Whether the condition appears suddenly after trauma, or gradually with worsening stiffness, it means the same thing: chronic inflammation has led to permanent degradation of the cartilage in a horse's joints.

HOW DOES ARTHRITIS DEVELOP?

A horse's knees, hocks and pasterns are designed to flex, compress, and extend hundreds or thousands of times each day, for years on end -- all while supporting his weight and enduring concussive forces.

Joints have several components: collateral ligaments, which prevent lateral movements of the bones; synovial fluid, which fills the space between the bones and provides lubrication and nourishment to the cartilage; the joint capsule, which stabilizes the joint; the synovial membrane, which regulates the joint fluids; and the articular cartilage, the soft structural tissue that covers and cushions the ends of the bones where they meet.

The cartilage is a framework of tissue made up of collagen fibers, which give the structure its strength. The collagen is interlaced with proteoglycans--long, protein-based molecules with negative charges that trap water within the matrix. As the joint flexes, the cartilage compresses and expands, forcing water in and out of the spaces, which helps to provide a shock-absorbing effect.

David Frisbie, DVM, PhD, DACVS, of the Equine Orthopedic Research Center at Colorado State University, provides a helpful description: “Collagen is like the cotton in your clothes. Take a wad of intricately laced cotton, put it in water, and it will soak it up like a sponge. Press down and it will expunge it out and then refill again. That's how cartilage works. The collagen is the framework, and the proteoglycans are stuck in the collagen to keep the sponge full and the water interspersed.” 3

As a horse moves, the flexing and compression can produce minute damage within the joint structures that triggers mild inflammatory responses to make the repairs. Normally, the body's own defenses control inflammation and the joint remains healthy and sound.

Sometimes, however, either from a single acute injury or from many years of use, the inflammatory process overwhelms the body's ability to contain it. At that point, a snowball effect begins:

  • inflammatory enzymes break down the lubricating synovial fluid  
  • synovial fluid gets thinner
  • proteoglycans are lost
  • collagen fibers lose integrity
  • cartilage's ability to retain lubricating water is diminished
  • diminished lubricating water stimulates even more inflammation
  • increased inflammation fills the joint capsule with fluids, leading to pressure, pain and stiffness
  • inflammatory enzyme buildup further breaks down the synovial fluid and propels forward the escalation of cartilage damage

What is even worse: the damage is irreversible. According to Margaret Brosnahan, DVM, of Oklahoma State University, ”The reality is that you're not going to fix the joint or cure arthritis. Your goal is to reduce the inflammation, pain and further damage.” 3

So, how does an owner reduce his horse’s pain? How does a veterinarian prevent further damage to a horse’s joints? How does a thoroughbred trainer stop the cycle of a horse’s joint inflammation and return him to health?

Since all horses are at risk for developing arthritis, providing proactive support is a smart choice for horses of any age or workload. While there is no sure-fire way of preventing arthritis altogether, there are steps you can take to help keep your horse going strong for as long as possible.

SOLUTION

COX 2 INHIBITION

The major cellular constituent of cartilage is the chondrocyte. In osteoarthritic cartilage, the isolated chondrocytes have been shown to produce elevated levels of pro-inflammatory cytokines and mediators. Among these are prostaglandins which arise through elevated activity of the Cox 2 enzyme. Therefore, inhibition of the activity of the Cox 2 enzyme will reduce the concentration of the inflammatory prostaglandins.

Of the numerous mechanisms involved in the inflammatory process, two pathways are of particular interest: the Cyclooxygenase (or COX) and Lipoxygenase (LOX) pathways, both of which constitute Arachidonic Acid Cascade. The LOX pathway produces agents known as Leukotrienes, which are highly chemotactic and influence vascular permeability. Cyclooxygenase-1 (COX-1) has a physiological role and influences the normal activities of platelet aggregation, gastric mucosa, and kidneys. Cyclooxygenase-2 (COX-2) induces inflammatory stimulation releasing pro-inflammatory prostaglandins.

The COX-1 pathway is claimed to be useful and beneficial in having an anti-inflammatory effect without negative side effects. Traditional NSAIDs are known to block both COX-1 and COX-2, but blocking the beneficial COX-1 pathway can cause unwanted side effects such as gastric irritation like vomiting, ulceration, bleeding, and stoppage of platelet clotting.  

CHONDRO PROTECTION AND ANTI-INFLAMMATION

Glycosaminoglycans (GAGs) and Proteoglycans

Known for:

  • rejuvenation of joints, cartilage, and connective tissues
  • assisting in the uptake of synovial fluids in the joint
  • articular support
  • inhibiting and slowing the breakdown of joints.

Omegas and Essential Fatty Acids (EFAs)

Have demonstrated profound anti-inflammatory properties not only in a horse’s joints (chondrocytes), but also in conditions such as:

  • stomach inflammation
  • bowel inflammation
  • Crohn’s disease
  • ulcerative colitis

Additionally, EFAs assist:

  • brain function (DHA)
  • eye health (EPA)
  • and give horses’ coats a healthy sheen and an attractive dappling effect.

Minerals

The absorption of all nutrients occurs on the colloidal scale; thus the attributes of minerals in colloidal form (suspended in liquid), rather than macro-metallic form, are better utilized by the body. Mineral nutrients in colloidal form perform many biological functions and are readily needed and accepted by the body. In colloidal form, the body can absorb 98% of the minerals. On the other hand, the body can only absorb 8-12% of metallic minerals; the rest passes through the body. 4

Vitamins

Vitamins are required by the body for many functions and can enhance the uptake of minerals. Both vitamins and minerals are a necessity to enhance the anti-inflammatory benefits of Omegas and EFAs.

JOINT SUPPLEMENTS: PREMIUM QUALITY, ALL NATURAL

BEFORE ONSET: PREVENTATIVE MEASURES

Administering a high quality supplement prior to the onset of arthritic symptoms and poor joint condition or injury is recommended for increased mobility and as a preventative for aging joints.

High quality joint supplements help ensure your horse’s body has a consistent, ready supply of the ingredients it needs to cope with the stress of exercise and to maintain healthy joints. Because joint supplements are used to help keep joints healthy and avoid future problems, the best time to start a joint supplement is actually before your horse starts to show signs of joint pain and discomfort.

But, make no mistake, joint supplements are also a smart choice for senior horses because they can help ensure your horse has a steady supply of the ingredients he needs to handle the added stress his aging joints are under, as well as help support a normal inflammatory response and manage joint discomfort.

AFTER ONSET: ADVANCED JOINT CARE AND WELLBEING

The key to helping a horse live comfortably with arthritis is to catch it early and get the inflammation under control to stop the cycle of damage. But in most cases, by the time a horse is lame, the arthritis is already advanced. If your horse has been diagnosed with arthritis, prescription medications may be an important part of your horse’s treatment and management program.

Adequan®  is the  only FDA-approved, disease-modifying drug for the treatment of degenerative joint disease. It contains polysulfated glycosaminoglycan (PSGAG), which travels into injured joints and stimulates new cartilage production, while also relieving signs of arthritis.

Legend® Injectable Solution provides hyaluronate sodium for IV or IA injection, and is FDA-approved for the treatment of joint dysfunction of the knee or fetlock due to non-infectious synovitis associated with arthritis in horses.

For the management of arthritis, a veterinarian may also prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as phenylbutazone (bute), Equioxx® Oral Paste, or Surpass® Topical Cream.

Phenylbutazone (bute) has long been a staple in most barns, but it is not the best choice for long-term use in all horses because it can damage the lining of the gastrointestinal tract. 5

What if there was an all natural prevention, treatment, and management program? One with zero negative side effects?

Considering Technyflex® Equine

What is Technyflex® Equine?

Technyflex® Equine is a natural joint care treatment for horses that relieves pain due to inflamed joints, arthritis, lameness, and joint injuries.  Technyflex® Equine is made from the green-lipped mussel (Perna canaliculus) that grows only in the pure ocean waters of New Zealand.  This little shellfish has a unique combination of nutrients that have amazing anti-inflammatory properties.  In fact, scientific research shows that Technyflex® Equine is significantly more effective at inhibiting inflammation than aspirin, ibuprofen or glucosamine/chondroitin supplements.

FIGURE 1

SOURCE: Davis, P., Bio Investigations Unit, School of Medicine, University of Otago, NZ.

How can Technyflex® help your horse?

  • Arthritis Relief: Technyflex® is a natural way to relieve arthritis symptoms and alleviate soreness and inflammation in joints.
  • Natural Anti-Inflammatory: Our 100% enriched green-lipped mussel extract naturally contains high levels of omega-3 and 6 essential fatty acids (EFA’s). These EFA’s [eicosatetraenoic acid (ETA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)] are scientifically proven to inhibit and block inflammation pathways in the body, thus reducing inflammation effectively and naturally. These fatty acids have been shown to have profound anti-inflammatory effects on not only the horse’s joints, but also in conditions such as stomach and bowel inflammation. They also contribute to eye health, brain function, and give horses’ coats a healthy sheen.
  • Prevention:  Giving Technyflex® on a daily basis before problems with arthritis begin can prevent wear and tear on joints, and reduce the onset of symptoms.
  • Rebuilding Joints:  Technyflex® contains GAG's (glycosaminoglycans and mucopolysaccharides).  These are carbohydrates found in the body that help collagen and elastin stay strong and flexible.  Collagen is a major component of all bone, tendon, ligament, and collagen, and is a very strong substance.  GAG's also provide the necessary building blocks to regenerate cartilage and connective tissues.  GAG's help make synovial fluid thick and gummy.  Synovial fluid is found in healthy joints and serves to reduce friction in joints during movement.  
  • Pain Relief:  Technyflex® contains omega-3 essential fatty acids which provide natural pain relief for worn joints and joint injuries.
  • Nutrition: Along with GAG's and omega-3 essential fatty acids, Technyflex® also contains naturally occurring minerals and vitamins that help your horse stay healthy and strong.  
  • All Natural: Made from 100% New Zealand green-lipped mussel meat, not shell.  No additives, no preservatives, no fillers.  No known side effects.

Technyflex®, EFAs, and Omega 3s have been found effective in unravelling the complexities of mammalian inflammatory pathways. Possessing naturally occurring EFAs, Technyflex® has shown high-strength anti-inflammatory properties with no known side effects. 6,7

Technyflex® has demonstrated COX-2 inhibition. EFAs also have shown to inhibit LOX-5. 6,8

What are the nutritional benefits of Technyflex® Equine?

  • Total omega-3 essential fatty acids:  36.3 mg (EPA 17.7 mg, DHA 10.9 mg, ETA 2 mg, ALA 4.2 mg)
  • Minerals:  boron 32 ug, calcium 19.4 mg, chromium 4 ug, copper 9.2 ug, iodine 27 ug, iron 0.92 mg, manganese 30 ug, magnesium 9 mg, potassium 22 mg, phosphorus 19.8 mg, selenium 2 ug, sodium 70 mg, sulphur 36 mg, taurine 58 mg, zinc 1.26 mg
  • Vitamins:  A, B2, B3, B6, B12, C, D, and E
  • Glycosaminoglycans (GAGs) 11-15%, predominantly chondroitin sulphate
  • Proteoglycans up to 30%

FIGURE 2

SOURCE: Study conducted by the Hawthorn Institute, an independent GMP registered laboratory. The test method used: AOAC 18th Edn 963.22.

KEY FINDINGS

  • Nearly twice the number of fatty acid profiles were found in Technyflex® than in Shark Cartilage, Abalone, and other green-lipped mussel powders.
  • Nearly 40 times the number of fatty acid profiles were found in Technyflex® than in Glucosamine and Chondroitin.

What is Technyflex® Equine Gel?

Technyflex® Equine Gel is a topical pain relieving gel for use on sore joints and muscles.This soothing gel can be used alone, or in combination with Technyflex® powder, to soothe stiff, sore joints, muscles or tendons.

Technyflex® Equine Gel contains 100% cold-pressed mussel oil from the New Zealand green-lipped mussel, combined with a blend of essential oils:

  • New Zealand Green-lipped Mussel Oil
  • Arnica Montana Flower Oil
  • Grapeseed Oil
  • Eucalyptus Globulus Oil
  • Wintergreen Oil
  • Birch Oil
  • Black Pepper Oil
  • Ginger Oil
  • Melaleuca (Tea Tree) Oil

The green-lipped mussel oil contains very high levels of ETA (eicosatetraenoic acid) which is applied topically to the tendon, joint, or muscle to support joint function. The essential oils are blended specifically for use on joints and muscles.

The omega-3 essential fatty acids contained in Technyflex® green-lipped mussel oil are proven to fight inflammation and improve joint function, soothing joints quickly and helping maintain optimum mobility and flexibility.  ETA in particular is hard to find in most foods, but is plentiful in the New Zealand green-lipped mussel.

Many of the important nutrients in the green-lipped mussel only exist when the mussels are raw, not cooked.  Although some manufacturers steam the mussels to extract the oil, we use a cold process to extract the oil.  This insures that the essential fatty acids, lipids, and GAGs stay intact and effective.

Is Technyflex® Equine a quality product?

The New Zealand green-lipped mussel (Perna canaliculus) is a marine shellfish containing many nutritional benefits.  It is the only mussel species in the world offering this unique combination of healthy nutrients.  The New Zealand green-lipped mussel is a farmed species, and therefore, growing conditions and quality can vary.  But because we have a comprehensive knowledge of the growth cycles of mussels, and know what quality indicators to look for, we can offer superior quality products year-round.  

We carefully select the best mussels from the clean, pristine waters of New Zealand, then harvest and process them in the shortest possible time frame to obtain the highest quality nutrients.  Because we are passionate about quality, we make sure every step of the manufacturing process meets our high standards.  This results in in the most effective New Zealand green-lipped mussel products available.  

CONCLUSION

Technyflex® Equine provides an overall synergistic approach that offers building blocks to rebuild cartilage and connective tissues in the joints in the form of GAGs and proteoglycans with a wide range of Omega 3s, Minerals, and Vitamins.  In addition, by inhibiting COX-2 pathways, it can reduce inflammation without the harmful side effects associated with NSAIDs.

Giving Technyflex® Equine on a daily basis before problems with arthritis begin can prevent wear and tear on joints and reduce the onset of symptoms.

Technyflex® Equine Gel can be used alone or in combination with Technyflex® powder, to soothe stiff, sore joints, muscles or tendons.

The best way to keep your horse going strong is to support his joints inside and out. The right joint supplement combined with smart management practices will help your horse’s joints keep up with the demands of riding, training, competing, and aging.

WORKS CITED

  1. “Common Causes of Equine Arthritis.” Equine Guelph. University of Guelph. n.d. Web. 8 Jun. 2016.
  2. Cantley, C. E. L., Firth, E. C., Delahunt, J. W., Pfeiffer, D. U. and Thompson, K. G. (1999), Naturally occurring osteoarthritis in the metacarpophalangeal joints of wild horses. Equine Veterinary Journal, 31: 73–81. doi: 10.1111/j.2042-3306.1999.tb03794.x
  3. Meszoly, Joanne. “Coping With Arthritis In Horses.” EQUUS: The Horse Owner’s Resource. EQUUS. Jul. 2008. Web. 8 Jun. 2016.
  4. “Colloidal Minerals: The Truth Vs. Fiction.” Supralife International. n.p., n.d. Web. 8 Jun. 2016.
  5. “Arthritis in Horses.” SmartPak: Healthy Horses, Happy Riders. SmartPak. n.d. Web. 8 Jun. 2016.
  6. Davis, P., Trinity Bioactives, Wellington, NZ. Inhibition of COX-2 inflammatory pathway of NHNZone GLM on Chondrocyte cells.
  7. Davis, P., Bio Investigations Unit, School of Medicine, University of Otago, NZ. Effects of NHNZone GLM on neutrophil superoxide production.
  8. Miller, T.E., Ormrod, D.J., The Anti-Inflammatory activity of Perna canaliculus (NZ green-lipped mussel). New Zealand Medical Journal, 667:187-193.




























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