Few horsemen need an introduction to joint nutraceuticals anymore (if you do, see our November 1997 article), and even fewer need proof that they work. They readily plunk down big bucks to help lubricate their horse’s over-stressed joints. Some even wonder if it’s worth the money just as a preventative. In this article, we field test formulas not included in our first article and compare them to our previous findings.
Joint nutraceuticals are effective for a wide range of problems, including OCD, early to advanced degenerative arthritis and some “back problems,” which may involve changes in the joints that allow movement of the spine. Since joint nutraceuticals only directly address problems related to joint cartilage, incomplete responses or failures may be related to the exact pathology involved.
For example, a horse experiencing pain related to osteophyte formation around a joint or joint fractures/dislocations will continue to have this problem. Muscular spasm/pain, ligamentous pain or pain related to chips of bone/cartilage or cartilage flaps will also be unchanged. Accurate diagnosis of all components contributing to pain is essential to matching the treatment program to the horse.
Despite similarities in the nutritional requirements for the maintenance of healthy joint cartilage and tendons/ligaments, we found no strong evidence that joint nutraceuticals are of benefit in treating tendonitis/desmitis.
What Works Best
With two exceptions (Corta-Flx and Cosequin), we again found the most reliable, rapid response was to glucosamine at our recommended dosage. Most horses show obvious improvement in seven to 10 days. With chondroitins or mixed glycosaminoglycans and perna, response is slower and usually not as dramatic.
Lameness/stiffness may quickly return after stopping glucosamine, but improvements from chondroitin products or perna are more long lasting (four to six weeks). You can also expect a longer remission of symptoms after stopping the supplements in horses that have been on treatment for several months rather than several weeks.
The battle rages on concerning whether glucosamine hydrochloride (HCl) or glucosamine sulfate is preferred. The sulfur is important to the formation of strong cross-bridges in connective tissue. Nevertheless, no studies definitely prove glucosamine sulfate has a better clinical effect than glucosamine hydrochloride. We didn’t see a difference either.
Horses on low-protein diets (10% or less) or those not receiving high-quality protein sources may have borderline sulfur status. The horse’s primary source of sulfur is believed to be sulfur-containing amino acids, such as methionine. Supplying higher-quality protein or an organic sulfur source, such as MSM, may be helpful if using glucosamine HCl.
Glucosamine HCl is much less expensive than glucosamine sulfate. Another plus the hydrochloride has over the sulfate is that the sulfate has a noticeable odor that caused some palatability problems.
An important point in the first article was that effective dosages do not necessarily correspond to the manufacturers’ recommended dosages. Initial glucosamine dosage for a 1,100-pound horse should be nine to 10 grams/day; perna mussel, chondroitin sulfate or mixed GAGs 7,500 mg/day minimum. Lower dosages usually yield less obvious responses. It is more cost efficient to begin with these dosages and attempt tapering later than to feed the lower dose for four weeks, only to find you need to increase it to tell if the product helps.
On the other hand, exceeding these dosages does not appear to result in further improvement. We also again found that horses who improve on the dosages above may need to be maintained at that level. Attempting to drop down to suggested “maintenance” dosages results in partial or full return of symptoms in many horses, especially those in work.
Which Type Is Best'
We had few failures with any joint nutraceutical, and in each case there was an explanation pertaining to the problem being addressed. On the whole, glucosamines provided more rapid relief of pain, more obvious improvements in general attitude and better palatability.
Chondroitins also obviously help, although response seems better in older or less-active horses. A typical description of the response to chondroitins is that the horse is moving more freely, although any individual joint that was particularly problematic before supplementation is still usually easy to pick out.
Perna-based products are the most problematic in terms of palatability (fishy base) and take the longest to show a benefit, although the eventual effect is usually excellent, especially in older horses, and may be related to the naturally high levels of omega fatty acids (anti-inflammatory nutrient) and other trace nutrients as well as the glycosaminoglycans. The effects of pernas also last the longest if the supplement is discontinued.
When we spot a product with a prominent guarantee, we’re tough on it. For one thing, a money-back policy doesn’t compensate you for lost time. Manufacturers also know it is a great selling point, and most people won’t bother to try to get their money back, even if it doesn’t work. If a guarantee appears to make an outlandish claim, however, we get in gear.
Corta-Flx claims guaranteed “dramatic results five days.” That’s pretty brave, but after trying this product on a wide variety of horses/problems — young and old, active and retired — we are convinced. In fact, most horses responded at three days. “Dramatic” is also accurate. Not only are pain, stiffness and range of movement improved, but the horse’s attitude improves as well. Horses that would shuffle off slowly with their heads down when turned out were observed to trot out freely, even buck and run, as it took effect.
The Corta-Flx formula is unique. In addition to the quantified ingredients listed, the product contains vitamin C, superoxide dismutase (SOD), manganese, zinc, sulfur and a full complement of amino acids. The chondroitin sulfate/mucopolysaccharide fraction is specially processed to make it water soluble, therefore more available for digestion. The manufacturer reports it was the water-soluble nature of the product combined with the correct amount of amino acid precursor for glucosamine that gave them the best results and culminated in this formula. Palatable in liquid or powder, we found the liquid worked faster.
Arthroglycan (Vetrepharm Canada) is another liquid chondroitin product, in a distilled-water base. We had no response at the label-suggested dose of 10 cc (2,500 mg) per day in a retiree with longstanding arthritis. At 5,000 mg per day, equivocal response was seen in a 10-year-old racehorse with old arthritis problems; the horse was described as “freer” (typical description of a chondroitin response). At 7,500 mg day, equivalent to effective dose for powders, there was more obvious satisfactory improvement noted after five days in a six-year-old racing mare with moderate arthritis in the hocks.
Xtra Flex and Xtra Flex Plus (Med-Vet/United Vet) are high-grade chondroitin sulfates, with purity independently tested by the manufacturer. Both performed well with clear improvement noted at both the 5,000 and 7,500 mg/day feeding levels, better at 7,500. The exemplary quality-control program helps make them an excellent choice.
Nu-Flex With Ester C (Select The Best) contains guaranteed 95% pure chondroitin, like their Nu-Flex CS, and is backed by the company’s independent analyses of incoming raw material, an extremely important plus. Nu-Flex with Ester C has yucca and an antioxidant package that is not as generous as their glucosamine. But it is a new formula that incorporates hydrolyzed collagen, the material targeted in arthritic conditions that has an autoimmune component. We did not have this product long enough to do field trials beyond palatability.
Maxflex Chondroitin and Maxflex Pure Chondroitin (Farnam) both performed quite well at the 7,500 mg/day feeding level for all classes of horses with inactive/older horses showing more response at the 5,000 mg/day mark than horses in work.
Bone And Joint (Uckele Health and Nutrition) is a mixed chondroitin product (bovine trachea origin) with added calcium and phosphorus in 1:1 ratio, making it compatible with any hay. As is typical of the chondroitins, obviously freer movement was seen at the 10- to 14-day mark at a dosage of 7,500 mg/day; less obvious results below this dosage.
Flex Formula CS Pellets (Nu-Solutions) is an alfalfa-based pellet that made for less waste and good palatability. We had no effect feeding this product at manufacturer’s recommended dose (1,750 mg/day chondroitin sulfates) or when doubling the dose — undoubtedly because of the low daily dose.
This product could be considered for maintenance, especially in horses not being actively worked who usually have lower dosage requirements. However, the high manganese level, not balanced by the addition of other important trace minerals, could give an unbalanced mineral picture to the diet. The methionine is a good idea but is probably too small to make much difference.
Joint Renew II (Peak Performance Nutrients) contains no fillers, meaning you can feed much smaller amounts for equivalent effects, a real plus for finicky eaters. The recommended dosage is in line with our findings — 10 grams (two servings) per day of glucosamine. The array and dosage of supporting nutrients is also excellent: Ester C, bioflavinoids, devil’s claw, manganese and zinc. Response was excellent. Within five to seven days, we saw marked pain relief and improvement in gait and attitude, even in horses heavily worked.
Gluco-Max (Pro Formula) is a state-of-the-art glucosamine product that focuses on the common areas of deficiency in most diets, making it compatible with most feeding programs. Liberal levels of vitamin C and bioflavinoids provide antioxidant coverage. A full gram of the key sulfur-containing amino acid methionine is provided in each serving, with betaine added to enhance metabolism of methionine. Results were also excellent; the only problem was with some palatability.
Maxflex Glucosamine (Farnam) contains a full 10 grams of glucosamine in each two-ounce serving. Response was excellent; results were less obvious at the five grams/day level, especially in working horses. While the levels of vitamin C and yucca could be higher for maximal benefit, levels of key amino acids lysine and methionine, as well as the chelated key trace minerals copper, zinc and manganese, make it a good choice for horses receiving little/no grain and/or mineral supplementation, and are compatible with any hay.
Engage (EquiHealth) mixes high-grade glucosamine with vitamin C from Ester C and manganese as well as herbal support from boswellia. However, the company preferred to keep exact dosages of the latter three ingredients proprietary, so we can’t comment on adequacy. Fussy eaters are likely to detect the herbal component, despite the small volume you need to feed. Response was very good with clear improvements noted within seven days when feeding at least 7,500 mg glucosamine/day.
Glucosamine HCL and Glucosamine XL (Med-Vet/United Vet Equine) offer a choice of the hydrochloride or sulfate forms of glucosamine. Both provide excellent results at the nine to 10 gram/day feeding level with dosage drop to five grams per day possible for some horses, others (usually hard-working animals) require the higher dose be maintained. The hydrochloride is less expensive and more palatable.
Glucosamine XL Plus (Med-Vet/United Vet Equine) is billed as “the comprehensive joint lubricant formula,” and it did provide excellent results within seven days. Some finicky eaters took a little time to accept the taste but were not a problem. We would like a higher vitamin C and amino-acid level. Level of chelated minerals, however, is excellent and makes this a good choice for horses who receive no supplemented grain or trace mineral supplements. This company also ranks with the best for quality control.
Nu-Flex Glucosamine Pure and Nu-Flex Maximizer With Ester C (Select The Best) are glucosamine with purity of incoming materials verified by independent testing, putting Select The Best in the top category of companies for quality control. It was no surprise that both products produced reliable results in short order (about seven days). The Nu-Flex Maximizer also has an excellent anti-oxidant package and a whopping dose of yucca. It was effective at a dosage somewhat lower than usually needed for peak effect, possibly because of the yucca. Palatability was excellent.
Nu-Action Plus Pellets (Nu-Solutions) are alfalfa-based tiny pellets that provide excellent palatability with less waste than powdered products. This is probably why we had good results even at slightly under the usual effective dose for glucosamine (8,000 mg).
We also liked the supplements package with conservative but sufficient amounts of chelated trace minerals zinc, copper and manganese. We feel the vitamin C level should be raised, however.
“Mixed” Products And Perna
Multi Flex from Multivet USA (Nupro) combines an effective dose of glucosamine sulfate with a generous amount of perna, the latter a rich source of trace minerals, amino acids, fatty acids and GAGs. Results were obtained rapidly (same time frame as other glucosamine products) and the reasonable price makes this product an excellent choice.
Vetriflex E.Q. (Vetritech Laboratories, Inc.) provides one of the highest dose of glycosaminoglycans (GAGs) per serving at 4,875 mg, with triple dosing recommended during a two-week loading period. There is also a good amount of yucca. The generous dosages and adequate feeding recommendations for horses undoubtedly contribute to this product’s rapid onset of effect (seven to 10 days). Stabilized rice bran is used as a source of fatty acids (contributes to the anti-inflammatory effects).
Arthrisoothe (The Garmon Corp.) is another mixed GAG product and combines mixed chondroitins with perna. It contains correct amounts of antioxidant vitamins E and C to help protect working joints from free-radical damage and the herbal anti-inflammatories yucca and boswellia.
Response to Arthrisoothe after two to three weeks in two older horses with assorted and quite obvious joint problems was good, although we found that dropping below loading levels (two servings per day) resulted in obvious deterioration again — this is most likely due to the somewhat low levels of chondroitin and perna per dose.
Perflexxion (Paragon Performance/Equilife) combines chondroitin and perna mussel with pantothenic acid and unspecified amounts of yucca, biotin, methionine, brewer’s yeast and wheat germ. Positive response was seen at two ounces per day with benefits taking approximately two weeks to become apparent.
Sure Flex (Sure Nutrition) is a blend of GAGs and perna mussel. Although results took a while (about two weeks) to become obvious, response was good. We feel the perna component was probably largely responsible since the level of chondroitins is relatively low per dose, although a synergy between the two cannot be ruled out. The addition of linseed meal with high levels of beneficial fatty acids naturally in perna makes for good anti-inflammatory effect. As with all products containing perna, acceptability may be a problem with some finicky eaters.
Next Level (Sure Nutrition), a liquid, is an innovative new formula. Palatability was unsurpassed, despite the ingredients that send many horses charging into the corner when in powder form (glucosamine sulfate, perna, shark cartilage). The three effective chondroprotective agents are combined with a large dose of Ester C and bromelain, a protein-digesting enzyme to aid in the assimilation of the chondroprotectives . We did not have this product long enough to do field trials beyond palatability.
Picking a clear winner in joint nutraceuticals is like trying to claimthat Advil works better than Nuprin (both ibuprofen), or Tylenol (acetaminophen) is better than either. Different products work by somewhat different mechanisms, and every horse has its individual biochemistry and variations in disease process that could influence response.
In November 1997, we stated that the combination of chondroitin and glucosamine (as in Cosequin or your own mixture of products) is theoretically the best approach. On the basis of what is known from research, this is still true, although our last article’s winning glucosamine-only product (Grand Flex) did prove to give equivalent results, both symptomatically and in terms of joint fluid. We do not recommend readers who are successfully using Grand Flex or Cosequin change to another product.
After our current field study, however, we believe the new Corta-Flx offers advantages in terms of both degree of response and speed of response. It contains the amino acid precursor to glucosamine, and the chondroitin has been specially processed to make it more “digestible” (meaning easier to break down to glucosamine). So, it isn’t clear if this is a result of mixed actions from chondroitin and glucosamine or predominantly a glucosamine effect.
We also looked at a variety of innovative combinations — perna with glucosamine or chondroitins and products with added herbals or beneficial fatty acids — which also gave us good results. We do want to repeat our caution to make sure any heavily supplemented product (minerals) is compatible with your current diet. Long-term overdosing any mineral is never good.
Also With This Article
Click here to view "Old Favorite Grand Flex Shows Long-Term Benefits."
Click here to view "New Crop Of Joint Nutraceuticals Ingredients And Palatability Ratings."
Click here to view "Patent Challenge."
Click here to view "Quality Control Is A Major Issue."
Click here to view "Chondroitins Fight Inflammation."
Click here to view "Joint Nutraceuticals And The Older Horse."
Click here to view "Joint Nutraceuticals And The Young Horse."
Click here to view "Not A Preventative."
Contact Your Local Tack Store Or:
Vetrepharm Canada Inc.
383 Sovereign Rd.
London, ON, Canada N6M 1A3
Joint Renew II
Peak Performance Nutrients, Inc.
3395 North Dixie Highway #8
Boca Raton, FL 33431
PO Box 311
Aiken, SC 29802
Equine Nutritional Products
5610 East La Palma Avenue
Anaheim, CA 92807
Vetritech Laboratories, Inc
3768 Hanson Loop Road,
Burbank, WA 99323
The Garmon Corp.
27461-B Diaz Rd.
Temecula, CA 92590
901 E. Penn Blvd.
Feasterville, PA 19053
EquiHealth/Global Health Inc.
6330 Gunpark Dr.
Boulder, CO 80301
4121 SW 47 Ave. #1303
Ft. Lauderdale, FL 33314
Max Flex Products
PO Box 34820
Phoenix, AZ 85067-4820
Bone And Joint
Uckele Animal Health & Nutrition
PO Box 160
Blissfield, MI 49228
Nu-Flex Products, Glucosamine HCL Pure, Chondroitin Sulfate Pure
Richdel/Select The Best
PO Box 1968
Carson City, NV 89702
Nu-Action Plus GL Pellets, Flex Formula CS Pellets
5905-A Hamptom Oaks Parkway
Tampa, FL 33610
Multivet USA, Inc (Nupro)
10 Stella Court
Stony Point, NY 10980
Flexxion, Perflexxion, Arthroflex
Equilife/Paragon Performance Products
PO Box 5005
Glendale, CA 91221
MedVet/United Vet Equine
14101 West 62nd St.
Eden Prairie, MN 55346