Osteoarthritis (OA) is a common disease in adult and elderly dogs and cats, but it is often underdiagnosed and undertreated. It is a degenerative and inflammatory joint disease characterized by the chronic and progressive degradation of articular cartilage, with the formation of osteophytes, thickening and sclerosis of the subchondral bone, synovitis, synovial fluid effusion and fibrosis [1, 3, 5]. It can be caused by trauma, alterations or deterioration of joints and cartilage, hip or elbow dysplasia, patellar or shoulder luxation and osteochondritis. This is a chronic degenerative disease that affects cartilage, bone and skeletal muscle, causing joint remodeling [1, 3]. In addition, obese dogs, because of the high levels of stress on their joints, and dogs with disorders such as diabetes or on long-term steroid treatment are also at greater risk of developing the disease [3].
Although there is no cure, it can be treated with excellent long-term results. Treatment usually starts with pain control, which is a key step, followed by nutritional support for the joints. Equally important is weight control of the animals for better management of OA [1, 3, 5]. It is important to notice that joint problems are not "normal aging problems" and should not be underestimated as they reduce the vitality and quality of life of the animal.
But how do you know that your pet has osteoarthritis?
Usually, the guardian notices greater difficulty when moving or going up or down stairs, but there are other common clinical signs, including:
Lameness [1;3]
Joint stiffness [1;3]
Crepitation [1]
Periarticular swelling [1]
Palpable effusion and pain after manipulation of the joint and limb[1].
The pathophysiology of OA is complex and involves processes such as inflammation and proteolytic degradation of cartilage, which is why it requires multimodal treatment. In conventional veterinary medicine, pain and inflammation associated with osteoarthritis are often managed by pharmacological suppression. Non-steroidal anti-inflammatory drugs, which are widely used in these cases, are known to have significant adverse effects, especially when long-term use is required. In this sense, the use of nutraceuticals is a viable and effective alternative for the prevention and treatment of the disease, especially as they can be used safely over long periods of time to relieve pain and prevent cartilage degradation [1,3].
Below you can learn about some nutraceuticals that have antioxidant, anti-inflammatory, antinociceptive and chondroprotective action in osteoarthritis.
Glucosamine sulphate and chondroitin sulphate:
Both are components of the extracellular matrix of articular cartilage. Glucosamine is a glycosaminoglycan constituent that plays a role in the growth and repair of joint cartilage, considered a building block of the cartilage. It has the function of protecting and repairing the proteoglycans contained in cartilage, promoting increased collagen production and stimulating the production of synovial hyaluronic acid.
Chondroitin sulphate, in turn, is a sulphated glycosaminoglycan which is also a normal constituent of joint cartilage [1]. It plays a structural role in the extracellular matrix and in the structure of articular cartilage aggrecan. Aggrecans are a central protein of specific cartilage proteoglycans that confer flexibility, deformability, resistance to tension and twisting, and the ability to absorb shocks and trauma. Chondroitin acts synergistically with glucosamine and is often combined in supplements. A good therapeutic response is observed after 4 to 6 weeks of use.
Curcumin:
This is the active ingredient obtained from the roots of Curcuma longa. Studies have shown that curcumin reduces the synthesis of pro-inflammatory mediators, providing a chondroprotective effect. Oral administration of curcumin significantly reduces the progression of OA[1], as well as inhibiting macrophage proliferation and increasing the synthesis of type II collagen, exerting an antioxidative, anti-inflammatory and chondroprotective effect[1]. For greater bioavailability and efficacy, curcumin should always be preferred in the form of phytosomes, which provide a 29-fold increase in absorption.
A study published recently by Italian researchers from the University of Perugia showed that curcumin in combination with Palmitoylethanolamide, which we'll see below, reduced chronic pain in patients with osteoarthritis in a statistically significant way [6].
PEA (Palmitoylethanolamide):
This is an endogenous fatty acid amide belonging to the N-acylethanolamide family. It is produced "on demand" by various types of cells, including mast cells, astrocytes and microglia, and is involved in modulating inflammation and pain, and can be supplemented when necessary.
It has a cannabimimetic action, which means it binds in parallel to endocannabinoid receptors, mimicking the effect of their natural receptors. It neutralizes the action of pro-inflammatory mediators, modulates neuroinflammation by acting on microglia and mast cells, and acts on somatic and visceral pain receptors. It is very effective in the treatment of inflammatory, neuropathic, mixed, acute and chronic pain [6, 7]. Some studies show its activity not only in reducing pain, but also in preserving peripheral nerve morphology, reducing endoneural edema, recruitment and activation of mast cells and the production of inflammatory mediators at the site of injury [8].
MSM (methylsulfonylmethane):
Due to its high sulphur content, it is used by the body to maintain normal cartilage tissue. It works well as an anti-arthritic due to its antioxidative potential, anti-inflammatory and analgesic activity. In osteoarthritis, MSM has the same function as non-steroidal anti-inflammatory drugs, but without the side effects[1].
Boswellia Serrata:
Although it is not a nutraceutical but a herbal extract, I decided to include in this paper due to its great therapeutic and anti-inflammatory properties. The beneficial effects of Boswellia Serrata are attributed to boswellic acids which exhibit anti-inflammatory effects and anti-arthritic properties, inhibiting the synthesis of leukotrienes, providing improved joint mobility and comfort [1,3]. It inhibits 5-lipoxygenase, NF-κB and MMP-3, as well as positively impacting biomarkers of inflammation and arthritis, reducing clinical signs [1].
Eggshell membrane:
Eggshell membrane can be extracted and ground into a powder, which concentrates a high percentage of collagen, elastin, hyaluronic acid, chondroitin sulfate, glucosamine and lysozyme. The combination of these compounds makes this nutraceutical excellent for the prevention and treatment of joint diseases as it regenerates and recovers cartilage, reduces pain and increases motor capacity, improves joint mobility, aids muscle development and reduces inflammation [1,4].
UC-II
Type II collagen is the main structural protein found in cartilage. It provides flexibility and support to bone joints and is responsible for their resistance to traction and tension. It is effective and improves the pain associated with arthritis, and can be used for long periods. In cases of osteoarthritis, UC-II can promote a reduction in inflammation, as it reduces COX-2 and inflammatory cytokines such as IL-1 and IL-6 [2].
Conclusion:
As osteoarthritis requires long-term treatment, both to improve the quality of the joint and to reduce pain, nutraceuticals are an excellent option because, as in addition to having their efficacy scientifically proven, they can be used for long periods, effectively and safely, improving the quality of life of animals.
References:
1. GUPTA, R. et al. Nutraceuticals in Veterinary Medicine. Ed. Springer Nature Switzerland AG, 2019.
2. GUPTA, R. et al. Comparative therapeutic efficacy and safety of type-II collagen (uc-II), glucosamine and chondroitin in arthritic dogs: pain evaluation by ground force plate. Journal of Animal Physiology and Animal Nutrition; 2011; Blackwell Verlag GmbH.
3. MUSCO, N. et al. Effects of a nutritional supplement in dogs affected by osteoarthritis. Vet Med Sci. 2019; v. 5; pp. 325–335.
4. RUFF, K.J. et al. Effectiveness of NEM® brand eggshell membrane in the treatment of suboptimal joint function in dogs: a multicenter, randomized, double-blind, placebo-controlled study. Veterinary Medicine: Research and Reports 2016:7 113–121.
5. RYCHEL, J.K. Diagnosis and Treatment of Osteoarthritis. Top Companion Anim Med . 2010 Feb;25(1):20-5.
6. Della ROCCA, G. et al. Palmitoyl‑glucosamine co‑micronized with curcumin for maintenance of meloxicam‑induced pain relief in dogs with osteoarthritis pain. BMC Veterinary Research (2023) 19:37.
7. Della ROCCA,G & RE, G. Palmitoylethanolamide and Related ALIAmides for Small
Animal Health: State of the Art. Biomolecules 2022, 12, 1186
8. D’AMICO, R. et al. ALIAmides Update: Palmitoylethanolamide and Its Formulations on Management of Peripheral Neuropathic Pain. Int. J. Mol. Sci. 2020, 21, 5330.
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