A much higher dose of thesulfate salt, almost 50% more, is re-quiredto provide an equal amount of bioactive glucosamine as the HClsalt.
In vitro studies support the roleof glucosamine as a modulator of cartilage metabolism, improving car-tilage integrity through stimulationof proteoglycan production.
Clinicalstudies also document the efficacy of glucosamine for the symptomatic re-lief of arthritis in humans.
Howev-er, few controlled studies support achondroprotective effect from glu-cosamine in vivo,
and no publishedcontrolled veterinary trials exist onthe use of glucosamine alone to treatarthritis.
Chondroitin sulfate, the most abun-dantGAG in the body, is especially important in articular (hyaline) carti-lage. In the ground substance of car-tilage, CS aggregates with hyaluronicacid, other GAGs, and proteins toform proteoglycan macromolecules.The CS chains of these aggregatesbind with collagen to form the char-acteristic resilient matrix of articularcartilage.
Oral administration of GAGs has been controversial becauselarge, highly charged molecules areless likely to cross the gastrointestinalmucosa. Early studies were criticized
May 2000Small Animal/Exotics
because of the lack of sensitivity of the method of CS analysis.
However,recent studies using radiolabeled, pu-rified, low molecular-weight CS havedocumented oral absorption in rats,dogs, and humans.
Chondroitin sulfate apparently hasantiinflammatory and regulatory ef-fects on chondrocytes, synoviocytes,and leukocytes.
In various studies,exogenous CS has been shown to de-creaseinterleukin-1 production, block complement activation, and compet-itively inhibit metalloproteinases,thereby slowing degradation of carti-lage and other joint tissue.
Pure CShas been shown to have a clinical ef-fect in decreasing pain in human tri-als.
Unlike glucosamine, exten-sive in vitro research also exists todocument pure CS as a disease-mod-ifying agent.
The serum half-livesof endogenous products are difficultand expensive to determine. Al-though the specific pharmacokineticsof glucosamine and CS may vary from patient to patient, the averageonset of therapeutic effect is 4 to 6 weeks.
For reasons already stated, nutra-ceutical manufacturers are prohibitedfrom including therapeutic claims(indications) on product labeling.Despite the lack of formal medicalclaims, glucosamine HCl and puri-fied low molecular-weight CS ad-ministered in combination are usedextensively to support cartilage func-tion and structure in dogs, cats, hors-es, and humans. Several investigatorsreported relief of joint pain from os-teoarthritis after combinations of CSand glucosamine HCl were adminis-tered.
The best results for chondro-modulationare anticipated in patientsthat do not have severe structuralchanges in joint tissue, specifically,that some viable chondrocytes arestill present in affected joints.
Because glucosamine and CS areendogenous compounds, they wouldbe expected to have few contraindica-tions when used as labeled. Animalsafety studies confirmed the safety of these compounds when glucosamineHCl and low molecular-weight CS were administered at 1.5 to 2 timesthe therapeutic dose to dogs, cats,and horses.
Adverse effects occa-sionally reported (less than 2%) indogs included stool softening and in-creased intestinal gas.
Safety studiesin pregnant or lactating animals havenot been published for combinationproducts or either agent alone.
The acute oral LD
of combined glu-cosamineHCl and low molecular- weight CS in rats was greater than 5g/kg of body weight; therefore, it isclassified as nontoxic.
No publishedreports indicated acute or chronictoxicity from overdose of the com-bined product or glucosamine or CSadministered individually. However,the FDA has recorded adverse effectsfrom some products that were labeledas containing glucosamine and/or CSin mixtures with other ingredientssuch as herbal extracts.
Oral high-dose studies evaluating hemostatic pa-rameters, including platelets, as wellas hematology and serum chemistry
Client Counseling Information
Glucosamine and chondroitin sulfate are nutritional supplements withdifferent but synergistic mechanisms of action that support cartilagestructure and joint function. Do not use any brand other than the oneprescribed by your veterinarian.
The best results are obtained if these products are used before extensivechanges in joint structure have occurred.
If your pet is going to respond to glucosamine–chondroitin sulfatetherapy, improvement should be noted within 4 to 6 weeks.
Side effects (including softening of the stool and increased intestinal gasin dogs) are mild, dose dependent, and reversible. If you notice any adverse effects in your pet, please contact your veterinarian immediately.
There are no known contraindications or drug interactions for theseproducts, but please consult your veterinarian before using any medication in conjunction with glucosamine and chondroitin sulfate.