As the demands on our competition horses increase due to longer competitive seasons and increasing numbers of events, the need to medicate these horses also grows.
Many of the Nutraceuticals ( nutrients used specifically as therapeutic agents ) offer alternatives to drugs without the risk of a positive test and without risking the soundness of the horse. Nutraceuticals are mild in their action and will not mask pain; consequently, the horse can compete safely while being treated. Many of these natural products are very good at treating chronic conditions where western medicine tends to work less effectively. Sports medicine practitioners using natural medicines incorporate Nutraceuticals, homeopathic medicines and herbs. Because it is seldom possible to patent natural medicines, little true double-blind research is being done; however, there are hundreds to thousands of years of documentation concerning the use and effectiveness of homeopathy and herbal medicine. Nutraceuticals are generally single nutrients selected for a specific action. The nutrients are almost used as drugs, but without the side effects.
Neutraceuticals are made of one or a few specific ingredients and are selected for a specific action, as compared to supplements, which are much broader in spectrum. Most Nutraceuticals are relatively new on the market and generally do not have the years of experience the other forms of natural medicine have; however, many of them have some scientific research behind them. All branches of natural medicine have more science behind their principles than most practitioners are aware of. As with any form of medicine, the potential for abuse and incorrect use does exist. The Nutraceuticals are generally fairly safe to use, unless people insist on combining too many ingredients. Many horse owners treat their horses with little knowledge of either the disease or the products they are using.
The most common documented Nutraceuticals in the equine industry are products for joint therapy (1-4), but other nutrients such as anti-oxidants and immune modulators are also included. In natural medicine, the individual animal's physiology and reaction to disease is taken into account much more so than in conventional medicine. One of the complaints about Nutraceuticals in general is that they may work in some horses, but not in others. Do conventional drugs always work when we expect them to? No. A certain amount of individual variation exists in any system of medicine. More attention is paid to this individual variation with natural medicine. Many horses that do not respond to one product will respond favorably to products made from a different compound, and some horses will not respond at all. A study is underway to determine if the active ingredients in the joint products are really present in the quantity claimed on the label. Preliminary data indicate that many products do not live up to their label claims; this may account for the variable response rate.
Many riders today have become aware of subtle lameness as the standards of competition increase and the cost of replacing a horse becomes prohibitive. Anecdotal evidence of a product's efficacy is often considered by the scientific community to be invalid; however, improvements in a horse's movement sometimes are better evaluated by the rider and not by the veterinarian standing on the ground. Riders may feel a significant improvement in the animal's flexibility and the warm-up time is often dramatically shortened after the use of these supplements. Parameters such as warming up faster are difficult to see and may even be difficult to measure even with gait analysis equipment.
Commonly Used Equine Nutraceuticals
There are many compounds on the market with lots of advertising claiming that a particular company's product is better than another company's product. The best way to select a company to work with is to find out who the formulators are (they should be highly trained and qualified people). Commonly, a human practitioner will make the formulations, with minimal experience with animals. Or an obscure vet will lend a name to a product. It is also important to deal with com-panies who make high quality products without adding fillers and binders that could cause allergic reactions or reduce the efficacy of the product.
The most common class of neutraceuticals is the joint support formulas. The basic classes of joint products are the purified chondroitins and glucosamines; the extracts of green mussels; western herbal formulas; and Chinese herbal formulas. Each has a different action, all work, but in an individual one class of products may work better than another.
Another class of products is the anti-oxidants such as Co Enzyme Q 10 or pycnogenols. Vitamin C used in large quantities potentially becomes a Nutraceutical in this class. Co Q 10 is an excellent antioxidant in laminitis cases. Vitamins A, C, and E are considered antioxidants. Selenium has been known to be necessary in horses for years and is supplemented regularly in selenium deficient areas. Probiotics such as lactobacillus acidophilus, I. sporogenes and the yeast saccharomyces bulardii are used to help rebalance intestinal flora after antibiotic use or stress. The bioflavonoids quercitin and hesperidin have multiple functions in the body as supporting nutrients. Bioflavonoids occur in a broad spectrum in many whole food supplements such as blue green algae and barley grass. Amino acids used as individual nutrients can be very useful and varied in their effects. DL phenylalanine can be used as a calming agent while L-carnitine may enhance endurance performance. L-glutamine is perhaps one of the most important nutrients for the equine as it is the primary fuel for the enterocytes lining the intestinal tract. If an endurance horse (or surgical cases or a horse on restricted feed for medical reasons) is off feed for even a few hours, this nutrient should be supplied. L-lysine has an effect on the immune system and is useful in treating herpes infections and general immune system problems.
Other nutrients can be used for immune system support or stimulation. Plant sterols, vitamin C, and a number of individual herbs such as Echinacea can all act on the immune system in a positive way. But, the immune system can also be over-stimulated and can wear down, leaving the animal more susceptible to infections.
Other categories are essential fatty acids, digestive enzymes and relaxing or stress reduction compounds. Other compounds, including grapefruit seed extract to treat yeast infections and berberine-containing herbs to treat bacterial infections, can have antimicrobial action.
Nutraceutical medicine is a valuable complementary therapy to add to the sports medicine practitioner's tool chest. Though many people consider this form of natural medicine ineffective, the horse-owning public is using natural medicine more and more frequently. Practitioners do not need to practice natural medicine, but should become familiar with some of the treatments so they can guide their clients toward quality care.
1. Drovanti A, et al. Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo-controlled double-blind investigation. Clin Ther 3(4):260, 1980.
2. Hanson RR. Oral glycosaminoglycans in treatment of degenerative joint disease in horses. Eq Prac 18(10):18-22, YEAR?
3. Hanson RR, Smalley LR, Huff GK, et al. Treatment with an oral glucosamine-chondroitin sulfate compound for degenerative joint disease in horses: 25 cases. Journal info? Page numbers? Year?
4. Vaz, AL. Double-blind clinical evaluation of the relative efficacy of Ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee in outpatients. Curr Med: Res Opinion 8(3):145, 1982.
Joyce C. Harman, DVM, MRCVS, operates Harmany Equine Clinic, Ltd. In Washington, VA. 540-675-1855. Acupuncture, chiropractic, homeopathy, herbs, nutrition and saddle fitting make up most of the practice. Dr. Harman has a book on saddle fitting due out soon and a web site in preparation, www.harmanyequine.com