A review of nearly 400 studies of arthritis medications rated three nonsteroidal anti-inflammatory drugs (NSAIDs):
· Meloxicam (Metacam),
· Carprofen (Rimadyl) and
· Etodolac (EtoGesic)
as most effective against arthritis.
In previous blogs, we’ve examined what the authors of the “Systematic review of clinical trials of treatments for osteoarthritis in dogs” said and did not say about these three NSAIDs.
Chondroprotectives were also included in the review. Chondroprotective medications rebuild joint cartilage and maintain thick, healthy synovial fluid. Let’s examine three of the chondroprotective medicatins discussed in the “Systemic review”:
· Green-lipped Mussels (Perna),
· Polysulfated glycosaminoglycan (Glyco-Flex), and
· Chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate (Cosequin).
Perna
Green-lipped Mussels (Perna) according to the Systemic Review
Although two clinical trials of 62 dogs with arthritis conformed to rigid scientific standards determined by authors of the “Systematic review, ” the authors did not find the studies adequately addressed all issues of scientific quality. Based on the studies, the authors felt moderately comfortable with the use of Perna for the treatment of arthritis.
What the Systemic Review did not say about Green-lipped Mussels (Perna)
Perna, like all chondroprotective medications, takes several weeks to become effective. Perna does not act within hours to relieve pain and allow increased mobility and flexibility within hours as the NSAIDs (Metacam, EtoGesic, Rimadyl) do. Perna improves joints slowly, cell by cell. Over time, there is less pain because joint cartilage and fluid have become more normal. Because Perna is a whole food rather than a purified portion of food, it contains a multitude of molecules that nourish to cells. For example, Perna provides 9 glycosaminoglycans to nourish joints rather than just the two most commonly provided by joint medications—glucosamine and chondroitin. Unlike NSAIDs, Perna does not cause serious side effects: however, it is a shellfish and should not be used in pets with shellfish allergies.
Glyco-Flex
Polysulfated glycosaminoglycan (Glyco-Flex) according to the Systemic Review
Although one clinical trial of 63 dogs with arthritis conformed to rigid scientific standards as determined by authors of the “Systematic review,” they felt the trial did not adequately address all issues of scientific quality. Based on the study, the authors felt moderately comfortable with the use of polysulfated glycosaminoglycan (Glyco-Flex) for arthritis.
What the Systemic Review did not say about Polysulfated glycosaminoglycan (Glyco-Flex)
Glyco-Flex is a chondroprotective medication that takes several weeks to become effective. It contains perna, glucosamine, N-N-Dimethylglycine, and manganese. Glyco-Flex does not cause serious side effects that are more common with NSAIDs. However, Glyco-Flex contains shellfish (Perna) and brewers yeast, both which can both cause allergies. Due to the success of the original Glyco-Flex, additional Glyco-Flex products have been developed. Some of these contain MSM, which works rather like an herbal aspirin to control pain in the short term while the other ingredients work over the long term. For many pets, chondroprotective medications with MSM have the pain relieving benefit of NSAIDs without the side effects.
Cosequin
Chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate (Cosequin) according to the Systemic Review
Although one clinical trial of 19 dogs with arthritis conformed to rigid scientific standards as determined by authors of the “Systematic review,” they rated the study as not proving the benefit of Cosequin.
What the Systemic Review did not say about Chondroitin sulfate, glucosamine hydrochloride, and manganese ascorbate (Cosequin)
Cosequin is one of the most well-researched joint products in small animal medicine and it is considered so effective that many other joint products are modeled after it. Cosequin was one of the first joint products to focus on using very small molecules so that pets could absorb the ingredients. Intestinal cells cannot absorb large molecules, which pass through the intestines and out into the feces. By ensuring the molecules are small, more of the active ingredients in Cosequin are absorbed and can benefit pets. Because of the success of the original Cosequin, other chondroprotective products (Dasuquin) have been developed.
As a pet owner, it helps to have an overview on NSAIDs and chondroprotectives. Do not be swayed by advertising or by statements taken from scientific studies published in national veterinary journals to choose the wrong medication for your pet.
In future blogs, we’ll explore how to use NSAIDs and chondroprotectives together for the safest, most effective arthritis treatment.
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