Herbs: A Helping Hand for Osteoarthritis

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herbal treatment canine osteoarthritis

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The average age of companion animals has risen by 70% since the 1930s, and as a result veterinarians are spending more time caring for senior patients.1 Senior patients are often affected by degenerative joint disease (DJD), which has been identified as one of the most significant and under-diagnosed diseases of cats and dogs.² In dogs over 8 years of age, 80% have osteoarthritis (OA), and even within younger populations of patients, it is suggested that 20% of dogs over one year of age are affected by progressive changes of osteoarthritis, whether through conformational abnormalities, genetic predisposition or injury.3,4  

Non-steroidal anti-inflammatories (NSAIDs) are commonly prescribed to decrease pain and inflammation associated with OA, and may be associated with gastrointestinal adverse effects.5 The World Small Animal Veterinary Association (WSAVA) Guidelines for Recognition, Assessment and Treatment of Pain recognises multimodal therapy as the most effective way to address chronic pain such as OA.6 Similarly, integration of pharmacologic (NSAIDs, polysulfated glycosaminoglycans, nutraceuticals) and non-pharmacologic (weight optimisation, acupuncture, physical rehabilitation) treatments is recommended by the American Animal Hospital Association and American Association of Feline Practitioners for management of DJD, suggesting this integration benefits management of DJD more than any other pain condition.2 

The WSAVA Guidelines identify 3 groups of dietary supplements with potential benefits for pain management; omega-3 polyunsaturated fatty acids, glucosamine and chondroitin, and green-lipped mussel (GLM).6 Glucosamine hydrochloride and chondroitin sulfate appears to have pain relieving effects in dogs with hip/elbow OA comparable to carprofen though onset of efficacy is delayed.7 In this study, statistically significant improvements in pain scores, severity and weight bearing were identified in the supplemented group after 70 days compared to 42 days in the carprofen treated group.7 

Green-lipped mussel has been studied in dogs suffering from OA. GLM is rich in omega-3 polyunsaturated fatty acids, vitamins, amino acids and minerals, and is thought to act by inhibiting membrane arachidonic acid metabolism by blocking LOX and COX pathways, decreasing PGE2 and leukotriene synthesis and down-regulating the inflammatory sequence.5 This has been supported by significant improvements in peak vertical force, owner evaluated pain and motor activity in a group of dogs supplemented with GLM for 8 weeks compared to dogs given placebo.5

While rarely used as monotherapy, herbal dietary supplements are becoming a topic of interest in the scientific veterinary community, and are being integrated into management plans for chronic medical ailments.8,9 A survey of 2675 veterinarians in Austria, Germany and Switzerland found 75% of veterinarians use herbal medicine as adjunct therapies for chronic diseases.8 Herbal ingredients have demonstrated usefulness in canine and human osteoarthritis due to their multimodal anti-inflammatory effects, including Boswellia resin (known as frankincense) and curcumin (principal biochemical component of turmeric).10,11 

Boswellia resin is traditionally used in Ayurvedic medicine as an anti-arthritic, astringent, stimulant, expectorant and antiseptic.11 Pharmacological and clinical studies in humans and animals have identified the ability of Boswellia resin to reduce inflammation in a multimodal manner through inhibiting leukotriene production, activation of nuclear factor kappa B and tumour necrosis factor alpha generation.10 The use of Boswellia resin in osteoarthritic dogs resulted in a significant improvement in 71% of dogs after only 2 weeks, and by 6 weeks clinical signs such as intermittent lameness, local pain and stiff gait had diminished.9 Boswellia is recommended to be used in combination with turmeric for treatment of osteoarthritic pain.11 Curcumin demonstrates inhibitory actions against major inflammatory mediators.12 A turmeric extract was given to dogs in a randomised, double-blind, placebo-controlled parallel group study for 8 weeks.11 While the treated group did not vary significantly from placebo in peak vertical force measurement, owner evaluation of improvement was significant, and investigator assessment showed a statistically significant treatment effect in favour of the extract.11 

Dietary supplements are candidates for management of OA in conjunction with other therapies.5 Since OA is a chronic disease, products with minor adverse effects such as dietary supplements are preferred for long-term use, since administration can start at time of diagnosis.5

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References

1. Coupland, S., & Reynolds, H. (2018). Do dog owners recognise behavioural indicators of canine cognitive dysfunction and can environmental enrichment techniques slow its progression? The Veterinary Nurse, 118-123.

2. Epstein, M., Rodan, I., Griffenhagen, G., Kadrlik, J., Petty, M., Robertson, S., & Simpson, W. (2015). 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats. JAAHA, 67-84.

3. Rialland, P., Bichot, S., Moreau, M., Guillot, M., Lussier, B., Gauvin, D., . . . Troncy, E. (2012). Clinical validity of outcome pain measures in naturally occurring osteoarthritis. BMC Veterinary Research, 1-12.

4. Sanderson, R. O., Beata, C., Flipo, R. M., Genevois, J.-P., Macias, C., Tacke, S., . . . Innes, J. F. (2099). Systematic review of the management of canine osteoarthritis. Veterinary Record, 418-424.

5. Comblain, F., Serisier, S., Barthelemy, N., Balligand, M., & Henrotin, Y. (2015). Review of dietary supplements for the management of osteoarthritis in dogs in studies from 2004 to 2014. Veterinary Pharmacology and Therapeutics, doi: 10.1111/jvp.12251.

6. Mathews, K., Kronen, P. W., Lascelles, D., Nolan, A., Robertson, S., Steagall, P. V., . . . Yamashita, K. (2014). WSAVA Guidelines for Recognition, Assessment and Treatment of Pain. Journal of Small Animal Practice, 1-59.

7. McCarthy, G., O’Donovan, J., Jones, B., McAllister, H., Seed, M., & Mooney, C. (2007). Randomised double-blind, positive-controlled trial to assess the efficacy of glucosamine/chondroitin sulfate for the treatment of dogs with osteoarthritis. Veterinary Journal, 54-61.

8. Wynn, S., & Fougere, B. (2007). Introduction: Why Use Herbs? In S. Wynn, & B. Fougere, Veterinary Herbal Medicine (pp. 1-4). St Louis, Missouri: Mosby Elsevier.

9. Reichling, J., Schmokel, H., Fitzi, J., Bucher, S., & Saller, R. (2004). Dietary support with Boswellia resin in canine inflammatory joint and spinal disease. Schwiez Arch Tierheilk, 71-79.

10. Miscioscia, E., Shmalberg, J., & Scott, K. C. (2019). Measurement of 3-acetyl-11-keto-beta-boswellic acid and 11-keto-beta-boswellic acid in Boswellia serrata Supplements Administered To Dogs. BMC Veterinary Research, https://doi.org/10.1186/s12917-019-2021-7.

11. Wynn, S., & Fougere, B. (2007). Materia Medica. In S. Wynn, & B. Fougere, Veterinary Herbal Medicine (pp. 459-672). St Louis, Missouri: Mosby Elsevier.

12. Withers, S. S., York, D., Johnson, E., Al-Nadaf, S., Skorupski, K. A., Rodriguez Jr, C. O., . . . Rebhun, R. B. (2018). In vitro and in vivo activity of liposome-encapsulated curcumin for naturally occurring canine cancers. Vet Comp Oncol, 571-579.


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