About

Equine joint health

Nobody knows your horse like you do. You are the most important element when it comes to recognizing issues in both health and performance with your horse. Was he slow to move? Did he barely clear that last jump? Was the last time around the barrels much slower? How long has this been going on? Unfortunately, horses can't tell their owners if and where they help. However, we do know that perception is common to both humans and animals, so a guideline to follow is, if you think a certain activity would cause you discomfort, you can assume it will do the same to your horse.

Recognizing the signs
The key is to look for a change of behavior in your horse. Since the signs become more apparent as the concern worsens. It is important to observe horses closely for signs such as:

Decreased activity
Reluctance to walk, run, jump or play
Difficulty rising from a resting position
Acting aggressive or withdrawn
Exhibiting other personality changes

If you notice any of these changes, consult your veterinarian. The sooner the condition is recognized, the sooner your horse can be active and flexible again!

Understanding joint anatomy
joint diagram To understand your horse, one must become familiar with the anatomy of a healthy functioning joint. Let's start off with understanding the joint capsule. The joint capsule is a thick fibrous tissue that connects the bones, provides the outer layer of the joint and holds the fluid inside the joint cavity. The muscles serve to support the joint capsule and to provide joint movement. The tendon is an elastic cord that attaches the muscle to the bone and assist with movement. The synovial membrane is the inner lining of the joint capsule. It is highly vascularized and therefore is responsible for carrying nutrients to the joint and most importantly, producing the synovial fluid. The synovial fluid is a clear viscous fluid that lubricates the joints. It consists of blood plasma and hyaluronic acid. Without it, joint movement would be extremely painful and articular cartilage becomes damaged. The cartilage covers the ends of the bones and absorbs most of compression and stress in the joint. Because it is a slippery material, it allows the joints to move smoothly and easily. Overall, the parts of the joint have to work together, but the two most important parts are the synovial fluid which provides the lubrication for the joint and the cartilage, which absorbs the stress.

Veterinary validation of joint concerns
Validating joint concerns can be very difficult. Your veterinarian will have his own protocol, but listed below our some of the tools that you and your vet might use.

First your vet will evaluate the case history of your horse. As part of this backgrounding your vet may ask you several questions about your horse's care and activities to determine a potential cause.
Next your vet will do a physical examination of your horse. This usually involves palpating the areas of concern. Most vets are very skilled with their hands and can often feel if a joint is swollen.
The veterinarian will inspect your horse at a walk and a trot. They will walk them in a straight line watching for abnormal gait.
Your veterinarian may perform a flexion test. This is done by bending the joint and holding for at least one minute and then released. After the joint is released, the horse is observed while walking and trotting. Often times this will exaggerate the concern and make it more clearly visible during activity.
It may be necessary to perform a radiographic x-ray examination to get a visual representation of what may be cause.
Your veterinarian may remove by needle some of the synovial fluid located in the joint to determine if an infection is present.

Deterring joint issues
Older horses have a variety of joint issues due to a number of environmental stressors, but you can help some of these stresses by:

Avoiding obesity and heavy loads.
Providing routine foot care every 6-8 weeks.
Avoiding quick changes in duration or intensity of exercise.
Avoiding hard and unstable ground surfaces, ride on soft surfaces such as grass or appropriate arena footing
Feeding a diet high in protein and other nutrients. Joints can never become stronger without proper nutrition.

In summary
Joint issues can be very difficult and horse owners should become very familiar with recognizing them. Because joint issues are progressive, early action on your part can give your horse a better chance at getting back to their normal activities such as walking and running. If intervention is not started early, often times the joint is far past repair and it is quite likely that the horse will never regain normal movement.

Hyalun® in-depth

Description
Patented Hyalun® is a solution containing hyaluronic acid for oral administration. The hyaluronic acid in Hyalun® is one of the purest and highest in molecular weight.

Chemical name
Sodium Hyaluronate (COO Na) (CH2OH)

Chemistry
Hyaluronic acid, a glycosaminoglycan, can exist in the following forms depending on the chemical environment in which it is found. As the acid, hyaluronic acid; and as the sodium salt, sodium hyaluronate. It is composed of repeating subunits of D-glucuronic acid and N-acetyl-D-glucosamine linked together by glycosidic bonds.

"Nature's moisturizer"
joint diagram Hyaluronic acid is muco-polysaccharide that occurs naturally throughout the horse's body. It is one of the most hydrophilic molecules in nature and can be described as "natures moisturizer". Backed by thousands of clinical trials in the fields of orthopedics and eye surgery, one of hyaluronic acid's most important functions in the body is to lubricate joints as an integral component of synovial fluid. While hyaluronic acid is in the "family" of glycosaminoglycans, it is unique in its restorative ability, and will often provide improvement, where glucosamine and chondroitin have failed to do so.

Benefits of hyaluronic acid

Supports joint health and cartilage function.
Reduces joint friction.
Maintains joint mobility.
Lubricates the joint.

Comparing Hyalun® to Other Hyaluronic Acid Supplements

High quality
The hyaluronic acid in Hyalun® is one of the purest and highest in molecular weight of any oral hyaluronic acid product on the market today. Higher molecular weight acid can hold more water, has better lubrication properties and better shock absorbing properties than low molecular weight hyaluronic acid1

Easy-to-administer
Hyalun® is a tasteless liquid solution that your horse won't even detect or resist. Simply administer Hyalun® once daily with the convenient administrator.

Directions for storage and warnings

Store at room temperature. KEEP OUT OF REACH OF CHILDREN. DO NOT USE IF SEAL IS BROKEN. FOR SMALL ANIMAL ORAL USE ONLY – NOT FOR INJECTION USE.

Further directions

To avoid contamination of product, use caution when removing the dropper from bottle avoiding contact with any surface or other object other than the inside of the bottle.

Frequently asked questions

What is Hyalun®?
Patented Hyalun® is a liquid solution of hyaluronic acid for oral administration with horses. Hyaluronic acid has been shown to support healthy joint and cartilage function as well as maintaining normal, healthy joint function.

How do I give Hyalun® to my horse?
Administer 1ml (full dropper) of Hyalun® one time daily. Hyalun® is available in a 30 day and 90 day supply.

How long before I will see results?
There is no exact time. Most animals observed have improved noticeably within 7 to 14 days. Results vary depending on severity of the joint health problems and the dose of Hyalun®.

How much does Hyalun® cost?
Hyalun® comes in 3 different sizes and forms. The original Hyalun® is a 30-day supply and comes with a medicine dropper for administration. Hyalun® is available for $39.95 retail per bottle. Hyalun® 90 has the same HA concentration as Hyalun®, but it contains a 90-day supply and has been fitted with a trigger system making it easier to administer for multiple horses. Hyalun® 90 is available for $99.95 retail per bottle. Hyalun® Gel is a 30cc syringe designed specifically as a pre/post event booster and also as a preload to the daily oral solution. Hyalun® Gel is six times more powerful than the daily Hyalun® and is available for $29.95 per syringe.

What does Hyalun® taste and smell like?
Hyalun® is basically an odorless and tasteless product. However, it can be debated that Hyalun® exhibits a slightly salty taste.

What is hyaluronic acid?
Hyaluronic acid is a mucoplysaccharide that occurs naturally throughout the horse’s body. Backed by thousands of clinical trials in the fields of orthopedics and eye surgery, one of hyaluronic acid's most important functions in the body is to lubricate joints as an integral component of synovial fluid.

Where does your hyaluronic acid come from?
Our acid comes from an extracellular protein produced by natural fermentation. Our products are not derived from any animal source. Hypersensitivity reactions should not be a concern. The weight of the molecule directly influences its "moisture-binding" capability, and Hyalun® is the highest molecular weight HA on the market, which explains the results we have experienced.

Why is the molecular weight of supplemental hyaluronic acid important?
A study done by Wobig et al in 1999, compared hyaluronic acids of various molecular weights and found there are far more benefits derived from higher molecular weight acid. The higher molecular weight acid can hold more water, has better lubrication properties and better shock absorbing properties. The hyaluronic acid in Hyalun® is one of the purest and highest in molecular weight.

How does hyaluronic acid compare to glucosamine or chondroitin?
Glucosamine is a precursor of hyaluronic acid. Hyaluronic acid in turn makes the synovial fluid. Glucosamine must combine with a glucoronic acid molecule to make hyaluronic acid. Often times the body is not able to join these two molecules together and the the production of the much needed hyaluronic acid is never achieved. By administering hyaluronic acid, you take away the risk of this integral process not happening and may see results with hyaluronic acid that you did not see with glucosamine or chondroitin.

Why would I want to give my horse a hyaluronic acid (HA) product?
Hyaluronic acid is naturally produced by the body as a constituent of synovial fluid that lubricates the cartilage between the joints. As the horse ages, it produces less HA and it becomes more and more difficult to replace the lost HA. Proper lubrication is lost and joints can become less flexible. HA products will pick up where the horse’s body fails them.

How does hyaluronic acid benefit a horse’s joints?
The HA in Hyalun® acts to help maintain proper joint movement, lubrication and cushioning. If we can compare the joints of the horse to an automobile engine; the synovial fluid in the joint mimics the oil in a car engine. At regular intervals we replace the oil in our car engines because the heat and friction of normal operation causes a breakdown of the oil viscosity. The oil becomes thinner and less able to protect the metal surfaces from excessive wear. Hyalun® acts the same way in the joints. With age the viscosity of the joint fluid breaks down. It becomes thin and is unable to cushion the joint, leading to increased friction and wear on the joints. Administering Hyalun® helps maintain the normal viscosity of joint fluid.

What if my horse does not have joint issues?
Because of the natural anatomical construction of the horse's limbs, all horses are susceptible. Just as we change the oil in our vehicles for routine maintenance, using Hyalun® can help by maintaining proper joint fluid viscosity. The horse's ability to produce hyaluronic acid slows down considerably with age thus resulting in the loss of lubrication and healthy movement.

Do veterinarians use hyaluronic acid?
Yes. Hyaluronic acid has been directly injected by needle into the joint for several years. This has yielded great results by immediately increasing the viscosity of the joint fluid and restoring proper lubrication and shock absorption in the joints.

Because it is an acid, will HA burn the skin or stomach of me or my horse?
Hyaluronic acid is often called an acid and this is a misnomer. Hyaluronic acid as a sodium salt (sodium hyaluronate)(Hyalun®) will have a neutral pH measurement not an acidic. Because of the water retention capacity of hyaluronic acid, it is actually a very good moisturizer for the skin and is being used in many facial cream and body lotions.

Will Hyalun® create a test positive?
No. HA is something that is created by the horse’s body naturally and it will not show up in a post-competition test. However, if competing under a “zero supplement” regulation, the horse will not suffer any complications due to supplement withdrawal.

We are using a multi-technique approach to helping our horse's joints by using several different techniques and joint supplements. Should Hyalun® be something we try as well?
We always recommend that whenever you are helping your horse with joint problems, that you utilize one joint supplement at a time. If multiple products are being used at once, it could become very difficult to determine which supplement is working the best for your horse.

Hyaluronic acid research

Hyaluronic acid is one of the most researched substances in medicine today and is backed by thousands of clinical trials in the fields of orthopedics and eye surgery. If you'd like to learn more about the benefits of hyaluronic acid, the following resources will provide you with a starting point for further research.

Marshall KW. Viscosupplementation of HA: current status, unresolved issues and future directions. J Rheumatol 1998;25:2056-8.
George E. Intra-articular hyaluronan. Ann Rheum Dis 1998;57:637-40.
Wobig M, Bach G, Beks P, Dickhut A, Runzheimer J, Schwieger G, et al. The role of elastoviscosity in the efficacy of viscosupplementation for the knee: a comparison of hylan G-F 20 and a lower-molecular-weight hyaluronan. Clin Ther 1999;21:1549-62.
Cohen MD. Hyaluronic acid treatment (viscosupplementation) for the knee. Bull Rheum Dis 1998;47:4-7.
Balazs EA, Denlinger JL. Viscosupplementation: a new concept in the treatment for the knee. J Rheumatol 1993;20(suppl 39):3-9.
Weiss C, Balazs EA, St. Onge R, Denlinger JL. Clinical studies of the intraarticular injection of HealonR (sodium hyaluronate) in the treatment of human knees. symposium. Palm Aire, Fla., October 20-22, 1980. Semin Rheum. 1981;11(suppl 1):143-4.
Peyron JG. Intraarticular hyaluronan injections in the treatment of the knee: state-of-the-art review. J Rheumatol 1993;39(suppl):10-5.
Henderson EB, Smith EC, Pegley F, Blake DR. Intra-articular injections of 750 kD hyaluronan in the treatment of the knee: a randomised single centre double-blind placebo-controlled trial of 91 patients demonstrating lack of efficacy. Ann Rheum Dis 1994;53:529-34.
Lohmander LS, Dalen N, Englund G, Hamalainen M, Jensen EM, Karlsson K, et al. Intra-articular hyaluronan injections in the treatment of the knee: a randomised, double blind, placebo controlled multicentre trial. Hyaluronan Mulicentre Trial Group. Ann Rheum Dis 1996;55:424-31.
Dougados M, Nguyen M, Listrat V, Amor B. High molecular weight sodium hyaluronate (hyalectin) for the knee: a 1 year placebo-controlled trial. Cart 1993;1:97-103.
Marshall KW. Viscosupplementation: current status, unresolved issues and future directions. J Rheumatol 1998;25:2056-8.
Listrat V, Ayral X, Paternello F, Bonvarlet JP, Simonnet J, Amor B, et al. Arthroscopic evaluation of potential structure modifying activity of hyaluronan (Hyalgan) in the knee. Cart 1997;5:153-60.
Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patient's knee: a randomized clinical trial. J Rheumatol 1998;25:2203-12 [Published erratum appears in J Rheumatol 1999;26:1216].
Wobig M, Dickhut A, Maier R, Vetter G. Viscosupplementation with hylan G-F 20: a 26-week controlled trial of efficacy and safety in the knee. Clin Ther 1998;20:410-23.
Adams ME, Atkinson MH, Lussier AJ, Schulz JI, Siminovitch KA, Wade JP, et al. The role of viscosupplementation with hylan G-F 20 (Synvisc) in the treatment of the knee: a Canadian multicenter trial comparing hylan G-F 20 alone, hylan G-F 20 with non-steroidal anti-inflammatory drugs (NSAIDs) and NSAIDs alone. Cart 1995;3:213-25.
Lussier A, Cividino AA, McFarlane CA, Olszynski WP, Potashner WJ, De Medicis R. Viscosupplementation with hylan for the treatment of: findings from clinical practice in Canada. J Rheumatol 1996;23:1579-85.
Disla E, Infante R, Fahmy A, Karten I, Cuppari GG. Recurrent acute calcium pyrophosphate dihydrate arthritis following intraarticular hyaluronate injection. Arthritis Rheum 1999;42:1302-3.
Maheu E. Hyaluronan in knee: a review of the clinical trials with hyalgan. Eur J Rheumatol Inflamm 1995;15:17-24.

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