ASU--that stuff in the new Cosequin

[vineyridge]

Apparently it works.

There was a study done at Colorado State.

The researchers evaluated ASU in horses with experimentally-induced osteoarthritis. This clinical trial concluded that ASU significantly reduced the severity of joint damage and significantly increased the synthesis of cartilage glycosaminoglycans (i.e., the “building blocks” of articular cartilage) in joints with osteoarthritis, compared to horses treated with a placebo.

“While ASU did not decrease clinical signs of pain in horses with osteoarthritis, a disease-modifying effect was identified suggesting that oral administration of ASU can be useful in the management of horses with osteoarthritis,” Frisbie reported.

Despite the need for further research to identify the exact cause of the observed beneficial effects of ASU, the ramifications of this landmark trial are potentially far-reaching. According to Frisbie, this is the first peer-reviewed, placebo-controlled study evaluating an oral nutritional supplement conducted in live horses with osteoarthritis.

“Evaluation of avocado soybean unsaponifiable extracts for treatment of horses with experimentally induced osteoarthritis” was published in the June 2007 edition of the American Journal of Veterinary Research. Contributing researchers were Frisbie, Kawcak, DVM, PhD; McIlwraith BVSc, PhD; Werby DVM; and Park DVM, PhD.

Whole article from The Horse is here:

The Horse – Your Guide to Equine Health Care

[Simkie]

WOW.

[JB]

I’ve read that and meant to start a thread to discuss it, so thanks for doing that

But, this is the part that confuses me:

While ASU did not decrease clinical signs of pain in horses with osteoarthritis, a disease-modifying effect was identified suggesting that oral administration of ASU can be useful in the management of horses with osteoarthritis,

So it helps with the underlying cause, but doesn’t decrease the horse’s pain? Am I not interpreting “clinical signs of pain” correctly?

Help!

[vineyridge]

The way I interpreted it was that it helps prevent the disease from progressing but didn’t do much to cure the damage that was already there. Or if it did help repair, the time and process were very, very slow. I could be wrong.

The actual study should be available in full at PubMed.

While I was searching for the original article (AJVR is not one of the PubMED journals, alas) I found this pre publication 2009 abstract on the topic of equine arthritis treatments.

An amphiphilic hyaluronic acid (HA) derivative has been obtained by the amidation of the carboxylic group of the glucuronic acid. This derivative, HYADD4®-G (HY4), is the hexadecylamide of 500-730 kDa hyaluronic acid, derived from Streptococcus equi at about 2% degree of substitution (2 mol hexadecylamine per 100 mol hexuronic acid). Its viscoelastic properties, at a concentration of 5 mg/mL in phosphate buffer saline, have been compared with those solutions of native HA, having the same molecular weight. Changes in the viscoelastic properties of equine synovial fluid (SF) when mixed with HY4 over a series of volume ratios-viz 1:2, 1:1, 3:1, and 7:1-have been evaluated. HY4 is able to associate into aqueous solution, and its rheological behavior is typical of a weak gel. Throughout the frequency range investigated (0.1-10 Hz), the elastic modulus G’ is higher than the viscous modulus G’’, and both moduli are frequency independent, and G’ value is about two orders of magnitude higher than that of a comparable solution of native HA. The addition of HY4 to equine synovial fluid (SF) increased its viscoelasticity at all the SF:HY4 ratios tested. These results demonstrate that HY4 is able to integrate with SF, increasing the synovial fluid rheology, and could be an interesting new option in viscosupplement therapy of osteoarthritis, particularly considering its low degree of chemical modification from native HA. © 2009 Wiley Periodicals, Inc. J Biomed Mater Res, 2009.

Effect of hyaluronic acid amide derivative on equine synovial fluid viscoelasticity.

Borzacchiello A, Mayol L, Schiavinato A, Ambrosio L

[BeastieSlave]

When my vet (lameness go-to guy in these parts) suggested Cosequin ASU for one of my beasties I asked him about that study and another I found (see below) - specifically about the numbers. The amounts of ASU they recommended were significantly lower than what’s in the Cosequin ASU. He was confident that the stuff worked and said “Some initial thoughts when I read this article previously was that the model used is not a degenerate joint disease model but an inflammation model…” He spoke to Nutramax and got back to me with an answer that satisfied me, though I can’t remember all the particulars. I do remember that they said the ASU product they have can be used to up the amount of ASU in the Cosequin or on its own.

[I]Recent studies have shown that Avocado-Soybean unsaponifiables may be of use as a chondroprotective; however, there is a glaring disparity in the milligram levels proven effective clinically, and the milligrams recommended for use in commercial products. The most recent study conducted at Colorado State University, on experimentally induced equine osteoarthritis, established the recognized benchmark for oral ASU, by producing a noticeable change in the disease progression using 6 grams of ASU daily. While this dose (6g) meets the criteria of the authors as a DMOAD, commercially available products fall well short of clinical parameters. Currently products available to consumers such as Cosequin ASU (1 gram ASU) and Platinum Performance CJ (2 grams ASU) provide a mere 1/6 and 1/3 of the proven relevant dosing respectively. As a clinician or a consumer one should be well- informed about the facts prior to recommending or purchasing products that may not provide an efficacious level of the desired compounds. Full and timely disclosure of available data may help clear up this confusion in the future.

Colorado State Equine Osteoarthritis Model: as published in VLS round table discussion supplement to Compendium Equine vol. 3, no. 2 (A-March, 2008)
http://www.vlsstore.com/media/publicationsarticle/nutramax_rt_v3no2a_0308.pdf

This study was a blinded, experimentally controlled, randomized
block design that used 16 horses in an established model
of OA. On20day 0 of the study, arthroscopic surgery was performed
and OA was induced in the midcarpal joint of all horses.
Also on day 0, horses were divided into two groups: placebo
and ASU-treatment. The placebo group (n = 8) received molasses
orally one time daily, whereas the ASU-treated group (n = 8)
received 6 g (6,000mg) of ASU and a similar volume of molasses
orally; both treatments were continued throughout the study
0D
period. On day 14, horses began treadmill exercise, which
continued for the remaining 8 weeks of the study. All horses
completed the study, and no adverse events were recorded.
At the termination of the study, horses treated with ASU were
observed to have clinically improved total gross examination
score (articular cartilage erosion + synovial membrane hemorrhage
score) in their OA joints compared with placebo-treated
control horses. There was also significant decrease in intimal
hyperplasia in the synovial membrane, as well as a decrease
in the histologic cartilage disease score. There was a trend for
a decrease in lameness. Significant decrease in the cartilage
disease points this product toward being a DMOAD.

Kawcak CE, Frisbie DD, McIlwraith, et al. Evaluation of avocado and
soybean unsaponifiable extracts for treatment of horses with experimentally
induced osteoarthritis. Am J Vet Res 2007;68:598-604.[/I]

[JB]

@vineyridge;3991654

The way I interpreted it was that it helps prevent the disease from progressing but didn’t do much to cure the damage that was already there. Or if it did help repair, the time and process were very, very slow. I could be wrong.

I might buy that, but they say “the clinical signs of pain”, as opposed to “clinical signs of arthritis”

[In_The_Ribbons]

While this dose (6g) meets the criteria of the authors as a DMOAD, commercially available products fall well short of clinical parameters. Currently products available to consumers such as Cosequin ASU (1 gram ASU) and Platinum Performance CJ (2 grams ASU) provide a mere 1/6 and 1/3 of the proven relevant dosing respectively.

So if you follow the recommended dose, you’ll need to feed 6 scoops of Cosequin ASU daily. At $159.95 for 80 scoops (at Smartpak), it’ll cost you $1.99/scoop x 6 scoops = $11.99 per day. Or $359.88/month!

[spacehorse]

[QUOTE=In_The_Ribbons;3992022]
While this dose (6g) meets the criteria of the authors as a DMOAD, commercially available products fall well short of clinical parameters. Currently products available to consumers such as Cosequin ASU (1 gram ASU) and Platinum Performance CJ (2 grams ASU) provide a mere 1/6 and 1/3 of the proven relevant dosing respectively.

So if you follow the recommended dose, you’ll need to feed 6 scoops of Cosequin ASU daily. At $159.95 for 80 scoops (at Smartpak), it’ll cost you $1.99/scoop x 6 scoops = $11.99 per day. Or $359.88/month![/QUOTE]

:eek::eek::eek::eek:

Up till this post, I was considering doing some research…

[Simkie]

[QUOTE=In_The_Ribbons;3992022]
So if you follow the recommended dose, you’ll need to feed 6 scoops of Cosequin ASU daily. At $159.95 for 80 scoops (at Smartpak), it’ll cost you $1.99/scoop x 6 scoops = $11.99 per day. Or $359.88/month![/QUOTE]

You could use this product: http://www.amazon.com/Avocado-Unsaponifiables-Maximize-Maximum-International/dp/B00113PJ38

$3.16 a day or about $95/month. Still expensive, but less.

[pattnic]

When making the decision of whether to put my dog on a joint supplement, the vet recommended Dasequin (the doggie version). She said that she recommends it in part because of independent studies showing that it actually improves the effect Rimadyl has, when they are both given, so that if you use Rimadyl, you are able to use less and have the same effect.

Not sure if there is anything that could be used for horses in conjunction with the ASU, but I wouldn’t be surprised.

[HelenC]

It works.

I’m not a scientist but here’s my story. My mare had her hocks injected last June. The vet said that she may or may not need additional help via Adequan a few months down the line depending on how bad her hocks had deteriorated. Sure enough a couple of months later she didn’t want to walk down hills. She didn’t want to move forward off of my leg and basically was not the same horse.

I did some research and decided to try the ASU before committing to more injections. There is an initial loading dose where she’d get 2 scoops/day for a week and then 1 scoop/day following. I am not kidding, by the end of the loading dose week she was moving forward, stomping down hills, and we were back to jumping. So YES Cosequin ASU works. I pay about $167 for an 80 day supply from Valley Vet. The best money I’ve ever spent.

[BeastieSlave]

[QUOTE=In_The_Ribbons;3992022]
So if you follow the recommended dose, you’ll need to feed 6 scoops of Cosequin ASU daily. At $159.95 for 80 scoops (at Smartpak), it’ll cost you $1.99/scoop x 6 scoops = $11.99 per day. Or $359.88/month![/QUOTE]

Yup, that’s pretty much where my math started. For my next step I added up how much it would be to add the extra ASU to the Cosequin ASU to bring it up to 6g. Still pretty pricey… I asked my vet about it and even after talking to Nutramax he was really confident that the amount in each dose of Cosequin ASU was sufficient.

I decided to give it a try (knowing that I could add ASU if I wanted/needed to). It’s been about three weeks now and I think it’s working. This horse had some mild positive flexions, but was generally just kind of ‘short’ not lame. I can see him track up more these days and he seems to be much free-er in general. My beastie is pretty darned big and he’s getting 1 1/2 scoop daily.

[Melyni]

There are a number of new joint preps out

there are a number of new joint preps out with some limited clinical results. and ASU in one of them.

The sad thing is that there just isn’t enough money to do real studies, most of the ones out have been paid for by the companies and tend to be suspect.

But anecdotally I have heard good things about ASU.
MW

[ZiggyStardust]

[QUOTE=In_The_Ribbons;3992022]
While this dose (6g) meets the criteria of the authors as a DMOAD, commercially available products fall well short of clinical parameters. Currently products available to consumers such as Cosequin ASU (1 gram ASU) and Platinum Performance CJ (2 grams ASU) provide a mere 1/6 and 1/3 of the proven relevant dosing respectively.

So if you follow the recommended dose, you’ll need to feed 6 scoops of Cosequin ASU daily. At $159.95 for 80 scoops (at Smartpak), it’ll cost you $1.99/scoop x 6 scoops = $11.99 per day. Or $359.88/month![/QUOTE]

This was the problem my vet had with it. It’s probably at least worth a try, but if the dose is so much lower than the study, it seems more like a marketing tool to me. Possibly it would be enough to make a differences for some horses and not for others. Even with the regular dose, it’s an awfully pricey way to find out by trying. My vet was holding out for a stand-alone ASU product.

[FatPalomino]

[QUOTE=Melyni;3993572]

The sad thing is that there just isn’t enough money to do real studies, most of the ones out have been paid for by the companies
MW[/QUOTE]
I was just going to point that out The supplement couldn’t hurt and may help, but sometimes it’s a matter of prioritizing the budget .

[BeastieSlave]

[QUOTE=ZiggyStardust;3993622]
My vet was holding out for a stand-alone ASU product.[/QUOTE]

Nutramax has the stand-alone product too…

[deltawave]

Apparently it causes some measurable changes in the function of some cells. That’s a far cry from saying “it works”, when they specifically state that it did not decrease symptoms or manifestations of pain. Treating arthritis in reality (making a horse more sound) is very different than noticing things under a microscope.

Still, it is good to see some studies going on, even on 16 horses. Until funding picks up, that’s probably as good as it’s going to get. I wouldn’t call it earth-shattering, but it’s more information, which is a good thing.

[ZiggyStardust]

[QUOTE=BeastieSlave;3994458]
Nutramax has the stand-alone product too…[/QUOTE]

Thanks Beastie, I hadn’t heard that. It looks like it’s just the Avoca ASU for humans? That’s the only one Google found for me. 3 tablets has only 400 mg of the “ASU blend” and 120 tabs cost $33. Hmm, don’t think that one’s in the horse budget for me, either.

[FatPalomino]

[QUOTE=deltawave;3994488]

Still, it is good to see some studies going on, even on 16 horses. Until funding picks up, that’s probably as good as it’s going to get. I wouldn’t call it earth-shattering, but it’s more information, which is a good thing. :)[/QUOTE]

I was intrigued with how small CSU’s equine orthopedic research groups were. One study I helped with (this was back in 2006) had only 8 horses. I remember the ground for the Surpass study was pretty small, too. Makes for an easy morning, though, tread milling horses

[Horsegal984]

One thing to keep in mind is that because ‘supplements’ are not ‘drugs’ there is VERY little regulation on the quality of the ingredients. Many supplements are hard to keep the active ingredients stable, and some companys just don’t try as hard to do it. So while one product might have 300g and the other has 300,000g the one with the smaller amount might be more beneficial due to how it was handled, and the bioavailability of the active ingredients.

Another thing to note is that the Colorado State study didn’t compare horses getting diffferent amounts of ASU, just those getting it to those that aren’t. Maybe the horses in their study were given 6g, but they may not have been any more improved than horses who were only getting 1g. Without doing those studies directly comparing it can be hard to determine how much you really need of something, compared to how much is in it. Look at a human multivitamin, a lot of them have 150-200% of the reccomended daily value, because it looks better on the label, but your body is just going to flush out whatever excess it has.

As far as ‘reducing pain’ it can be hard to determine in animals how much of a lameness is based on a pain response versus a mechanical one. The ‘easy’ way is to add something like bute which we know relieves pain and see if there is improvement; but the flaw with that is the anti-inflammatory properties of it as well. Is the improvement due to pain relief or inflammation relief? Unfortunately pain from osteoarthritis is usually so subtle and slowly acquired it is not particularly beneficial to monitor heart and respiration rates as pain indicators, and since the horses can’t just tell us we still have to guess a lot.

Overall I will say that Nutrimaxx is a good company, and puts a lot of time and effort into helping us keep our fourlegged friends more comfortable. And I will say that I personally noticed a change in my comfort level after changing to Cosamin ASU, which was before I knew what the ASU was Also, if you can find it, bluegreen algae is another product that works well as a natural anti-inflammatory.