1 The
Use of Supplements in Canine and Feline Medicine
Introduction
A variety of
supplements are available to feline and canine veterinary patients with
professed health benefits for a number of disease conditions. In order to
determine the type of supplement product available to cat and dog owners in
both the veterinary and commercial markets, a brief survey of local veterinary
practices and pet supply stores was conducted. A formal discussion of the
supplements available for different disease conditions are included in articles
pertaining to the individual disorder or supplement class written by the
individual students.
Materials and Methods
A brief survey was
developed and distributed to 22 veterinary clinics and seven local pet supply
retailers in Saskatoon, Saskatchewan. The survey contained questions pertaining
to the type of supplements or diets recommended for apparently healthy animals and
animals with joint disease, skin and allergic diseases, gastrointestinal
disease, liver disease, cardiac disease or urinary tract diseases, as well as
the rationale for the recommendations. Additional questions investigated the
most common supplements sold, the source(s) of information used to evaluate
available supplements, where clients were directed in order to purchase
supplements (i.e. veterinary clinic, pet store, or human pharmacy), and
information regarding to use of alternative or naturopathic therapies within
the clinic. When specific supplement formulations were recommended by a pet
store or veterinary clinic, the ingredients and health claims pertaining to the
supplement were obtained from the manufacturer’s label in order to determine
the type of supplements contained within each product. The mean number of
respondents recommending a given type of supplement was tabulated based
independently on the survey results obtained from veterinary clinics and retail
pet stores.
Results
Although information
regarding available supplements was provided by all of the pet supply retailers
surveyed, inconsistent knowledge of available products or managerial
intervention preventing disclosure of product recommendations made it difficult
to evaluate the nature of supplement recommendations in the majority of the
stores. As such, data pertaining to supplements in the retail pet supply market
was limited to an analysis of the ingredients of different supplement
formulations available in local pet stores relative to health claims made by
the manufacturer.
Of the local
veterinary clinics approached to complete the survey, only 41% (9/22)
veterinary clinics responded. Only 78% of the veterinary clinics surveyed
reported referring clients to human pharmacies or pet stores as alternate
sources for pet supplements. The most common sources of information regarding
the use of supplements in canine and feline patients were journal articles and
product representatives, which were each used by 56% of the respondents from veterinary
clinics, followed by veterinary conferences or continuing education (44%),
non-peer reviewed veterinary literature (33%) and from senior clinicians or
colleagues (22%). According to the responding veterinary clinics, the most
common supplements purchased by clients, with or without a veterinarian’s
recommendation were glucosamine (56%), chondroitin (44%) and omega fatty acids
(44%). Over half of the respondents from local veterinary clinics reported
recommending the use of supplements in apparently healthy animals, including
glucosamine and chondroitin, omega fatty acids, cranberry, lysine and amino
acid supplements. Alternative or naturopathic therapies including therapeutic
laser treatments, acupuncture, chiropractic care and herbal medicine were used
by 78% of the veterinary respondents.
Supplements for Joint
Support and Mobility
In retail pet stores,
16 different supplements were available with alleged or perceived benefit for
joint disease, as outlined in Table 1. According to evaluation of the
ingredients contained in joint supplements available through retail pet stores,
the most common ingredients encountered in supplements for joint disease
available to the pet stores surveyed were glucosamine (81%), chondroitin (69%),
methylsulfonylmethane or MSM (56%), and vitamin C (44%). Additional ingredients
contained within commercially-available joint supplements with alleged
therapeutic benefit include omega fatty acids (19%), hyaluronic acid (13%),
vitamin E (13%), green lipped mussel (13%), Boswellia extract (13%), Grape seed
extract (13%), yucca extract (13%), turmeric extract (6%), rosemary extract
(6%), ginger extract (6%), miscellaneous herbs (6%) and cetyl myristoleate
(6%).
2 The Use of
Supplements in Cats and Dogs
Table 1. Supplement Formulations for Joint Support in Cats and Dogs Supplements
Available through Retail Pet Stores
|
|
Supplement
|
Manufacturer’s Claims and
Ingredients
|
Advanced Cetyl M (Response Products)
|
Marketed benefits include joint
support, and relief of pain and discomfort associated with athleticism.
Contains cetyl myristoleate, glucosamine hydrochloride, garlic root, and
ginger root extract.
|
BioJoint (Biologic Vet)
|
Supplement marketed for dogs with
joint discomfort and reduced mobility. Contains Boswellia serrata extract,
vitamin C, grapeseed proanthrocyanidins, chondroitin sulfate, glucosamine
hydrochloride and methylsulfonylmethane (MSM).
|
Cosequin for Cats (Nutramax
Laboratories)
|
Supplement marketed for joint
support and bladder health. Contains glucosamine hydrochloride and
chondroitin sulfate.
|
Cosequin DS (Nutramax Laboratories)
|
Supplement marketed for maintaining
mobility. Contains glucosamine hydrochloride and chondroitin sulfate.
|
Flax Forward (Juka Organics)
|
Marketed for improved pet nutrition.
Contains omega fatty acids, lignans, protein, minerals and fiber.
|
Glucosamine/Chondroitin (21st Century)
|
Supplement marketed for joint health
and support. Contains glucosamine hydrochloride, chondroitin sulfate,
methylsulfonylmethane (MSM), vitamin C, and hyaluronic acid.
|
Glucosamine HCl (Ubavet)
|
·
Marketed as a preventative for all pets.
Contains glucosamine hydrochloride, chondroitin sulfate, green lipped
mussels, Yucca, methylsulfonylmethane (MSM), vitamin C, vitamin E, and flax.
|
Hip & Joint Plus Paw Gel
(Nutri-Vet)
|
·
Marketed to maintain healthy cartilage and
joint function. Contains glucosamine, methylsulfonylmethane (MSM),
chondroitin sulfate, Yucca extract, and vitamin C.
|
Hip & Joint Level 2 Canine
(Nutri-Vet)
|
Supplement marketed for support of
joint function and connective tissue. Contains glucosamine hydrochloride
(from shellfish), methylsulfonylmethane (MSM), and green-lipped mussel.
|
Hip & Joint Level 3 Canine
(Nutri-Vet)
|
Supplement marketed for support of
joint function and connective tissue in dogs with long-stranding joint
problems. Contains glucosamine hydrochloride (from shellfish), chondroitin
sulfate (from bovine trachea), methylsulfonylmethane (MSM), vitamin C, and
hyaluronic acid.
|
Hip & Joint (Pet Naturals)
|
Marketed benefits include mobility
support, comfort and exercise tolerance. Contains glucosamine hydrochloride,
methylsulfonylmethane (MSM), chondroitin sulfate and vitamin C.
|
Joint Stress (Homeopet)
|
Marketed benefits include for relief
of joint stiffness, lower back and joint pain, and muscle tension. Contains
monkshood, leopard’s bane, pot marigold, witch hazel, St. John’s wart, chick
pea and poison oak.
|
Liquid Joint Care (Spring Meadows)
|
Marketed benefits include joint
lubrication, cartilage repair, anti-inflammatory and improved mobility.
Contains glucosamine hydrochloride, chondroitin sulfate, bioflavinoids, and
grape seed extract.
|
Stride Powder (TRM Pet Products)
|
Supplement marketed for the maintenance
of cartilage and joint health. Contains glucosamine hydrochloride,
chondroitin sulfate, methylsulfonylmethane (MSM) and vitamin E.
|
Muscle & Joint (Vet’s Best)
|
Supplement marketed for support of
normal joint function and muscle discomfort during normal activity. Contains
methylsulfonylmethane (MSM), Boswellia extract, Turmeric extract, Yucca
extract, Rosemary extract and a proprietary antioxidant blend.
|
Vita-Glo Hip & Joint Supplement
(Halo)
|
Supplement marketed for the
maintenance of hip, ligaments and joint health. Contains glucosamine
hydrochloride, chondroitin sulfate, vitamin C, and flax seed meal.
|
Table 2 Supplements Recommended by Local
Veterinarians
|
|
Supplement
|
Manufacturer’s Claims and
Ingredients
|
Adequan (Novartis)*
|
Marketed as a veterinary product
with demonstrated empirical efficacy for IM use in dogs with osteoarthritis.
Contains polysulfated glycosaminoglycans.
|
Chondroflex (Sogeval)
|
Marketed for the support of healthy
joint function and alleviation of pain associated with normal activity in
cats and dogs. Contains glucosamine hydrochloride, methylsulfonylmethane
(MSM), chondroitin sulfate, vitamin C, and shavegrass.
|
Cosequin (NutraMax)
|
Marketed benefit for maintaining
optimal joint function by supporting cartilage production and preventing
cartilage breakdown. Contains glucosamine hydrochloride and chondroitin
sulfate.
|
Dasuquin (NutraMax)
|
Supplement marketed for
comprehensive joint health management. Contains glucosamine hydrochloride,
chondroitin sulfate and avocado/soybean unsaponifables (ASU) powder.
|
Flexadin (Vetoquinol)
|
Marketed for the support of joint
function in cats and dogs. Contains glucosamine hydrochloride, chondroitin
sulfate and Harpagophytum procumbens (Devil’s Claw).
|
Liquid Plus (Ubavet)
|
Marketed as a fast-acting supplement
suitable for all pets. Contains glucosamine hydrochloride, chondroitin
sulfate, methylsulfonylmethane (MSM), green lipped mussels, bioflavinoids, Angelica
pubescens, Rehmania glutinosa, Gentiana macrophylla, Acantopanax
gracillustylus, and Piper futokadsura.
|
Omega-3 Pro (Pro Concepts Animal
Health)
|
Manufacturer’s label not available.
Contains omega fatty acids.
|
Hip Action (Zukes)
|
Supplement marketed to help prevent
decrease joint pain and improve mobility. Contains glucosamine hydrochloride,
chondroitin sulfate, flax seed and vitamin C.
|
* Despite its recommendation as a
supplement, the manufacturer’s product label limits the use of this product
to licensed veterinarians.
|
In patients with joint disease, 90% of
responding veterinarians recommended the use of a veterinary diet formulated
for joint support, including Royal Canin Mobility Support (56%), Hills J/D
(56%) and Purina JM (33%). Nutritional supplements for feline and canine
patients with joint disease were recommended by all of the veterinarians
surveyed. Rationale for the inclusion specific supplements recommended by
veterinarians included anti-inflammatory effects, evidence of benefits for
joint health and the need to supplement deficiencies in the normal diet of
veterinary patients. Specific formulations were outlined in recommendations
from some of the veterinarians surveyed (Table 1). Flexadin (Vetoquinol),
Adequan (Novartis), and Liquid Plus (Ubavet) were the most commonly recommended
supplements for joint disease by veterinarian practitioners, however there was
considerable variability in the specific product recommendations among clinics.
The most common supplement ingredients recommended by veterinarians for feline
and canine patients with joint disease were glucosamine hydrochloride (89%),
chondroitin sulfate (78%) and omega fatty acids (56%). Methylsulfonylmethane or
MSM (33%), polusulfated glycosaminoglycan (33%), devil’s claw (22%),
miscellaneous herbal supplements (22%), vitamin C (11%), and ASU powder
containing avocado and soybean unsaponafiables (11%) were also found in the
supplements recommended through local veterinarians. Chondroflex, Dasuquin,
Flexadin and OmegaPro-3 are veterinary exclusive products.
Supplements for Skin and Allergic
Diseases
Supplements for skin and allergic
diseases were available through 71% of the retail pet stores, with specific
reference to dietary changes noted by 40% of the pet stores surveyed (Table 2).
The majority of the products surveyed contained omega 3 (73%) and omega 6 (53%)
fatty acids, derived from fish oil (47%), flax seed (20%), sunflower oil (27%),
safflower oil (13%), soy (13%), olive oil (0.7%), wheatgerm oil (0.7%), and
garlic oil (0.7%). Additional supplemental ingredients with suggested benefit
for patients with skin disease or allergies included vitamin E (53%), vitamin A
(27%), antioxidants such as rosemary extract (27%), vitamin D (20%), omega 9
(0.7%), vitamin B6 (0.7%), bioflavinoids (0.7%), zinc (0.7%) and mixed herbs
(0.7%). The nutrient content of omega 3 (DHA/EPA) and omega 6 was not available
for all of the formulations, making it difficult to determine whether the
guaranteed analysis was sufficient to achieve potentially therapeutic levels of
fatty acid supplementation and the recommended dose.
Supplements recommended by veterinary
practitioners were based on the anti-inflammatory properties of the ingredients
within the supplements. All of the veterinary practitioners surveyed
recommended at least some form of supplementation in veterinary patients with
skin disease or allergies. Based on recommendations and ingredients available
from specific product references the most common supplements used by
veterinarians in patients with skin disease are omega 3 fatty acids (100%) and
omega 6 fatty acids (56%), as well as vitamin E, vitamin A, and vitamin D. The
majority of specific supplement formulations recommended by veterinarians
(Table 2) contained omega 3 fatty acids (67%), omega 6 fatty acids (33%) derived
from fish oil (33%), flax seeds (17%) or other essential oils such as hemp, tea
tree or primrose oil (33%). Vitamin E (50%), vitamin D (17%), vitamin A (17%)
and antioxidants such as rosemary oil (17%) were also found in these
supplements. One supplement, Oximunol (Avivagen) contained OxCbeta 5, a
proprietary ingredient.
Several veterinary and commercial
diets were recommended by veterinary practitioners for the treatment of
allergic and skin disease. The most common recommendations with regard to diet
were Royal Canin Hypoallergenic (89%), Royal Canin Hypoallergenic HP (44%),
Royal Canin Skin Support (44%) and Royal Canin Sensitivity RC (22%). Additional
dietary recommendations included Acana Lamb and Apple, Orijen 6 Fish, Purina
Dermatologic Management (DRM), Iams Skin & Coat Plus Response FP, and Hills
Prescription Diet Duck and Potato d/d. The most common ingredients were
encountered in these diets were single protein sources (90%), omega 3 (80%) and
6 (40%) fatty acids from fish oil (80%), vegetable or soy oils (40%) and
sunflower oil (10%), novel proteins (40%), hydrolyzed proteins (10%) and
digestive aids (60%) such as prebiotics and probiotics. Additional ingredients
suggested to improve skin condition or to alleviate allergies include pathothenic
acid, inositol, nicotinamide, choline, histidine, curcumin, taurine, vitamin C,
vitamin E, aloe vera extract, rosemary extract, marigold extract and various
other herbal supplements.
Supplements for Liver Disease
None
of the retail pet stores surveyed contained supplements with claimed benefits
for patients with liver diseases. In contrast, 78% of the veterinary clinics
surveyed had specific supplement recommendations with regard to patients with
liver disease including s-adenosylmethionine or SAMe (56%), milk thistle (44%),
and vitamin E (22%). With regard to s-adenosylmethionine, specific reference
was made to commercially available products including Zentonil (Vetoquinol) and
Denosyl (Nutramax Labs). More than half (56%) of the veterinarians surveyed
also recommended the use of a liver-specific diet including Royal Canin Hepatic
(44%) with soy protein and restricted dietary copper, sodium and zinc, and
Hills Prescription Diet Liver Health L/D (11%) containing L-carnitine,
antioxidants and reduced sodium.
Supplements for Gastrointestinal
Disease
Supplements for gastrointestinal
disorders in dogs and cats were available through 89% of the retail pet stores
surveyed. Commercially available gastrointestinal supplements available through
retail pet stores are summarized in Table 3. The most common supplement
ingredients contained in formulations available through retail pet stores
included dietary fiber sources (46%), probiotics (38%) and prebiotics (38%).
Additional ingredients included probiotic fermentation products or digestive
enzymes (15%), slippery elm (15%), colostrum (15%), miscellaneous herbal
supplements (15%), ginger root (8%) and omega fatty acids (8%). In addition to
supplements, 43% of the retail pet stores surveyed also recommended dietary changes
or specific diets for patients with gastrointestinal disease.
Of the veterinary practioners
surveyed, 89% recommended at least one supplement for use in patients with
gastrointestinal disease and 78% of practitioners recommended a specific
dietary formulation. Rationale for supplement recommendations included
anti-inflammatory properties of the supplement, restoration or augmentation of
normal gastrointestinal microbiotia and vitamin supplementation. The most
common supplement ingredients included probiotics (67%), prebiotics (56%),
vitamin B12 (22%), dietary fiber (22%) and omega fatty acids (11%). Specific
formulations recommended by veterinary practitioners included Purina FortiFlora
(44%), Iams Prostora Max (22%), Vetoquinol Progut (22%), Aventix Florentero
(22%) and Metamucil (11%). Within these supplements, the most common
ingredients with supposed benefit for patients with gastrointestinal disease
included probiotics (60%), prebiotics (40%), and psyllium fiber (20%). Specific
diet recommendations included Royal Canin Gastro, Royal Canin Fiber Response,
Royal Canin Hypoallergenic, Purina Dual Fiber Control, Purina Hypoallergenic,
Purina Diabetes Management DM , Purina Gastroenteric and Iams Skin Support FP.
Table 3. Supplement
Formulations for Gastrointestinal Diseases in Dogs and Cats Supplements
Available through Retail Pet Stores
|
|
Supplement
|
Manufacturer’s Claims and
Ingredients
|
Digestive Support Probiotics (21st Century)
|
Marketed to promote the growth of healthy
bacteria in the digestive tract. Contains dried whey, cellulose, probiotics (Lactobacillus
salivarius, Lactobacillus acidophilus, Bifidobacterium bifidum, Streptoccous
thermophilus), frutooligosaccharides, citrus pectin.
|
Digestive Upsets (Homeopet)
|
Marketed as a homeopathic remedy for
minor digestive problems. Contains silver nitrate, arsenic oxide, bitter
cucumber, St. John’s wart, pasque flower and white hellbore.
|
Esbilac (PetAg)
|
Marketed as a complete food source
for orphaned or rejected puppies.
|
Gas Buster (Vets Best)
|
Marketed for the maintenance of a
healthy digestive system. Contains slippery elm bark, parley, ginger root,
apple pectins and allzyme.
|
Groundwork (Juka Organics)
|
Marketed for a healing energy and
synergism within the cell and cell membrane. Contains flax hulls, black
currant, raspberry, blueberry, alfalfa, papaya, spirulina, kale, milk thistle
and green tea.
|
Holistic Solution (Eagle Pack)
|
Marketed for the prevention and
relief of diarrhea, loose stool or gastric upset. Contains probiotics (Saccharomyces
cerevisiae, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium
subtilus, Bifidobacterium subtillus, Bifidobacterium coagulans, Aspergillus
niger, Enterococcus faecium), digestive enzymes (A.niger extract, A.
Oryzae extract), inulin and rice bran.
|
Holistic Transition (Eagle Pack)
|
Marketed to maintain a healthy
digestive system under normal conditions. Contains rice bran, probiotics (Lactobacillus
acidophilus, Lactobacillus casei, Enterococcus faecium, Bifidobacterium
subtillus, Bacillus licheniformis, Bacillus coagulans, Aspergillus oryzae).
|
KMR (PetAg)
|
Marketed as a complete food source
for orphaned or rejected kittens.
|
Milk Replacer for Kittens (21st Century)
|
Marketed as a food supplement for
newborn kittens. Contains dried colostrum.
|
Milk Replacer for Puppies (21st Century)
|
Marketed as a food supplement for
newborn puppies. Contains dried colostrum.
|
Probiotics Capsules (NutriVet)
|
Marketed to support a strong immune
system and promote vitality. Contains dried whey, cellulose, probiotics (Lactobacillus
acidophilus, Lactobacillus salivarius, Bifidobacterium bifidum, Streptococcus
thermophilus), frutooligosaccharides, and citrus pectin.
|
Proviable DC (Nutramax)
|
Supplement claims to re-establish a
healthy intestinal flora. Contains fermentation products from several
probiotic species (Bifidobacterium bifidum, Streptococcus thermophilus,
Lactobacillus bulgaricus, Enterococcus faecium, Lactobacillus acidophilus,
Lactobacillus casei and Lactobacillus plantarum), as well as
fructooligosaccharide.
|
Slippery Elm (Urban Carnivore)
|
Marketed claims to sooth, coat and
lubricate the mucous membranes of the digestive tract. Contains slippery elm
bark.
|
Table 3. Supplement
Formulations for Gastrointestinal Diseases in Dogs and Cats Continued Supplements
Recommended by Local Veterinarians
|
|
Supplement
|
Manufacturer’s Claims and
Ingredients
|
Florentero (Aventix)
|
Marketed to improve overall health
and defenses against pathogens, as well as for use in patients with
gastrointestinal disorders. Contains niacin, probiotics (Lactobacillus
acidophilus, Enterotoccus faecium, Lactobacillus sporogenes), prebiotics
(fructo-oligosaccharides, manno-oligosaccharides), and B vitamins (cobalamin,
thiamine and vitamin B6).
|
FortiFlora (Purina)
|
Marketed for the management of
patients with diarrhea. Contains probiotics (Enterococcus faecium),
and vitamins (A, E, and C).
|
Metamucil
|
Marketed for humans for a number of
health benefits including promoting digestive health and reducing
cholesterol. Contains natural psyllium fiber.
|
Prostora Max (Iams)
|
Marketed for the maintenance of
digestive balance in dogs. Contains probiotics (Bifidobacterium animalis)
and whey.
|
Progut (Vetoquinol)
|
Marketed as a nutritional supplement
for patients with intestinal disease. Contains fructi-oligosaccharides.
|
Supplements for Cardiac Disease
Flax
Forward (Juka Organics), which contains flax seed oil with omega 3 and omega 6
fatty acids, was recommended by one retail pet store for patients with cardiac
disease. Specific supplements recommended by 44% of veterinary practitioners
surveyed including L-carnitine (22%), vitamin E (11%), taurine (11%) and
coenzyme Q-10 (11%). In contrast, 78% of veterinarians surveyed recommended
specific diets for patients with cardiac disease including Royal Canin Cardiac
Diets (67%), which are marketed for patients with hypertension and cardiac
disease or cardiac failure, and contain polyphenols, moderate phosphorus,
restricted sodium, taurine and L-carnitine. Royal Canin Reduced Protein (22%)
and Royal Canin Mature (11%) were also recommended.