Supplements targeting joint health are some of the most sought-after dietary supplements for horses, especially due to the high prevalence of joint injuries and deterioration later in life.

But which equine joint supplements actually work and which are all hype? Many of the ingredients often touted for improving joint health have limited research in horses.

And some of the most popular supplements believed to work have been demonstrated ineffective when actually studied in equine populations. (You may be surprised by which ingredients DON’T work.)

That being said, there are some compounds that have been well-researched in horses and demonstrate efficacy for improving metrics of joint comfort, health and function.

In this article, we will review the research behind 8 of the most popular joint supplements for horses and help you decide which are worth your money and which should be avoided.

Equine Supplements for Joint Health

Joints consists of cartilage which connects to bones, acting as padding while encapsulating the joint. Synovial fluid keeps the joint lubricated and limits friction, or wear-and-tear, between the bones. [1]

As horses age, perform heavy work, or become injured, their joints can become weak and damaged in several ways. The composition of synovial fluid may change, resulting in less lubricant for the joint. There can be inflammation in the cartilage causing it to deteriorate. This can cause significant pain to the horse and hinder performance and comfort. [2]

When the cartilage of the joint begins to degenerate, the horse might be diagnosed with osteoarthritis. This condition can have several consequences including: [1]

  • Persistent pain
  • Reduced training days
  • Early retirement
  • Lameness
  • Euthanasia

Senior or heavily exercised horses are likely to benefit from a supplement that supports joint health. Choosing the right supplement for your horse can be overwhelming. Some factors to consider are the current health status of your horse, other goals (ie. weight gain or loss) and demonstrated efficacy in horses.

Dietary supplements to support joint health may have several mechanisms of action that achieve any of the following: [3] [4]

  1. Slow the rate of or inhibit enzymes that deteriorate cartilage
  2. Increase capacity for cells called chondrocytes to synthesize collagen and other important proteins
  3. Improve synthesis of hyaluronic acid by synovial cells
  4. Improve synovial fluid composition
  5. Reduce inflammation and/or oxidative stress
  6. Manage pain

Here we provide a summary of the potential mechanisms, bioavailability, safety and efficacy of some of the most popular supplements available on the equine market today. We also rate the ingredients on the strength of the evidence in horses supporting their efficacy or inefficacy.

Before adding any new supplement to your horse’s diet, it is recommended to consult with an equine nutritionist or other equine healthcare professional. You can submit your horse’s diet online for a complementary evaluation and to receive individualized recommendations for your horse.

Top 8 Joint Supplements for Horses

1. Methylsulfonylmethane (MSM)

Found in alfalfa and grains, methylsulfonylmethane, or MSM, is a readily available natural form of sulfur. It is well-tolerated by horses and is considered one of the safest supplements to add to your equine feeding program.

Sulfur is important in the horse’s diet as a component of glucosamine and collagen which are found in connective tissue and cartilage.

Proposed Mechanisms of Action:[5]

  • Decreases levels of pro-inflammatory compounds interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-a) which can help lessen swelling of the joint
  • Acts as an antioxidant by neutralizing free radicals that cause damage to cells
  • By inhibiting the enzyme cholinesterase, MSM can help decrease muscle spasms and reduce pain in the joint

To learn more about MSM for horses, our recent article highlights the top 9 benefits of MSM for horses.

Bioavailability and Safety: MSM appears safe for consumption in a variety of animal models and is relatively bioavailable, although may need further evaluation for horses. [5]

While naturally present in small amounts in fresh forage and grains, MSM must be supplemented at higher dosages to support beneficial effects.

Efficacy: The use of MSM for joint health in horses still requires more research, but initial studies report positive results.

The available in vitro studies that look at isolated cells in culture show some protective effects against inflammation and degradation of cartilage. Similarly, in vivo studies in mice and rats show benefits with MSM for reducing inflammation. [5]

While there is currently limited information on MSM and joint health in horses, there are very promising results:

In a 2008 study using horses (8-13 years of age), it was determined that competitive jumping horses experienced increased oxidative stress as identified by higher levels of nitric oxide and carbon monoxide. [6]

Compared to a control group, the daily supplementation of MSM at 8 mg/kg for five weeks protected these horses from oxidative stress and the exercise-induced inflammation that occurred from weekly competition over the study period. [6]

From these results it appears that MSM supports joint health by acting as an antioxidant and anti-inflammatory mediator.

Typically recommended serving sizes are 2 grams per 100 kg bodyweight. Some horses might benefit from a higher initial serving size of 20 grams per day until improvements are noted, followed by 10 grams per day on an ongoing basis.

THE VERDICT: Suitable evidence of efficacy in performance horses.

Effective

 

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  • Supports joint health
  • Cartilage & connective tissue
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2. Glucosamine

Glucosamine is a naturally occurring compound that is an important building block of cartilage, the structural tissue that is found between joints throughout the body.

As a dietary supplement, glucosamine is commonly harvested from beef and marine sources, but it can also be produced synthetically. There are three forms of glucosamine: hydrochloride, sulfate, and N-acetyl-D-glucosamine.

Proposed Mechanisms of Action: [3]

  • Slows the progression of cartilage deterioration by providing sulfur which helps build strong cartilage
  • Increases the sulfur content in synovial fluid, improving its overall composition
  • Exerts anti-inflammatory effects by reducing pro-inflammatory markers such as IL-6 and TNF-a
  • Increases production of proteins called proteoglycans and prevents their degradation. This can improve joint function and prevent cartilage degradation

Bioavailability and Safety: Glucosamine supplementation has shown no adverse effects in the horses. However, the bioavailability of glucosamine in horses is low (0 – 5.9 %) and may require large doses to achieve a therapeutic effect. [7]

Efficacy: Glucosamine has been heavily studied for its potential as a joint health supplement in many species.

In cell culture studies, cartilage taken from horse joints was improved when treated with glucosamine. It appears to exert beneficial effects for preventing degradation of cartilage and delaying onset of symptoms of osteoarthritis. [8]

However, these studies use high doses that are unlikely to be achieved in animal feeding programs. When it is added to the horse’s diet, the evidence is much less conclusive.

In a review that evaluated all scientific studies in animals, it has been consistently shown that the efficacy of glucosamine for supporting joint health is low. [9] [10]

There are also flaws in many studies including no control group, lacking blinding to supplementation, small sample sizes, and/or varied criteria for diagnosis of lameness. This makes it difficult to interpret these studies and how well glucosamine works.

Early studies in horses could not identify an effect of glucosamine on joint health when compared to control groups:

Yearling quarter horses were provided daily supplementation of glucosamine over 8 weeks in combination of exercise or walking compared to a control for biomarkers of joint metabolism. There were no reported differences between supplemented horses that were exercised or walked. And no differences when compared to the control. [11]

Similarly, in young Standardbred horses undergoing race training, 4 grams of glucosamine supplementation every 12 hours for 48 weeks did not alter serum (blood) biomarkers of improved joint health.[12]

There does not appear to be a benefit from glucosamine supplementation on joint health in horses. Higher quality studies may be beneficial in further understanding potential effects for glucosamine.

THE VERDICT: Insufficient evidence, poor efficacy in horses.

Some Inefficacy

 

3. Chondroitin Sulfate

Chondroitin sulfate is a chain of various sugar molecules found in cartilage. It is typically obtained from bovine species to incorporate in nutraceuticals. However, it is difficult and expensive to extract, and synthetic forms are often difficult to synthesize. Therefore, it is commonly paired with glucosamine in supplements.

Proposed Mechanisms of Action:[13]

  • May reduce nitric oxide concentrations and regulate prostaglandins for anti-inflammatory effects
  • May prevent cartilage degradation by inhibiting glycosaminoglycans (GAG)-degrading enzymes and stimulating cartilage synthesis by chondrocytes
  • Improves hyaluronic acid concentrations which could aid in maintaining synovial fluid of the joint and may act to reduce inflammation

Bioavailability and Safety: The bioavailability for chondroitin sulfate is relatively low and is inconsistent, with a range of 0-32 % in horses. [14]

Efficacy: Similar to glucosamine, studies using isolated cells show promising results for chondroitin sulfates and alleviation of inflammation. However, in vivo studies in animals using chondroitin sulfate are inconclusive. [10]

Importantly, the benefits observed in cell culture studies required extremely high doses that would be difficult to supplement in the horse. These studies are considered low quality, and conclusions cannot be drawn from them.

While there do not appear to be benefits of chondroitin sulfate supplementation alone, there may be a benefit to a supplement combination of chondroitin sulfate and glucosamine.

However, when 2 grams of chondroitin sulfate and 5.5 grams of glucosamine were orally supplemented in horses, there was no indication of absorption into blood. [14]

Even at 3.5 grams and 8.5 grams of chondroitin sulfate and glucosamine, respectively, there was again no indication in the serum (blood) of these horses that these supplements were absorbed. [14]

Therefore, the low bioavailability of these supplements may be a major factor in the low effectiveness observed in previous studies.

THE VERDICT: Insufficient evidence. Poor efficacy in horses.

Some Inefficacy

 

4. Hyaluronic Acid

Hyaluronic acid is an important component of many tissues, including the joints, cartilage, and connective tissues. It is known to be effective for promoting joint health when injected directly into the joint. Dietary supplements for oral administration of hyaluronic acid are increasing on the market.

Proposed Mechanisms of Action: [15] [16]

  • Increases hyaluronic acid content of synovial fluid in the joint which can make it thicker and improve lubrication between the bones of the joint
  • Improve the integrity of cartilage and elasticity of connective tissue by contributing hyaluronic acid content
  • Might reduce pain associated with deterioration of joints

Bioavailability and Safety: Hyaluronic acid has been used to treat osteoarthritis in horses for decades with no reported adverse effects, either when injected or given orally. [15]

Efficacy: When injected directly into a horses’ joint that is affected by osteoarthritis, hyaluronic acid improves joint health and reduces lameness. [15] Oral administration of hyaluronic acid may have similar efficacy for supporting joint health in horses.

When hyaluronic acid was supplemented at 250 mg per day for 60 days, young horses tended to have increases in hyaluronic acid levels and improved synovial fluid composition demonstrating a benefit to joint health. [17]

Similar results on synovial fluid following oral supplementation of hyaluronic acid at a lower dose were also found in yearlings. [16]

Yearling Thoroughbred horses diagnosed with osteochondritis dissecans were supplemented for 30 days with 100 mg per day of hyaluronic acid. This decreased fluid accumulation (effusion) in affected joints, suggesting decreased inflammation and swelling of the joint. [16]

Overall, oral supplementation of hyaluronic acid appears to exert similar efficacy of injected forms of administration. However, more research may be required to determine an optimal dose.

THE VERDICT: Evidence of high efficacy in horses. More research required.

Effective

 

5. Resveratrol

While mostly known as a component in wine, resveratrol is found in many plants such as blueberries, pines, and Japanese knotweed. Resveratrol is a polyphenolic compound which is suggested to be beneficial in joint health mostly due to its antioxidant effects.

Proposed Mechanisms of Action: [18]

  • Resveratrol acts as an antioxidant by neutralizing free radicals to reduce oxidative stress and support healthy cells in the joint.
  • Increase cartilage production by chondrocytes to protect against degradation
  • Exerts anti-inflammatory effects by reducing synthesis of inflammatory compounds such as interleukins

Bioavailability and Safety: Supplementing horses with resveratrol appears to be safe. Although determining the bioavailability for this supplement is difficult, it appears to be higher when resveratrol is encapsulated. [19]

Efficacy: There is limited research in horses. It has shown significant benefits for reducing inflammation and oxidative stress, and ultimately protecting against osteoarthritis in other species.

A large volume of cell culture studies show the protective and preventative properties of resveratrol. Similarly, studies in mice and humans show anti-osteoarthritic effects with resveratrol. [20]

Supplementing resveratrol in horses with osteoarthritis may improve symptoms[21], enhance performance and reduce lameness. [22]

In one study, horses with mild lameness were given 2000 mg per day of powdered resveratrol for 10 days was followed by 18 days at 1000 mg per day. [21] This reduced markers of lipid peroxidation, a marker of oxidative stress. Enzymes involved in cartilage degradation were reduced after resveratrol supplementation in these horses. [21]

Supplementation at 1000 mg per day of resveratrol for four months in horses previously treated with an intra-articular injection appeared to have improved, but not completely resolved, lameness. [22]

Alternatively, supplementing healthy horses with 450 mg of resveratrol twice per day for only 3-weeks did not result in reduced oxidative stress. This lack of effect could be because they already had adequate antioxidant protection, the dose was too low, or was not given for long enough. [23]

Resveratrol supplementation appears to exert benefits on joint health in the horse. However, more research on an effective serving size may be required. Furthermore, there is some inconsistency in reports of its effects over a short supplementation duration and this should be further investigated.

THE VERDICT: Some evidence of efficacy in horses with osteoarthritis or mild lameness. More research required on effective serving size.

Some Efficacy

 

6. Fatty Acids (Omega-3’s)

Omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in marine oils and plants such as flaxseed. They have been making headlines for a variety of beneficial effects in humans, companion animals, and horses.

Proposed Mechanisms of Action:[3]

  • Anti-inflammatory effects by reducing production of pro-inflammatory eicosanoids, cytokines, and arachidonic acid
  • Acts as an antioxidant by decreasing the presence of reactive oxidative species

Bioavailability and Safety: There are currently no known adverse effects of supplementing horses with omega-3 fatty acids from animal or plants and bioavailability appears relatively high.[3]

Efficacy: In humans, there is strong evidence for omega-3 fatty acid supplementation for arthritis prevention and protection. [25] Using equine derived cells in cell culture, omega-3 fatty acids are suggested to be important nutrients for minimizing osteoarthritis. [24]

In one study, horses were supplemented with 38 grams of marine-derived fatty acids (EPA and DHA) or flaxseed derived fatty acids for 90 days. Synovial fluid composition and levels of pro-inflammatory compounds were unchanged. [26]

However, this study only analyzed the effects of supplementation at the synovial fluid. It did not analyze other markers of inflammation or joint function and cartilage composition that may be impacted by omega-3 fatty acids.

Another study in horses showed promising results in improving symptoms of osteoarthritis when supplemented with omega-3 fatty acids. [27] Horses were fed a diet with 5.95 grams of omega-3 fatty acids compared to a control diet for 75 days.

After 75 days of supplementation, horses supplemented with fatty acids appeared to have longer stride lengths during exercise and higher DHA plasma levels. However, no effect on circulating levels of inflammatory markers were observed and no change in lameness was observed. [27]

Similarly, in a study using horses diagnosed with arthritis, omega-3 supplementation provided evidence for their benefits in reducing symptoms when given 15 g of EPA and 19.8 g of DHA per day for 90 days. This reduced pro-inflammatory prostaglandin concentrations and improved synovial fluid concentrations, demonstrating the potential for anti-inflammatory effects of omega-3 fatty acids in horses. [28]

Finally, a systematic review evaluating the efficacy of different supplements for the prevention and protection against clinical symptoms of osteoarthritis in dogs, cats, and horses, considered omega-3 fatty acids to have the highest strength in evidence. [29]

THE VERDICT: High quality evidence. Good efficacy in horses with arthritis.

Effective

 

w-3 Oil Essential Fatty Acid Supplement
  • Promotes joint comfort
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  • Skin & coat condition
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7. Avocado/Soybean Unsaponifiables

Unsaponifiables are a combination of vitamins, sterols, and triterpene alcohols extracted from avocado and soybeans. The plant sterols are thought to play a primary role in promoting benefits for joint health by acting on chondrocytes, the cells that produce cartilage.

Proposed Mechanisms of Action:[30]

  • Inhibits enzymes, such as collagenase, to deter degradation of collagen and cartilage
  • Increases concentrations of growth factors which may be important in synovial fluid composition and cartilage repair
  • Reduces inflammation by inhibiting pro-inflammatory mediators such as IL-6 and TNF-a
  • Might reduce pain associated with osteoarthritis and deteriorating joint function

Bioavailability and Safety: Avocado/soybean unsaponifiables appear safe with no adverse effects. Unfortunately, there is limited research on the bioavailability of this supplement. [19]

Efficacy: The use of avocado/soybean unsaponifiables demonstrate a protective effect against joint pain and disease by inhibiting pro-inflammatory cytokines and by potentially stimulating cartilage repair of damage induced by osteoarthritis.[30]

Research is limited in horses. However, research in human clinical trials consistently show that avocado/soybean unsaponifiables aid in pain management of osteoarthritis. [31]

In a review of avocado/soybean unsaponifiables on osteoarthritis, it was also concluded that joint function was improved with supplementation. [30]

A study evaluating avocado/soybean unsaponifiables supplementation at a 1:2 avocado to soybean ratio in horses could not confirm its effects on pain reduction that has previously been observed in humans. However, it appeared to increase cartilage synthesis and inhibited cartilage degradation compared to a control group. [32]

Avocado/soybean unsaponifiables may be beneficial in supporting healthy joints in equines. But more research will be required in horses to determine optimal serving sizes and to further investigate its effects on lameness, pain, and inflammatory markers associated with joint health.

THE VERDICT: Some efficacy in horses. More research required.

Some Efficacy

 

8. Green Lipped Mussel

Freeze dried extracts of the New Zealand green lipped mussel, Perna canaliculus, contain the protein pernin, and have a high omega-3, glucosamine, and chondroitin sulfate content. This makes them a supplement of interest for reducing inflammation and supporting joint health. [33]

Proposed Mechanisms of Action: [33] [34]

  • Anti-inflammatory effects by reducing synthesis of pro-inflammatory prostaglandins
  • Through its anti-inflammatory effects, green lipped mussels may aid in pain management

Bioavailability and Safety: The bioavailability of green lipped mussel extract is relatively unknown and may depend on the form it is provided in.[35] Green lipped mussel supplements appear safe for consumption in horses with no adverse effects reported.

Efficacy: Interest in green lipped mussel extracts began in the 1970s and research into its use as a supplement has been ongoing.
However, due to the many different forms of green lipped mussel extracts, it is difficult to determine how effective dietary supplementation is.

A clinical trial in horses with lameness resulting from osteoarthritis evaluated the effects of a green lipped mussel extract supplement on pain, inflammation, and lameness.

Green lipped mussel was supplemented to horses at 25 mg per kg body weight for 56 days compared to a control group. It was shown to have benefits for pain management, reducing inflammation, and lowering the severity of lameness in horses. [35]

Research continues to grow on green lipped mussel extracts and joint health support with benefits demonstrated in many species, including humans and dogs. [29]

THE VERDICT: Some Efficacy in A Single Study. More Research Required.

Some Efficacy

 

Additional Equine Joint Supplements

Below are a list of supplements that may benefit joint health given their known effects in humans and other species. However, these have not been directly studied for joint health in horses.

This list is by no means exhaustive, as there are many supplements with purported benefits to joint health.

  • Vitamin C, E, or A due to their antioxidant properties. These are typically paired with copper, selenium, or manganese, respectively.
  • Curcumin is a bioactive component of turmeric used for its anti-inflammatory and antioxidant properties.
  • CBD Oil made from cannabidiol is a non-psychoactive component of cannabis that may aid in pain management in horses, and many other species.
  • Rose Hip contains vitamins such as A, D, and E, fatty acids, and flavonoids, and sugars that work to inhibit pro-inflammatory mediators.
  • Boswellia or Indian frankincense a plant extract used for anti-inflammatory purposes.
  • Capsaicin is extracted from chili peppers (Capsicum) and may be able to provide pain management in horses for joint health.
  • Collagen is a protein and component of joints. Supplementation of collagen may increase collagen synthesis for joint health support.
  • Cetyl myristoleate is considered a fatty acid derived from animals.
  • Devil’s Claw is an herb that also goes by Harpagophytum. It been used as a pain reliever, although research is limited on its efficacy.
  • Cissus Quadrangularis is a plant, or vine, that has been used for centuries in traditional medicines of Asia.

Factors to Consider when Choosing a Supplement

Which joint health supplement should you add to your horse’s feeding program? Important factors to consider when choosing a joint health supplement may include:

  1. Life stage of your horse
  2. Current joint health status
  3. Bioavailability of a supplement
  4. Conclusiveness and quality of the efficacy of a supplement backed by research

Life stage is important to consider due to the higher prevalence of connective tissue deterioration in senior and/or racing horses. It could be beneficial for a racehorse to receive supplementation for joint health in its earlier years and throughout its maturity in order to prevent workload damage.

Joint health status is important in determining which supplement may be of more benefit. While all of the above supplements may aid in supporting healthy joint function in your horse, if your horse has individual needs or is currently on medications, it is important to assess a supplement for drug interactions.

In this case, supplements may provide additional support, but it is advisable to consult with your veterinarian about potential contraindications and negative interactions with medications.

The bioavailability of supplements is often overlooked but is an important factor to consider. Bioavailability refers to the amount of a nutrient that is actually absorbed in the digestive tract of the animal and used by cells of the body.

If a supplement is not bioavailable, it won’t matter how much of the supplement is given – it cannot provide benefits because it will not reach its therapeutic target.

When evaluating supplements for their efficacy based on research results, it is also important to note the type of study that the conclusions are drawn from.

Many purported effects of supplements are based on in vitro (cell culture) data rather than in vivo studies (performed in animals). Generally, in vivo studies provide higher quality evidence, although species differences might affect how well supplements work in difference animals.

Lastly, the quality and depth of studies as a whole will help to determine which supplements are superior to others.

While this may help you to navigate through the marketplace of equine supplements for joint health, every horse is different. A supplement that works for one horse may not work for another.

For those looking for a supplement program to support joint health, we recommend Mad Barn’s pure MSM powder and our blend of marine and plant sources of fatty acids, w-3 Oil with DHA and Vitamin E. These two products are research-validated and can help to alleviate inflammation and maintain healthy joints, cartilage, and connective tissue.

Our equine nutritionists are available to answer questions you may have about different joint health support supplements and your horses’ diet. Submit your horse’s diet for a complimentary analysis and our nutritionists can give you personalized recommendations.

Is Your Horse's Diet Missing Anything?

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References

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  2. Berenbaum, F. Osteoarthritis as an inflammatory disease. Osteoarthr Cartil. 2013.
  3. Trumble, TN. The use of nutraceuticals for osteoarthritis in horses . Vet Clin North Am Equine Pract. 2005.
  4. Vervuert, I. and Stratton-Phelps, M. The safety and efficacy in horses of certain nutraceuticals that claim to have health benefits . Vet Clin North Am Equine Pract. 2021.
  5. Butawan, M. et al. Methylsulfonylmethane: Applications and safety of a novel dietary supplement. Nutrients. 2017.
  6. Marañón, G. et al. The effect of methylsulphonylmethane supplementation on biomarkers of oxidative stress in sport horses following jumping exercise. Acta Vet Scand. 2008.
  7. Du, J. et al. The bioavailability and pharmacokinetics of glucosamine hydrochloride and chondroitin sulfate after oral and intravenous single dose administration in the horse. Biopharm Drug Dispos. 2004.
  8. Fenton, JI. et al. Glucosamine HCl reduces equine articular cartilage degradation in explant culture . Osteoarthr Cartil. 2000.
  9. Pearson, W. and Lindinger, M. Low quality of evidence for glucosamine-based nutraceuticals in equine joint disease: Review of in vivo studies. Equine Vet J. 2009.
  10. McIlwraith, CW. Oral supplements in the management of osteoarthritis . Equine applied and clinical nutrition: health, welfare and performance. 2013.
  11. Fenton, JI. et al. Effect of longeing and glucosamine supplementation on serum markers of bone and joint metabolism in yearling quarter horses . Can J Vet Res. 1999.
  12. Caron, JP. et al. Serum concentrations of keratan sulfate, osteocalcin, and pyridinoline crosslinks after oral administration of glucosamine to Standardbred horses during race training. Am J Vet Res. 2002.
  13. Frisbie, DD. et al. Efficacy of intravenous administration of hyaluronan, sodium chondroitin sulfate, and N-acetyl-D-glucosamine for prevention or treatment of osteoarthritis in horses . Am J Vet Res. 2016.
  14. Welch, CA. et al. Plasma concentration of glucosamine and chondroitin sulfate in horses after an oral dose . J Equine Vet Sci. 2012.
  15. Gupta, RC. et al. Hyaluronic acid: molecular mechanisms and therapeutic trajectory. Front Vet Sci. 2019.
  16. Bergin, BJ. et al. Oral hyaluronan gel reduces post-operative tarsocrural effusion in the yearling thoroughbred. Equine Vet J. 2006.
  17. Carmona, JU. et al. Effect of the administration of an oral hyaluronan formulation on clinical and biochemical parameters in young horses with osteochondrosis. Vet Comp Ortho Traumatol. 2009.
  18. Burhmann, C. et al. Herbal remedies as potential in cartilage tissue engineering: an overview of new therapeutic approached and strategies. Molecules. 2020.
  19. Soo, E. et al. Enhancing delivery and cytotoxicity of resveratrol through a dual nanoencapsulation approach. J Colloid Interface Sci. 2016.
  20. Li, W. et al. Intra-articular resveratrol injection prevents osteoarthritis progression in a mouse model by activating SIRT1 and thereby silencing HIF2?. J Orthop Res. 2015.
  21. Ememe, MU. et al. Ameliorative effects of resveratrol on oxidative stress biomarkers in horses. J Equine Vet Sci. 2015.
  22. Watts, AE. et al. A randomized, controlled trial of the effects of resveratrol administration in performance horses with lameness localized to the distal tarsal joints. J Am Vet Med Assoc. 2016.
  23. Martin, LM. et al. Effects of orally administered resveratrol on TNF, IL-1B, leukocyte phagocytic activity and oxidative burst function in horses: a prospective, randomized, double-blinded, placebo-controlled study. Int J Mol Sci. 2020.
  24. Caron, JP. et al. Omega-3 fatty acids and docosahexaenoic acid oxymetabolites modulate the inflammatory response of equine interleukin1 ?-stimulated equine synoviocytes. Prostaglandins Other Lipid Mediat. 2019.
  25. Calder, PC. et al. n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr. 2006.
  26. Ross-Jones, T. et al. Effects of omega-3 long chain polyunsaturated fatty acid supplementation on equine synovial fluid fatty acid composition and prostaglandin E2. J Equine Vet Sci. 2014.
  27. Woodward, AD. et al. Supplementation of dietary long-chain polyunsaturated omega-3 fatty acids high in docosahexaenoic acid (DHA) increases plasma DHA concentration and may increase trot stride lengths in horses. Equine Comp Exerc Physiol. 2007.
  28. Manhart, DR. et al. Markers of inflammation in arthritic horses fed omega-3 fatty acids. Prof Anim Sci. 2009.
  29. Vanderweerd, JM. et al. Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis. J Vet Intern Med. 2012.
  30. Christiansen, B. et al. Management of osteoarthritis with avocado/soybean unsaponifiables. Cartilage. 2015.
  31. Simental-Mendia, M. et al. Efficacy and safety of avocado-soybean unsaponifiables for the treatment of hip and knee osteoarthritis: A systematic review and meta-analysis of randomized placebo-controlled trials. Int J Rheum Dis. 2019.
  32. Kawcak, CE. et al. Evaluation of avocado and soybean unsaponifiable extracts for treatment of horses with experimentally induced osteoarthritis. Am J Vet Res. 2007.
  33. Saltzman, ET. et al. Perna canaliculus and the intestinal microbiome. Mar Drugs. 2017.
  34. Cheras, PA. et al. Vascular mechanisms in osteoarthritis: rationale for treatment with a marine-based complementary medicine. Osteoarthr Cartil. 2005.
  35. Cayzer, J. et al. A randomised, double-blinded, placebo-controlled study on the efficacy of a unique extract of green-lipped mussel (Perna canaliculus) in horses with chronic fetlock lameness attributed to osteoarthritis. Equine Vet J. 2012.