Definition and cause
Osteochondrosis is a growth disturbance, often leading to an overproduction of cartilage. This thickened cartilage leads to degeneration and necrosis. Coupled with improper nutrition and trauma, this excessive cartilage can lead to ostechondritis dessecans in the shoulder, elbow, or stifle joint. In addition, it is believed that improper nutrition and trauma to the cartilage surface contributes to the disease, often leading to a degenerative joint.
Medical therapy rationale, drug(s) of choice, and nutritional recommendations
Anti-inflammatory medications are used to control symptoms. They do not address the underlying degeneration, nor do they help to promote healing. Surgery is often indicated, especially when a flap of cartilage has formed. While surgery is often beneficial, it also does not address the underlying process and continual degeneration of the joint.
Shoulder disease responds well to surgery and often results in pain-free and full mobility. The prognosis for other joints such as the stifle and elbow is more guarded. This depends upon the progression of the lesion and the extent of the associated degenerative joint disease.
Integrative veterinary therapies
The cause of osteochondrosis is linked to developmental and nutritional factors. Suggested remedies include weight loss to ease the stress on the joint as well as chondroprotective agents that protect and strengthen the cartilage surfaces. In addition, the use of nutrients, antioxidants, phytonutrients, and antiinflammatories that nourish tissues and reduce free radical cellular reaction as compared to medical suppression of the inflammation are beneficial for short- and long-term prognosis. Medicinal herbal and homeopathic remedies also further improve the prognosis.
General considerations / rationale
The focus of nutritional support is on reducing inflammation, nourishing joint cells and tissues, improving circulation, and enhancing healthy cellular and tissue formation.
Chondroprotective agents: Several studies have demonstrated the effectiveness of glucosamine and chondriotin in the management of arthritis in dogs. Numerous double-blind studies have compared the effectiveness of glucosamine against various NSAIDs, resulting in as good or, in many cases, even better pain control and removal of the clinical signs associated with osteoarthritis. Additionally, the newer trend in the management of arthritis is toward chondroprotective agents such as glycosaminoglycans, pain-relieving agents such as methyl sulfonyl methane (MSM), and free radical scavengers such as superoxide dismutase (SOD).
Super oxide dismutase: Super oxide dismutase (SOD) is a potent destroyer of free radicals that can protect cells against oxidative damage. McCord (1974) reported that SOD can protect hyaluronate from free-radical damage and that it may have an antiinflammatory effect.
Vitamin C: Vitamin C has been studied clinically in animals. Brown (1994), Berg (1990), and Newman (1995) reported on the benefits of vitamin C in the treatment of degenerative joint disease and movement in dogs and in horses. Belfield (198) reported on the beneficial effects of using vitamin C in treatment and prevention of hip dysplasia in dogs.
Botanical Cox2 inhibitors: Botanical Cox2 inhibitors have been shown to have antioxidative and antiinflammatory effects. Botanical Cox 2 inhibitors offer the benefit of inflammation reduction without the inherent side effects of Cox2 medications.
Chinese herbal medicine / acupuncture
General considerations / rationale
Osteochondrosis is the result of Kidney Qi and Yang Deficiency. Wind, Cold, and Damp invade the body, leading to Qi and Blood stagnation. The Kidneys control the bones in traditional Chinese medicine theory. When the Kidney is deficient in energy (Qi) and heat (Yang), the bones can suffer. Wind can blow pathogens into the body and from one joint to the other. Cold and Damp make the joint stiff and painful. Application of warmth eases discomfort. When Qi and Blood cannot flow they accumulate and cause pain. Treatment involves decreasing inflammation and pain. Traditional Chinese medicine is different from Western medicine as different areas of the body are treated differently, even in the face of a single Western diagnosis. Therefore, separate formulas and acupuncture points are given for forelimb verses hindlimb disease.
Appropriate Chinese herbs for hindlimb osteochondrosis
Achyranthes (Niu xi): Has analgesic effects. This was demonstrated in body torsion and hot plate experiments in mice. It also has antiinflammatory effects. It can prevent egg-white-induced foot swelling and formaldehyde-induced arthritis.
Aconite / chuan (Chuan wu): Has a centrally mediated analgesic effect. In mice it was shown to be effective for decreasing inflammation and pain. It is stronger than aspirin at reducing inflammation. It controlled the signs in 92% of 150 human patients with arthritis when given in combination with Cao wu, Qiang huo, Du hua, Fu zi, Mo yao, Ru xiang, Dang gui, Chuan niu xi, Ma huang, Gui zhi, Wu gong, Chuan xiong, and Ma qian zi.
Angelica (Bai zhi): Has demonstrated antiinflammatory effects in mice. It also decreases pain.
Angelica root (Dang gui): As strong as aspirin at decreasing inflammation and is 1.7 times as strong as aspirin for pain relief. Dang Gui plus ligusticus (Chuan xiong) was 97% effective in treating lower back and leg pain.
Atractylodes (Cang zhu): Has analgesic effects. This was demonstrated using body torsion and heat-induced pain tests. It also has antiinflammatory effects. It has been shown to prevent xylene-induced ear swelling and carrageenin-induced foot swelling.
Cinnamon bark (Rou gui): Inhibits both acute and chronic inflammation. It has demonstrated the ability to inhibit carrageenin-induced foot swelling and prevent adjuvant-induced arthritis.
Corydalis (Yan hu suo): Has antiinflammatory properties. It inhibits histamine release and formation of edema in rats and has been shown to be effective for both acute and chronic inflammation. It increases the efficacy of acupuncture in inducing analgesia.
Dipsacus (Xu duan): Has antiinflammatory properties. It can inhibit foot swelling in hamsters and dimethyl benzene-induced ear inflammation.
Dragon’s blood (Xue jie): Has been used to treat arthritis. In one study involving 150 participants with arthritis, 84% reported marked reduction in symptoms and 10% more reported some pain relief.
Drynaria (Gu sui bu): Was used to treat 160 mice with osteoarthritis with good results.
Eucommia bark (Du Zhong): An effective analgesic.
Jujube (Da zao): Has antiinflammatory effects. It has been shown to prevent dimethylbenzene-induced ear swelling in mice and egg-white-induced toe swelling in rats.
Lycopodium (Shen jin cao): Has antiinflammatory and analgesic effects. It ameliorates heat-induced pain and reduces dimethylbenzene-induced ear swelling.
Mastic (Ru xiang): Contains boswellic acids, which have antiinflammatory effects in vivo and in vitro. Mastic decreases signs of arthritis in dogs.
Myrrh (Mo yao): A very good analgesic, especially when combined with ru xiang.
Pubescent angelica root (Du hou): Has demonstrated analgesic and antiinflammatory effects in mice.
White atractylodes (Bai zhu): Has been used with some success in patients suffering from chronic leg pain.
White peony (Bai shao): Contains paeoniflorin, which is a strong antiinflammatory. In one trial, 65% of people suffering from painful conditions experienced relief when given white peony.
Appropriate Chinese herbs for forelimb osteochondrosis
Aconite / chuan (Chuan wu): See above.
Angelica (Bai zhi): See above.
Cinnamon twigs (Gui zhi): Have analgesic properties. In one trial, 30 patients were treated with a formula containing cinnamon twigs and other herbs. There was complete recovery in 50%, marked improvement in 20%, and some improvement in 17%. Thirteen percent did not respond.
Ginger (Sheng jiang): Has antiinflammatory effects. It decreases dimethylbenzene-induced ear swelling in mice and egg-white-induced toe swelling in rats. It has been used to treat patients with arthritis. In one trial 113 of 125 people with arthritis responded to injections of ginger into acupoints.
Jujube fruit (Da zao): See above.
Licorice (Gan cao): Has analgesic effects, especially when administered with white peony (Bai shao).
Lycopodium (Shen jin cao): See above.
Mastic (Ru xiang): See above.
Myrrh (Mo yao): See above.
Notopterygium (Qiang huo): Has both antiinflammatory and analgesic effects. It can inhibit xylol-induced ear lobe swelling and carrageenin-induced foot swelling in mice, and increase the thermal pain threshold.
White peony (Bai shao): See above.
Many people seek acupuncture therapy for musculoskeletal pain. Clinical trials have shown that arthritis can be treated successfully using acupuncture.
General considerations / rationale
Osteochondrosis represents a Deposition or Degeneration phase homotoxicosis. Therapy is directed at improving the status of the mesenchymal tissues. In early cases, these lesions may heal without surgery, and early intervention with antihomotoxic medications may assist the body in its innate reparative processes. Early diagnosis through radiography, MRI, or bone scans may assist in determining the optimal therapy for each patient.
Appropriate homotoxicology formulas
See Arthritis and Autoimmune Arthritis for a more complete discussion of remedies.
No controlled studies exist at this time for use of antihomotoxic agents in osteochondrosis, but appropriate selections include:
Coenzytne compositum: Supports energy metabolism. Succinate is useful in retarded development, which this condition may represent.
Discus compositum: Treats inflammation and degeneration of mesenchyme.
Lymphomyosot: Reduces swelling and improves lymphatic drainage with a corresponding decrease in local homotoxin levels.
Osteoheel: Supports bony structures. Can be alternated with Traumeel for maximal effect.
Placenta compositum: Provides support of stem cells and vasculature.
Molybdan compositum: Provides trace elements in degenerative conditions.
Thyroidea compositum: Acts on the thymus and therefore may assist in growth irregularities and support a wide variety of endocrine tissues. It is also a powerful agent in drainage of the mesenchyme.
Traumeel S: Used for inflammation and to unblock inactivated enzymes.
Ubichinon compositum: Provides support of energy metabolism in deeper homotoxicoses.
Zeel: An antiinflammatory agent with regenerative potential through activation of stem cells.
Authors’ suggested protocols
Cartilage / ligament / muscle / skeletal support formula: 1 tablet for every 25 pounds of body weight BID.
Eskimo fish oil: One-half to 1 teaspoon per meal for cats. 1 teaspoon for every 35 pounds of body weight for dogs.
Evening primrose oil: 1 capsule (500 mgs) per 25 pounds of body weight, daily.
Zyflamend: One-half dropper for every 25 pounds of body weight BID.
SOD: Follow manufacturer’s suggested dosage.
Chinese herbal medicine
The author recommends Formula H3 ElboPhlex for osteochondrosis of the front legs and H97 HipGuard for osteochondrosis of the hind legs at a dose of 1 capsule per 10 to 20 pounds, twice daily. They can be combined with NSAIDs and / or nutraceuticals as needed. Generally speaking, it takes up to 3 to 6 months for complete resolution of signs in most cases.
H97 HipGuard: Contains achyranthes (Niu xi), aconite / chuan (Chuan wu), angelica (Bai zhi), angelica root (Dang gui), astragalus (Huang qi), atractylodes (Cang zhu), cinnamon (Rou gui), citrus (Chen pi), corydalis (Yan hu suo), curcuma (Yu jin), dioscorea (Chuan shan long), dipsacus (Xu duan), dragon’s blood (Xue jie), drynaria (Gu sui bu), eucommia bark (Du Zhong), eupolyphaga (Tu bie chong), jujube (Da zao), lycopodium (Shen jin cao), mastic (Ru xiang), morinda (Ba ji tian), myrrh (Mo yao), pubescent angelica root (Du huo), white atractylodes (Bai zhu), and white peony (Bai shao). The herbs not mentioned above (under Appropriate Chinese Herbs) help increase the efficacy of the formula.
H3 ElboPhlex: Contains aconite / chuan (Chuan wu), angelica (Bai zhi), centipede (Wu gong), cinnamon twigs (Gui zhi), codonopsis (Dang shen), dioscorea (Chuan shan long), ginger (Sheng Jiang), jujube fruit (Da zao), licorice (Gan cao), lycopodium (Shen jin cao), mastic (Ru xiang), mulberry twig (Sang zhi), myrrh (Mo yao), not-opterygium (Qiang huo), papaya (Mu gua), pueraria (Ge gen), and white peony (Bai shao). The additional herbs not discussed above (under Appropriate Chinese Herbs) increase the efficacy of the formula.
For the hindlimbs, the author recommends the following acupuncture points: ST36, ST37, Baihui, BL60, GV4, and BL23. For the forelimbs, the author recommends LI11, PC6, SI9, Baihui, and BL23.
Discus compositum: Give every 3 days PO or SQ, alternating with Thyroidea compositum. Give Ubichinon compositum twice weekly.
Aesculus compositum, Traumeel, and Lymphomyosot: Mix together and give orally BID.
Osteoheel, Calcoheel, and / or BHI-Bone: Give orally BID as indicated by the individual case.
Zeel: Give tablets BID, and / or Zeel P vials injected into acupoints for the affected joint every week.
Molybdan SID: Use for mineral donor support.
Cartilage / ligament / muscle / skeletal support formula:
Animal Nutrition Technologies. Alternative: Cosequin — Nutramax Labs; Glycoflex — Vetri Science; Musculoskeletal support — Standard Process Veterinary Formulas; Nutriflex — Vet Rx Vitamins for Pets; Arthragen — Thorne Veterinary Products.
Evening primrose oil: Jarrow Formulas.
Eskimo fish oil: Tyler Encapsulations.
Zyflamend: New Chapter. Alternative: Botanical Treasures — Natura Health Products.
SOD: Cell Advance — Vetri Science; NaturVet SOD; BioPet International; N-Zymes.com.
Chinese herbal medicine
Formulas H3 ElboPhlex, H97 HipGuard: Natural Solutions, Inc.
BHI / Heel Corporation