About

Pet joint health

Recognizing the signs:

Are they slow getting up from a resting position?
Do they have trouble getting in the car or up the stairs?
Are they much slower on recent walks?
Are they sensitive to touch and become aggressive?

It is important to observe pets closely:

Decreased activity?
Reluctance to walk, run, jump or play?
Lagging behind on walks?
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Acting aggressive or withdrawn?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 pet can be active again!

Understanding joint anatomy:
joint diagram To understand joint health, 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 limited and articular cartilage becomes vulberable. 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. When these two are damaged, problems are unavoidable.

How vets recognize problems:

First your vet will evaluate the case history of your pet. As part of this backgrounding your vet may ask you several questions about your pet's care and activities to determine a potential cause of the joint concern.

Next your vet will do a physical examination of your pet. This usually involves palpating the areas of concern. Most vets are very skilled with their hands and can often feel if a joint is not functioning correctly.

The veterinarian will inspect your pet at a walk and a run. They will walk them in a straight line watching for any abnormalities.

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 pet is observed while walking and running. Often times this will exaggerate the condition 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 might be the cause.

Your veterinarian may remove by needle some of the synovial fluid located in the joint to determine if an infection is present.

Deterring health problems:
Older pets have a variety of health problems due to a number of environmental stressors, but you can help relieve some of these stresses by:

Avoiding obesity and heavy loads

Providing your pet with suitable bedding

Avoiding quick changes in duration or intensity of exercise

Avoiding hard and unstable ground surfaces

Feeding a diet high in protein and other nutrients. Joints can never repair or become stronger without proper nutrition.

In summary
Pet owners should become very familiar with recognizing joint health in their pets. Because joint problems are progressive, acting early can give your pet a better chance at getting back to their normal activities such as walking and running. Often times, the joint is far past repair and is quite likely that the animal will never regain normal movement.

HyaFlex™ in-depth

Description
HyaFlex™ is hyaluronic acid (HA) in solution for oral administration. The hyaluronic acid in HyaFlex™ is one of the purest and highest in molecular weight. The molecular weight is no less than 2.4 million Dalton’s. HyaFlex™ Oral HA helps to support your pet's joint, skin, eye and gum health.

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.

What is hyaluronic acid?
Hyaluronic acid is a special mucopolysaccharide occurring naturally throughout the animal’s body. One of the most heavily researched substances in medicine today with thousands of clinical trials mostly in the fields of orthopedics, eye surgery and oncology. Its function in the body is, amongst other things, to bind water and lubricate movable parts of the body, such as joints and muscles. Its consistency and tissue-friendliness allows it to be used in skincare products as an excellent moisturizer. Hyaluronic acid is one of the most hydrophilic molecules in nature and is described as “nature’s moisturizer”.

Key benefits of hyaluronic acid

Joint mobility
Joint flexibility
Joint function
Cartilage function

Directions for use
Add one (1) ml (full dropper) one time daily or as recommended per body weight.

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 hyaluronic acid (HA) and what is its function?
Hyaluronic acid is a naturally occurring compound found in the joints and connective tissue of all mammals. HA acts as the lubricant for joints--kind of like liquid ball bearings. Hyaluronic acid has been introduced directly into the knee joints of humans and horses for many years, yielding excellent benefits.

Why does my pet need a hyaluronic acid product?
Hyaluronic acid is naturally produced by the body as a constituent of synovial fluid that lubricates the cartilage between the joints. As your pet ages, their body produces less and less HA and it becomes more and more difficult to replenish it and the cartilage and other structures of the joint begin to need support. Joints become less flexible and movement is limited. HA supplements pick up where their bodies fail them.

What does HA do for my pet's joints?
The HA in HyaFlex™ helps to improve joint movement and cushioning. If we compare the joints of your pet's body to and automobile engine, the joint fluid in their body mimics the oil in a car engine. At regular intervals we replace the oil in our car engines because the heat and friction breakdown the oils viscosity. The oil becomes thinner and less able to protect the metal surfaces from excessive wear. HyaFlex™ acts the same way in our joints. As your pet ages, the viscosity of their joint fluid breaks down and becomes thin and is unable to cushion the joint cartilage. This leads to increased friction on the cartilage surfaces of their joints. Taking HyaFlex™ helps maintain the normal viscosity of joint fluid.

What if my pet doesn’t have joint issues?
If you are not currently experiencing joint issues then HyaFlex™ may be used to provide benefits in the long run. Just as we change the oil in our car to help stop problems, taking HyaFlex™ may help your pets by maintaining proper joint fluid viscosity. Also, hyaluronic acid production slows down considerably as pets age, which accounts in part for the wrinkling of the skin, and the joint issues, so it makes good sense to compensate with HA.

How do I give HyaFlex™ to my pet?
Just administer the specified amount (shown on the side of the box) of HyaFlex™ to your pet once daily. HyaFlex™ is odorless and tasteless so your pet won’t even notice it. Each bottle of HyaFlex™ contains a 30-60 day supply depending on the weight of the animal.

Where does the hyaluronic acid in HyaFlex come from?
The hyaluronic acid in Hya-Flex comes from an extracellular protein produced by natural fermentation. This product is not derived from any animal source. Hypersensitivity reactions should not be a concern. Natural fermentation can yield higher molecular weight HA. The weight of the molecule directly influences its "moisture-binding" capability, and HyaFlex™ has the highest molecular weight HA in the market. This may explain the phenomenal results we are experiencing.

Do doctors and veterinarians use hyaluronic acid?
Yes. Hyaluronic acid has been directly injected by needle into affected joints. This has yielded great results by immediately increasing the viscosity of the joint fluid and restoring proper lubrication and cushioning. More work has been done in the field of orthopedics, cosmetic and eye surgery.

How long has HA been used?
Hyaluronic acid was first used commercially in 1942 when Endre Balazs applied for a patent to use it as a substitute for egg white in bakery products. He went on to become the leading expert on HA, and made the majority of discoveries concerning HA.

Because it is an acid will it burn mine or my pet’s skin or stomach?
Hyaluronic acid is often called an acid and this is a misnomer. Hyaluronic acid as a sodium salt (sodium hyaluronate)(HyaFlex™) 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.

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 OA of 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 Arthritis 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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