Dietary Supplements Guide for Joint Health in Dogs

If your pets are anything like ours, we’re willing to bet they’ll jump through hoops for you. But the older they get, the harder literally jumping can be.

Arthritis — specifically osteoarthritis, a degenerative inflammatory disease caused by the loss of joint cartilage — affects one in four dogs, or roughly 15 million in the US. And for older canines, osteoarthritis (OA) affects more than 80% of the house-dog population^1,2.

---

Dog Joint Problems: Causes & Symptoms 

There are many risk factors for joint issues in our canine friends. One major factor is age¹, with OA affecting greater than 80% of elderly dogs.³ Other risk factors include weight, trauma, male gender and breed.^1,2 Large breed dogs as a whole are more prone to joint problems, possibly due to increased weight, genetic predisposition, rapid aging, and increased risk of injury.^4,5

However, some issues are merely breed-specific, for example, Bulldogs and Boykin Spaniels, despite their medium build, are known to be at risk of hip dysplasia, a form of OA present in hip joints²; and Newfoundlands experience cruciate ligament disease, an orthopaedic disorder of the knee, more than any other breed.^6,7 

The list of risk factors continues to grow, and newer research is even looking into how your dog’s microbiome affects their joint health.

Joint Issue	Breeds at High Risk
Osteoarthritis	Old English Sheepdogs, Rottweilers, Dogue de Bordeauxs, and large breed dogs in general
Hip dysplasia	Bulldogs, Boykin Spaniels
Cruciate ligament disease	Newfoundlands

Regular maintenance of joint stability with strengthening and exercise can be a major prevention tactic of more serious, irreversible diseases.

Additionally, several dietary supplements (discussed in detail below) are proving to help maintain canine joint health and prevent more serious conditions. So regularly supplementing your dog may be something to consider before clinical symptoms of joint pain even occur. However, even with preventative measures taken, the high prevalence of joint issues in our canine friends means all pet owners should be aware of signs and symptoms.

Watch out for signs of pain, which is the number one symptom of impaired joint health in dogs.¹ Also look for mobility issues, cracking joints, joint stiffness, weakness, and fatigue.^2,8 Additionally, as a result of these symptoms, especially pain, joint issues in dogs are associated with anxiety, fear, and overall reduced quality of life.^3,9 Once joint diseases occur, therapeutic methods shift from prevention to management of your pet’s pain and their clinical symptoms, as well as slowing the disease progression.¹⁰ 

---

An Overview of Treating Joint Pain in Dogs 

Historically, non-steroidal anti-inflammatory drugs (NSAIDs), i.e. carprofen and meloxicam, and corticosteroids have been the conventional treatment methods for canine joint pain.² However, NSAIDs come with potential detrimental side effects such as gastrointestinal bleeding, kidney dysfunction, liver disease, and vomiting.⁴

Other treatment options range from a balanced diet with elevated protein and essential fatty acids to weight management and lifestyle changes to physical therapy and in some cases of severe predisposing abnormalities, surgery.¹⁰

Joint supplements for dogs are proving themselves as a viable alternative to drug-based treatment methods, providing the same clinical advantages without the damaging side effects.⁸  Furthermore, they are gaining popularity not only as a treatment option but as a potentially preventative option, addressing more than just the pain, but also the development of the condition.¹¹ Coming in many different forms—like chewables, powders, pills, and supplements in your dog’s food—joint supplements have the added bonus of versatility! 

With the rising buzz about dietary supplements for joint health, there is a lot of information and intrigue flying around. So much so, it can become hard to distinguish truths from claims. So let’s narrow it down here and focus on what the science says.

---

Dietary Supplements  

Eggshell Membrane

 

What is it? 

Eggshell membrane is a newfound dietary supplement, extracted from the layer between the calcified shell and the albumin in chicken eggs. It is a natural source of fibrous proteins and essential molecules of cartilage (glycosaminoglycans).¹² 

Where is it found?

Eggshell membrane is commercially available as 100% Natural Eggshell Membrane (NEM®) from Stratum Nutrition - ESM Technologies LLC, Carthage, MO, USA.¹³  A common brand of NEM® for dogs is REDD Remedies RE-NU for Pets is easily found online.¹⁴ While the same NEM® Eggshell Membrane is used in human grade products, and would be safe for your dog, pet-specific products show ideal dosages and are designed to taste delicious!

How does it help joint health in dogs?

 

Studies show dietary supplementation with 150mg of eggshell membrane daily for 6-weeks, decreased pain and mobility issues associated with joint degradation in dogs. Additionally, serum levels of CTX-II, a known biomarker of joint degradation in dogs, were decreased.³ Furthermore, eggshell membrane has been shown to increase canine quality of life and has exhibited great tolerability, posing no safety concerns other than egg allergy.³ Thus, eggshell membrane has demonstrated itself as a safe dietary supplement for cartilage health in dogs, displaying not only symptom relief but chondroprotective effects (delays joint space narrowing and protects cartilage cells). 

Eggshell membrane, while mainly composed of fibrous proteins also contains glycosaminoglycans such as chondroitin and glucosamine.¹³ Chondroitin and glucosamine, have also shown some promise as dietary supplements for joint care for dogs.³ 

Glucosamine/Chondroitin

 

What is it? 

Glucosamine is a precursor of glycosaminoglycan, which is fundamental in joint cartilage production.¹⁵ Glucosamine, is involved in joint lubrication, helps to rebuild cartilage, and has anti-inflammatory properties. Chondroitin, a type of glycosaminoglycan, helps hydrate joints, repair damaged tissue, and protect degenerated cartilage.² 

Where is it found? 

 

There are a wide variety of glucosamine and chondroitin products for dogs readily available on the market. The products differ in their doses (300 to 1600mg glucosamine combined with 400 to 1200mg chondroitin) and additional active ingredients (i.e. MSM, Type II Collagen), and some products offer varying doses dependent on dog size.¹⁶ DASUQUIN® with MSM Chewable tablets, available at your local pet store or online, offers a small to medium dogs (<10lbs - 59lbs) product containing 600mg glucosamine and 250mg chondroitin, with the recommended dose ranging from ½ tablet to 2 tablets based on weight. The large dog (60-120lbs) product contains 900mg glucosamine and 350mg chondroitin with a suggested dose of 2 tablets initially and 1 tablet for maintenance.^16,17 Commonly available forms include soft chews, tablets, and liquid made to taste delicious with dog-specific doses!¹⁶

How does it help joint health in dogs?

 

Both glucosamine and chondroitin production decreases with age, so dietary supplementation is imperative.² In dogs, glucosamine and chondroitin given in combination has yielded positive results including stimulating cartilage metabolism while inhibiting deterioration, decreasing pain, and improving ability to support weight.¹⁵ Minor gastrointestinal issues were the only associated side effect.¹⁵ Although the ideal dosage and form of glucosamine and chondroitin is still being investigated, complementary effects have been noted when given in combination versus alone.^8,15 Different durations of monitoring periods have led to varying results, however, it’s likely that glucosamine and chondroitin when effective take about 2 months to produce results.

Additionally, one study demonstrated that glucosamine and chondroitin given in combination with undenatured type II collagen (UC-II) was more successful overall at reducing pain and improving activity in dogs than glucosamine and chondroitin given alone.⁸

Type II Collagen

What is it? 

 

Type II collagen is the main structural protein found in cartilage, and is essential for maintenance of strength and stability.⁴ Undenatured (natural, not processed) type II collagen (UC-II), being a protein, is composed of amino acids, which are essential for cartilage reconstruction and vitality.⁸

Where is it found? 

 

The supplemental form of type II collagen, is almost exclusively the undenatured (natural) form as it has been shown to be much more effective for joint health than the denatured (processed) form.⁴ A trusted and patented collagen product is, UC-II® produced by InterHealth Nutraceuticals Inc., Benicia, CA, USA from chicken sternum cartilage in capsule form, available in 1mg or 10mg dosages.⁴ UC-II® is readily incorporated into a chew treat for dogs usually in combination with other nutrients (i.e. MSM, glucosamine, omega-3 fatty acids, vitamin E), try Flexadin Advanced Chew with UCII or TRP-TRi-COX soft chews are easily found at your local pet store or online. Human grade UC-II® products are safe for dogs, and might be an option for pet owners looking to supplement their dog with solely UC-II, however, human products are often provided at a 40mg dose as opposed to the recommended 10mg for dogs. 

How does it help joint health in dogs?

 

Dietary supplementation with both 1mg and 10mg UC-II daily, has been shown to be effective at reducing pain and increasing overall activity in arthritic dogs.^4,18 UC-II, taken as a dietary supplement has exhibited no negative effects, and may work by countering the immune response aimed at destroying type II collagen in joint cartilage, thus improving joint mobility and inflammatory balance.^4,18 With continuous and prolonged supplementation, a 10mg dose of UC-II appears highly tolerable and effective at improving the lifestyle of dogs with joint pain.^4,18

Vitamin E

What is it? 

 

Vitamin E, is an essential fat-soluble vitamin with potent antioxidant and anti-inflammatory effects, known to protect cell membranes from destruction by free radicals (unstable cell-damaging molecules).¹⁹

Where is it found? 

 

Vitamin E, consists of four tocopherols, with alpha-tocopheryl acetate serving as the main form found in tissues and used in dietary supplements for dogs.^19,20 Vitamin E is produced naturally by plants and found readily in peanuts, sunflower seeds, almonds, and many fruits and vegetables. Furthermore, vitamin E being fat-soluble, is commonly found in foods that contain fat which includes many meats as well.²⁰ Most nutritionally balanced dog food will contain at least the minimum requirement of vitamin E for dogs. However, when dogs could benefit from additional vitamin E, available forms vary from capsule, liquid, and soft chew. Your vet may recommend a human-grade vitamin E oil or capsule for vitamin E supplementation alone. However, vitamin E for dogs is often found in combination with MSM, glucosamine, and collagen, in products like VetriScience Laboratories Glyco-Flex III soft chews.¹⁶

How does it help joint health in dogs?

 

Free radicals, form constantly within the body, and they can be extremely destructive to joint tissues in dogs. Free radicals inhibit collagen synthesis, and with collagen being the main structural protein found in cartilage, this can be crippling to joints. Furthermore, free radicals activate cartilage degrading enzymes and promote inflammation.^21,22 The anti-inflammatory properties of vitamin E supplementation in humans is well accepted,²⁰ additionally, there is evidence that vitamin E supplementation may be helpful at improving OA progression in humans.²³ More studies are displaying these joint protective properties are transferable to dogs. One study demonstrated that supplementation with a multivitamin antioxidant, containing vitamin E, improved clinical symptoms of OA in dogs.²² Another study showed dogs receiving 400 IU of vitamin E daily reduced production of pro-inflammatory markers, experienced less joint pain, had lower free radical concentrations, and reduced cartilage damage.¹⁹ Vitamin E as a cell-protecting antioxidant should be highly considered as a dietary supplement for maintenance of joint health in dogs. 

Methylsulfonylmethane

What is it? 

 

Methylsulfonylmethane (MSM) is a naturally occurring organic sulfur-containing compound that has anti-inflammatory properties.²¹

Where is it found? 

 

MSM can be found naturally in small amounts in some foods including milk and several fruits, vegetables, and grains. However, it is commonly produced commercially from the oxidation of dimethylsulfoxide (DMSO) for use in dietary supplements.²⁴ Commonly, it is found in multicomponent dietary supplements, often in combination with glucosamine and chondroitin, and may even aid in enhancing the absorption of glucosamine.²⁵ Many of these supplements contain MSM in dosages ranging from 400mg to 1000mg, with the dosage varying based on product composition and dog size.¹⁶ Several of the joint support multicomponent dog chews mentioned already contain MSM within them including, DASUQUIN® with MSM Chewable tablets, TRP-TRi-COX soft chews, and VetriScience Laboratories Glyco-Flex III soft chews.

How does it help joint health in dogs?

 

MSM is often recommended as a dietary supplement to support joint health in dogs. This is because MSM is an antioxidant, has anti-inflammatory and analgesic effects, and may serve as a source of sulfur which is an important precursor to joint health.²¹ Studies analyzing the effects of MSM alone are absent, however, MSM is often used in multicomponent dietary supplements for joint health in dogs.²⁵

Omega-3 Fatty Acids

What is it? 

Omega-3 fatty acids are a class of polyunsaturated fatty acids that are associated with many health benefits and are essential in the diet. The three main forms of omega-3 fatty acids are alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).⁸

Where is it found? 

 

Omega-3 fatty acids are found in the foods we eat, such as fish, flaxseeds, and walnuts.⁸ Fish oil, is commonly used to provide EPA and DHA, with a suggested supplemental dose of 50-75mg EPA+DHA (combined) per kg body weight.²⁶ Not all fish oil supplements are created equal, and it is best to make sure to choose a supplement from a company with high standards of production and quality control.²⁶ Historically, wild salmon were the primary source of fish oil, however, nowadays concerns around overfishing and heavy metal toxicity exist.²⁷ Furthermore, farm-raised salmon may not solve the issue, as omega-3 fatty acid content will depend on their diet and there are concerns about contamination and parasites due to low-quality fish farms.^27,28 To address environmental, toxicity, and quality concerns, the ideal sources of fish oil are from smaller non-predatory fish including anchovies and sardines.²⁷ Nordic Naturals Omega-3 Pet, is a third-party tested, sustainably sourced anchovy and sardine oil, with dosing recommendations based on dog size, available as a liquid or soft gel.

How does it help joint health in dogs?

 

Supplementing your dog with healthful oils, like fish oil, as a source of omega-3 fatty acids, may be something to consider for joint health and mobility. Several studies have shown that dogs with OA can improve weight bearing, mobility, and clinical symptoms of OA via fish oil supplementation.^10,11 Another study indicated that a fish oil-enriched diet containing 1.75g EPA/kg diet and 2.2g DHA/kg diet, was associated with reduced inflammatory markers in dogs.²⁹ It was also shown in dogs with inflammatory joint disease, that supplementation with fish oil helped improve mild to moderate joint inflammation.³⁰ However, it should be noted, that omega-3 supplementation in dogs may have some potential adverse effects, including diarrhea, weight gain, altered immune function, and possible drug interactions.³¹ Nonetheless, as a bonus, beyond their role in joint care, omega-3 fatty acids have also shown to be beneficial to heart, kidney, and neurological health in dogs.³²

---

The Bottom Line

Evidence indicates that dietary supplements are a safe method of preventing, slowing progression, and controlling clinical symptoms of joint diseases in dogs. As with humans, none of these supplements can reverse structural damage already present within a dog’s joints, but they can reduce inflammation and strengthen joint tissues. 

The high prevalence of joint issues in dogs indicates that starting your dog on a supplement to promote healthy joints and prevent problems may be something to consider. The list of joint supplements discussed here is not comprehensive, and the best joint supplement for your dog will depend on external factors such as overall health. Finally, all dietary supplements are not created equal and vary in quality, form, and dose. So, as always, before adding any joint supplements into your dog’s life, talk to your veterinarian.
 

---

References

1. 1. Brown, D. C. What can we learn from osteoarthritis pain in companion animals? Clin. Exp. Rheumatol. 35, S53–S58 (2017).
   2. Bland, S. D. Canine osteoarthritis and treatments: a review. 1 (2015). doi:10.4081/vsd.2015.5931
   3. Ruff, K. J. et al. Effectiveness of NEM® brand eggshell membrane in the treatment of suboptimal joint function in dogs: a multicenter, randomized, double-blind, placebo-controlled study. Vet Med (Auckl) 7, 113–121 (2016).
   4. Deparle, L. A. et al. Efficacy and safety of glycosylated undenatured type-II collagen (UC-II) in therapy of arthritic dogs \S. J. Vet. Pharmacol. Ther. 28, 385–390 (2005).
   5. Anderson, K. L. et al. Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Sci. Rep. 8, 5641 (2018).
   6. Eckstein, S. Dog Joint Health: Pain, Osteoarthritis, and Other Joint Problems in Dogs. WebMD (2009). Available at: https://pets.webmd.com/dogs/guide/dog-joint-health-pain-osteoarthritis-and-other-joint-problems. (Accessed: 25th June 2019)
   7. Wilke, V. L. et al. Inheritance of rupture of the cranial cruciate ligament in Newfoundlands. J. Am. Vet. Med. Assoc. 228, 61–64 (2006).
   8. Comblain, F., Serisier, S., Barthelemy, N., Balligand, M. & Henrotin, Y. Review of dietary supplements for the management of osteoarthritis in dogs in studies from 2004 to 2014. J. Vet. Pharmacol. Ther. 39, 1–15 (2016).
   9. Lascelles, B. D. X., Brown, D. C., Maixner, W. & Mogil, J. S. Spontaneous painful disease in companion animals can facilitate the development of chronic pain therapies for humans. Osteoarthritis Cartilage 26, 175–183 (2018).
   10. Fritsch, D. et al. Dose-titration effects of fish oil in osteoarthritic dogs. J. Vet. Intern. Med. 24, 1020–1026 (2010).
   11. Roush, J. K. et al. Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. J. Am. Vet. Med. Assoc. 236, 67–73 (2010).
   12. Ruff, K. J. et al. Beneficial effects of natural eggshell membrane versus placebo in exercise-induced joint pain, stiffness, and cartilage turnover in healthy, postmenopausal women. Clin. Interv. Aging 13, 285–295 (2018).
   13. Ruff, K. J., Winkler, A., Jackson, R. W., DeVore, D. P. & Ritz, B. W. Eggshell membrane in the treatment of pain and stiffness from osteoarthritis of the knee: a randomized, multicenter, double-blind, placebo-controlled clinical study. Clin. Rheumatol. 28, 907–914 (2009).
   14. All Natural Pet Joint Health Ingredient Containing 3X the Benefits | NEM®. Available at: https://www.stratumnutrition.com/ingredients/pet/nem%C2%AE. (Accessed: 23rd August 2019)
   15. McCarthy, G. et al. Randomised double-blind, positive-controlled trial to assess the efficacy of glucosamine/chondroitin sulfate for the treatment of dogs with osteoarthritis. Vet. J. 174, 54–61 (2007).
   16. Bhathal, A., Spryszak, M., Louizos, C. & Frankel, G. Glucosamine and chondroitin use in canines for osteoarthritis: A review. Open Veterinary Journal 7, 36–49 (2017).
   17. DASUQUIN® with MSM Chewable Tablets | Dasuquin.com. Available at: https://www.dasuquin.com/en/dasuquin-chewable-tablets-w-msm/. (Accessed: 23rd August 2019)
   18. Peal, A. et al. Therapeutic efficacy and safety of undenatured type-II collagen (UC-II) alone or in combination with (-)-hydroxycitric acid and chromemate in arthritic dogs. J. Vet. Pharmacol. Ther. 30, 275–278 (2007).
   19. Rhouma, M., de Oliveira El Warrak, A., Troncy, E., Beaudry, F. & Chorfi, Y. Anti-inflammatory response of dietary vitamin E and its effects on pain and joint structures during early stages of surgically induced osteoarthritis in dogs. Can. J. Vet. Res. 77, 191–198 (2013).
   20. Jiang, Q. Natural forms of vitamin E: metabolism, antioxidant, and anti-inflammatory activities and their role in disease prevention and therapy. Free Radic. Biol. Med. 72, 76–90 (2014).
   21. Budsberg, S. C. & Bartges, J. W. Nutrition and Osteoarthritis in Dogs: Does It Help? Vet. Clin. North Am. Small Anim. Pract. 36, 1307–1323 (2006).
   22. Impellizeri, J. A., Lau, R. E. & Azzara, F. A. Fourteen week clinical evaluation of an oral antioxidant as a treatment for osteoarthritis secondary to canine hip dysplasia. Vet. Q. 20 Suppl 1, S107–8 (1998).
   23. Chin, K.-Y. & Ima-Nirwana, S. The Role of Vitamin E in Preventing and Treating Osteoarthritis - A Review of the Current Evidence. Front. Pharmacol. 9, 946 (2018).
   24. Kim, L. S., Axelrod, L. J., Howard, P., Buratovich, N. & Waters, R. F. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage 14, 286–294 (2006).
   25. Martinez, S. E., Lillico, R., Lakowski, T. M., Martinez, S. A. & Davies, N. M. Pharmacokinetic Analysis of an Oral Multicomponent Joint Dietary Supplement (Phycox®) in Dogs. Pharmaceutics 9, (2017).
   26. Lenox, C. E. Role of dietary fatty acids in dogs & cats. TVP Journal 83–90 (2016).
   27. Kwochka, K. W. Fatty acids in veterinary dermatology and beyond: mechanism of action, clinical indications and quality. in SPONSORS OF THE 8 TH WORLD CONGRESS OF VETERINARY DERMATOLOGY 216 (pdfs.semanticscholar.org, 2016).
   28. Lenox, C. E. Timely Topics in Nutrition: An overview of fatty acids in companion animal medicine. J. Am. Vet. Med. Assoc. 246, 1198–1202 (2015).
   29. LeBlanc, C. J., Horohov, D. W., Bauer, J. E., Hosgood, G. & Mauldin, G. E. Effects of dietary supplementation with fish oil on in vivo production of inflammatory mediators in clinically normal dogs. Am. J. Vet. Res. 69, 486–493 (2008).
   30. Hansen, R. A. et al. Fish oil decreases matrix metalloproteinases in knee synovia of dogs with inflammatory joint disease. J. Nutr. Biochem. 19, 101–108 (2008).
   31. Lenox, C. E. & Bauer, J. E. Potential adverse effects of omega-3 fatty acids in dogs and cats. J. Vet. Intern. Med. 27, 217–226 (2013).
   32. Bauer, J. E. Therapeutic use of fish oils in companion animals. J. Am. Vet. Med. Assoc. 239, 1441–1451 (2011).