VOLUME 54 (4) 1999 CLINICAL TRIAL WITH “CARTOFLEX” AS A TREATMENT AGAINST LIMITATIONS CAUSED BY DEGENERATIVE JOINT DISEASE DUE TO HIP DYSPLASIA IN DOGS U. Bargai Koret School of Veterinary Medicine, The Hebrew University, P.O. Box 12 , Rehovot , Israel 76100 Summary "Cartoflex”, a natural collagen type II product was given to a group of 8 dogs with hip dysplasia and degenerative joint disease. The dogs received 30 mg of the product per os in a capsule each day. Five dogs remained under treatment for a period of 12 months. In four of them, clinical signs of lameness disappeared completely. In contrast there was no improvement in DJD radiographic examination. Introduction "Cartoflex" is a product made from natural collagen type II, that was reported to suppress arthritis in rats (1).In human clinical trials it was shown to have beneficial effects in patients suffering from rheumatoid arthritis,when given by mouth(2,3). The clinical limitations seen in dogs suffering from DJD in the pelvic joint due to hip dysplasia are a concern to their owners. As the degenerative changes progress, the dog is increasingly unable to run freely for more than a few hundred meters or to climb stairs . These dogs may even be reluctant to rise from a resting position. When a veterinarian is approached by an owner of a dog with DJD his advice of the course of therapy will be modified by several factors . The age of the dog , its daily routine, the ability of the owner to meet the cost of the treatment and the expectations of the owner from the treatment.Many dogs will not be candidates for surgical treatment, but may respond to medical treatment. Medical treatment however has limitations, such as undesirable side- effects , that steroids have. Their beneficial effect may be short- acting such as pain killers. Even modern NSAID, may have side effects . Thus the dilemma of the practising veterinarian is not easy. In this communication we describe the beneficial effects for dogs of the food additive, "Cartoflex ". Objectives of the study: 1) To test the efficacy of feeding "Cartoflex" to relieve the limitations of movement seen in dogs with hip dysplasia.s 2) to investigate by radiography of the pelvis if the progresion of the DJD in the joint is altered by feeding "Cartoflex". Materials and Methods Eight dogs of various ages and breeds with clinical hip lameness and radiographic findings of DJD due to hip dysplasia were selected for the study. Two more dogs without clinical signs but with radiographic findings of severe hip dysplasia were also included. The grade of the dysplasia of each dog was recorded according to the Israeli Kennel Club , which follows the rules of the International Federation of Cyanology (FCI). The clinical signs were graded in four grades of severity and recorded for each dog at the start of the trial. Each dog received daily by oral administration a capsule of "Cartoflex" containing 30 mg of natural type II collagen powder. The ampules were provided by "LICENTEC" Company, by the Netherlands, and the dose rate was recommended by the manufacturer. The owners of the dogs were thoroughly briefed about the nature of the study and the importance of their cooperation . Every three months the owners were required to get a new supply of capsules and at the same time had to report their effect on tdog , including any side effects. At the end of 6 months, the dogs were given a physical exam and a pelvic radiograph. For five dogs the trial lasted about 12 months. Another four other dogs dropped out earlier because the owners failed to request the capsules. The positive effects of the capsules were recorded on a 4- grade scale, in which complete disappearance of clinical signs was recorded as a 4 grade improvement (++++). 1) In 8 out of 10 dogs which had clinical signs at the onset of the trial, there was an improvement in the clinical condition. 2) In 2 dogs there were no clinical signs at the onset of the trial; one dog dropped out after 1 month. The other dog participated in the trial for the entire 12 months. No clinical signs have developed in this dog during the clinical trial in spite of the very severe dysplasia (grade D). 3) In all the four dogs which participated in the trial for the whole year, the clinical signs of lameness disappeared completely, and the improvement was scored as 4+. 4) Comparison of the pelvic radiographs at the onset of the trial with those of the end did not reveal any improvement of DJD; The opposite was true .The changes progressed as dysplasia. expected in dogs with such a degree of hip 5) Three weeks after the trial ended , the owners of the dogs which did improve considerably were contacted by phone and informed that the improvement was still apparent but to a lesser degree. Results Table 1. The dogs in the clinical trial listed by breed, degree of dysplasia, severity of signs, degree of improvement and duration of the treatment. Discussion The clinical trial described here shows that a daily intake of 30 mg type II collagen in the form "Cartoflex" is very beneficial to dogs with clinical signs of hip dysplasia and the best results were seen in dogs with severe grades of dysplasia (D and E). In these dogs the signs of lameness or clinical physical limitations disappeared entirely. There was no improvement of DJD in the radiographs of the dogs in the trial indicating that collagen II had no effect on the osseus components of the pelvic joint. The beneficial effects of 'Cartoflex" could therefore be attributed to its action on the soft tissues in the joint , such as the cartilage and the synovial membranes. It is well known that pain in an inflamed joint is associated with joint effusion. In the clinical trials of daily intake of "Cartoflex" by human patients with rheumatoid arthritis it was found that there was a marked reduction in the quantity of joint fluid in the inflamed joints of the patients whose condition improved (3). It is therefore reasonable to assume that this occured in the pelvic joint of the dogs in the trial. It is also that there was a process of rejuvenation of growth of cartilage in the joint, as was found in rats (1), but these possibilities have to be examined histologically. Since "Cartoflex" is a natural product of animal origin, it could be given without any time limit. This explains why the product is sold in the Netherlands without prescription. It has a big advantage over chemical drugs, and its use should be encouraged by veterinarians. References 1. Zhengyi Jenny Zang et al . Suppression of adjuvant arthritis in Lewis Rats by oral administration of Type II collagen. Journal of Immunology, Oct 15, 1990. 2. Trentham David E,. Effect of oral administration of type II collagen on rheumatoid arthritis. Science , Sept 24, 1993. 3. Sieper Joachim et al. Die therapie mit oralem Kollagen Typ II also neue Moglichkeit der selektiven immunosuppression in der therapie der reumatoiden arthritis. Zeittschrift Rheumatologie, Band 53 , Heft 2, 1994.