FlexAbility Plus - Horse Joint Supplement
- One of the most comprehensive joint supplements available with proven ingredients provided at effective levels
- The only joint supplement in the UK with a published, peer reviewed paper in The Journal of Equine Veterinary Science
- Unique combination and optimum levels of scientifically proven ingredients
- Glucosamine HCl, Chondroitin Sulfate, MSM, Hyaluronic Acid (HA), Omega 3 – including marine DHA & EPA Omega 3, Vitamin C
- For all horses, young and old, with results seen in as little as 14 days
- 7 lb (1.7kg) tub gives approximately 1-month supply
FlexAbility+ PLUS is one of the highest specification joint supplements available in the UK and now in the US. FlexAbility Plus has two clinical and scientific studies demonstrating the positive effects of joint supplementation, and is the only joint supplement in the UK with a published, peer reviewed paper in The Journal of Equine Veterinary Science. The study is the largest undertaken in recent history and the findings were also accepted and presented at the British Equine Veterinary Association Congress. The clinical trials showed reduction in lameness scores, increased range of motion, increased muscle tone, increased ease of movement, and increased joint flexion. We provide declared levels of key nutrients involved in cartilage synthesis and support, using a unique combination and optimal levels of scientifically proven ingredients, including glucosamine, low molecular weight chondroitin, MSM, omega 3 fatty acids including marine DHA & EPA, Hyaluronic Acid (HA), and bioavailable Vitamin C. With low dust, high palatability, clinical trials, significant results, and manufactured under the strictest conditions in our approved and certified UFAS and BETA NOPS-approved manufacturing facility, you can be confident that this product actually provides results – not just promises. See below for the science behind each active ingredient.
Wear and tear on the skeletal system - particularly the joints - occurs both as the result of exercise training and simply as part of the aging process. A key factor in maintaining joint health and function is an adequate supply of the nutritional building blocks needed to support cartilage turnover and joint lubrication. FlexAbility+ PLUS helps to promote and maintain normal mobility and joint function for all horses and ponies and provides nutrient support for joints against the rigors of training and competition. It can also help to maintain normal mobility and joint function in older animals
Joint damage is much easier to prevent than to treat. Cartilage in particular has limited capacity to heal, so the best time to supplement joint health is before damage has occurred. FlexAbility Plus is suitable for all horses and ponies in training and competition to provide nutrient support for joints, to help to maintain normal mobility and joint function in older animals, and for use in young animals to support normal joint health, development, and mobility. Feed at loading rate for 14 days then reduce to the maintenance rate. Effects can be seen in as little as 7 days, but normally by 10-14 days. What to expect: freer movement, longer stride, less stiffness, increased rolling, more athleticism
The science behind each active ingredient.
We believe that when comparing joint supplements, the key elements to consider are:
- The actual level of active ingredients as declared by the manufacturer
- The rate at which each manufacturer is advising you to feed (This needs to be sufficient to provide the correct level for a horse - not a smaller animal)
- The quality and bioavailability of the ingredients used (Are they an approved and certified manufacturer? When my horse eats this, will it actually be in a digestible and useable form?)
- Do they have any published or clinical data to support their claims?
Chondroitin is a natural component of Aggrecan (a proteoglycan – a protein combined with carbohydrates), a large molecule found in cartilage. Chondroitin has been extensively studied and found to have a synergistic effect when used in combination with Glucosamine. Both Glucosamine and Chondroitin act as building blocks for repair, but also have their own anti-inflammatory properties. Together they counteract inflammation by inhibiting the synthesis of Nitric Oxide Synthase (NOS) and Prostaglandin E2 (PGE2). Chondroitin supplementation has been evaluated in horses in combination with Glucosamine and other ingredients.
Glucosamine is an essential building block for proteoglycans which make up the non-structural component of cartilage. Glucosamine has been recognized as a beneficial nutraceutical for joint health in both horses and humans for many years. It has been shown to reduce inflammation and cartilage turnover. Glucosamine and Chondroitin work synergistically to reduce inflammatory mediators in the joint as well as improving repair.
DHA & EPA are specific types of Omega 3 fatty acids which are only found in substantial amounts in Omega 3 from marine sources. DHA and EPA have been found to be beneficial to many body systems in the horse, including joints, blood, skin, and lungs. It is important to note that Omega 3 from plant sources does not result in increased DHA and EPA in body tissues in horses, which is why we use a unique encapsulated marine DHA and EPA and not a cheaper plant source.
Hyaluronic acid is an essential component of both synovial fluid and proteoglycans. It has been studied in horses - both as an oral nutraceutical but also in injectable forms for use straight into joints or into the vein. Hyaluronic acid shows to improve the visual swelling seen with joint disease, and for use as an oral supplement in isolation daily servings upwards of 100 mg should be used.
MSM Methyl-Sulfonyl-Methane is a natural ingredient used in many supplements because it has two very important properties. Firstly, MSM is a source of sulfur. Sulfur is essential for the maintenance of repair of many structural tissues within the body like skin, hoof and cartilage. Secondly, MSM itself has anti-inflammatory properties, which is why we include MSM to aid in joint comfort and encourage joint health.
Vitamin C (Ascorbyl monophosphate) A natural water-soluble anti-oxidant which under normal situations is made by the horse in the liver. During certain times when excessive amounts of vitamin C are used, and the liver cannot keep up with the demand. Horses in work and older horses all have increased demand for Vitamin C, and studies show that blood and tissue levels are often low in these groups of animals. Vitamin C has been shown to be able to pass from the blood into joint fluid of horses, which allows it to neutralize damaging free radicals that have been produced as a result of excessive wear and tear. As the horse can produce its own Vitamin C, its gut did not adapt for efficient absorption of the vitamin as it occurs naturally in fruit and vegetables in the form of L-Ascorbic acid, unlike the human. When supplementing vitamin C to horses it is important to use a form which can be absorbed efficiently, which is why we only use the more bioavailable and stable for of Vitamin C Ascorbyl monophosphate.
Instructions for Use & Feeding Guide:
Use the 25ml (22.75g) scoop provided
Maintenance* Level 25ml (22.75g) scoops per day
Pony - approximately 550lbs 1.5
Horse - approximately 1100lbs 2.5
Large Horse - over 1650lbs 4
Pony - approximately 550lbs 3
Horse - approximately 1100lbs 5
Large Horse - over 1650lbs 8
*If using FlexAbility for the first time, feed at the loading rate for the first 14 days.
-Mix thoroughly with feed and split between meals where possible.
-Introduce to feed slowly.
-Do not exceed the recommended intake
Ingredients & Composition:
One of our core values is transparency. That’s why we list all the active ingredients per daily feeding rate so you know exactly what your horse is getting.
Per 1100lb maintenance dose (2.5 x 25ml) 55.6g FlexAbility Plus delivers: Glucosamine HCl 10g, MSM 6.5g, Vitamin C (stabilized and bioavailable to horses) 5g, Chondroitin Sulfate (Low Molecular Weight) 4.1g, Omega 3 20g (DHA & EPA 2.9g), Hyaluronic Acid (HA) 150mg.
Glucosamine HCl, Methyl Sulfonyl Methane (MSM), Calcium ascorbyl monophosphate, Chondroitin Sulfate, Fish Oil (EPA & DHA), Hyaluronic Acid (HA).
Crude Protein 17%; Crude Fiber 1%; Crude Oils & Fats 4%; Crude Ash 1%; Sodium 30g/kg; Moisture 3%; Calcium 1%; Phosphorus 1%.
Additives (per kg):
Vitamins: Vitamin C (3a312) 82g. Sensory Additives: Vanilla flavor 2.2g.
Research (limb motion, lameness, ease of movement, muscle tone):
QUESTION: Does feeding an oral joint supplement improve equine limb motion, and orthopedic, physiotherapy and handler evaluation scores?
This study has been published: Murray et al. (2017) A Randomised, Blinded, Crossover Clinical Trial to Determine the Effect of an Oral Joint Supplement on Equine Limb Kinematics, Orthopaedic, Physiotherapy, and Handler Evaluation Scores. Journal of Equine Veterinary Science 50 121–128.
Available at: https://www.sciencedirect.com/science/article/pii/S0737080616304749
*Note: This study was conducted on the original formulation of FlexAbility. The only ingredient difference is FlexAbility PLUS also contains hyaluronic acid.
- Blinded, placebo-controlled crossover study to determine effect of joint supplement.
- Horse limb kinematics, clinical orthopedic, physiotherapy, and handler evaluation.
- Supplement S (FlexAbility, Science Supplements) or placebo was fed to 24 horses for 21 days each.
- S associated with improved kinematics, orthopedic, physiotherapy, and handler grade.
- Potential benefit to use of supplement S in clinical patients during rehabilitation.
Despite the range of oral joint supplements available, there has been very limited research into their efficacy. The study aimed to determine the effect of an oral joint supplement on limb kinematics, orthopedic, physiotherapy, and handler evaluation in horses. Supplement S or placebo P was fed to 24 horses for 21 days each in a random order. Horses were evaluated at days 0 (baseline), 21 (after first treatment), and 42 (after second treatment). Assessments included the following: clinical orthopedic evaluation for straight line/lunging circle in walk and trot; high-speed motion capture determined hind limb kinematics for straight-line trotting; grading of limb range of motion (ROM) and muscle tone based on standardized physiotherapy criteria; handler grading of specific criteria during pasture, groundwork, and ridden exercise. Effect of treatment, sequence, limb, and interactions were investigated using linear-mixed models. S was associated with significantly lower lameness grade in a straight line (P = .001) and circle (P = .010), with individual horses improving up to 2/10 grades over P/baseline. S was associated with significantly improved ROM and muscle tone. Ridden/groundwork scores were significantly higher with S compared to P/baseline. With S, horses were graded significantly higher for “ease of movement” at pasture compared with P/baseline. For horses with hind limb lameness, S was associated with significantly greater tarsal flexion than baseline (4.2% greater, P < .020) or P (2.7% greater, P < .037). S was associated with less lameness and improved physiotherapy scores, ridden/groundwork scores, and pasture “ease of movement.” Increased mid-stance tarsal flexion of lame limbs may indicate improved mobility/comfort during peak loading, supporting a positive effect of S.
Keywords: Horse, Lameness, Nutraceutical, Physiotherapy, Oral joint supplement
- Despite the broad range of equine oral joint supplements available, there has been very limited research into their efficacy.
Aim of Study
To determine the effect of an oral joint supplement on limb motion, and orthopedic, physiotherapy and handler evaluation in horses.
Placebo-controlled = some horses received the joint supplement and some received a supplement with no active ingredients (placebo). Use of a placebo helps reduce bias (seeing a false positive result) and allows for the fact that an improvement might be observed from horses spontaneously improving.
Randomized = which horses were given placebo first was pre-determined by a random system rather than a person deciding at the time of seeing a horse. This removes bias in the results caused by selecting only certain horses (e.g. less lame horses) to have a particular treatment.
Blinded = none of the people assessing the horses knew which horses received the joint supplement and which received the placebo supplement. Blinding removes bias caused by people wanting to see a positive effect with the joint supplement e.g. by giving it to the least lame horses or grading these horses less harshly.
Crossover = all horses received both the joint supplement and the placebo which allows the response of a horse to the real supplement to be compared with the same horse's response to the placebo supplement. Removing horse to horse variation in this way makes crossover trials potentially more efficient than similar sized, parallel group trials in which each horse is exposed to only one treatment.
Seventeen mares and seven geldings completed the study, with an average age of 8 years. No horse had received any medication for at least 7 days prior to the study or was on any ongoing treatment that could have had an effect on performance/locomotion, as per International Equestrian Federation guidelines. The joint supplement (FlexAbility, Science Supplements) or placebo was given to horses in their feed, twice daily, for 21 days each, following manufacturer’s recommendations. FlexAbility contained chondroitin sulfate, glucosamine, vitamin C, methyl sulfonyl methane, docosahexaenoic acid, eicosapentaenoic acid in a rice flour carrier with a vanilla flavor. Placebo contained only the inert rice flour carrier and vanilla flavor and was indistinguishable from FlexAbility. All horses received FlexAbility and placebo in a crossover design. All staff involved in feeding and handling the horses, and all people evaluating the horses were blinded to treatment. Horses were evaluated at day 0 (baseline), 21 (after first treatment) and 42 (after second treatment). Assessments included: clinical orthopedic evaluation for straight line/lunging circle in walk and trot; high-speed motion-capture determined hind limb motion for straight line trotting; grading of limb range-of-motion and muscle tone based on standardized physiotherapy criteria; handler grading of specific criteria during pasture, groundwork and ridden exercise. Effect of treatment, sequence, limb and interactions were analyzed using statistics.
- Horses fed FlexAbility had significantly lower grade lameness scores in a straight line and circle, with individual horses improving up to 2/10 grades over placebo/baseline (Table 1). For horses with hind limb lameness, FlexAbility was associated with significantly greater hock flexion than baseline (4.2% greater) or placebo (2.7% greater) (Table 2).
- FlexAbility was also associated with significantly improved limb range-of-motion and muscle tone and ridden/groundwork scores were significantly higher with FlexAbility compared to placebo/baseline.
- Horses fed FlexAbility were graded significantly higher for ‘ease-of-movement’ at pasture compared with placebo/baseline.
Take Home Message
- Feeding FlexAbility at the manufacturer recommended level was associated with less lameness, and improved physiotherapy scores, ridden/groundwork scores and pasture ‘ease-of-movement’.
- Increased mid-stance hock flexion of lame limbs may indicate improved mobility/comfort during peak loading, supporting a positive effect of the supplement.
Research (lameness and flexion):
QUESTION: Does feeding an oral joint supplement improve lameness and flexion scores under clinical orthopedic examination?
Clinical Evaluation of the Efficacy of FlexAbility - A Double blind, Placebo Controlled, Cross-over Study
Trial carried out at the Equine Therapy Centre, Hartpury College by Kathryn Nankervis (Centre Manager, BSc, MSc), Jane Elliott (Veterinary Surgeon) and Jenny Read (MSc student)
A large number of oral joint supplements are sold to horse owners with little evidence of efficacy. The purpose of this study was to determine the efficacy of FlexAbility, a joint supplement containing glucosamine, chondroitin sulfate, methylsulfonylmethane, a bioavailable form of Vitamin C (as horses cannot absorb natural vitamin C i.e. L-ascorbic acid) and the Omega 3 fatty acids EPA and DHA, in horses with low grade lameness.
Methods & Materials
Horses were recruited that were at least 10 years old and had not received any NSAID, other medication or joint supplement within previous 28 days. Horses had not been treated with intra-articular corticosteroid within previous 3 months. All horses were in regular ridden work before and during the study period. Ten horses participated in the trial. They consisted of 7 geldings and 3 mares, mean age 12+/-2 years (range 10-14 years) and mean weight of 576+/-54 kg. Horses were randomly assigned to group 1 or group 2.
Horses in group 1 received 60g/500kg of FlexAbility (Science Supplements Ltd) for 14 days whilst horses in group 2 received a placebo, indistinguishable from the active compound in color, smell, appearance, or taste. The investigators were not aware of which treatment was the active and which was the placebo. Following a washout period of 28 days, the treatments were reversed. Horses were assessed before and at the end of each 14 day period. Assessment included a clinical orthopedic examination. Examinations were performed by a qualified and experienced veterinary surgeon. Horses were assessed at walk and trot in a straight line and on a circle on a firm surface. Lameness was scored on a 10 point scale. Flexion tests were performed on all 4 limbs. Following flexion horses were trotted in a straight line.
Out of seven horses that received the placebo for 14 days, 3 improved, 1 stayed the same and 3 deteriorated. Of the seven horses that received FlexAbility, 6 improved and 1 remained unchanged. Thus, the rate of improvement on FlexAbility was twice that for horses receiving the placebo.