12 Veterinary Times

ation reactions. It also has a role as a precursor of sulphur-containing compounds and in the production of polyamines.

Administration of SAMe protects against hepatotoxicity. Protection against acetaminophen toxicosis is afforded through its status

as a potent thiol donor, thus, attenuating GSH depletion. Oral administration to humans with cirrhosis of the liver replen-ishes hepatic glutathione and is thought to improve resistance to free radical and reperfusion injury. SAMe is also listed by the VMD as being medicinal by function and, therefore, requires a marketing authorisa-tion as an authorised veterinary medicinal product.– Silymarin.This is a flavonolignans that is extracted from the fluid, seeds and leaves of milk thistle (Sily-bum marianum). This extract has been used for centuries as a natural remedy for diseases of the liver and biliary tree. In human medicine it is indicated in the treatment of patients with amanita mushroom hepa-totoxicity, alcoholic and non-alcoholic cirrhosis and paraceta- mol intoxication.

The extract contains about 60 per cent polyphenol silibinin, which is believed to be the most active component responsi-ble for the hepatoprotectant and antifibrotic effects. These effects have been attributed to a number of properties includ-ing the extract’s direct antioxi-

dant activity, its enhanced toxin detoxification, and its ability to end lipid peroxidation reaction. It also has anti-inflammatory and immunomodulatory effects and can stimulate cell repair.

As a herbal remedy, milk this-tle extract is a medicinal product and is, therefore, regulated by the MHRA. Unfortunately, the regulations governing herbal medicine are a little complicated, products can be put on the market as: l Unlicensed herbal remedies –these products do not have to meet specific standards of quality and safety;l Registered traditional herbal medicines – this scheme began on the October 30, 2005 and requires that registered prod-ucts meet specific standards of quality and safety. They will also be accompanied by agreed indications and systematic patient information. This information will apply to humans but not to animals;l Licensed herbal medicines – some herbal medicines in the UK already hold a product licence or marketing authorisation for use as authorised human medicines. This is also the case for certain veterinary herbal products.

ConclusionsNutraceuticals and novel ingredi-ents remain popular with clients and animal owners. They are often readily accessible over the counter in pharmacies, pet shops and through mail order catalogues. They promise much and give the impression that they can confer significant health benefits.

Providing these products do not make claims to be able to treat disease or act as medicinal products, they do not have to conform with the strict veterinary and human medicines legislation. This can give rise to differences in quality, safety and efficacy. Our role as veterinary surgeons should be to inform and advise our clients so that they can make appropriate informed choices.

Clients should be advised clearly how to establish the quality, safety and efficacy of any product they are considering to purchase. Licensed products will always be more expensive than unlicensed products but they will, at least, have been required to demonstrate their efficacy, safety and quality. Why, then, should we not, unashamedly, encourage our clients to purchase veterinary medicinal products?

Further readingThe website for the Medicines and Healthcare products Regulatory Agency provides information on the regulatory structures that ensure that all medicinal products are safely regu-lated. A section on the regulation of herbal and homoeopathic medicines details how these products are regu-lated (http://www.mhra.gov.uk/).

The website of the Food Standards Agency (http://www.foodstandards.gov.uk/) provides information on the regulation of food and food additives. The Agency is advised by the Advisory Committee on Novel Foods and Processes (ACNFP) (http://www.acnfp.gov.uk) and infor-mation is available on the relevant consultation processes.

The Veterinary Medicines Directorate website provides useful information on what they consider to be non-medicinal products and what consti-tutes a veterinary medicinal product (http://www.vmd.gov.uk/Industry/Non-Med/non-med.htm).

The supplement guide pages on the Arthritis Foundation’s website provides useful information on the full range of dietary supplements available as therapeutic options for the treatment and management of arthritis (http://www.arthritis.org/conditions/supplementguide/).

The Vetoquinol site provides further details on “Zentonil”, its preparation of S-adenosylmethionine (http://www.vetoquinol.co.uk/products/product_info/zentonil.htm).

n Nutraceuticals – from page 11

Supplementation is widely used for both skin disease and joint disease in the dog. How-ever, nail problems can pre-sent as an equally debilitating problem to the pet and pet owner alike and little is known of the types of supplement that are effective.

The claw of the dog is com-posed of horn, which is a special-ised epidermal product derived from the underlying nail matrix. Whilst horn shares some com-mon keratins and matrix proteins with the epidermis many are unique to the horn itself. It is, therefore, simplistic to use the same range of supplements for nails as for skin.

Supplements can be divided into those that are used to treat disease and those that are merely used to manage nail abnor-malities that do not necessarily represent a disease state but possibly only a variation from the normal. Treatment of nail disease is beyond the scope of this article as it involves the use of a whole range of drugs including antibiot-ics, peripheral vasodilators and immune modulating modalities.

The aim of this paper is to look at nutraceutical supplements in improving nail quality which can, in itself, help in the management of disease.

In the same way that some people have perfect nails that require little attention there are individuals that have nails that are soft (onychomalacia); have horizontal splits or lamellation (onychoschizia) or are rough-ened and ridged (trachyonychia) nails. Specific diseases can cause severe variants of many of these changes but milder manifesta-tions can be caused by environ-mental factors such as trauma, excessive wetting or contacts with chemicals or are idiopathic variants of normal.

Changes in nail consistency may be due to the impairment of one or more of the factors on which the health of the nail depends: especially varia-

tion in the water content and keratin constituents.

Essential fatty acids in controlling water lossApproximately 15 per cent of the human nail is water. Constant wetting of the nail increases its water content and leads to softening. In dogs, excessive licking or wetting of nails while, for example, out for a walk, could produce this sort of change. If the lipid content of the nail is low once wetting occurs, the nail cannot retain the water, so that over-drying results in increased fragility.

Supplementation with essen-tial fatty acids, especially those high in gamma linolenic acid, has been suggested in man to help reduce this problem. This would certainly suggest that similar neutroceuticals would be useful in the dog.

Supplements in keratin formation improvementGelatine, cystine, methionine, collagen, iron, vitamin A, B, 1, biotin, pantothenic acid as well as millet, yeast and mineral salts (zinc, chromium, calcium, iron and silicon) have been consid-ered either separately, or in various combinations, in clinical trials in man.

There has been no evidence from studies in man to suggest increased mineral supplementa-tion can improve nail quality. This work probably holds true for dogs based on mineral analysis of abnormal nails by Harvey et al (1996). This paper looks at the composition of nails of normal dogs and those with idiopathic onychomadesis. The authors describe the mineral composi-tion of normal nails for calcium, magnesium, manganese, iron, potassium, sodium, copper, zinc and phosphorus and com-pares their composition with the nails of German shepherd dogs and non GSDs with idiopathic onychomadesis.

With the exception of manga-nese, analysis of abnormal nails from non GSDs revealed no deficiencies in any of the mineral measured compared to normal nails. In fact, in many cases, min-eral levels were elevated, nota-bly calcium, iron, copper and zinc. This finding was suggested by the authors to be a reflec-tion of the increased speed of growth rather than a deficiency state. GSDs with idiopathic ony-chomadesis showed decreased

concentrations of manganese, potassium, sodium and phos-phorus. The relevance of these findings remains unexplained.

There is one report in the human literature suggesting iron may be important to improve nail quality. However, this is a single paper from 1981 (Campbell and McEwan) and most other refer-ences are anecdotal. Gelatin, biotin, cysteine and methionine were also suggested in 1981 to be important in accelerating nail growth in man (Runne and Orfanos). Gelatine has since been dismissed as being of any real value as a nail supplement.

Biotin, on the other hand, has been shown to improve hoof quality in horses and pigs and recent studies in man have confirmed its promise. A study from Switzerland (Hochman, 1993) demonstrated a 25 percent increase in nail plate thickness in patients with brit-tle nails who received biotin supplementation.

A second paper (Colombo et al, 1990) used qualitative assess-ment data by scanning electron

Nutraceutical nail supplements: fact or fiction?Sue PaTerSoN MA, VetMB, DVD, DipECVD, MRCVS

talks about the use of supplements to maintain healthy nails in animals

NuTrITIoN

microscopy to demonstrate reduction in lamellar separation in individuals with brittle nails and onychoschizia. Biotin would, therefore, seem to hold consid-erable promise as a nail supple-ment in dogs and should perhaps be used in combination with essential fatty acids to improve keratin quality and decrease water loss from the nails.

ReferencesCampbell, A J and McEwan, G C (1981), Treatment of brittle nails and dry eyes, British Journal of Derma- tology, 105: 113.

Colombo, V E, Gerber, F, Bronhofer M et al (1990), Treatment of brittle finger nails and onychoschizia with biotin: scanning electron microscopy. Journal of the American Academy of Dermatology, 23: 1,127-1132.

Harvey, R G and Markwell, P J, The mineral composition of nails in normal dogs and comparison with shed nails in canine idiopathic onychomedesis Vet. Derm, 7: 29-34.

Hochman, L G, Scher, R K and Meyerson, M S, (1993) Cutis, 51: (4) 303-305.

Runne, U and Orfanos, C E (1981), The human nail, Current problems in dermatology, 9: 102-149.

Left: onychodystrophy and onychorrhexis of the claw. Inset: onychomadesis and early signs of onychorrhexis of claws.

Two examples of onycholysis of the claw.

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