BONHAREN Intravenous

10 mg/ml solution for injection for horse, dog and cat

• Veterinary drug
• IVN application
• Active substance: SODIUM HYALURONATE 10 mg

INDICATIONS

Orthopaedic

• acute and chronic arthrosis, polyarthrosis
• subacute and chronic non-infectious arthritis
• acute and chronic tendovaginitis, tendinosis and bursitis
• osteochondrosis

Ophthalmological

• acute and chronic keratitis
• conjuctivitis and keratoconjuctivitis
• keratoconjuctivitis sicca
• corneal ulceration
• cornea injury

CAUSES OF JOINT DISEASE

• Trauma
• Excessive workload or uneven weight- bearing
• Degenerative disease
• Developmental orthopaedic disease
• General wear and tear (linked to the old age)

HEALTHY JOINT - synovium

SYNOVIUM = SYNOVIAL MEMBRANE

• Lines the knee capsule
• Secrets synovial fluid that lubricates and nourish the joint
• Synovial fluid is viscouse substance that prevents friction and damage of cartilage (HA is important part)

INJURY OR CONTINUOS JOINT STRESS CAUSED BY SPORT ACTIVITY CAN CAUSE SYNOVITIS

• Synovial membrane is inflammed and thickens
• Secrets excessive fluid
• Inflammatory mediators negativelly affect lubricating properties of synovial fluid

Symptoms of synovitis

• Lameness (sometimes not obvious if affected more limbs)
• Stiffness
• Pain on flexion / decreased joint mobility
• Joint swelling (result of increased vascular leakage)

If not recognized and treated in time Synovitis may lead to the development of  DEGENERATIVE JOINT DISEASE (osteoarthritis)

Inflammatory disease is also characterised by

• higher vascular leakage

• vasodilatation (widening of blood vessels)

• extravasation (movement of white blood cells from capilaries to the surrounding tissue)

• increased blood flow

• joint swelling

• sensitization of nerves (pain)

• local heat

Based on the recent studies, it is assumed that the protective antiinflammatory effect of IVN administration of hyaluronic acid is achieved through formation of protective glycocalyx coating of the lumen of blood vessels.

ROLE OF GLYCOCALYX

Hyaluronic acid is one of the key parts of glycocalyx in blood vessels

Glycocalyx

• Maintains homeostatis
• Controlls vascular permeability
• Regulates leukocyte adhesion
• Forms barrier against protein and macromolecule movement

Glycocalix during inflammation

Inflammation leads to the degradation

of glycocalyx and increased vascular leakage

Imunne cells penetrate into the surrounding tissue:

↓

• Vasodilatation
• Extravasation
• Increased blood flow

Sodium hyaluronate IVN application – effect on glycocalix 

Intravenous application of SH

• Coats glycocalix
• Prevents vascular leakage
• Reduces penetration of imunne cells into the surrounding tissue

↓

• Reduces inflammation
• Reduces swelling
• Improves rheologic properties synovial fluid

EFFECTS OF BONHAREN IVN APPLICATION

• Reduces inflammation of the synovial membrane
• Induces normalization of rheological properties of the synovial fluid
• Reduces oedema of the joints

HAS POSSITIVE EFFECT FOR ALL JOINTS OF THE ANIMAL BODY

Systemic anti-inflammatory drug effect prevents development of chronic synovitis  and related further damage of joint structures (DJD)

SODIUM HYALURONATE 

• Ensures the elasticity of joint fluid
• Reduces the activity of inflammatory cells
• Inactivates free oxygen radicals.
• Prevents the degeneration of cartilage
• Stimulates chondrocytes to produce hyaluronic acid

Scientific data implicate that exogenous supply of HA stimulates the endogenous production of HA. The exact mechanism is not elucidated.

SODIUM HYALURONATE INTRAVENOUS vs. INTRAARTICULAR APPLICATION

SODIUM HYALURONATE
Intravenous vs intraarticular application

INTRAARTICULAR

Risk of needle induced infection

Risk of cartilage damage

Risk of adverse joint reaction

    (swelling, pain)

The animal should undergo anestheshia (risky for old animals, increases cost of the joint treatement)

INTRAVENOUS

Easy to apply

Minimal risk of infection

No risk of cartilage damage

Anesthesia not needed for application

Can be applied by any vet

SODIUM HYALURONATE

Intravenous vs intraarticular application

Pharmacodynamics

INTRAARTICULAR

Immediate mechanical effect – lubrication of one particular joint

In human medicine IAT products are registered as Medical Devices

SH applied into the joint „dissapears“ usually within 24 hours (degrades, penetrates into the surrounding tissue)

INTRAVENOUS

Systemic anti-inflammatory effect affecting condition of all joints.

Improvement of rhelogical properties of all joints

Benefits of HA treatment compared to non-sterioid antiflogistics (NSAID)

• NSAID drugs immediatelly reduce pain (and inflammation)
• The animal does not feel the pain and continues in normal movement and further wears the joint.
• This can lead to further damage of the joint. The real problem can be hidden.
• In severe cases of strong pain combined threatment of NSAID + sodium hyaluronate can be beneficial.

Number of doses per treatment: 

5 - optimum for long time effect

3 – might be sufficient for non severe cases

Dosing interval

7 days

Volume per dose

Horse: 6 ml per dose (one vial)

Dog: 3 – 5 ml (depending on the weight of the animal)

NO RISK OF OVERDOSING

Bonharen DOES NOT CONTAIN any DOPING SUBSTANCE.

COMPARISON WITH COMPETITORS

EQUINE JOINT CARE - Bonharen Intravenous

MARKETING FOCUSE

Advantage of IVN application in horses

• IVN application has systemic anti-inflammatory effect, reaches all joints of the body
• Easy to apply, no risk of adverse reactions, very good efficacy

Advantage of application in dogs

• IAT application complicated
• IVN application is easy to apply, without risk of joint irritation