Geriatric Case Study

David McCluggage, D.V.M., C.V.A.


A mixed breed retriever type, female, 15 years old, was presented with a complaint of unable to rise, developing cataracts, poor hair coat, and difficult defecation.

Physical Examination:        

  1. Trouble rising, partially due to the hips and partially due to mild paresis
  2. Dry, dull coat, mildly obese
  3. Developing mild posterior cataracts in both eyes
  4. The dog has hard stools and tends to fall down when defecating

Blood Test Results:

  1. T4 (thyroid): low normal
  2. SGPT: mild elevated

Therapeutic plan:

  1. Active Bovine Glandular Thyroid, 4 grains twice daily
  2. Glucosamine sulfate, 500 mg twice daily
  3. DL Phenylalanine, 500 mg twice daily
  4. Dimethylglycine, 100 mg twice daily


Over the course of two months, the coat dramatically improved, weight was reduced 10%, and dog seemed much more energetic

The cataracts stopped progressing

The dog started to sleep normally at night

She was able to climb stairs and play again

The owners reported her to be more active than in last 2 years


Glucosamine Sulfate

In some ways, considered to be the Gold Standard of nutraceutical supplements for arthritis


Glycosaminoglycan (GAG) are chemically similar to the mucopolysaccharides of cartilaginous tissue, hyaluronic acid

There are a number of different GAGs in the body, including:

  1. chondroitin-4-sulfate
  2. dermatan sulfate
  3. chondroitin-6-sulfate
  4. heparin & heparin sulfate
  5. keratan sulfate
  6. hyaluronic acid
  7. proteoglan

For formation of joint fluids, there must be the the precursor GAG's available, including:

  1. Glucosamine sulfate
  2. Glucosamine HCl
  3. N-acetyl-D-glucosamine

All are formed from D-glucose; the rate-limiting step (most important step) is the conversion of D-glucose to D-glucosamine

Why Glucosamine sulfate works so well:

  • Active uptake through intestine
  • Sulfur group supports the formation of Gags
  • Decrease the pain of arthritis
  • Improve joint function

Consider Glucosamine Sulfate for:
  • Degenerative joint disease
  • Inflammatory bowel disease
  • Chronic colitis (N-acetyl-D-Glucosamine maybe best-supports glycoprotein-mucous membrane of gut lining)1

    1.Burton AF, et al Decreased incorporation of 14C-glucosamine relative to 3H-N-acetyl glucosamine in the intestinal mucosa of patients with inflammatory bowel disease. Am J Gastroenterol.;78(1):19-22, Jan 1983.

  • Disc disease
  • Food allergies (see #3, colitis)

Glandular Thyroid
  • Bovine thyroid with active thyroid hormone was used
  • Thyroid glandulars may provide nutrients needed by the thyroid gland
  • May provide "oral tolerance" thus sparing the thyroid gland
  • Will provide a low but significant dose of thyroxine
  • Less negative feedback inhibition of thyroid gland
  • Smaller fluctuations in T-4 throughout the day

There are a number of thyroid glandular products on the market, some with active thyroid hormone and some without. If the dog is receiving levothyroxine (synthetic thyroid, Synthroid, Soloxine), only glandulars with no active thyroid should be used.

Dimethylglycine (DMG, N,N-Dimethyglycine)
  • The dimethylated derivative of glycine
  • An intermediary metabolite in cell metabolism
  • Transmethylation
  • Methyl groups are moved from one molecule to another
  • DMG is required for this process
  • Vitamins, hormones, neurotransmiters, enzymes, antibodies, and nucleic acids all require transmethylation

DMG is:
  • Synthesized in the body
  • Thus, not a vitamin
  • Still, there are indications that supplementation can increase the health of cells and be beneficial in a wide variety of disease processes
  • DMG readily crosses the blood brain barrier
  • Increase methyl group transfer with neurons, thus improving brain function