Arizona
When your horse is in pain, the first priority of the owner is to relieve the pain. Given the time and expense of a veterinary visit, owners commonly administer pain relievers themselves without the guidance of their veterinarians.
There are several drugs however that when administered incorrectly can cause serious complications that horse owners should be aware of. The three drugs to be especially aware of are Banamine and Equioxx and Bute.
Banamine can be found in three forms; an oral paste, oral granules and injectable. It is best given by owners orally, however many people find that they have the injectable form on hand. The best route of administration of the injectable is directly into the jugular vein; however most owners do not feel comfortable giving IV injections and end up giving Banamine into the muscle tissue (IM). This is where the danger lies.
Injecting Banamine in doses higher than 5ccs into the muscle tissue (10 cc is the normal dose) puts the horse at high risk of developing Clostridial Myonecrosis; a severe and potentially deadly complciation. While it is true that the drug is labeled as being able to be injected intra-muscularly, this is statement that applies to small doses suitable for smaller animals. In the case of the horse, it is inaccurate.
Horses that develop clostridial myonecrosis usualy require long and expensive hospital stays and unfortunately even with appropriate care, up to 40% of the infected horses will die as a result of the disease. Those that survive require prolonged wound management, intensive care and long term medications.
If for some reason your horse is given Banamine IM and you are concerned about clostridial infection, you should monitor your horse carefully for the following symptoms for a period of at least 3 days: a warm swollen area at or near the injection site, fever, inability to turn or move neck, lethargy and inappetance. If you notice any of these signs after administering Banamine IM to your horse, contact your veterinarian.
If yon need to use Banamine, the best way to use the drug is in the oral form. If you do not have the oral formulation, the injectable form may be given by mouth as well. If you are faced with a situation where you need to give a Banamine injection, research shows that one injection of 5 cc(mls) or less in one spot the muscle will significantly decrease the likelihood of Clostridial infection, so the best strategy is to two injections of no more than 5cc's each, on either side of the neck.
Always keep in mind what other medications your horse is taking at the time of Banamine use and know that using Banamine in combination with other non-steroidal anti-inflammatory drugs (NSAIDS such as phenylbutazone- bute) or given in large quantities you may cause GI ulceration, kidney dysfunction and other systemic problems. It is best to avoid using multiple NSAIDS at once in your horse or for long periods of time.
The second of these drugs, Equioxx (Firocoxib) is an anti-inflammatory coming in to fashion for pain relief in horses sensitive to more common NSAIDS like Bute or Banamine. It is often used to decrease pain associated with performance limiting lameness due to soft tissue or boney injury. It's danger lies in the counter-intutive dosage requirements.
Because Equioxx is a new drug that is currently only offered by one manufacturer it is therefore quite expensive and many horse owners have found a seemly equivalent drug offered as a small animal product: Previcox. It is in fact the same drug but it is critical however that horse owners understand the difference between the small animal and the large animal doses.
The small animal dose (by body weight) is actually 500 times larger than the dose for a horse. The difference is so large in fact that if you gave the same dose to a horse as you would give to a dog, you would still grossly overdose the horse and put him/her at risk of NSAID toxicity, which includes kidney failure, right dorsal colitis, and GI ulceration. These are very serious (and expensive) complications.
Because of the complexity of getting the dosing correct and the ramifications of administering the wrong dose, we recommend that horse owners never use Previcox for pain relief in horses.
Phenylbutazolidine (Bute) is an age old drug available as an oral paste, powder and tablet as well as injectable. It has been in use by owners and veterinarians for years as a pain reliever. Like the other NSAIDS we discussed today, the are a few risk factors to consider when using Bute for your horse.
Bute may also be associated with the development of Gi ulcers, right dorsal colitis and kidney dysfunction when used in high does or for extended periods. If your horse has been on Bute for a long period of time, it is possible that a low dose plus a little stress can cause these serious complications to occur. If you are concerned about your horse, contact your veterinarian.
Finally, Bute used for IV injection can be very caustic to the surrounding tissues if it gets out of the vein. It is not suggested that Bute be used IV by any person who does not have excellent IV injection skills. If you are using Bute IV and you note a swollen hard area, discoloration and/or sloughing of skin near the injection site these are indicators of extravenous injection or you are concerned that you may have injected some drug outside the vein contact your veterinarian.
In summary, while administering pain relief drugs yourself to your horse sometimes, you should be very careful in dosage, method of administration, and aware of cross drug complications. When in doubt, the safest course is always to contact your veterinarian
Katie Harrington, DVM--
Chaparral Veterinary Medical Center
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