Tuesdays with Tony
I hear this a lot around here: do you want paste or powder bute? We’re going to give this colic an injection of banamine. Here’s Equioxx for you to add to Flicka’s grain everyday to help manage arthritis. It got me wondering, what’s up with bute, Banamine (flunixin), and Equioxx (firocoxib)? Must a horse owner have all three to be a good horse mom? Is one better than the other? Horses are soooo confusing sometimes!
Non-Steroidal Anti-Inflammatory Drugs are one of the most commonly prescribed drugs around here. It seems they have a myriad of uses in the equine from colics, to lamenesses, to wounds.
I myself have had this drug class once in my lifetime (so far) when Teanie got mad at me for an ever so slightly sarcastic comment I sent her way, and broke my leg. It took the dull, throbbing pain down a notch which allowed me to contentedly sleep in my chair. The Docs said pain relief is one of their primary uses for these drugs. They also can be used to block the really bad things that happen when bacteria start dying in big numbers in an infection. NSAIDs, most importantly, block inflammation. It’s right there in the name. Blocking inflammation helps all kinds of stuff. You know that redness you get around an infected wound? That’s inflammation, and sometimes it gets so bad it makes it hard for the body to get the healing cells in there. Same goes for swelling. NSAIDs can do wonders to bring down swelling!
Why these three drugs?
There are lots of NSAIDs out there, but my extensive countertop research has determined that bute, Banamine, and Equioxx are the biggies for equine. Why? A few reasons: price, ease of administration, and efficacy in the equine. When I broke my leg I got a drug called meloxicam. It works a lot like bute, but a horse dose would cost $4,614.70 per dose. At least they only get one dose per day. So meloxicam is out for full size horses (it does get used in minis, and foals sometimes). All three can be given either IV, or by mouth, so there are good administration options. Also, all three work pretty well in horses, so there’s that. And all three have minimal side effects when given appropriately (that last word is important!).
Colic = Banamine
It is a well known “fact” in the horse world that all colics must get Banamine, and then be walked. Going to let you in on a secret: neither of these are facts. Colics don’t need to be walked, and they can get bute, Banamine, or Equioxx. The Docs give Banamine because it is the easiest to have on the truck at all times. It doesn’t require refrigeration, like bute, the IV form is much more cost effective than the IV form of Equioxx, and if they are trying to get it in a super painful, jumping around colic it’s OK if a little bit gets out of the vein. If bute ends up in the skin around the vein, it can cause the whole area to slough!!! If you’ve ever watched them trying to hit a vein on a super painful colic, you will really understand why they prefer Banamine. There is a rumor out there that Banamine is better at managing colic pain than any other NSAID, but it’s just that, a rumor. There’s no hard science behind it. Eyes are a different story. Banamine is the best NSAID for eye pain. When my Docs see eye things, they reach for Banamine first.
Arthritis = Bute
Much like it is a known “fact” that all colics get Banamine, it is an often-known “fact” that all arthritis responds to bute. At this point in the blog, you will likely not be surprised to learn this isn’t quite true, either. Just like people all respond differently to drugs, horses do, too. Now, it is true that bute is generally the first NSAID my Docs reach for when it comes to pain relief, and it’s for a bunch of different reasons. First, bute is pretty darn cheap. Second, it is well-tolerated by nearly all horses. Third, it comes in easy options to get it into horses. There’s paste, powder, tablets, and injectable. Bute gets a bad rap for being hard on horse stomachs. While there are some horses that are really sensitive to bute, those horses are few and far between. More commonly, my Docs see horses that are given WAY, WAY too much bute in very short amounts of time. You should never, never, never give more than 2 grams in 24 hours unless you are 9,000% sure your veterinarian said to!!! And then you should ask them again to be really sure.
So Who gets Equioxx?
Equioxx is one of the newer NSAIDs on the market. It doesn’t work any differently than bute or Banamine with one important exception: it is easy on the stomach. If your horse has a history of issues with bute or Banamine, or has a stomach issue, my Docs will reach for Equioxx first. Otherwise it’s going to be one of the options for you to try on your horse. Just like people respond differently to aspirin, Advil, and Aleve, horses respond differently to each of these NSAIDs. My Docs will often recommend you do trials of all three drugs (separately, you don’t want to go giving bute, Banamine, and Equioxx all at the same time) to determine which works best for you and your horse. It seems the old, arthritic guys do like Equioxx quite a bit, but that result varies by horse. I also have it on good authority, Dr. Lacher likes Equioxx for hers because it’s super easy to give. She puts it in her hand with a little bit of grain, and the horses eat it up. No arguing over the tube of bute paste, or wondering if they ate the powder.
Moral of my NSAID story: talk with my Docs about what is the best answer for you and your horse. Oh, and the equine world is full of Ol’ Wives Tales, but then you knew that.
Until next week,
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Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!