Which pain medication should I give my horse?
“Bute” (phenylbutazone) and Banamine (flunixin meglumine) are the most commonly used non-steroidal anti-inflammatory drugs (NSAIDS) in the horse. In recent years, new types of NSAIDS have been developed. The goal of this newer generation of NSAIDS has been to target the “bad” prostaglandins of inflammation and spare the protective ones, and thus be a safer medication. Currently, the most prominent of these in the equine world is Equioxx (firocoxib). These are prescription drugs, meaning that they can only be bought legally with a veterinarian’s prescription.
NSAIDS reduce inflammation by blocking prostaglandin synthesis. Prostaglandins come in many types. Some are products of the inflammatory cascade, while others have vital maintenance functions in the body. For example, one type has the role of protecting the stomach and intestinal lining from acid and digestive enzymes. This same prostaglandin has a protective role in the kidney. Unfortunately, NSAIDS not only decrease the production of “bad prostaglandins” of inflammation, they also reduce the formation of these “good prostaglandins” and can cause problems to organs normally protected.
Bute and Banamine remain the mainstay of anti-inflammatory therapy in the horse. Used correctly, these drugs rarely cause noticeable problems. On the other hand, all have potential side effects including:
• Intestinal and stomach side effects including gastric and colonic ulcers. Foals are especially sensitive to the intestinal side effects and easily develop ulcers from the use of these medications.
• Kidney problems. This is especially true of young horses, but caution must also be used in treatment of old horses and those that are otherwise ill or dehydrated.
• NSAIDS have the ability to “mask” a problem, making it look less severe than it really is and give cause for false hope and delayed treatment that may change your horse’s prognosis.
Equioxx is available in paste and intravenous injection formulations. Equioxx is a good choice for horses that are more susceptible to stomach ulcers such as: foals, horses that are sick, traveling, under stress, or need to be on higher doses for long periods of time. Equioxx does not give the horse as fast or prominent pain relief as the other NSAIDS, so it is commonly given a 2-3X dose the first day.
Banamine is available in paste and injectable formulation. Injectable banamine works well in the vein, but do see some severe absecsses from intra-muscular use. If you need pain relief fast and can not get it in the vein I would still give it in the muscle if you have a new needle, syringe and a sterile bottle. Otherwise, I would just give the injectable solution orally keeping in mind that you will receive about 50% absorption compared to injectable, and it will take about an hour for effect. Injectable dosage is 1 ml or cc per 100#s body weight. Most adult quarter horses will weigh approximately 1,000 pounds requiring an injection of about 10 mls or 15-20 mls via mouth. Banamine is best known for its use in horses with abdominal pain – colic. No doubt, this drug is a potent pain reliever and it has extra anti-inflammatory benefits that make it especially good for treating intestinal problems (anti-endotoxic effect). The endotoxin binding ability of banamine is of primary importance with grain overload and diseased intestine, other than that bute is typically sufficient for most colic patients.
The most important concept regarding the use of NSAIDS in the treatment of colic symptoms is to understand that colic is not a disease but is the horse’s way of demonstrating abdominal pain. If the cause of colic pain is simply gas or a spasm, a simple dose of bute or banamine may be all it takes to break the cycle and solve the problem. If, however, there is a mechanical problem in the gut such as a feed impaction or displacement, NSAIDS will temporarily make the horse look better but does nothing to fix the underlying problem.
Bute paste would be my 1st choice NSAID if I was going to have only one in my first aid kit due to price, effectiveness, and increased number of doses per tube. Bute is also available in tablet, powder and intravenous injection formulations. If the injectable form is accidentally given outside of the vein it can be very irritating and traumatic to the tissue. Cost comparisons of the paste formulations average/dose: Banamine $10.00, Equioxx $6.50, Bute (4 grams) $4.50.
I recommend all horse owners to have bute or banamine on hand for emergency situations, but will advise to consult with your veterinarian, especially for colic.
Dr. Darin Peterson, DVM, was born and raised on a horse and cattle ranch in Rosholt, S.D., and received his B.S. in Animal Science from SDSU. He concentrates most of his work time with large animals. He can be reached at 701-347-5496 or email@example.com.