Feeding Bute/Equioxx in addition to Monthly Legend Injections?

[MustangTwist]

Hi everyone!

My horse is 24 years old this year and still going (relatively) strong. He’s been on monthly Legend injections for years and they seem to help, but it’s been pretty rainy and cold recently and he’s been feeling stiffer than usual. He’s also got standard-issue arthritis that tends to get a little worse in the winter, and every year with age.

His trainer recommended trying him on Previcoxx/Equioxx or giving him a daily dose of Bute, in addition to Legend.

I’m a little wary about overloading his system but I also want him to be as comfortable as possible, given that he still seems pretty happy to be in work. I know that long-term bute isn’t supposed to be great for horses’ GI tracts, but he’ll probably only be in steady work for another year or so. I’ve heard Equioxx is better for long-term use, but I don’t know a ton about it.

I already have a 3 month supply of Legend, so I plan to at least use that up, but does anyone have any opinions on trying a small dose of Equioxx or Bute in addition? I plan to call his vet to talk through it before making any changes to his regimen, but wanted to get some thoughts beforehand so I can go into the discussion more informed.

Thank you all in advance!

PS - The Equioxx site says: “As a general rule, neither EQUIOXX nor other NSAIDs should be used in conjunction with other NSAIDs (for example, aspirin, phenylbutazone, diclofenac, ketoprofen or flunixin) or systemic corticosteroids (for example, prednisone, cortisone, dexamethasone or triamcinolone).” The primary active ingredient in Legend is listed as hyaluronate sodium which isn’t on the “do not mix” list, but I want to be sure before I make any changes.

[betsyk]

A lot of older horses are managed with both Legend and an NSAID (both bute and equioxx are NSAIDS). Talk to your vet about which is better for your situation. My understanding is that bute is better short term, so if you plan a ride on a weekend you might give him a gram of bute before or after if you think it might help. Equioxx seems to work better if they get it consistently. I also know that before our vet gives banamine for a colic, they always ask if the horse is getting any other NSAIDS regularly, or if they’ve had any that day, because banamine plus Equioxx can be a problem (not sure exactly what KIND of problem, but it’s important enough that they ask every person every time). These are all things to talk to your vet about. If your horse is a colicky type, I’d ask a lot of questions before putting him on regular Equioxx just to be sure I understood what info I needed to give the vet in an emergency.

[MustangTwist]

@betsyk

A lot of older horses are managed with both Legend and an NSAID (both bute and equioxx are NSAIDS). Talk to your vet about which is better for your situation. My understanding is that bute is better short term, so if you plan a ride on a weekend you might give him a gram of bute before or after if you think it might help. Equioxx seems to work better if they get it consistently. I also know that before our vet gives banamine for a colic, they always ask if the horse is getting any other NSAIDS regularly, or if they’ve had any that day, because banamine plus Equioxx can be a problem (not sure exactly what KIND of problem, but it’s important enough that they ask every person every time). These are all things to talk to your vet about. If your horse is a colicky type, I’d ask a lot of questions before putting him on regular Equioxx just to be sure I understood what info I needed to give the vet in an emergency.

Thanks! Knock on wood, we’ve never had problems with colic before, but he’s also older and just moved to a new facility, so I don’t want to overload him. He gets ridden 5x/week (with turnout and/or a trail ride on his “off” days) so I think maybe Equioxx might be a better fit. Will definitely discuss w/ my vet before making any changes to his regimen

[JB]

Phenylbutazone and firocoxib are entirely different from Legend. Legend isn’t an NSAID

The best thing is to talk to your vet, since s/he knows your horse and his situation. I would probably be doing monthly Adequan or Pentosan over monthly Legend. A loading dose of Adequan would get you a long way, then a monthly Pentosan would help keep that up.

Legend tends to be faster-acting but shorter-lived.
Adequan takes the 7-dose loading dose to have the fullest effect, and then last a lot longer than Legend.

You can also do a loading dose of Pentosan - it’s a cheaper option.

Then, for strenuous situations, you could back that up with a few days of Equioxx around each side of the event.

[MustangTwist]

@JB

Phenylbutazone and firocoxib are entirely different from Legend. Legend isn’t an NSAID

The best thing is to talk to your vet, since s/he knows your horse and his situation. I would probably be doing monthly Adequan or Pentosan over monthly Legend. A loading dose of Adequan would get you a long way, then a monthly Pentosan would help keep that up.

Legend tends to be faster-acting but shorter-lived.
Adequan takes the 7-dose loading dose to have the fullest effect, and then last a lot longer than Legend.

You can also do a loading dose of Pentosan - it’s a cheaper option.

Then, for strenuous situations, you could back that up with a few days of Equioxx around each side of the event.

Thanks! I’ve heard a lot about Pentosan but I’ve never actually used it, it’s an intriguing option.

As stated in my post, I’m planning to talk to my vet before making any changes, but I like to get a sense of other people’s experiences so I can go into that conversation better knowing what questions to ask, etc…

He’s actually been on Adequan before and I just didn’t feel like it made as much of a difference vs. Legend. When he was still eventing at the upper levels he was actually getting both. At any rate, I have a full bottle of Legend that I’ve already paid for will last me a few months so I’m not planning to change that up in the near future (though I’d certainly look into Pentosan when that bottle is empty).

My horse is in regular work and does lower-level dressage, hacking, trail rides, and the occasional (very low) jump school. I’m primarily looking at integrating some bute/equioxx into his regimen just to make him more comfortable for everyday riding. For context, I will probably retire him in the next year or so…whenever it looks like he’s not enjoying being in work anymore.

[fanfayre]

A Legend/Equioxx blend has worked for my mare (but she’s only 10), but we’ve since weaned her off the Equioxx and just give the monthly Legend, with firocoxib on hand for ‘serious’ competition (like the 3-day last summer)
BUT
I was specifically warned by my vet NEVER to give bute/banamine while she is on the Equioxx because it will do very bad things to her kidneys (basically stop them in their tracks). Plus, withdrawal times for firocoxib is quite long, so we may have to wait a month or more after the last equioxx before giving bute or banamine.
Something for you to consider.
(in the past I have a dose of banamine on hand because my horse likes to impact on me)

If this were me, I’d keep on with the Legend/Equioxx while you’re still riding him, then when you retire, just give him the Equioxx. Horses around here have lived many years on firocoxib with no long-term problems

[MustangTwist]

@fanfayre

A Legend/Equioxx blend has worked for my mare (but she’s only 10), but we’ve since weaned her off the Equioxx and just give the monthly Legend, with firocoxib on hand for ‘serious’ competition (like the 3-day last summer)
BUT
I was specifically warned by my vet NEVER to give bute/banamine while she is on the Equioxx because it will do very bad things to her kidneys (basically stop them in their tracks). Plus, withdrawal times for firocoxib is quite long, so we may have to wait a month or more after the last equioxx before giving bute or banamine.
Something for you to consider.
(in the past I have a dose of banamine on hand because my horse likes to impact on me)

If this were me, I’d keep on with the Legend/Equioxx while you’re still riding him, then when you retire, just give him the Equioxx. Horses around here have lived many years on firocoxib with no long-term problems

That’s great information, thank you! I’ve heard you shouldn’t give bute and equioxx simultaneously, but had no idea the equioxx stayed in their system so long. That’s a little concerning, but something I will definitely bring up with my vet!

[JB]

The half life of phenylbutazone is 4-8 hours.

The half life of firocoxib is 30-40 hours, so even though it’s a good bit longer, there’s no need to wait anywhere near a month between the last dose of Equioxx and a dose of bute.

But no, never double up on any NSAID, whether it’s banamine, bute, or equioxx/previcox, unless it’s a life or death situation or the vet says you really need to and provides regular monitoring.

[dani0303]

I use a Pentosan/Previcox blend on my 2 aged jumpers (18 and 25). It works wonderfully for both of them and is a more economical option than Legend. My vet has assured me that Previcox is safe to use daily and for long term use. Their blood work seems to confirm that.

[MustangTwist]

@dani0303

I use a Pentosan/Previcox blend on my 2 aged jumpers (18 and 25). It works wonderfully for both of them and is a more economical option than Legend. My vet has assured me that Previcox is safe to use daily and for long term use. Their blood work seems to confirm that.

That’s great to hear. I’m planning to call my vet today about it. I did notice that there seems to be an Equioxx backlog right now (almost every online pharmacy seems to be out of stock), but Previcox is still available. Is there a general consensus on whether Previcox and Equioxx are equally safe (so long as you get the dosage right)? I understand many vets don’t want to prescribe Previcox for horses since it’s “off label” use, but my trainer apparently says her vet is willing to do this.

[dani0303]

@MustangTwist

That’s great to hear. I’m planning to call my vet today about it. I did notice that there seems to be an Equioxx backlog right now (almost every online pharmacy seems to be out of stock), but Previcox is still available. Is there a general consensus on whether Previcox and Equioxx are equally safe (so long as you get the dosage right)? I understand many vets don’t want to prescribe Previcox for horses since it’s “off label” use, but my trainer apparently says her vet is willing to do this.

Mine uses Previcox because it’s cheaper. I just break the pills into 1/4ths to get the dosage correct. A 60 (full sized) pill supply cost me $180 and will last 8 months

[Princess_Sparkles]

@MustangTwist

I did notice that there seems to be an Equioxx backlog right now (almost every online pharmacy seems to be out of stock), but Previcox is still available. Is there a general consensus on whether Previcox and Equioxx are equally safe (so long as you get the dosage right)? I understand many vets don’t want to prescribe Previcox for horses since it’s “off label” use, but my trainer apparently says her vet is willing to do this.

In Canada we do not have Equioxx (and don’t want it, thank you very much, Previcox is so much cheaper!) and it is the same drug at a fraction of the cost. I cut a large tablet into quarters to get the proper 57 mg dose. It’s one of those interesting drugs that horses metabolize differently than dogs (Previcox is the dog version) so a horse takes the same dose as a small dog, a QUARTER of the dose of a large dog. The only thing you might have a problem with is the pill is usually beef-flavoured. Most horses vacuum it up anyway, but mine is a princess and could find it in a carrot/apple and spit it out. I had to mix it into a bit of beet pulp to get her finally eating them.

My horse is on a daily Previcox routine and during show season is also on Legend. (Being in Canada we unfortunately do not have Pentosan or Adequan, so Legend it is . . .). I was dosing her every 2 weeks with Legend plus the Previcox. So it is perfectly safe to do, with the caveat of talking to your vet of course.

In terms of withdrawal from Previcox, I think someone above already corrected this, but it is nowhere NEAR a month. My vet advised me to take my horse off Previcox 7 days prior to a show to ensure a clean test (this was before it was approved for use at shows, we are allowed a 57 mg dose 12 hours out from competition now).

And as others have said, don’t stack NSAIDs, so don’t give bute or banamine on top of a regular Previcox dose without talking with your vet first. I did it a couple of times after talking to my vet for specific situations, but it’s not generally a great idea to do as a matter of course (and absolutely not permitted when showing, so there’s that as well).

[MustangTwist]

@Princess Sparkles

In Canada we do not have Equioxx (and don’t want it, thank you very much, Previcox is so much cheaper!) and it is the same drug at a fraction of the cost. I cut a large tablet into quarters to get the proper 57 mg dose. It’s one of those interesting drugs that horses metabolize differently than dogs (Previcox is the dog version) so a horse takes the same dose as a small dog, a QUARTER of the dose of a large dog. The only thing you might have a problem with is the pill is usually beef-flavoured. Most horses vacuum it up anyway, but mine is a princess and could find it in a carrot/apple and spit it out. I had to mix it into a bit of beet pulp to get her finally eating them.

My horse is on a daily Previcox routine and during show season is also on Legend. (Being in Canada we unfortunately do not have Pentosan or Adequan, so Legend it is . . .). I was dosing her every 2 weeks with Legend plus the Previcox. So it is perfectly safe to do, with the caveat of talking to your vet of course.

In terms of withdrawal from Previcox, I think someone above already corrected this, but it is nowhere NEAR a month. My vet advised me to take my horse off Previcox 7 days prior to a show to ensure a clean test (this was before it was approved for use at shows, we are allowed a 57 mg dose 12 hours out from competition now).

And as others have said, don’t stack NSAIDs, so don’t give bute or banamine on top of a regular Previcox dose without talking with your vet first. I did it a couple of times after talking to my vet for specific situations, but it’s not generally a great idea to do as a matter of course (and absolutely not permitted when showing, so there’s that as well).

Thanks! This sounds great. I’m going to talk to my vet today and I’m hoping it’ll make my horse a little more comfortable in his daily routine

[fanfayre]

I stand (happily) corrected, and must have misunderstood my vet. I know I had taken my horse a month off Previcox before I gave her a gram of bute and my vet lectured me sternly about withdrawal of Prev being slow, so I thought a month was the “safe” zone

[PDDT]

My horse has been on Previcox and some one tried to tell me that I needed yo break the pills up for the correct dose, however O re

[JB]

@MustangTwist

Is there a general consensus on whether Previcox and Equioxx are equally safe (so long as you get the dosage right)?

Exactly the same thing - firocoxib. You just want a 57mg dose of Previcox, not the 227mg pills. Or quarter the 227mg pills but that’s not a reliable way to consistently get 57mg.

I understand many vets don’t want to prescribe Previcox for horses since it’s “off label” use, but my trainer apparently says her vet is willing to do this.

Technically it’s illegal, not just off-label. Off-label is legal as long as there isn’t anything equivalent for the same use with the same mechanism, and the vet (or Dr) does their due diligence in determining safety, efficacy, etc.

But many vets do prescribe Previcox for a client’s “dog”, or clients to get a Rx for their actual dog but the dog doesn’t get it

[MustangTwist]

@JB

Exactly the same thing - firocoxib. You just want a 57mg dose of Previcox, not the 227mg pills. Or quarter the 227mg pills but that’s not a reliable way to consistently get 57mg.

Technically it’s illegal, not just off-label. Off-label is legal as long as there isn’t anything equivalent for the same use with the same mechanism, and the vet (or Dr) does their due diligence in determining safety, efficacy, etc.

But many vets do prescribe Previcox for a client’s “dog”, or clients to get a Rx for their actual dog but the dog doesn’t get it

Thank you! You’re such a wealth of information Waiting for my vet to call me back as we speak…