I have a 33 y.o. whose knee is giving out. I know he doesn’t have long left but is still enjoying eating and sunbathing. The vet said I could try “voltaren” which is now OTC (and much cheaper than Surpass!) but doesn’t have any hard and fast rules on frequency of use. I think he’s getting some relief. Has anyone’s vet advised on how often to use this topical med?
When I was using Voltaren to help my guy recover from a bad wreck, my vet said once a day and it worked great for him.
Here’s hoping it helps your old guy. 
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The directions for Surpass are for twice daily application. It’s also for only 10 days 
Bute and firocoxib are only labeled for 14 days but obviously they get used for years. Meaning you kind of have to find what works. I’d work towards once a day. Maybe you can even do once every other day once you get to a stable point of improvement. Or 5 days on, 1-2 days off, something like that.
Keep in mind it is a steroid, so more isn’t better. If he’s insulin resistant, definitely work on as little as possible while also as much as necessary. It’s less systemic than any oral or injection of a steroid, but it’s also not going to just stick to the knee, it will just concentrate there.
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I think Voltaren (diclofenac) is a NSAID, not a steroid.
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You’re right! I was totally spacing, no idea why, as I KNOW that!
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Something like 3% of the diclofenac (an NSAID) is absorbed systemically–it’s a very small, nearly negligible amount. As someone who has used it quite a bit myself, apply it as often as you like. Especially if you’re using it to provide some comfort in end of life. There is a small risk of gastric upset, so watch for that, and a small risk of skin irritation. The human version stings like a mofo on broken skin, so keep it away from any nicks.
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My own prescription for myself allows up to 4x a day. I get by with 1-2 times. I have hock (talus) OCD.
For the hose, it depends on what it’s for and whether it’s something you’d wrap or not, but I would lean towards 1-2x a day as well unless really acute. When my horse tore a muscle and had a huge hematoma, vet said ice, ice, ice, laser, PEMF, Voltaren. Because he’s a sensitive red head, I wound up not being able to use much of it topically after a few days because his skin got scurfy. Of course it did.
So there is a difference (you said the human version stings) between Surpass and the human version? It’s twice as expensive!!
I will say, however, if you have a horse sensitive to NSAIDs, be careful applying too often. My sensitive gelding went off his feed after 2 days applying Surpass twice a day to a swollen knee. I sold the tube remnants to a boarder. Not worth it to me. This same horse gets yucky on bute also.
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Yeah, they’re different products…? They both have diclofenac but the base is different between the two.
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Here’s a pretty good thread which talks about some of the differences. They have the same active ingredient, but, as Simkie said, are different products.
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Awesome, I love it. This comment is especially useful:
Just my anecdotal feedback…I far prefer Surpass for human use. I think it works quite a bit better for my pain, the cream feels better going on the skin, it doesn’t stink, and it doesn’t sting.
That said, Voltaren is cheap, and is available, and does work. So I just use that nearly all the time.
I do use Voltaren gel on horses for “won’t hurt, might help” scenarios, but never on any amount of broken skin and if there’s something serious where it really NEEDS to work, we use Surpass instead.
Or there is mixing Voltaren with DMSO. I haven’t tried it myself but have been poking around this very issue.
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That’s really interesting. I saw some Voltaren at Costco the other day (3 pack for 35.99!) and took a photo of the label to compare to Surpass - it said the same thing. I wonder if there are different types of Voltaren?
Not in the US. Canada has some different strengths. The stuff in the US is all 1% diclofenac. Same as Surpass. The carriers between the two are quite different.
I should have clarified - I’m wondering if there is Voltaren with different carriers on the market. The Voltaren I saw at Costco had “diclofenac sodium” on the label vs “diclofenac diethylamine” on the label in the Reddit post.
No. The Reddit picture is the Canadian product. Very slightly different active ingredients. (Although both diclofenac.) Probably the same carriers.
Oh, gotcha. That makes much more sense. Thanks for the clarification!
Voltaren has gone otc in the US recently…in the last year? Six months? Before that, you could get it from Canadian pharmacies by mail, where it was OTC with a few different strengths. So, much of the discussion you’ll find online might be about the Canadian prep. The US stuff is really similar, but not exactly the same, as you’ve seen from the labels 
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You can get 2% in the US by Rx (for humans). Otherwise you’re correct that it’s all 1% OTC.
