Mixing Supplements/NSAIDS: Previcox + Devil's Claw?

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My vet came out to look at my kissing spine / cervical arthritis horse recently, and prescribed him Previcox for day to day pain management. I just realized that he has been on the Uckele Devil’s Claw supplement this entire time. Should I be discontinuing the Uckele Devil’s Claw? I was using it for general joint supplement management, given I think it helps with his creakiness… but I thought I remembered reading somewhere that Previcox should not be given with other NSAIDs?

I’ve shot off a message to my vet, but probably won’t hear from her until later this afternoon.

Which makes me wonder how bad or good it is that we as equestrians have access to a whole bunch of supplements and NSAIDs, and are we mixing anything indiscriminately? As a general rule what supplements/pain relievers should not be ever mixed together?

[JB]

Yes, I would absolutely drop the DC. It still works on prostaglandin reduction for pain management, and you don’t want to add any of that to something that already does that.

It is a blessing and a curse to have access to the number and type of supplements we do. So many of them are both harmless and useless. It’s not very likely someone could cause a problem with pain management with typical use of things like DC or other herbs, not at the normal uses. That’s because most of them do so little anyway, or work via different mechanisms

Are “we” mixing things indiscriminately? Absolutely! Why? Because marketing says we should be doing all sorts of things so WE feel better about doing “all we can”.

What shouldn’t we mix? Things that contain bentonite/Montmorillonite clay shouldn’t be used with daily dewormers (and probably many medications), so many supplements should be discontinued while using those. Beyond that? Not sure, but there probably are others.

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Thank you JB! Consider the DC dropped as of tonight’s feeding.

Next question, which I only just discovered while reading up on Previcox just now… I’m seeing a lot of “3 weeks on” 1 week off type deal; my vet didn’t mention that. Should I be doing it too? During this time, should I swap to the DC, or just continue without the DC or any sort of pain reliever during that one week off?

Probably another question for my vet, huh?

I believe the goal is to be on Previcox long term, as he is not going to get better. The Previcox is to help manage his neck and back pain.

I wish there were more conclusive studies on pain management/relievers and their efficacy. I feel like so much of what we buy doesn’t make a difference… but for anyone shopping around for joint supplements, I definitely noticed a difference on the Uckele’s Devil’s Claw with my guy. Haven’t noticed a difference with Previcox yet but it’s only been a few weeks.

Of course this happens right after I buy and open the biggest bucket possible of DC… lol! Guess I should just feed it to another horse.

Thanks about the info about wormers and bentonite clay. I did not know that, either.

One thing I did know that may be helpful to other peeps out there: if you are feeding Sandclear or some other Psyllium Seed Husk, you should discontinue your supplements or feed them hours before the Sandclear. This was told to me by a vet, who said that the Psyllium will pick up the supplements and you will be wasting your money.

[JB]

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Next question, which I only just discovered while reading up on Previcox just now… I’m seeing a lot of “3 weeks on” 1 week off type deal; my vet didn’t mention that. Should I be doing it too? During this time, should I swap to the DC, or just continue without the DC or any sort of pain reliever during that one week off?

Firocoxib is only labeled for use for short durations (as is bute). It’s the (very, very common) off-label use to use it longer. The goal should always be as little as possible, but as much as necessary, both from a duration and dosage standpoint (within safety margins of course, ie don’t just continue with 114gm firocoxib just because that’s what gave the best results)

No, don’t add back the DC for any time off the firo

That said, if you find you can do 5 days on, 1 day off (or 3 on 1 off, or whatever), that’s better than full time on

[qutoe]I believe the goal is to be on Previcox long term, as he is not going to get better. The Previcox is to help manage his neck and back pain.

[/quote]

Yep, that’s why long-term use of NSAIDs is done, despite the labeling only for much shorter durations

I wish there were more conclusive studies on pain management/relievers and their efficacy. I feel like so much of what we buy doesn’t make a difference… but for anyone shopping around for joint supplements, I definitely noticed a difference on the Uckele’s Devil’s Claw with my guy. Haven’t noticed a difference with Previcox yet but it’s only been a few weeks.

The Previcox should have made a difference within a few days. If it’s not helping after a few weeks, then I wouldn’t stay on it

Thanks about the info about wormers and bentonite clay. I did not know that, either.

You shouldn’t be using a daily dewormer anyway, so… I’m betting you’re not. It’s not a concern with the normal paste dewormers, not with the amount of clay in most things. That said, if you happened to use clay as a supplement on its own for some reason, I wouldn’t use it on the day you dewormed

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@JB

Firocoxib is only labeled for use for short durations (as is bute). It’s the (very, very common) off-label use to use it longer. The goal should always be as little as possible, but as much as necessary, both from a duration and dosage standpoint (within safety margins of course, ie don’t just continue with 114gm firocoxib just because that’s what gave the best results)

No, don’t add back the DC for any time off the firo

That said, if you find you can do 5 days on, 1 day off (or 3 on 1 off, or whatever), that’s better than full time on

Yep, that’s why long-term use of NSAIDs is done, despite the labeling only for much shorter durations

The Previcox should have made a difference within a few days. If it’s not helping after a few weeks, then I wouldn’t stay on it

You shouldn’t be using a daily dewormer anyway, so… I’m betting you’re not. It’s not a concern with the normal paste dewormers, not with the amount of clay in most things. That said, if you happened to use clay as a supplement on its own for some reason, I wouldn’t use it on the day you dewormed

Thank you again. I’ll have to quiz my vet more on what she thinks is appropriate (time off/on). I will be keeping this all in mind.

I haven’t noticed a difference… but… he was also on the DC this entire time. Maybe because he was on both…?I guess I’ll see if there’s a difference for the worse with the DC pulled, and that’ll be my sign. He is on one full pill of Previcox daily.

I had tried him on Previcox in the past, about two years ago, when the KS was first discovered. I didn’t see a difference, and discontinued.

To be honest sometimes I can’t tell with him, anyway. I know the injections really helped. The difference under saddle was incredible. The feed through supplements, other than DC, I have never seen a difference. I don’t think someone looking at him in the paddock would know he is sore. He moves around beautifully in the paddock. It comes out more under saddle, and even then pretty subtle. He has a toe drag and slips in his stifle on small turns, and has a rare bolt at the canter. He has a high respiratory rate when you put the saddle on him, but doesn’t kick or pin his ears. These made me look at his neck even though my trainer did not feel that he was lame. I haven’t ridden him since the Previcox was started, since he’s a glorified pasture puff for the most part and I suspect he is hiding much more than he is letting on. To be honest I have a bit of an ethical dilemma with him, because everyone tells me he is servicably sound, and he does like to work, but sometimes when I ride him in the school I can tell he is not entirely comfortable. He seems fine on hacks.

No daily dewormer here. I pull fecals and worm as indicated.

[colorfan]

I just confirmed this week with a vet that the most I can give my mare is 1/4 tablet, I suppose Previcox can come in different doses.
I had had my mare on Bute for pain managment, 3 on 2 off, but was concerned about being on it long term (life) so last year discussed with my regular vet what alternatives there were, I was actually expecting a very grim alternative so was
quite delighted when he suggested Previcox, there was a noted improvement almost immediately. (just my experience)

Perhaps because the DC was already doing its job switching one for the other will just maintain your geldings condition as is?
Like you I wonder about what I can mix without doing harm.

I do not ride my mare anymore, even tho she would march herself up to the saddle post and look at me as if to say lets go.

[JB]

We need to talk in terms of mg, not tablets.

Previcox comes in 2 tablets sizes - 57mg and 227mg.
Equioxx comes in 1 table size - 57mg.

Dogs can get either dose, or in between, but horses should ONLY get a 57mg dose. A vet might prescribe a higher dose for a very short while, just don’t try that at home.

So, “1/4 tablet” applies to a 227mg Previcox tablet. Not a 57mg Previcox, not a 57mg Equioxx.

If DC does the job, and changing to firocoxib doesn’t improve anything, then I’d definitely continue with the DC and drop the firo. At least that’s safer than firocoxib. Not safe, just safeR. They all come with risks.

[walkinthewalk]

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Which makes me wonder how bad or good it is that we as equestrians have access to a whole bunch of supplements and NSAIDs, and are we mixing anything indiscriminately? As a general rule what supplements/pain relievers should not be ever mixed together?

In terms of “—how bad or good is it that we equestrians have access to a whole bunch of -----”, infers none of us are capable of managing our horses’ health issues and mayhaps a higher authority (like the government) should be telling us what to do. Sorry but I take offense.

The onus is on the horse owner to demonstrate good common sense and do their homework (that means researching credible articles AND credible comments from credible people), whenever they stuff anything – anything at all down a horse’s throat.

Just because something is the Popular Flavor of The Month" on a forum or on Facebook doesn’t mean a person should just jump right on the bandwagon and start feeding it.

It also means paying attention to what is already being given to the horse. When it comes to herbal supplements, NSAIDS, and other similar products, I don’t make a move without asking one of the vets who care for my horses — thankfully for me, two of them are also up-to-speed on alternative medicines along with being traditional.

Common sense common sense common sense-----------let it prevail -------

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I’m not sure how you can take offense to my question, or infer that I think some government official should be watching your medicine cabinet, but okay…

I guess you are insinuating I lack common sense for asking these questions.

In the thirty years I have had horses I have never had a vet ask me what supplements I am feeding my horses before they prescribe medication… I am not a medical expert, I trust the expertise of my vet when it comes to what I should be administering. I’ll read up on these things but I am not an expert. That’s my vet’s job. My vet knew he was on Uckele’s Devil’s Claw, as I had run it by her last year when I first was suggested to try it.

Are you competing, by any chance?

I don’t think I could list on one hand what a HJ competitor gets in their morning grain. None of which I am sure is meant to be fed in conjunction with other supplements. Most which aren’t even legal or are off-label use. I’d like to be a walking dictionary but I’m not, so it took me a few days to remember that Previcox isn’t supposed to be fed with other NSAIDs. I read about that years ago, frankly I am surprised I remembered it.

Hopefully this thread is informative to other people.

[EverElite]

@JB

What shouldn’t we mix? Things that contain bentonite/Montmorillonite clay shouldn’t be used with daily dewormers (and probably many medications), so many supplements should be discontinued while using those. Beyond that? Not sure, but there probably are others.

Sorry, OP - going to briefly hijack your thread!

JB - mind expounding on this a bit? I feed an ulcer-prone mare Redmond’s Daily Gold Stress Relief in combination with other supplements and previcox (previcox is generally given ~10 mins before her concentrate meal). I’ve been wondering if the bentonite clay found in the Daily Gold may impede the effectiveness of other supplements and meds fed in conjunction, but haven’t found any persuasive science either way.

[alibi_18]

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I’m not sure how you can take offense to my question, or infer that I think some government official should be watching your medicine cabinet, but okay…

Don’t worry, some people are just self-centered and dont understand other people might not be as diligent as they are and that’s why there are regulations and experts.

If you knew how many people mix-n-match their own medecine/supplements/alternative meds… It is scary.
A friend of mine is pharmacist and he says people don’t just forget about what they take (which is normal), they also lie to doctors and to him! :rolleyes:

My questions :

If you tried Previcox before and it didn’t work, why are you trying again?

Is it at the same amount as before?

If the DC supplement was working well, why did you decide to start Previcox again?

Did you do a loading dose?

How do you feed it?

I used to give it to an older gelding I was training and it did wonder. He was injected as well but the frequency decreased from every year to every 2 years.
We gave him a loading dose and also decreased the amount up to only 3 pills/week for years.
We only had to increase it a few times as he got older and the injections were no longer warranted.

He was a spitter and we had to be really cautious about feeding him his pills… He would pretend to eat it, swallowing throat move and all, and you would find the pill on the ground half an hour later… :rolleyes:
I loved him so much! :lol:

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alibi_18 –

If you tried Previcox before and it didn’t work, why are you trying again?
It was prescribed in conjunction with “pain therapy” when KS and cervical arthritis was first discovered. It was used temporarily between when we diagnosed and when he got injected to help maintain any body pain. I discontinued before injection as I didn’t see much difference. This time we are trying it because I had the vet out for a wellness exam to check how KS/CA are progressing. Vet noticed he actually palpitated sore over his back this time, tested positive in hoof testers in his RF and RH (caudal heel pain) but the horse is shod all around, so she estimates maybe from all the stomping at flies. We don’t think abscess or stone bruise as he trotted sound on pavement and in tight circles. So the Previcox was prescribed as an all around pain management since he does seem NQR but isn’t limping on any leg. The KS isn’t going to get better, and we are trying to see what we can manage without injections. They are costly for me but I am willing to get them done if he needs them. My vet is very cost/care conscious. I have only injected his neck once (August 2018). He is not being ridden at the moment and vet doesn’t think he needs another neck injection at this time.

Is it at the same amount as before?
I believe so.

If the DC supplement was working well, why did you decide to start Previcox again?
Because of above ^ The DC was just for general joint maintenance since he has KS/CA and is a teen ex-racer.

Did you do a loading dose?
No… I was told 1 pill a day, daily. He is 3 weeks in now.

How do you feed it?
Put one pill on the back of a Fig Newton. No problems. He is very food motivated.

I will check the ground. I feed him a handful of Fig Newtons at once. I don’t think he knows there is a pill in there, he is a pig!

I have some threads about my journey with this gelding, if you or anyone else are curious about pain management with Kissing Spine. It’s a very frustrating disease. I go through weeks where I feel he is feeling on top of the world, and then weeks where I think he is in pain. It’s constant highs and lows, though he is never so sore that my vet feels he needs to be PTS.
https://www.chronofhorse.com/forum/f…-and-arthritis
https://www.chronofhorse.com/forum/f…int-injections

[JB]

@EverElite

Sorry, OP - going to briefly hijack your thread!

JB - mind expounding on this a bit? I feed an ulcer-prone mare Redmond’s Daily Gold Stress Relief in combination with other supplements and previcox (previcox is generally given ~10 mins before her concentrate meal). I’ve been wondering if the bentonite clay found in the Daily Gold may impede the effectiveness of other supplements and meds fed in conjunction, but haven’t found any persuasive science either way.

I don’t know I would check the data sheet for the drugs, as they will have actual research behind them, and something as common as bentonite clay may be listed as contraindicated. drugs.com can be a good place to find some of these things

My take on daily clay intake - a waste of $$, and I will always assume that because there are things it’s known to interfere with, such as pyrantel tartrate (the daily dewormer), there are probably quite a lot of other things. Whether that’s an actual nutrient, as opposed to a non-nutrient chemical (ie that pyrantel, and all dewormers in general), I don’t know. You could probably research bentonite clay pretty easily to see what it’s known for binding with.