NSAIDs, anti inflammatory, pain releif

[patt-annE]

First off: I am going through all this with my vet, but i do like to gather info before approaching her so i have as many things to consider/ask as possible. I’m not looking for an internet vet, just for y’all experiences.

Here we go…so, she’s been on previcox for a while and was also taking a supplement to help prevent stomach ulcers because she’s prone to them. Recently I’ve been wanting to take her off previcox because I’m not comfortable with her taking it every day for it to be effective, when I know that its anti inflammatory effect isn’t consistently needed. She doesn’t always need that pain relief 24 hours a day, but i can’t just give her a pill when she’s sore because you’ve got to give loading doses etc. So I started looking for alternatives that act fast, that I wouldn’t need to give her every single day.

Asprin
Bute
Meadow sweet
Devil’s Claw

all research I’ve done says that NSAIDs can create active ulcers or open up new ones. When I first researched devils claw i read that it DIDN’T cause ulcers, but now I read from several places that it actually does because just like the others, it blocks certain things indiscriminately( including in the stomach, processes in digestion and stomach acid). At first I read that it was a safer option over bute, but then I read somewhere else that it wasn’t, especially for horses prone to ulcers.

I’ve heard “Bute” a lot over the years, even before I knew what it really did. What’s the concencus on it? Apparently some folks consider it the best product to use and whenever pain releif is talked about people say, “put em’ on some bute” as if Bute is a must-have for the barn. But at the same time, there are the bad side effects. Vet said that previcox (equicoxx, too) is safer than bute, but so many people still choose bute…

Meadow sweet was an herb I found when I was looking for raspberry leaves. I’m not nessessarily sold on herbal remedy type treatment overs synthetic drugs, but medicine did/does come from plants. The few things I read about it considered it an anti inflammatory but I couldn’t find any actual written accounts from people who experienced that in their horse–especially in comparison to the more serious heavy duty meds that are out there. Has anyone tried it? Know anything about it?

Asprin … Guaranteed to help, but seems risky. I could buy a small tub of pure asprin for her, its readily available but I’m concerned (again) about its effect on her. When I tried to get more info on this, several sources said its a safe precaution to also give vitamin c (or k? I can’t remember) for the tummy. Does anyone actually use asprin for their horse? She would get it, I’m predicting, 2-4 times a week and I worry that asprin is a “once in a while” kind of drug and shouldn’t be used so frequently… At the same time, any research on all of these say they shouldn’t be used frequently because they’re all somewhat dangerous.

​​​​​and, you know, if after all of this the vet says she wants me to keep giving her previcox… Ill do it, of course. But I really don’t like the idea of her being on medication like that… If it makes sense to say that. Her previous owner started her on it because after causing an old injury to worsen, she still wanted to use her more or less in the same way. I bought her with acknowledgment of all this, with the intention of her being a w/t/c flat work and trail horse. She’s only 13 and it seems to stupid to continue riding her in ways that hurt her body, mask the pain with drugs, when she’s still so young and would last longer on a lower impact kind of riding with safer pain relief when she needs it.

But for now… Yeah… If anyone can add things to my list, cross any off, would be very helpful.

[joiedevie99]

Any NSAID (drug or herbal) is going to have GI risks associated with it. As you noted, Previcox/Equioxx has a slightly lessened risk, but takes 4 days to reach full effectiveness (so you can’t give it one off). Bute has a slightly higher risk, but can be given as needed.

For most horses (especially one with preexisting GI issues), I’d try to treat the problem directly and discontinue systemic NSAIDS. Is the problem in a specific joint that you could inject, or shockwave, or apply Surpass to topically?

[mmeqcenter]

I’ve given Previcox one-off plenty of times over the years and it’s always worked great, both for dogs and horses.

Tumeric/curcumin may help you.

[lorilu]

What about willow? It’s the original source of asprin, and there is a supplement “Easy Willow” …https://www.finishlinehorse.com/index.php/product/easywillow/

[Ecarter1023]

We had to start my gelding on previcox just recently, and this is what I recall from the conversation with my vet:

Bute:
-NSAID
-cox1 inhibitor (this is where it differs from previcox): whatever it is that cox 1 inhibitors do, they also can cause the gastric upset/ulcers or liver/kidney issues, whereas cox 2 inhibitors are less likely to cause those issues
-CHEAPER

Previcox:
-NSAID
-cox2 inhibitor (still an nsaid, but less likely to cause those issues)
-more expensive
-vet recommended I get kidney/liver panel done once a year to monitor levels (my gelding is 13)

So, the reason you hear that most people use bute, is because it is cheaper, especially for short term issues.

With my senior mare when she was alive, I was in the “put her on bute for a few days” camp, and it worked. She was 27 when she died, so in my mind, any liver/kidney/gastric issue the bute could have done would be worth getting her comfortable. When she had her eye removed last summer, she was on bute for two months, and then this spring right before she had to be put down, it helped her arthritis for her last few months!

My current gelding (also 13, just like your mare) was diagnosed with mild hock arthritis. Riding and exercise is actually better for the arthritis, but I absolutely HATE knowing that while he’s not “lame”, he’s just not quite right. The previcox helps him be more comfortable while riding and even just in the pasture be able to frolick and act like an idiot like he loves to do.

I know nothing about the other options you listed.

Take all of this with a giant grain of salt, though, because I won’t pretend to be an expert on the case… this is just what my vet and I agreed to do for my horse and the reasons why. Hope this helps a little!

[findthedistance]

@patt-annE

I’ve heard “Bute” a lot over the years, even before I knew what it really did. What’s the concencus on it? Apparently some folks consider it the best product to use and whenever pain releif is talked about people say, “put em’ on some bute” as if Bute is a must-have for the barn. But at the same time, there are the bad side effects. Vet said that previcox (equicoxx, too) is safer than bute, but so many people still choose bute…

Bute has been on the market for ages. It is widely understood with decades of use in horses. This is part of why you have heard about it so much. Equioxx in pill form is relatively recent, and even paste Equioxx & dog Previcox are recent enough additions to the market that they’re still under patent.

The other reason many people consider bute to be a must-have is that it is EFFECTIVE. In general, you get better pain relief, and faster, from bute than Equioxx. If your horse spikes a high fever or has an acute injury, your vet is likely to recommend bute (or Banamine). Sometimes I’ll have bute prescribed to a specific horse on a PRN basis for an ongoing issue – for example, before the farrier comes – but most of the time we use bute to treat an acute problem. That said, I have known horses who happily lived on 1g of bute a day for YEARS, in the land before Equioxx. I wouldn’t do it with a horse with known gastric issues, but it’s not necessarily the wrong choice in some situations.

You might also ask about trying the Equioxx every 36 or 48 hours. The half-life is so long, some people find that equally effective.

[newhorsemommy]

Bute is harder on their stomachs than previcox and if using long term I would stick with the previcox. If only needed occasionally, I would use Bute because it’s faster and more effective.

My gelding is actually on meloxicam daily for stifle arthritis. I found it more effective than previcox. It’s used more frequently for horses in Europe than here. Another advantage is that my gelding will eat the tabs in his feed but could sniff out the liver flavored previcox a mile away and refuse to eat it.

[Ghazzu]

Just to further muddy the waters–

Willow bark, like meadowseet, contains salicylates, which are primarily responsible for its anti-inflammatory effects. Salicylate is an NSAID. It is not COX-2 selective, so it would carry the same issues wrt gastrointestinal ulceration as would the other non-selective NSAIDs (eg, phenylbutazone).

Additionally, standardization of the dose can be problematic with herbs.

IME, adverse GI effects can vary widely. I have known individuals who existed happily on phenylbutazone for years, and others who developed right dorsal colitis after a couple doses of flunixin.

As for aspirin, it is uncommonly used in the horse because of its pharmacokinetics. (It is more rapidly metabolized than some other NSAIDs, requiring a shorter dose interval.)

[S1969]

What exactly is the injury? Seems like there might be alternatives to regular use of any kind of pain relief if the injury can/will heal.

[bt1]

JUST ASK YOUR VET THEIR ADVICE do not present them with 100000011111 options you have googled. By all means have a further discussion if you are not 100% comfortable with their advice or want to understand exactly why they gave it, but just let them do what they paid to learn and what you pay them for as a start. I personally have had success with giving Banamine along with Ulcerguard/Gastrogard on an as needed basis per my vets’ recommendation to my ulcer prone horse (previcoxx just didn’t really seem effective on him and he has kissing spines)…yes any anti inflammatory is unfriendly to the GI tract, but I figure the stress of pain is just as likely, if not more to cause ulcers…so the vet & I treat the inflammation with the most appropriate/effective drug for that and then add a side of ulcer prevention medication.

[IFG]

Previcox stopped working for my horse (he is 26 and retired), so we went back to bute with monthly polyglycan shots.