We are currently treating my 35 year old horse for ulcers with Omeprazole.Vet recommended to keep her off her daily low does Bute for a while since there can be complications doing both drugs at the same time.Day 4 today with the Omeprazole and have to give 15ml for another 14 days .Since the horse is off bute,she is very stiff and does not want to move much anymore as her arthritis is now fully catching up with her.When will it be safe to start her on Bute again ? She gets 1 mg per day
Bute and omeprazole are often used at the same time, because omeprazole treats or prevents the gastric ulcers that bute can cause.
It may be worth asking the treating vet for more info here, but I’d certainly have no concerns using them together, especially when bute is being used to ensure quality of life in a aged horse.
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thank you ! that is good to know - i was going to doublecheck with my vet in any case on monday but thought to get the group s wisdom here as well
From EVJ, March, 2021:
Impact of concurrent treatment with omeprazole on phenylbutazone-induced equine gastric ulcer syndrome (EGUS)
“In the current study, as expected, EGGD score increased in PBZ but not PBZ/OME. Clinical signs associated with adverse intestinal events were observed in both the PBZ and PBZ/OME groups, with PBZ/OME having the highest rate of complications. These findings suggest that omeprazole, when administered together with phenylbutazone, protects against EGGD but may increase the rate of intestinal adverse events.”
Have you tried firocoxib? It is somewhat more Cox-2 selective, and has less of an adverse effect on the gastric mucosa.
PS–I’m assuming the phenylbutazone dose you mentioned (1 mg) was an error, and that you meant 1 gram.
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thanks for posting this,it says exactly what we are worried about ,hence the advice to try and stay away from bute,and yes you are right on i made a mistake ,it is 1 gr ! - we had tried firocoxib last year ,it was not as effective as bute and it sounded to me the vet thought it best to stay away from either drug,bute and firocoxib ,for 4 to 5 days at least
He did mention the risk of adverse effect was LOW but still ,with her being a bit on the shaky side now,any risk should be avoided
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If you really do need to use both together, and I get it, I would add in sucralfate. It complicates the feeding, since suclralfate and omeprazole need to be separated by 60-90 minutes, but it will help protect against the potential (likely?) issues of bute + omeprazole
i heard mentioning of sucralfate,thanks for pointing it out.feeding routine can be managed ,we have the horses here at home.
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