Non-steroidal anti-inflammatories (NSAIDs) are the most commonly prescribed class of pain medications
currently used for our equine patients. This class of drugs includes medications such as phenylbutazone
(Bute), firocoxib (Prevequine), and flunixin meglumine (Banamine). Below we will discuss the different
uses of these medications, potential side effects, issues with over-dosing and combining NSAIDs, and the
importance of screening bloodwork.
Phenylbutazone, more commonly known as Bute, has been on the market for use in equine patients for a
long time. This medication is still very commonly prescribed by veterinarians for short-term use (1-2
weeks), primarily for musculoskeletal pain and inflammation. Bute may be prescribed for cases such as
laminitis, acute lameness, wounds, fever, and sole abscesses. This medication is safest given once daily
for a short period of time. In severely painful cases, veterinarians may recommend twice daily
administration if needed.
Firocoxib, more commonly known as Prevequine, is now the most commonly prescribed NSAID for long
term use in equids. Prevequine has fewer side effects than Bute, and is therefore safer for long term use.
This medication is also given once daily at a very specific dose.
Finally, flunixin meglumine, more commonly referred to as Banamine, is the third NSAID commonly
used for horses. This medication is most commonly used for gastrointestinal pain (colic), ocular pain, and
to reduce fever. It can be used in place of Bute for musculoskeletal pain and inflammation. Banamine is
not generally recommended for long term use, and is most often used for no longer than a few days to
weeks.
The most significant side effects that can occur with NSAID use are damage to the kidneys and ulceration
of the gastrointestinal tract. The above medications are considered safe for the average patient when
administered at the correct dosage, frequency, and duration prescribed by the veterinarian. The risk of
gastrointestinal ulcerations and renal damage significantly increases when animals are administered over-
doses of these medications, medications are given more frequently or for longer than prescribed, the
patient is significantly dehydrated, and/or medications are combined. It is very important to read the
prescription label written by your veterinarian, and follow their recommendations.
Horses should not be administered more than one type of NSAID at a given time. There are certain
circumstances, such as colic, when your veterinarian may recommend and elect to give a second NSAID.
However, this is a decision best made by your veterinarian. It is important to make your veterinarian
aware if your horse has already been given Bute, Prevequine, or Banamine during these emergent
situations.
One tool that we can use to monitor the effects of NSAIDs on the kidneys is screening bloodwork. If your
horse is on Prevequine long term, your veterinarian will likely recommend running annual bloodwork.
This allows the veterinarian to assess your horse’s kidney enzymes and determine if it is safe to continue
using a daily NSAID.

Amelia Whitelaw, DVM

​​Client Education

Normal Incisors

At the time of your annual wellness exam, your veterinarian will likely discuss a multitude of preventative measures for the health of your horse such as diet, vaccination, deworming, dentistry, hoof care, or any other concerns you may have. An effective vaccination program is one of the most important factors in keeping our horses healthy and in the case of some diseases, alive. Though it may be easy to forget annual vaccines, an individualized annual vaccine program will help protect your horses from diseases even in your own backyard! 


At the time of your wellness exam, your veterinarian will help to determine which vaccinations are recommended for your horses based on risk of disease, consequence of disease, anticipated effectiveness of the vaccination, potential for adverse reaction, and cost of immunization vs. cost of potential disease outbreak. Risk of disease varies for each horse based on geographic area, environmental factors, anticipated exposure, age, breed, sex, and use of the horse. 


Equine vaccines are divided into two groups: core vaccines and risk-based vaccines. The core vaccines are for diseases that have a high risk of morbidity/mortality or public health significance. They have a high level of efficacy and safety exhibiting high benefit and low risk to justify their use in the majority of horses. An example is the tetanus vaccine, tetanus is found in the soil and so preventing exposure is very difficult. Annual vaccination for tetanus is safe and highly effective at preventing disease and the risk of death in unvaccinated horses is high. Each of the vaccinations within this “core category” have similar criteria. The AAEP recommends the following “core” vaccines for horses: tetanus, eastern & western equine encephalomyelitis, rabies, and west nile virus. 


Risk-based vaccines are the remaining equine vaccines where use is justified regionally based on geographic exposure, effectiveness of the vaccines, and risk factors of the horse. Specific to the horses of Vancouver Island, we often recommend equine influenza and equine herpesvirus (rhinopneumonitis) vaccination due to potential exposure between horses and relatively common outbreaks within the local equine community. While these vaccinations are not as effective at preventing disease as a “core” vaccine, they are still effective at limiting the severity of disease and minimizing spread during an outbreak. Other risk-based vaccinations may be discussed for your herd based on specific exposure risks. 


No matter your horse’s specific needs from backyard companion to internationally traveling sport horse, the team at Danielle Fritz DVM Inc. is here to help you keep your horses healthy and performing to their best ability. At the time of your annual appointment, we will be happy to discuss the best vaccine program for your herd and answer any specific questions you may have. For more information on equine vaccination the following are excellent resources: 


https://aaep.org/horse-owners/owner-guidelines/owner-vaccination-guidelines

https://www.bicanadaequine.ca/horse-vaccines

https://www.equineguelph.ca/Tools/equiplanner.php 

Lower Incisors after extraction

Past Events

Equine Vaccines

EOTRH

Equine Odontoclastic Tooth Resorption and Hypercemetosis, or EOTRH for short, is a progressive and painful dental disease of the incisors and occasionally canine teeth wherein the tooth roots begin to reabsorb and develop bulbous deposits of cementum (one of the components of teeth) around the roots which then cause the bone around the tooth to painfully deform. EOTRH is still not completely understood, and we don't entirely know what triggers the start and progression of this disease. What we do know about EOTRH is it occurs in middle-aged to older horses, and is far more common in male horses than females. The clinical signs of EOTRH that owners may notice include oral pain (hesitation to bite hard treats like carrots, or reactivity to being bridled, or taking bit contact), weight loss, and head shy behaviour. An oral exam of affected horses often reveals gingival recession, gingivitis (often with red dots on the gingiva around affected teeth), draining tracts from abscessed teeth, and a bulbous or lumpy appearance to the bone and tooth roots. EOTRH is diagnosed by taking radiographs of the incisors and canine teeth and looking for signs of resorptive lesions, bulbous growths around the roots, and bone loss around the tooth roots. The only treatment for these painful teeth is to extract them. Often the horses affected by EOTRH are very stoic and hide the fact that they are living with significant dental pain, and because of this many owners struggle with the thought of removing all the affected teeth. However, once those painful teeth are removed these horses often “come back to life”: gaining back lost weight, becoming less head shy, eating voraciously, and grazing on all but the shortest grass. In these post-extraction patients after a relatively short recovery from their extractions the only way you can tell they’re missing any teeth is the tip of their tongue that hangs out from between their lips!

DR. DANIELLE FRITZ DVM INC 

Est. 2006

Serving the Cowichan Valley

Diseased EOTRH Incisors

Upper Incisors after extraction

NASIDs