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Common Equine Medications and Their Effects

Common Equine Medications and Their Effects. Matt Kornatowski, DVM. My Perspective. Many questions about drugs Misconceptions Reasons for choosing certain drugs Safety for you and your horse . Sedatives NSAIDs (Non-steroidal Anti-inflammatories) Antibiotics Gastroprotectants.

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Common Equine Medications and Their Effects

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  1. Common Equine Medications and Their Effects Matt Kornatowski, DVM

  2. My Perspective • Many questions about drugs • Misconceptions • Reasons for choosing certain drugs • Safety for you and your horse

  3. Sedatives NSAIDs (Non-steroidal Anti-inflammatories) Antibiotics Gastroprotectants Topicals Miscellaneous Outline

  4. Talking Points • Appearance • Uses • Administration routes • Side Effects

  5. Non-Talking Points • Doses • Steroids (Too much) • Reproduction drugs • Dr. Stanford’s talks • Dewormers • A whole different talk! • Supplements • Controlled drugs

  6. Abbreviations • PO = Per Os = Orally • IV = Intravascularly • IM = Intramuscularly • PR = Per rectum = enough said

  7. Sedatives • Acepromazine • Detomidine • Romifidine • Xylazine • Use caution!

  8. Acepromazine(Ace) • Affects dopamine receptors • Light yellow appearance Oral tablets/paste • Used for mild calming effect • Not strong analgesic/sedative • Given PO, IM, IV • Lasts 3-4 hrs • Side effects: Sedation, ataxia, hypotension, • persistent penile prolapse (paraphimosis)

  9. Detomidine(Dormosedan, Dorm) • Alpha 2 agonist • Clear in appearance • Used for heavy sedation, mild analgesia • Dentals, wound repair, etc • Given IM, IV • Lasts 45 min – 1 hr • Side effects: Ataxia, swaying, diuresis • Occasional hyperresponsiveness • Rarely recumbency • Reversal agents

  10. Romifidine(Sedivet) • Alpha 2 agonist • Clear in appearance • Used for moderate sedation • Wound repairs, oral exams • Given IM, IV • Lasts 1 – 1 ½ hrs • Side effects: Ataxia, sweating • Rarely facial edema

  11. Xylazine(Rompun) • Alpha 2 agonist • Clear in color, shortest acting • Used for mild sedation, mild analgesia • Given IM, IV • Lasts app. 30 min • Effects: Sedation, mild analgesia • Occasional hyper-responsiveness

  12. NSAIDs(Non-Steroidal Anti-Inflammatories) • Phenylbutazone • Banamine • Firocoxib • Aspirin • Piroxicam • Meloxicam

  13. NSAIDs(Non-Steroidal Anti-Inflammatories)

  14. Phenylbutazone(Bute) • Large white tablets, white paste, flavored powder • Used for musculoskeletal pain • Mild anti-pyretic effect • Given PO, IV • Lasts 12-24 hrs • Side effects: GI ulceration (high dose) • Renal papillary necrosis (dehydration) • Bone marrow suppression (anemia) • Long term use • IM injections cause tissue necrosis (death) • Use caution in pregnant mares • “Bute Babies”

  15. Flunixin Meglumine(Banamine) • White paste, clear liquid • Used for GI pain, fever reduction • Given PO, IV, (IM??) • Lasts 12 hrs • Side effects: GI ulceration • Renal ischemia (papillary necrosis) AND….

  16. Clostridial Myositis Result of IM injections

  17. Aspirin • White powder • Used for hypercoagulable states, Equine Recurrent Uveitis • Given PO • Side Effects: Same as above (less common), platelet inhibition, tinnitus (overdose)

  18. Firocoxib(Equioxx, Previcox) • Cox 2 specific • Used for musculoskeletal pain • Given PO • Lasts 24 hrs • Side effects: Less common but similar to other NSAIDS • GI ulceration, renal injury, oral erosions

  19. Piroxicam • Cox 1 • Used for Squamous Cell Carcinoma • Given PO, IV (less common) • Side effects: Same as above

  20. Meloxicam (Metacam) • Cox 2 specific, considered quite safe • Used in Europe • Coming soon??

  21. SMZs Penicillin G Gentamicin Ceftiofur Doxycycline Metronidazole Enrofloxacin Chloramphenicol Antibiotics

  22. Resistance • When a microorganism has the ability of withstanding the effects of antibiotics • Genetic mutation within the bacteria • Due to overuse or improper use • underdosing • Multi-drug resistant superbugs • MRSA (Methicillin Resistant Staph. Aureus)

  23. SMZs • Trimethaprim Sulfadiazine (Veterinary) • SMZs, Uniprim, Tucoprim • Trimethoprim Sulfamethoxazole (Human) • Tribrissen • 160 mg Trimethoprim • 800 mg Sulfa • Main difference: • Urine concentration • Metabolization

  24. SMZs • Paste, powder, white tablets • Given PO, IV (Rare) • Used for variety of infections • Mainly skin, uterine, urinary • Side effects: Colitis, Anemia (long term)

  25. Penicillin G • “G” = Gold Standard • White liquid • Limited spectrum of activity • Used commonly for Staphylococcus/Streptococcus - Skin, “strangles” • Given IM only! • Other forms of penicillin can be given IV • Side effects: Soft tissue reaction, Allergic reaction, anemia (long term use)

  26. Gentamicin(Gentocin) • Clear liquid, ophthalmic ointment • Synergistic with penicillin • Gentomicin is poor against Streptococcus • Given IV, IM, Ocular • Side effects: Nephrotoxic (Kidneys) • Rare ototoxicity (ears) • Neurotoxicity

  27. Ceftiofur(Naxcel, Excede) • White powder reconstituted to yellow liquid • Excede is brown, thick liquid • Used for respiratory infections, internal disease, surgery • Given IV, IM (Excede IM ONLY) • Side effects: Colitis & anemia (high doses)

  28. Doxycycline • Small, orange tablets • Used for various issues • Penetrates tissues very well • Given PO • Oxytetracycline given IV • Side effects: Congenital malformations • GI disruption • Relatively safe

  29. Metronidazole(Flagyl) • Oblong white tablets • Used for diarrhea, thrush, canker (anaerobic infections) • Given PO, PR, topically • Side effects: • Neurotoxicity (rare) • Disruption of GI protozoa

  30. Enrofloxacin(Baytril) • Liquid or oral paste • Used for variety of infections • Less resistance • Given PO, IV • Side effects: Colitis Neurotoxicity Tissue irritation (Oral lesions) Cartilage damage in young

  31. Chloramphenicol • Yellow pills, oral liquid, eye ointment • Used for variety of infections • “Big gun” antibiotic • Given PO, IV, Ocular • Side effects: Diarrhea, inappetance bone marrow suppression Relatively safe • Aplastic anemia in humans • Wear gloves!

  32. Gastroprotectants • Gastrogard • Ulcergard • Ranitidine

  33. Omeprazole(Gastrogard/Ulcergard) • Oral, white paste • Treat/prevent gastric ulcers • Proton pump inhibitor • Decreases acid secretion • Given PO • Side Effects: • No adverse effects listed

  34. Ranitidine(Zantac) • Small, circular yellow or white tablets • Treat gastric ulcers • Inhibits H2 receptors • Decreases acid secretion • Given PO, IV • Side effects: Very rare

  35. Topicals • Triple Antibiotic Ointment • Silver Sulfadiazine • Furazone • Surpass • DMSO

  36. Triple Antibiotic Ointment(Neomycin, Polymyxin, Bacitracin) • Clear gel comprised of 3 antibiotics • Topical antibiotic • Used for variety of issues • Eye ulcers (Ophthalmic), wounds, mild to moderate skin infections • Side effects: Contact dermatitis

  37. Silver Sulfadiazine(SSD) • Thick, white cream • Anti-bacterial, anti-fungal • Used for burns, eye ulcers, wounds • Side Effects: Skin irritation

  38. Nitrofurazone(Furazone) • Yellow gel • Can be mixed with DMSO • Antibacterial • Good for burns, skin infections • Scratches • Side effects: • Contact dermatitis • Renal impairment

  39. Diclofenac (Surpass) • White gel • Topical NSAID (Non-specific Cox 1 & 2) • Control of joint pain & inflammation • Side effects: • Well tolerated • Dermatitis (Let dry) • Possible weight loss, gastric ulcers, diarrhea

  40. DMSO(Di-Methyl Sulf-Oxide) • Clear gel • “Topical application to reduce acute swelling due to trauma” • Used in many other ways • Topical carrier agent • Some anti-inflammatory properties • Side effects: “Burning” (erythema) • Garlic odor • Relatively safe • Teratogenic properties in humans (Gloves!)

  41. Miscellaneus Meds • Pergolide • Isoxsuprine • Marquis

  42. Pergolide • Dopamine agonist • Decreases release of certain proteins • Used to treat Cushing’s Disease • Side effects: Few (Well tolerated) • In humans: Neuroses (hallucinations), nausea, vomiting, rhinitis

  43. Isoxsuprine • White tablets • Used for laminitis & navicular • Dilates blood vessels • Questionable efficacy • Given PO • Side effects: Unlikely • Tachycardia, hypotension • Hyperexcitability

  44. Ponazuril(Marquis) • Paste formulation • EPM treatment ONLY • Equine Protozoal Myelitis • Anti-protozoal • Affects organelle specific to protozoa! • Given PO • Side effects: • At 10x the dose, some soft manure • Very safe!

  45. Key Points • Sedatives • Ataxia, sweating, urination • NSAIDs • Gastric ulcers, kidney problems • Antibiotics • Resistance • Potentially cause colitis • Call your vet before administering any drugs!

  46. Questions?

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