Common Equine Medications and Their Effects

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

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

14. NSAIDs(Non-Steroidal Anti-Inflammatories)

15. 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”

16. 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….

17. Clostridial Myositis Result of IM injections

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

19. 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

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

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

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

24. 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)

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

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

27. 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)

28. 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

29. 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)

30. 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

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

32. 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

33. 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!

35. Gastroprotectants • Gastrogard • Ulcergard • Ranitidine

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

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

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

39. 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

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

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

42. 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

43. 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!)

45. Miscellaneus Meds • Pergolide • Isoxsuprine • Marquis

46. 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

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

48. 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!

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

50. Questions?