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  Discussion on Longterm NSAIDs for Ringbone
Author Message
Member:
Mwebster

Posted on Sunday, Sep 15, 2002 - 8:51 pm:

Just a quick update. My horse has been on the meclofenamate about 10 months now, and is doing great on 1-1.5 g/day (a relatively small dose for a 1350 lb equine). Suzanne's compounder is wonderful - they make up 1g packets for me, at a cost of $2/g. I just add a little water to the packet, dissolve the drug, and pour it on his sweet feed. No more opening 10-15 little capsules (and coughing upon inhaling the fine powder). No more syringing.

We recently spent a week at Acadia (becoming an annual trip!) and he was rarin' to go for 4hr rides each day.

Thanks, DrO, for the information that got us to this point! And thanks, Suzanne, for the great source -- my horse is very happy with their product. Hopefully, he'll continue to be his bright healthy self for a long time to come.

Melissa
Moderator:
DrO

Posted on Monday, Sep 16, 2002 - 7:47 am:

Thats just great Melissa, I hope he continues to have many good years of riding.
DrO
Member:
Suzym

Posted on Thursday, Oct 3, 2002 - 11:59 am:

That IS great, Melissa! Glad I could help :-)

Suzy
New Member:
Aewheele

Posted on Friday, May 23, 2003 - 3:00 pm:

Hello All. At the risk of repeating yourselves, I would appreciate some more comments on the treatment for Upper Ringbone. My 14 year old gelding was just diagnosed as possibly having the beginnings of Ringbone - based on radiographs. I am trying to map out a course of action. I have reviewed a lot of the posts here, and I'm very intrigued by the many comments on the use of meclofenamate, and I was wondering if you could give me more information about this product. Is it an analgesic or an anti-inflammatory?

There also seems to be a lot written regarding the proper dosage, how best to administer the drug, and where to purchase it. What's the latest on these?

I've been trying to stay away from bute because I was told that it can upset a horse's stomach and mine had an ulcer last year. Do I have to concern myself with gastral issues using meclofenamate?

As an aside, my vet indicated that my horse's heels are too high. The angle of the hoof is not the same as the angle of his pastern. Will lowering his heel so that the angle of the hoof is more in line with the angle of the pastern make him more comfortable and reduce the stress on the pastern and maybe slow down the deterioration of the pastern?

Do you have any shoeing recommendations for helping him go sounder?

Thank you all.

Andrea
Member:
Mwebster

Posted on Friday, May 23, 2003 - 3:47 pm:

Hi Andrea,

My gelding has low ringbone, so a very different situation from yours - with high ringbone, fusion of the joint (surgical or natural) eliminates pain and lameness, so you have a different set of options from me. You should read DrO's articles if you haven't already.

Meclofenamate is an NSAID, so carries the same kinds of risks that bute does. DrO can tell us whether there are any studies that show whether meclofenamate is any safer than bute, and whether a horse with ulcers will be at greater risk (I would guess so). By the way, the non-NSAID alternatives, such as BL Solution (aka Bute-less) which have Devil's Claw can also upset the stomach (and they don't work very well either), so they're not the answer!

I tried meclofenamate because, from DrO's article on NSAIDs, it seemed to be safer, and seemed to be more specific to the lower leg. Also, my horse just hates bute, it's so bitter, so it's a big quality of life thing for both of us that the meclofenamate is odorless and tasteless. I've used it now for more than a year and a half, it keeps my horse sound for trail riding at WTC, and it's very easy to administer. The veterinary compounder I get it from is wonderful to deal with: they package it in little envelopes of 1g and mix it with something like koolaid, and my horse actually licks his bowl clean after eating, something he's never done with just grain (he's pretty casual about his grain). So I just sprinkle it on his grain, I no longer even mix with water. And their price is great, and reorders are as simple as a quick phone call to let them know I'm running low -- they call my vet and charge my card and that's it. It costs a lot more than bute, that's the only downside.

I think shoeing properly is a "must" no matter what, so get a farrier you trust and fix those angles. I don't see why special shoes would be needed. But then I'm not experienced with high ringbone...
Moderator:
DrO

Posted on Saturday, May 24, 2003 - 6:52 am:

Andrea, as Melissa suggests above there is much written on your questions at Equine Medications and Nutriceuticals » Anti-inflammatories, Steroids, and Arthritis Treatment. All of these articles have received updates in the last 12 months.
DrO
Member:
Aewheele

Posted on Saturday, May 24, 2003 - 6:49 pm:

Thank you both for your comments. I really appreciate it. I will do my homework and review the various articles Dr. O has written. I will keep you posted.
Regards,
Andrea
Member:
Aewheele

Posted on Thursday, Jul 24, 2003 - 2:06 pm:

Use of NSAIDS over the long term.

Some things have developed since my last post.
In addition to the diagnosis of ringbone, my horse injured his stifle during a riding lesson. I have only owned him for a year, and I suspect that he sustained an injury to that stifle prior to my purchasing him. He has always shown a non-specific weakness in his right hind. After a month of stall rest and limited turnout the vet has told me that the stifle is much better and I can start working him again. However, I know he still feels some discomfort in one or both areas – his left rear pastern and his right stifle. Given that my horse is 14 years old and his joints are showing wear and tear with obvious long-term issues with his pastern, I want to start him on a pain management program. To start the process, my vet has recommended that I give him aspirin twice a day, every day. Unfortunately, I don’t think aspirin is doing enough. I read some of the articles that Dr. O wrote regarding the various NSAIDS. Based on everything I have read so far, I want to start him on a regime of Meclofenamic Acid or Naproxin or maybe even Bute, although he doesn’t like the taste. However, I don’t necessarily want to give it to him every day. Because these medications can cause ulcers, I would like to medicate him on those days when I am riding him so that he can work comfortably. I usually ride 3 to 4 days a week.

1. Is it acceptable to administer the NSAID right before I ride? If so, how long does it take for the drug to take affect? How much time do I need to give him before I can start riding?
2. Will administering the medication right before riding have a more adverse affect on his stomach then if it were given to him while he was at rest?
3. Does it make any sense to incorporate another supplement into his diet that will help reduce the possibility that he will develop an ulcer while on NSAIDS? He had one briefly last year, but I suspect it was due to his changing environment. His ulcer developed shortly after I purchased him. (I sometimes have that affect on people as well). We gave him an herbal supplement called “Stomach Happy” and his ulcer cleared up. Besides this rather costly supplement, does anyone have any other recommendations?

Please note, he currently gets Adequan injections once a month and he received cortisone and Legend injections in his hocks and stifle when he was injured. I also give him a glucosamine/chonDrOitin supplement (2 scoops of Equinyl CM) every morning. I want him to be as comfortable as possible. Before I decide whether I need to retire him, I would like to see whether any of the various medications that are available for pain & joint management can keep him working comfortably.

I have read a lot of postings and articles on this website, and have been encouraged by the fact that a lot of owners continue to work their horses successfully even though many of these horses suffer from the similar problems as my horse. Unfortunately, I have not seen much written regarding the amount of time it takes these drugs to take affect and whether they can be administered at a time that would allow for dosage right before riding (or within an hour for example). I also haven’t read anything definitive regarding usage of NSAIDS on an intermittent basis instead of every day.

Can you give me any advise?

Thanks,
Andrea
Member:
Mwebster

Posted on Thursday, Jul 24, 2003 - 5:41 pm:

I too had assumed withdrawing it when I wasn't riding would be a good idea. Some vets think that's the way to go, but my lameness vet said no, better to stay consistent and administer daily, to keep the horse comfortable and minimize the inflammation in the joints.

Moderator:
DrO

Posted on Friday, Jul 25, 2003 - 6:43 am:

As to whether it is better to use the NSAID episodically or not depends on the case. If you have ongoing acute inflamation daily constant use is logical. If you have a horse that stays pretty comfortable when not ridden, but the arthritis exacerbates with exercise, episodic use is rational. Because every horse is different the programs are tailored to maximize comfort while minimizing toxicity.

The timing and use of NSAIDs is addressed in detail in » Equine Diseases » Lameness » Diseases of Joints » Arthritis and DJD: An Overview. Look under the heading Long Term Management. Though this regimen would work with most NSAID's, meclofenamic acid appears to be a slow acting product and may not be best for this type treatment regimen.
DrO
Member:
Mwebster

Posted on Friday, Jul 25, 2003 - 10:31 am:

Thanks, DrO, for your (usual!) clarity. Yes, in our case, the horse is very sore when the NSAIDs are withdrawn, and exercise doesn't make him noticeably sorer, so that's why we go the continuous use route, and that's also why the (slower acting) meclofenamate is a good alternative (for this horse). I agree, depends on the horse. Just meant to offer that episodic use isn't necessarily the "best way to go" in every case.
M
Member:
Aewheele

Posted on Friday, Jul 25, 2003 - 11:04 am:

Thank you both for your comments. I will review again the article Dr. O mentions. I'll keep you posted.

I think one general comment is in order at this time. This website is a God-send. It is a fabulous tool for those of us who are just starting out in the world of horse-keeping. Dr. O, your committment to this site and the people who post here is really extraordinary. I wish all DVM's were as responsive and helpful.

Thanks again, everyone.
Andrea
New Member:
Collies

Posted on Monday, Jul 28, 2003 - 10:54 am:


I am new to the list and have an 8 year old Quarter horse gelding with ringbone. He is in a lot of pain and is very difficult to shoe. He is currently having chropractic done and vet stated he's a mess! He was ridden at a riding stale for three years before I got him and history unknown before tat. I had pads put on front feet with good results as prior to that he would pick his way on rocky trails. His back feet have not been trimmed as he wouldn't let farrier get near them, yet I can work around his legs fine. I just sent him to a trainer for evaluation and spoke with him last night. He said the ringbone is a real problem and if he gives him some bute he will let him pick up his feet so we are going to try that although I know it will be 3 or 4 shoings to see if he improves. He doesn't have a mean bone in his body but reacts violently with my farrier. I am at my wits end and am doing everything to help improve his condition. Dr. O do you know of any treatment for this problem?? I need all the help I can to see what else can be done. Thanks,}
Member:
Imogen

Posted on Tuesday, Jul 29, 2003 - 2:50 am:

Try a farrier known to be good with difficult horses... some are excellent and very fast at shoeing while keeping the foot low down, others can't adapt their technique and/or (and I don't blame them) are not prepared to deal with kickers.

All the best

Imogen
Moderator:
DrO

Posted on Tuesday, Jul 29, 2003 - 6:12 am:

Assuming the trainer is right and pain the problem with picking up the feet why not use some bute to help him with the farrier?
DrO
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