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  Discussion on Dexamethasone and Bute used together - Is this ok?
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Member:
Stacie

Posted on Saturday, Sep 18, 2004 - 3:36 pm:

My 20 year old App came up with Anterior Uveitus 09-11-04 -he is 17 hands and very big boned

1) Vet came out that day, gave him a shot of Dexamethasone
2) Put him on Dexamethasone 10MG orally every other day
3) 1st 5 days 3 times a day Ophthalmic Ointment
4) 2nd 5 days 2 times a day Ophthalmic Ointment
5) 3rd 5 days 1 time a day Ophthalmic Ointment
6) Put a Fly net over face to block most of the light out. This is what she recommended, but said he did not need to be stalled

Then on 09-13-04 he came up 3 legged lame - he has had issues this year with his foot, but never this bad, ever - has never been this lame since we have had him. Called the Vet back out - she said that she feels his leg is so sore due to too much toe and it is straining the tendons and ligaments in the leg, he needed to be shod again she felt. She did a hoof test, but never pulled his shoe. Felt his leg for heat and left. I called the farrier, he came out 09-14-04. Told him what she felt was wrong. He highly disagreed due to the fact that he has never been like this thru all our problems this year with the horse. He said he will take as much toe off as he can, wedged him 3 degrees as well to get the pressure off, also found an abscess, small though, which the Vet should have found he said if she pulled the shoe. His hoof has grown in less than 4 weeks 1 1/2 inches, which the Vet felt is extremely much. To make him comfortable, the vet recommended Bute:
1) 2 scoops 5 Days 2 times a day
2) 1 scoop 5 days 2 times a day
3) 1 scoop 5 days once a day and then nothing

Is this too much for him to tolerate on his belly, being on the Dexamethasone as well?? I do not need him to come up with ulcers as well or something worse. Please let me have any ideas on this - he has now been stalled since 09-13-04.
Moderator:
DrO

Posted on Saturday, Sep 18, 2004 - 6:00 pm:

Hello Stacie
The dex probably potentiates the chance of ulcers but there are no studies on the safety of the combination in horses. Neither are there any readily found cases of ulceration with the use of the combination. 10 mg dex every other day is a small dose and I cannot judge your bute since I do not know how much bute is in a scoop.

Was there heat in the foot, was the foot sore to the hoof testors, and once the abscess was pared out did the horse go sound in the next few days. I must say if there really was a abscess the shoe should not have been put back on, in my opinion.
DrO
Member:
Stacie

Posted on Saturday, Sep 18, 2004 - 6:32 pm:

We are giving 2 grams I beleive, each scoop of Bute powder is a gram. The jar is down at the barn, so I cannot be sure. No heat to the foot, hoof was a little sore to the tester when done, that is why he pared it out. I just came back from the barn, he blew out at the heel sometime this afternoon. He is still lame but not to the extent he was. I did not give him the bute in his food, thinking that the combination would hurt his tummy. I will leave him off of the bute unless he shows alot of pain again.
What does dex do to help with his Uveitus? His eye is still cloudy, but the vet says that I caught it before it was full blown. When she showed up it was clouded 1/3 of the eye and a streak running down the center. It is still like that, maybe a little lighter in color. How long does it usually take for the cloudy to go away. She said there looked to have very little damage to the eye.
Moderator:
DrO

Posted on Sunday, Sep 19, 2004 - 8:50 am:

Well that confirms the farriers diagnosis, see Equine Diseases » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels.

For an explanation of the importance of dex for the treatment of uveitis see Equine Diseases » Eye Diseases » Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness. However we can modify the route of administration to lessen the impact on the gastrointestinal tract. Why not switch to opthalmic dexamethasone?
DrO
Member:
Stacie

Posted on Monday, Sep 20, 2004 - 1:06 pm:

He is on opthalmic dex already as well as 10mg every other day of oral. We are down to twice a day on ointment and then Tuesday we start 5 days of once a day. I have discontinued the bute - he is doing pretty well. I put him in the upper field yesterday as he was tearing up the barn. Pulling the wood off the walls and such. He had been put up in a 10 x 28 stall for a week and I guess he just was getting tired of being kept cooped up. How long do I need to keep the fly netting over his eyes?? Just want to make sure I keep it on long enough for him to recoop from this Uveitus. Thanks much for your help!
Moderator:
DrO

Posted on Tuesday, Sep 21, 2004 - 5:55 am:

If you are just protecting the eyes while they are painful, you can discontinue it when the horse is comfortable in bright light. If bright sunlight contributes significantly to the uveitis, and the uveitis is recurrent, then you should consider always using it on sunny days.
DrO
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