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  Discussion on Equioxx and Surpass
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New Member:
madison

Posted on Monday, Mar 1, 2010 - 7:46 pm:

Hi,
My horse was diagnosed with right stifle osteoarthritis (DJD) and was prescribed Equioxx, Surpass, and Adequan, although I don't expect very much from the Adequan. He is prone to ulcers so I was wondering how COX 2 specific Equioxx is and if I should be worrying about ulcers with Surpass. He has been grade 3 lame many days this winter (I just moved him from Florida to Iowa when I moved for school) and has some days where he is very reluctant to stand. I was also wondering if DMSO and a steroid might work for him. I'd rather not give him equioxx or surpass all the time. Also, if I'm using surpass, how long should I wait if he needs equioxx? He's a 20 yr old ex racehorse and has been my best friend and mental health specialist since I was 10, so my goal is to get him pasture sound.
New Member:
madison

Posted on Monday, Mar 1, 2010 - 10:28 pm:

Is this too small?
Member:
paul303

Posted on Monday, Mar 1, 2010 - 11:40 pm:

Hi, Jessica: Welcome! How do you use your horse, and how long has he been in Iowa? Have you had him there since September, or did you just move him recently? If recently, perhaps the trip aggravated his condition, and it just needs some time to quiet down.

You probably already have him on a joint supplement like glucosamine and chonDrOitin. I can say that I've used Surpass with no measurable results. Surpass is a topical application, so it really should have no direct effect on ulcers. I have a 30 year old retired ( for many years )reiner that has been on previcox since last August. Previcox is the canine "Equioxx". It is drastically less expensive and is the same medication. Run a search on Previcox on this site. My horse had been on bute since the late eighties. Not daily, but she's never gone so long as 3 or 4 months without it. I was interested in switching to Previcox, since, from what I could glean from the info available, Firocoxib ( Previcox, Equioxx ),might be a bit easier on the stomach, ulcer and irritation-wise. My mare has been on it since last summer, and, so far, there has been a consistently better result than she had with bute. This is, of course, just my experience.

I have another appendix mare that has suffered from ulcers. Whenever bute is necessary, I always administer a gastroguard or ulcerguard treatment.

Because all horses are different, it may take awhile to discern which treatment benefits your horse the most. Turn-out and exercise situation must be factored in, along with weight and condition. You can use the many articles and discussions on this site: after you do, you'll realize that you're not alone. Research the older horse, also. There is a wealth of information here, and wonderful help and guidance from Dr. Oglesby.
New Member:
madison

Posted on Tuesday, Mar 2, 2010 - 11:42 am:

Thank you Lee!
There are so many great articles on this site! My horse moved to Iowa in August and had occasional stiffness and would rest his right leg often but was not clinically lame. I was riding him lightly maybe once a week but he began being on and off lame last October. Unfortunately now he is sore most of the time, mostly noticeable at the trot, and his stifle is swollen and painful when being palpated. He has significant muscle atrophy on the right side. I would like to leave him turned out all the time but he's the omega horse and thin so I want to make sure he gets his food. He is out during the day and in at night. This spring I hope to find a place to pasture board him. I walk him a few times a week for 15 minutes, rest 10, then another 15 and it seems to help a bit. Unfortunately I don't have time to walk him every night.

He is on cosaquin and I was using Bute and Gastroguard until I had him radiographed and the vet recommended this treatment. I will definitely look into Previcox! Equioxx is so expensive but I figured it was cheaper than Gastroguard! I assumed surpass would be fine but the summary said to tell your vet if your horse is ulcer prone, so I wasn't positive. Thank you! I was also wondering if pads on his back shoes might help to get the pressure off of his stifle. He is barefoot now and I would probably want to wait until spring if I were to put shoes on him.

Thanks!
Jessica
Moderator:
DrO

Posted on Wednesday, Mar 3, 2010 - 4:29 pm:

Welcome Jessica,
Firocoxib (Equioxx) is very COX-2 specific so theoretically should have fewer problems with gi ulceration. As to the combined use with Surpass (diclofenamic acid), I do not have any safety studies. I cannot attest to the safety of the procedure.

In fact we don't have good pharmacological data about the repeated use of Surpass at least that I can find. We do know the medication is picked up in the blood and one time administration studies show it is slow to clear the blood. That is it has a relatively long half-life. I have not used it in this since so if your veterinarian has used this combination in a large number of horses his experience might be your best guide.

For more on firocoxib use in the horse see, Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » EQUIOXX (firocoxib). Also of interest is a recent study showing that Surpass may have some unique positive benefits for a diseased joint health perspective:

Am J Vet Res. 2009 Feb;70(2):210-5.
Evaluation of topically administered diclofenac liposomal cream for treatment of horses with experimentally induced osteoarthritis.
Frisbie DD, McIlwraith CW, Kawcak CE, Werpy NM, Pearce GL.

Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.

OBJECTIVE: To assess the clinical, biochemical, and histologic effects of topically administered diclofenac liposomal cream (DLC) in the treatment of horses with experimentally induced osteoarthritis. ANIMALS: 24 horses. PROCEDURES: Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Eight horses treated with DLC were given 7.3 g twice daily via topical application. Eight horses treated with phenylbutazone were given 2 g orally once daily. Eight control horses received no treatment. Evaluations included clinical, radiographic, magnetic resonance imaging, synovial fluid, gross, and histologic examinations as well as histochemical and biochemical analyses. RESULTS: No adverse treatment-related events were detected. Horses that were treated with DLC or phenylbutazone had significant clinical improvement of lameness, unlike the control horses. Treatment with DLC induced significant improvement in staining and total articular glycosaminoglycan content, compared with no treatment. Treatment with phenylbutazone induced significant reduction in synovial fluid prostaglandin E2 concentration, compared with DLC and no treatment. Treatment with DLC induced significantly less radial carpal bone sclerosis and overall gross cartilage erosion, compared with phenylbutazone. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that DLC had both clinical sign-modifying and disease-modifying effects. Only clinical sign-modifying effects were detected in association with phenylbutazone administration. Treatment with DLC had significant beneficial effects, compared with phenylbutazone, and no detrimental effects. Results suggested that DLC is a viable therapeutic option for horses with osteoarthritis.

DrO
New Member:
madison

Posted on Saturday, Mar 6, 2010 - 3:24 pm:

Thank you Dr. O! I'm so glad I joined this site, there is so much great information and advice!
Member:
paul303

Posted on Sunday, Mar 7, 2010 - 12:46 am:

Jessica: You asked about DMSO. I keep it on hand and have used it whenever I thought it would help. Also, my vet did mix a steroid with it one time. That said, it must be used carefully, especially if you're not familiar with it's use. There is plenty of information on this site. Don't use it without reading about it. I, myself, am a fan...and have been since the seventies. Yet, I've seen many people get "stupid" with it and hurt both their horses and themselves. Where indicated, and, in the right hands, it can bring great relief.

Wish you much luck!
New Member:
madison

Posted on Sunday, Mar 7, 2010 - 11:36 pm:

Thanks Lee!
I've used it on him before but it was a very long time ago; I'll definitely read about it before I try it again. My dad is sending me some pharmaceutical grade DMSO and steroid (he's a small animal veterinarian). Hopefully this will help him out a bit!
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