New Treatment for Arthritis

One of the most common physical maladies faced by TREES' residents is, of course, arthritis. Some residents are afflicted as a result of overwork, some because of previous injuries, and some become arthritic as joints change during normal aging processes. More often than not discomfort can be managed through the use of joint supplements and attention to details in the horses' living quarters and turnout areas.

For some horses, however, there comes a time when symptoms of arthritis must be managed with medication. The most commonly used drug, for many years, has been phenylbutazone, or "bute." Bute is very effective, but also has well known side effects, such as damage to the gastrointestinal tract and kidneys.

During the past several weeks, it became apparent that our Grand Old Man, Jeb, a 40 year old Tennessee Walker gelding was becoming more uncomfortable. Joint supplements and management techniques alone were not controlling his arthritis pain. In cases like Jeb's, where the choice is to use bute and risk its side effects, or euthanize a horse because its pain cannot be managed, we have used bute.

As of July 5, 2007, however, we have another choice. The FDA, on that date, approved a COX-2 inhibitor sold under the brand name Equioxx, for the treatment of arthritis in horses.

An excerpt from an article in The Horse explains some of the difference between Equioxx and the older treatments:

Traditional NSAIDs such as phenylbutazone (Bute) and flunixin (Banamine), inhibit both COX-1 and COX-2. These drugs are known to cause ulcers, gastrointestinal bleeding, and kidney damage with prolonged use or high doses. COX-2-inhibiting drugs, including firocoxib and the human drugs Vioxx (rofecoxib) and Celebrex (celecoxib), selectively inhibit production of the inflammation-causing COX-2 enzyme, leaving the COX-1 enzyme free to perform its protective functions in the gastrointestinal tract and kidneys.

"On the equine market we've got the standard old NSAIDs, Bute and Banamine," said Anthony Blikslager, DVM, PhD, associate professor of equine surgery at North Carolina State University's College of Veterinary Medicine. "They're very effective for the control of pain, so they have very good efficacy. But the trouble is, they could be safer.

"I would hope that using a COX-2 inhibitor--if they can show that it's as effective as Bute--would still be safer because even though horses have overlapping function of COX-1 and COX-2, as compared to other species, you would still be leaving one of the enzymes alone to maintain organ function," Blikslager said.

Read the entire article:
New NSAID: First COX-2 Inhibitor for Horses Approved by FDAby: Erin Ryder, News Editor July 05 2007 Article # 9937 http://www.thehorse.com/ViewArticle.aspx?ID=9937

Jeb received his first dose of Equioxx yesterday. At this point, we can say that he does appear more comfortable and ate breakfast well. He is more interested in what goes on around him, and the dull look in his eye is gone. There is no predicting what the future will bring, but its good to have another weapon in the anti-arthritis-pain arsenal.

As a sidenote.........we'd like to publicly acknowledge Drs. Carrie McColgan and David Licciardello of the Rappahannock Equine Veterinary Clinic in Locust Grove, VA. TREES' elders are examined, evaluated and treated with the same thorough care and attention to detail as high-dollar show horses. We also feel that we always have their support in trying new techniques and products to further our education in geriatric horse care, and the more we learn, the more we can pass on to other elders' owners.

And so, we begin a trial of yet another new option. We'd like to hear others' experiences with Equioxx in the comments section, once you've had time to give it a fair trial.