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  1. #41
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    Quote Originally Posted by Lieslot View Post
    Wow cloudyandcallie, 2x a day is a lot. Would that have been a full dose (as in 0.5mg/kg, you know the standard banamine paste dose) twice a day?
    My vet had actually made the suggestion of going twice a day to make him really comfortable, but I just don't dare going that far.
    FWIW my pony was on a half dose (2.5cc--500 lb pony) twice daily. That actually seemed to work better than a full dose once daily. When he was having lots of good days depending on the time of year we would give the half dose every 18 hours.
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  2. #42
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    Quote Originally Posted by Lieslot View Post
    Thanks for that Ben and Me, very informative.
    Yes on the one hand I do not want to know, I've had more than enough worries, on the other hand I absolutely will have some regular bloodwork done, good to know what to check for, did not know that.
    Any suggestion as to have often one should check those values?

    I had heard that about Firocoxib, but since it doesn't offer him any painrelief at all, stopped using that.

    Stupid question probably, but if kidneys start to fail, any outward signs? He is luckily a good drinker, and I can easily increase his water consumption by giving a bucket with this yummy Horsequencher daily, (don't like the extra sugars, however but I'm sort of beyond caring about that now).
    Hi! Not a vet yet, so I would definitely go with your vet's recommendations for how often to check those values. Most of my experience with long-term NSAID use has been in hospitalized optho horses -- with their painful eyes, lots of them are on high doses of Banamine pretty long term, and a not-insignificant number of them end up with renal problems. And since they're hospitalized, we tend to monitor them a little more closely than they would if they were back at the farm.

    Usually the first detectable sign of kidney failure (which you'll see before an increase in creatinine) is a decrease in urine specific gravity (which is a measurement of the kidney's concentrating ability). Since the kidneys can't concentrate the urine as well, it will be more dilute and they'll lose more water in their urine than usual. Consequently, to make up for all that fluid loss, they'll start drinking more. So, one of the first signs you may see is an increase in water consumption and urination.


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  3. #43
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    Thanks Herbie.

    Usually the first detectable sign of kidney failure (which you'll see before an increase in creatinine) is a decrease in urine specific gravity (which is a measurement of the kidney's concentrating ability). Since the kidneys can't concentrate the urine as well, it will be more dilute and they'll lose more water in their urine than usual. Consequently, to make up for all that fluid loss, they'll start drinking more. So, one of the first signs you may see is an increase in water consumption and urination.
    Okay, thx! Scary stuff, I will now be keeping a very close eye on his drinking & urination habits.



  4. #44
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    Quote Originally Posted by Lieslot View Post
    Anyone having a horse on longterm Banamine?

    Does anyone know if the risk associated with Banamine (ulcers, kidney, liver) are higher with longterm Banamine vs longterm Bute? Sadly Bute note effective for him.

    Any suggestions what I could give him alongside the Banamine to support his GIT and liver/kidneys?

    Since this is may well be longterm, as in until his last breath, I'm leery of PPI's (blue pop ) daily, opens up another set of problems (affect Mg levels, digestibility in foregut) but open to anything else.

    At present he's on one cup of lecithin a day, after I read a study it can negate NSAID induced ulcers.

    Any other safe additive I could use? Would Aloe Vera make any sense?
    How about something to flush kidneys & liver?

    He gets half a tube of Banamine a day .

    Thanks.
    Quote Originally Posted by SuckerForHorses View Post
    I am not sure of your immediate questions, but are you giving the paste version? Because that can get expensive. Perhaps it would be more cost effective if you purchased the injectable, and administered that orally?
    You can also get an oral powder of Banamine that you can sprinkle on the feed.

    I am looking at having to start long-term banamine in my mare. The risks associated with GI problems are lower than that of bute. Banamine leaves the system quicker than Bute, which means it does not build up super-toxic like Bute can. Bute tends to linger and then compound itself, which means every 5 or 6 days, you need to stop Bute for a day or so to let the levels fall.

    Banamine, like Bute, can cause kidney problems, and if they're not noticed right away, the kidney damage can become permanent.

    My mare, at one point, was Rx'd 10 cc of Banamine at 9 AM and another 10 cc of Banamine at 9 PM for 5 days, then reduced down to 10 cc once a day for 5, then stop for 2 days. Then restart. She became a bit stoned on this high a dose, but not nearly as stoned as she got on bute. She was on 3 grams of bute a day in divided doses and within 3 days she began to bump into the fence, so it had to be stopped.

    We looked at Firocoxib and this drug is probably fine for an adult horse (and relatively cheap too). The horse only needs about 57 mg per 24 hours. The pills we got were 227 mg at $1.50 a pill, so 1/4 pill is all that is needed. HOWEVER. We are currently investigating the fact that this drug may be fetus toxic with birth defects and demise, so I would be very cautious in a pregnant mare. There is also a strong warning on the box that human women of childbearing age, who are pregnant or nursing should either not handle the drug, or wear gloves and wash their hands very thoroughly after handling - because of the fetomutogenic properties of this drug!!! I am still investigating this, but I'm likely not going to implement this drug with my mare since she is 7 months pregnant. It looks like it will be a good drug to use on any horse who is not pregnant or lactating.

    You can feed your horse ranitidine or gastroguard or blue pop rocks or the like simultaneous to using banamine.

    While they say you can give the injectible banamine orally, I've had 4 different vets tell me no specific study was done that shows how well the liquid is absorbed into the system.

    If you're concerned about the injections causing abscesses, ask your vet for the powdered/dissolvable Banamine. It has a peachy/banana like smell to it. At first my mare was a bit suspicious, but she got used to it. The scoop is 250 mg and she got that twice a day for 4 days, then down to 1 scoop once a day for a week. She gave zero signs of any sort of GI disturbance.

    Both banamine and bute can reduce vascular perfusion to the gut which CAN cause colic in some horses. Watch your horse carefully until you become confident with your horse's tolerance.

    I think I've become far too familiar with these drugs - evidence of all the reading I've been doing of late in my desperate attempt to help my mare.
    Last edited by rodawn; Feb. 28, 2013 at 10:39 PM.
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  5. #45
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    The risks associated with GI problems are lower than that of bute. Banamine leaves the system quicker than Bute, which means it does not build up super-toxic like Bute can
    Not so. Dosed properly, the risks are THE SAME. It is not the build up of toxic metabolites that causes the gut and kidney problems, but rather the direct action of the drug. Yes, if you are dosing the drugs inappropriately (several times per day when it's meant to be used no more than twice, for instance) you're asking for trouble. But there IS no NSAID that is safer than any other WRT gut or kidney risks. COX-2 inhibitors being the exception in terms of the stomach, but kidney risks are THE SAME.

    There are all sorts of goat, bird, and other animal studies WRT oral absorption of liquid banamine. It is not the same as a good horse study, but it's better than nothing.
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  6. #46
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    Quote Originally Posted by rodawn View Post
    While they say you can give the injectible banamine orally, I've had 4 different vets tell me no specific study was done that shows how well the liquid is absorbed into the system.
    I didn't need a study to tell me that injectable Banamine wasn't effective given orally--my pony told me that it was quite effective!
    Quote Originally Posted by EquineImagined View Post
    My subconscious is a wretched insufferable beotch.



  7. #47
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    Yeah, it brought my filly's 104 degree temp back to normal daily for four days until she fought off the virus. You could measure it working on your watch with a thermometer. No way you could get a needle in her IV or IM.



  8. #48
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    This is my book of choice - I use the human medicine version of it daily in my line of work. This is the veterinary version and it is INVALUABLE. If there is ever a book I would recommend a horse owner getting, it is the Merck's. It gives you just enough good and correct information you need to get you started with deeper investigation. At the very least, it provides enough information that you can ask intelligent informed questions to your vet.

    This is the link specifically to the variety of pain killers that can be used in horses, some NSAIDs, some COX-2, some other types.

    http://www.merckmanuals.com/vet/phar...ory_drugs.html

    For what it's worth - Banamine does have a much higher safety margin than bute. This is a well-known fact. Yes, the kidneys excrete it, just like they do for all drugs and yes if you use banamine inappropriately you can damage the kidneys. However, Bute lingers in the system and builds up, causing greater overall toxic effect. Banamine is readily excreted via the kidneys and it's half-life is much shorter than that of Bute. This is why it is said it can be safer on the gut. But like any NSAID, there is always risk of ulcerations starting from the mouth, to the stomach, to the hind gut. Any NSAID, whether it's aspirin, bute, banamine can be life-threatening when used incorrectly and in toxic doses. Severe kidney failure can be fatal.

    And, every horse is different. Some cannot tolerate even small doses of bute without problems. Some can tolerate large temporary doses of banamine and be just dandy as long as you dose back down to a smaller dose after a few days. The horse owner must watch their horse, monitor the water and food intake, check the mouth regularly for ulcerations, keep tabs on stooling and urination. This is the standard protocol for a horse on any sort of chronic medication, but especially so for NSAIDs.

    OP - do look into firocoxib for your gelding. Depending on what the problem is, gabapentin might also be an option - note with gabapentin it also increases blood perfusion and can increase the risk of bleeding with wounds, but it is excellent with regards to neurologic-based pain if NSAIDs do not seem to be doing the trick.

    We looked at gabapentin for my mare too, but she is still at too high a risk for aborting her fetus, so gabapentin is contraindicated for her until after she delivers (if we get her to term, that is).
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  9. #49
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    I would dearly love to see the citation that the Merck author refers to when stating that bute is > banamine WRT ulcer potential, all else being equal dosage-wise and interval-wise. I don't have the actual book--is there a bibliography and could you post the citation, please?

    Merck manuals are OK but they've gotten away from hard-core evidence-based in favor of "edited by" and that is the bane of most large and comprehensive texts. That said, I have gone on about this topic so much that I would actually appreciate the correction if in fact the claim that one NSAID is lower risk WRT ulcers than another is valid.
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  10. #50
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    Deltawave, I'm not into a fight. Nowhere was it said there was no risk. And nowhere in any of my posts did I say there was no risk. There is always risk. In the last 5 days, I have had discussions with no less than 10 veterinarians specifically because my own mare is in a fight for her life and that of her unborn foal. Without exception, each of them said banamine tends to show fewer GI side effects witnessed in their own practices, than that of Bute and each of them have also said they have had fewer incidences of acute kidney injury with banamine than when they have horses on bute. They will all cite there is risk for ulceration as is the case for ALL NSAIDS.
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  11. #51
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    I don't think DW is into a fight either, rodawn...just asking for info

    FWIW, I have a mare I cannot use bute on at all. Totally sets her off, ulcer-wise. I CAN use banamine. Once. Maybe (if I'm lucky) twice. And then she's just as unhappy on it as she is on bute and I have to pull out the omeprazole.

    So, add one more anecdotal experience for you: banamine might be "easier" on them, but will certainly still cause gastric problems. And it can happen fast. Stock up on the omeprazole!



  12. #52
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    OP - do look into firocoxib for your gelding. Depending on what the problem is, gabapentin might also be an option - note with gabapentin it also increases blood perfusion and can increase the risk of bleeding with wounds, but it is excellent with regards to neurologic-based pain if NSAIDs do not seem to be doing the trick.

    We looked at gabapentin for my mare too, but she is still at too high a risk for aborting her fetus, so gabapentin is contraindicated for her until after she delivers (if we get her to term, that is).
    Thanks for all the info rodawn.
    We actually have used firocoxib for several months, but it does nothing for him, no more than a sugar cube would, even tried two 57mg tabs daily .
    I also did 6 months of Gabapentin at the highest possible dose. He was getting 50 400mg pills daily or 20,000mg/day.
    It worked great as an anxiety reliever, but it did not address his painlevels sufficiently, so we stopped it after 6 months.
    Shame because it's said to be relatively safe for longer term use.

    He's at his best at 1500mg banamine a day (= full tube), when turned out he even decided to have a canter and a few bucks, so he pulled off a front shoe the other day. But I discussed with vet that I feel uncomfortable at that high a dose, eventhough he clearly gets the most painrelief from it, so we stick to the 750mg/day.
    I got the apple flavored powder from Wedgewood now, doing 3 scoops a day, I may try 4 of the 250mg scoops, putting him at 1000mg/day. Hoping this will be the right dose between comfort & risk I can somewhat live with .

    Sorry to hear about your mare, hope she pulls thru with a healthy foal.



  13. #53
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    "My mare, at one point, was Rx'd 10 cc of Banamine at 9 AM and another 10 cc of Banamine at 9 PM for 5 days, then reduced down to 10 cc once a day for 5, then stop for 2 days. Then restart. She became a bit stoned on this high a dose, but not nearly as stoned as she got on bute. She was on 3 grams of bute a day in divided doses and within 3 days she began to bump into the fence, so it had to be stopped"

    Rodawn: Can you please describe how a horse on banamine or bute appears 'stoned'? I've been in an environment where many horses received high doses of both and none appeared 'stoned'.. Painful due to other conditions, yes...

    Just curious.



  14. #54
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    Never, ever seen any creature stoned, sedated or otherwise had its level of consciousness impaired by NSAIDs.

    Again I would love to see some backup besides "conventional wisdom". Not fighting. Perfectly willing to change my mind, but only in the face of factual evidence and not "this is what we've always done".

    There is an ancient NSAID called indomethacin that was used (with published papers to back it up) for gout and pericarditis back in (IIRC) the 1960s or thereabouts. The fact is that back then indocin was fairly hot stuff, new, and pretty effective. The fact also is that since then there are many, many other NSAIDs that have come along, all equally effective and somewhat easier to dose (indocin is a 3-4 times daily drug). One will STILL see indocin prescribed for gout, simply because it was, 50 years ago, considered the "gold standard" and that's how people's minds get fixed. There is no particular benefit to this particular drug, but it enjoys--still!-- the status of having once been studied for two things and found to be effective when there were almost no alternatives.

    My *suspicion* is (and again I would LOVE to learn otherwise via factual citation) that this is kind of what happens with bute vs. banamine vs. aspirin vs. any other horse NSAID. One or the other seems to enjoy the status of "better than _____ for treating ______" with nothing but conventional wisdom to support these assertions. This is not to say one or the other is a bad choice! I simply like to figure out these historical proclamations, many of which belong in the archives of former and now outdated knowledge.
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  15. #55
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    I found this, but like you say DW, I don't think we'll find any cast & stone evidence.
    I do believe however if x number of vets from experience feel Banamine to be safer than Bute as for as ulcerations goes, there may be some value or truth to that, just that no clinical studies as such have been done.

    http://thalequine.com/bute-and-banam...s-should-know/
    Bute is considered more likely to cause ulcers, especially in the large colon, than Banamine® and other NSAIDS.
    It would be nice to know the 'why' behind it, there has to be a reason in the difference of working.
    I know it is thought all NSAID's work at reducing inflammation, but clearly some NSAID's work better for one thing vs another, Banamine being more effective for eye pain & colic f.ex. So there may be different ways in how they work in the body and effect things, dunno.


    Okay, so another stupid question, when a horse shows signs of kidney trouble, IV fluids were mentioned. So what exactly is "in" an IV fluid? Is it mostly electrolytes? If so would there be any benefit if I get him to drink half a buck of electrolyte water daily. He loves the orange flavored e-lytes, I can get him to drink that easily. Thanks .



  16. #56
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    I am perfectly willing to accept anecdotal evidence, but it doesn't get ranked as highly. We tend to cling to our personal perceptions, even as medical professionals, as to what is "best". Guilty as charged! But I make every effort to be honest with myself and to demand that even my own dearly-clung-to habits are backed up by evidence when available and discarded when appropriate. Phrases like "commonly considered better" or "generally considered safer" are little red flags to me to ask "why?".

    I do wonder if bute dosages are managed as carefully as they ought to be. The "one gram twice a day" is virtually universal, but that assumes a legitimate 1000 pound horse and dosed every 12 hours, not a gram for an 850 pound animal given at 8am and 5pm, which is not optimal. I know I was shocked when Keebler weighed in at a slim 910 pounds instead of the "nearly 1000" I assumed him to be.
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  17. #57
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    I think the best person to know is probably Dr Anthony Bikschlager (associate professor & surgeon at NCSU) he's done NSAID research with regards to colic & intestinal tract.
    This is interesting, and shows that whilst we may think or see less GIT symptoms from Banamine, what's going inside is a different picture, but requires more research.
    http://www.cvm.ncsu.edu/vhc/PDFS/rel...D_research.pdf
    New research raises additional concerns
    Recent research conducted by Dr. Anthony Blikslager, associate professor of equine surgery, has yielded surprising results and highlights the complexity of NSAID use. Eight horses with intestinal injury of the small intestine were treated with Banamine®, which is very beneficial for controlling
    pain and reversing some of the systemic effects of absorption of bacterial toxins from the damaged intestine. Surprisingly, the drug slowed down the intestinal repair process as compared
    to horses which received no Banamine®, although Banamine® did improve the comfort level of the horses. (None of the horses showed colic signs as they all received the alternative narcotic
    pain medication butorphanol, trade name Torbugesic®.) Banamine® stopped the intestinal lining from re-sealing for at least 18-hours, which could result in increased endotoxin absorption.
    According to Dr. Blikslager, “This effect was unexpected because Banamine® is used for its ability to reduce the clinical signs of endotoxin absorption. Now, we need to assess the clinical
    importance of these findings, and look at safer drugs in the NSAID class.”
    However, this article is like 10 yrs old.

    I do know published studies were done on Etodolac and it was proven safer on the gut.
    Sadly Etodolac doesn't offer the same painrelief as Banamine in my horse either, sigh.

    I don't know if Dr Blikschlager is contactable, perhaps I could email him a question about the latest.



  18. #58
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    Part of the answer may be found in this relatively recent 2011 full article.
    http://onlinelibrary.wiley.com/doi/1...1.00398.x/full

    Please be kind to me and don't hit me with "where exactly, because reading this stuff isn't easy on a non-medical brain", reading thru this I understand Banamine will cause reduced jejenual/SI recovery, which is your main concern from a GIT risk, however bute shows increasing right dorsal colitis risk.



  19. #59
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    Quote Originally Posted by Lieslot View Post
    Part of the answer may be found in this relatively recent 2011 full article.
    http://onlinelibrary.wiley.com/doi/1...1.00398.x/full

    Please be kind to me and don't hit me with "where exactly, because reading this stuff isn't easy on a non-medical brain", reading thru this I understand Banamine will cause reduced jejenual/SI recovery, which is your main concern from a GIT risk, however bute shows increasing right dorsal colitis risk.
    Very interesting, especially the part about Meloxicam. I wonder though, if Banamine is associated with reduced jejunal recovery and increased PMN infiltration, if its really an issue giving it in non-colic cases (such as the OP) since we would assume her horse's SI is relatively healthy? Of the two drugs, it would seem bute would be the most dangerous to a normal, healthy gut since its associated with hind gut ulcers.



  20. #60
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    From the article that is my reasoning too Eventer 13, from this I gather that Banamine is a good option for my horse. Shame the Etodolac wasn't effective however. The Meloxicam caught my eye too.

    Here's another interesting article, from which I now gather Banamine to be twice as effective as Bute and has 8x more analgesic properties, so this in part may explain why it works so well for my horse and none of the other NSAID's ever did.
    The NSAID's with the highest therapeutic efficacy would be Flunixin (Banamine) and Meclofenamic Acid (Arquel?).
    Now Meclofenamic Acid is one I have not tried yet, but at this point the Flunixin is working enough to keep him off death row, poor sod.

    http://evrp.lsu.edu/06nsaids.htm

    The other thing that I spot in this is the pain relieving properties of l-arginine & nitroglycine, I wonder if there's a such like topical commercially available I could use on at least the fetlocks.



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