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Talk to me about your experiences with Dexamethasone long term

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  • Talk to me about your experiences with Dexamethasone long term

    Let me start by saying the vet is very involved here, I just want to hear what others have experienced.

    Long story short my horse ripped part of his lower eyelid almost completely off a year ago. We gave Dex immediately for short term relief then switched to an antihistamine, fast forward a year and we are STILL trying to fix that eyelid. He tore the stitches originally, healed from that for about 4 months then developed tons of scar tissue. A resection was done, then an abscess followed along with tons of duct blockage and fluid pockets. Drainage has been performed multiple times for the duct and twice for the abscess (the most recent issue).

    Last night in desperation I asked what else could we do as he still rubs his face constantly, Dex was the answer. He is on Triple Crown lite and 24/7 pasture (mostly coastal bermuda and weeds) his hay is also coastal and is only fed once the grass is truly brown. The vet is well aware of all of these and feels he is a low laminitis risk considering his current weight and feed.

    What I want to know; what are the very earliest signs that he may have laminitis, what other things should I look for that you have seen as complications with Dex, success stories (give me the good news too). I am still fairly new to ownership with only 5 years of owning total so don't judge me for not knowing all of the signs. My horse is the first that the ladies I board with have seen do these things as well (most have owned for over 30 years each).

    My horse is a 13 year old paint, easy keeper, but never extremely fat even on sweet feed and otherwise in good health.

    Thanks in advance.

  • #2
    I had a QH/Paint (Double) that had a gnat allergy. Miserably itchy from spring to fall. Nothing helped except a fly sheet but it is too hot here for that.

    I put him on low dose dex. I got 4 mg tabs. Each evening feeding, I cut one 4 mg tab into quarters with scissors and dumped in his feed. That was all he needed. Solved all his problems. I upped it a bit before a big lesson or show and downed it a bit when he was not working as hard. He was not a laminitic type (despite being QH/Paint, he had lots of TB). This was only for part of the year, but he did fine that way for several years. I had many conversations with him about would he rather be miserable itching or be on dex. He was happier on dex.

    I ended up sending him to Colorado, the land of no gnats.
    Rest in peace Claudius, we will miss you.

    Comment

    • Original Poster

      #3
      Originally posted by ToTheNines View Post
      I had a QH/Paint (Double) that had a gnat allergy. Miserably itchy from spring to fall. Nothing helped except a fly sheet but it is too hot here for that.

      I put him on low dose dex. I got 4 mg tabs. Each evening feeding, I cut one 4 mg tab into quarters with scissors and dumped in his feed. That was all he needed. Solved all his problems. I upped it a bit before a big lesson or show and downed it a bit when he was not working as hard. He was not a laminitic type (despite being QH/Paint, he had lots of TB). This was only for part of the year, but he did fine that way for several years. I had many conversations with him about would he rather be miserable itching or be on dex. He was happier on dex.

      I ended up sending him to Colorado, the land of no gnats.
      My boy will scratch through the fly masks and use them as extra leverage to really scrub his skin raw! I am in NC so heat and humidity 6-8 months a year are not our friend. My boy loves his fly mask but I know he would also rather not itch at all.

      Glad to hear Dex worked for your guy that he is now gnat free!

      Comment


      • #4
        No suggestions on the Dex.. but have you considered putting a pool noodle around the cheek piece of his (leather) halter? It might offer enough distance where he can't scrub his eye up against a fence, or leg or something. If he does, the noodle would be in the way and it certainly would be softer.

        I can't imagine how frustrated you must be!

        Comment


        • #5
          Also when I worked at the clinic we had a mask that would completely cover the injured eye. I think this company makes them:

          http://tfloki.com/custom.html

          Comment

          • Original Poster

            #6
            Originally posted by Sansena View Post
            No suggestions on the Dex.. but have you considered putting a pool noodle around the cheek piece of his (leather) halter? It might offer enough distance where he can't scrub his eye up against a fence, or leg or something. If he does, the noodle would be in the way and it certainly would be softer.

            I can't imagine how frustrated you must be!
            This is why I love this forum! I had not thought of that. He currently has a break away on as he managed to undo (not break just removed the bottom jaw band) the buckle on the leather one and it is at home to be repaired and cleaned. I will be getting a pool noodle though as I have asked many times can I just bubble his entire head. Don't worry pictures will follow once the noodle is installed (lets see what fun color I can find )

            Frustrated is an understatement at this point....At least he likes the vet and is happy to see her every time she comes out. I don't know that the sentiment is reciprocated

            The best part of it all is the success story she told me last week of a horse with the same original injury. The owner lost the ointment halfway through the treatment/stitches period and the horse made a full (almost no scar or swelling) recovery.

            The bright side is the vet now drops almost everything to come treat him as we both know the longer she waits the harder her job will be when she does come.

            Comment

            • Original Poster

              #7
              Originally posted by Sansena View Post
              Also when I worked at the clinic we had a mask that would completely cover the injured eye. I think this company makes them:

              http://tfloki.com/custom.html
              We have gone through 4 masks and one very similar to this was used. I now have this minus the nose guard. We only use the hard masks for when he has had stitches as the vet and I both prefer the one in the link. She actually asked for the link so she could buy one! https://www.amazon.com/gp/product/B0...?ie=UTF8&psc=1
              This one seems to be preventing him from really rubbing hard webbing like his Cashel Crusader masks against his eye and causing damage.

              Comment


              • #8
                We had a horse that we bought at 4 and he lived to his mid 20's here when he was found dead one morning from, vet assumed, a stroke, maybe?

                Right off, he scratched like mad every spring, to the point of making his shoulders and face bleed.
                When the itching started, he would at times sit down like a dog and scratch his belly on the ground.
                Our vet gave him a shot of long lasting corticosteroid, Depo (means long lasting preparation) Medrol.

                With that in him, he always had a good one to three months of relief, where he didn't scratch at all.

                In dry summers, he may go all summer without another shot, in wet ones, he needed one more late summer.

                That he was on that corticosteroid didn't seem to ever have hurt him any.
                He didn't founder or had any other wrong with him from that medication.

                Best I remember, so many decades ago, about 16 years old he started not needing that shot any more most summers.

                Don't know if that story may help you with your horse, since your problem is other than an allergy.

                Comment

                • Original Poster

                  #9
                  Originally posted by Bluey View Post
                  We had a horse that we bought at 4 and he lived to his mid 20's here when he was found dead one morning from, vet assumed, a stroke, maybe?

                  Right off, he scratched like mad every spring, to the point of making his shoulders and face bleed.
                  When the itching started, he would at times sit down like a dog and scratch his belly on the ground.
                  Our vet gave him a shot of long lasting corticosteroid, Depo (means long lasting preparation) Medrol.

                  With that in him, he always had a good one to three months of relief, where he didn't scratch at all.

                  In dry summers, he may go all summer without another shot, in wet ones, he needed one more late summer.

                  That he was on that corticosteroid didn't seem to ever have hurt him any.
                  He didn't founder or had any other wrong with him from that medication.

                  Best I remember, so many decades ago, about 16 years old he started not needing that shot any more most summers.

                  Don't know if that story may help you with your horse, since your problem is other than an allergy.
                  Thanks! It is something to consider when discussing other options with the vet if needed.

                  Comment


                  • #10
                    Does cortizone cream on his face (but not so it will drip into eye) help? If its just an itchy eye, what about something like an antihistamine for horses...can Benadryl/Claritin be given to horses? I know Clenbutetol can help allergies, but usually just short term.

                    Comment


                    • #11
                      People have given Zyrtec to horses and reported the lessening of allergy related symptoms. So maybe that is something you could try or speak with your vet about.

                      Comment


                      • #12
                        The citirizine dose is .2-.4mg/kg every 12 hours. I know some horses are getting results with a lower dosage and/or once a day, so it's something to play with. Personally I'd opt for the .4mg/kg every 12 hours for max effect, and if it helps, see how a lower dose, or just once a day works
                        https://www.ncbi.nlm.nih.gov/pubmed/17581764
                        ______________________________
                        The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET

                        Comment


                        • #13
                          I have a friend with a mini who had an eye injury that healed, only to have him reinjure the eye a second time. She tried all types of masks to protect the eye and was frustrated because he would rub through the soft masks, until she and her husband sat down one day to attempt to troubled shoot the problem. The solution they came up with was to modify a human welder’s mask and attach it to a break away halter. The hard cover of the welder’s mask was enough to protect the eye until it was healed, which I think took a few months.

                          If the welder’s mask won’t work for your horse, maybe it will at least help in thinking outside the box for a solution.
                          "You can't fix stupid"- Ron White

                          Comment


                          • #14
                            I knew a horse whose allergies occasionally required a several-months-long low-dose course of dex to manage. He was a moderately easy keeper. No major negative side effects from the dex in the time I knew him. Minor side effects included becoming slightly more prone to skin conditions and being slightly quieter than usual.

                            Comment


                            • #15
                              I had an older draftX mare with heaves who got 5 mlDex as needed.... sometimes every day, sometimes less, as the weather changed. She was a very easy keeper. No issues with her feet altho I kept an eye on the situation.

                              Comment


                              • #16
                                My mare went from fine to crashing quickly with full blown founder. DMSO NG was what initially stemmed the tide then the veno gram is what kept her from being put in the ground. 10 months in the stall. Won't use dex on my farm in that way (IM) at therapeutic doses ever again.

                                Comment


                                • #17
                                  I used dexamethasone on my Appendix gelding with recurrent airway obstruction for over 15 years, so I have long-term experience with just a single horse. I am a retired surgeon and pharmacolocy researcher and worked with corticosteroids in humans for many years, so my vet just let me manage the daily details of the treatment regimen.

                                  Horse was positive on allergen testing for grasses,tree pollens, weed pollens, and all hay except alfalfa. He had significant airway problems every year which coincided with the 3 main pollen seasons - weed, grass, and trees.

                                  For years I gave him 8 mg IM every other day. Dose was increased up to 40mg daily with onset of severe obstruction, and tapered back to the 8 mg every other day as the breathing returned to normal. I was willing to risk the possibility of Cushingoid effects, since it was that or die. We euthanized him with colic at age 29. He had had no outward signs of Cushing's, and we had a lot of good years together.

                                  BTW, dexamethosone can be ordered over the counter from Canadaian sellers.. I ordered it by the case.

                                  Comment

                                  • Original Poster

                                    #18
                                    Thank you all for your replies! We did try another antihistamine prior to Dex with no success. Things have gotten worse and a new thread is coming as I am at my wits end. Again thank you all for your help, I will certainly consider so of these mask solutions for him!

                                    Comment


                                    • #19
                                      I am another that has used Dex long term. I have a 32 year old large pony that has Heaves. He gets 1-2 cc's of Dex for several days and then I taper down to 1/2-1 cc a day and then try tapering down to 1/2-1 cc every other day. It all depends on the allergens he is exposed to at a particular time and how his breathing is. He has been on this regimen for 7 years.

                                      Comment


                                      • #20
                                        I take care of my MIL's horse that has heaves. When he flares, for his size/weight he gets 10 cc a day for 5 days of 2mg/ml, then we taper to 5 cc a day, then we try to taper to 5 cc every other day. This past winter and spring he was off it altogether until July came (same time last year he started having trouble) and now we are back on.

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