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talk to me about fluphenazine

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  • talk to me about fluphenazine

    I have a horse that just had his pastern arthrodesed. He is already getting excited on stall rest in hospitalization. As we have been through rest before with collateral ligament injury reserpine, L tryptophan, Valerian root, other claimers, ace helped little in large repeated doses but didn't last long, I am wondering about fluphenazine.

    What are your experiences with fluphenazine? the good and the bad? What is a very safe dose? I would love to hear all your fluphenazine stories!

    Thankyou in advance!

  • #2
    HOT TOPIC HERE AT TIME :-)

    1) yes it can work

    2) Does not work on a lot of horses.

    3) some vets give it in conjunction with Depo

    4) Have had maybe 7 rehabs in the last 10 years we tried it on and it only made a difference in 4... Known many horses (over 35) who have been given drug on rehabs farm or for shows in old days and again mixed reactions as far as REALLY changing behavior. It was quite the drug of choice for many people including some BNT's but then tests became sharper and BIG BUSTS happened :-)

    5) Some feel it is dangerous, we have had no adverse reactions. but in recent years more research has been done on some not so pleasant effects that "might" occur.

    6) Highly illegal to show on.


    some people use:Reserpine

    Reserpine For Veterinary Use
    by Barbara Forney, VMD



    Overview
    Therapeutic Class
    Psychotropic agent
    Species
    Horses
    Commonly prescribed by vets for:
    Long acting tranquilizer.


    Basic Information

    Reserpine is a naturally occurring drug that has been used for centuries in ancient India. It is extracted from the root of Rauwolfia serpentina or Rauwolfia vomitoria, plants found in India and Africa. In traditional herbal medicine, the root was brewed as a tea and used in humans to treat hypertension, insanity, snakebite, and cholera. The purified alkaloid, reserpine, was isolated in 1952 and is considered the first modern drug for the treatment of hypertension. Reserpine irreversibly binds to the storage vesicles of neurotransmitters, particularly norepinephrine, serotonin and dopamine. Eventually, catecholamine depletion occurs because of the body's inability to store these neurotransmitters. It is an unusual drug; it takes many hours or days to reach full effect and continues to have some subtle sedating effects for many days after the last dose.

    Horses

    Reserpine is used as a long acting tranquilizer in horses. It is used to sedate excitable or difficult horses that are on enforced rest. It is sometimes used illicitly for the sedation of show horses, sale horses or in other circumstances where a "quieter" horse might be desired. Until relatively recently reserpine was difficult to test for, but there are now sensitive and accurate tests. Blood testing for reserpine use can be complicated by related herbs and plants found in supplements, pastures and hay which can also cause a positive drug test. Reserpine was once used in pregnant mares in an attempt to treat "fescue toxicosis." Domperidone has largely replaced reserpine for this use.
    Side Effects

    • Different horses vary greatly in their sensitivity to this drug.

    • Common side effects include, colic, gastrointestinal upset, mild diarrhea that may last for days, and sweating over the back and hind legs. Signs of sedation include depression, droopy eyes, and a dropped penis.

    • Reserpine increases gastric secretion in humans and increases the risk of ulcers.

    Precautions

    • There is little published information on the clinical use of reserpine in horses. As a consequence, much of the available information is anecdotal and should be considered as such.

    • Reserpine causes male horses to drop their penis; penile paralysis in stallions is a possible side effect.

    • Reserpine is a prohibited substance in most sanctioned competition and is a frequent cause of drug violations due to the long and variable withdrawal period. Some herbal products have been implicated in positive tests for reserpine.
    Drug Interactions

    • Reserpine may interact with drugs used for general anesthesia.

    • Methamphetamine is an antidote to reserpine.

    Overdose

    Overdose of reserpine increases the risk and the severity of the above-mentioned side effects.


    TEXAS VET NEWS
    By Dr. Bob Judd, DVM and the Texas Farm Bureau
    Texas Farm Bureau Radio Network
    Fluphenazine Reactions in Horses


    In the equine show horse and performance horse industry, many drugs are given that are unapproved of for use in horses. Many equine groups require drug testing of horses, which limits the use of these drugs. However, a large number of associations do not require any testing. Although it is unethical to use these drugs in my opinion, most of the time the horses are not harmed and there is not a fear of human safety. One of the most commonly used drugs is fluphenazine and horse owners may be using this drug in their horses and not know the concerns with it. Fluphenazine is a highly potent drug used in people for the treatment of schizophrenia and other forms of psychotic illness. A long-acting form of the drug is used in horses as a long-term sedative and is considered by the United States Equestrian Federation as a forbidden substance.

    The drug was initially used in horses who had an injury that required the horse to be stalled for long periods of time and needed to be sedated until the injury healed. However, the drug is now mostly used in performance horses that are a little too excitable and are somewhat uncontrollable. The ethical problem with this is that the best horse and rider may not win the competition. However, there is also a safety problem. A recent report described four horses with severe behavioral abnormalities consistent with parkinsonism. Clinically these horses developed profuse sweating, agitation, intense pawing, striking out with the forelegs, and uncontrolled swinging of the head. Three of the four horses recovered following intensive care, but one died. Not only can the horses die, but any humans around these horses when they develop this violent behavior could also be severely injured.

    Abstract
    Journal of the American Veterinary Medical Association
    Adverse extrapyramidal effects in four horse given fluphenazine decanoate

    John D. Baird, BVSc, PhD; Luis G. Arroyo, DVM, DVSc; Modest Vengust, DVM, DVSc, DACVIM; M. Kimberly J. McGurrin, DVM, DVSc, DACVIM; Alexander Rodriguez-Palacios, DVM, MSc; Daniel G. Kenney, VMD, DACVIM; Manickam Aravagiri, PhD; George A. Maylin, DVM, PhD
    Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada. (Baird, Arroyo, Vengust, McGurrin, Rodriguez-Palacios, Kenney); Veterans Administration Greater Los Angeles Healthcare System, Building 210, Room 4, 11301 Wilshire Blvd, Los Angeles, CA 91311. (Aravagiri); Equine Drug Testing and Research Program, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850. (Maylin)
    Dr. Vengust's present address is Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia.

    Address correspondence to Dr. Baird.
    Case Description—4 racehorses were examined because of markedly abnormal behavior following administration of fluphenazine decanoate.

    Clinical Findings—Clinical signs included restlessness, agitation, profuse sweating, hypermetria, aimless circling, intense pawing and striking with the thoracic limbs, and rhythmic swinging of the head and neck alternating with episodes of severe stupor. Fluphenazine was detected in serum or plasma from all 4 horses. The dose of fluphenazine decanoate administered to 3 of the 4 horses was within the range (25 to 50 mg) routinely administered to adult humans.

    Treatment and Outcome—In 2 horses, there was no response to IV administration of diphenhydramine hydrochloride, but the abnormal behavior in these 2 horses appeared to resolve following administration of benztropine mesylate, and both horses returned to racing. The other 2 horses responded to diphenhydramine administration. One returned to racing. The other was euthanized because of severe neurologic signs, respiratory failure, and acute renal failure.

    Clinical Relevance—Findings indicate that adverse extrapyramidal effects may occur in horses given fluphenazine decanoate. These effects appear to be unpredictable and may be severe and life threatening. Use of fluphenazine decanoate as an anxiolytic in performance horses is not permitted in many racing and horse show jurisdictions, and analytic procedures are now available to detect the presence of fluphenazine in serum or plasma.
    To be successful, you have to have your heart in your business, and your business in your heart

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    • Original Poster

      #3
      It is such a scarry thought, I am in a rock and a hard place, because his whole future rides on him staying quiet the next 4 months, soundness verses perminent lameness. I wish the reserpine could work. Even two bottles of ace each week was not working.

      Comment


      • #4
        It's worth a try if your vet thinks it's a good option. My old girl was on it earlier this year while on stall rest for a superficial tendon injury (three separate tears! ) It worked pretty well and kept her quiet enough.

        Comment

        • Original Poster

          #5
          is there any other long lasting sedatives out there?

          Comment

          • Original Poster

            #6
            Would it be less risky if I took gave him a really low dose? Has anyone used fluphenazine and ace together?

            Comment


            • #7
              No direct experience, but fluphenazine = prolixin which may help as you search for info. It is classified as a long-term antipsychotic. My recollection is that you can give it once, or maybe twice and then no more so you would want to look into how long it was expected to last. There are undoubtedly other drugs out there that might do the trick. My dad is a psychiatrist and he's amused (or maybe appalled?) at what he considers the old-school high-side-effect drugs that we use on horses for sedation. I asked a vet once about other drugs and why they weren't used and her response was that they were largely untested and expensive to give to a large animal.
              The Evil Chem Prof

              Comment


              • #8
                Isn't fluphenazine the same stuff they use in Prozac or Zoloft or some antidepressant? Why would it be useful for a rehab?

                I'm really curious; I don't know. It was given to a horse I know that had a very bad rearing problem and that made it go away until it wore off. That's about the bulk of my knowledge.

                Comment


                • #9
                  Originally posted by Across Sicily View Post
                  Isn't fluphenazine the same stuff they use in Prozac or Zoloft or some antidepressant? Why would it be useful for a rehab?

                  I'm really curious; I don't know. It was given to a horse I know that had a very bad rearing problem and that made it go away until it wore off. That's about the bulk of my knowledge.
                  No. As mentioned in previous posts, it's an antipsychotic. It's used as a long[er]-term tranquilizer in horses.

                  Also it was used quite successfully on a young gelding I used to care for that had a medial collateral ligament injury (he was on stall rest for I don't know how long and was not going to be a good candidate for that without SOMETHING).

                  Comment


                  • #10
                    Caused my students horse to go into seizures and become so violent they could barely get out of the stall. Had to make an emergency trip to New Bolton where he was seizing in the trailer. Horse had kidney failure and many other issues that I can not remember do to the drug and they didn't think he would live but he pulled out of it. Use with caution.
                    http://www.benchmarksporthorses.com/

                    Comment


                    • #11
                      Have Horses on Both

                      I have one long term lay-up a colt who is on Reserpine w/ little to no bad side effects. I was advised to pre-treat him w/ Banamine due to the stomache upset. But it has taken him a bit of time to wind down and be tractable and not harm himself being strong. No droppy penis or eyes no sweats.
                      The other guy is on your questioned product. He had nasty wet droppings intially but now they are a bit to tight. He is calm unless there is a sudden commotion or he gets startled then he will get wound up sharply, react, then calm down.

                      Have you tried a smaller stall? Stall toys, a friend he can see thru grill in ajoining stall, a radio w/ soft music (it does work)
                      There are cocktails your vet can mix for him, but all have backlash plus his penis runs a risk especially w/ ACE. anyone have thoughts on Rompum, dermosidan, torb??? yeah I can't spell the stuff.

                      Comment


                      • #12
                        fluphenazine also known as Modecate, a DEPOT major tranquilizer that has fallen out of favour in human psychiatry due to high side effects, unpredictable rates of absorption, high incidence of abscess at injection sites. No relation to Prozac ( fluoxetine) or the other antidepressants.

                        There was another thread on this recently- you might want to do a search of the froums. It had to do with a vet that had given the drug and then the horse tested positive weeks later at a show, IIRC. It works, but the duration is unpredictable, and as someone mentions, it lowers the seizure threshold in all animals, so seizures can be a very dangerous side effect if you guess the dose or dosing interval wrongly.

                        Reserpine is an interesting drug and I am not sure I'd want to give it to my animals either. It was mainly used in the 1960's and 1970's to produce an animal model of depression, since it mimics the biochemical effects of human depression. I am not sure how much "emotion" animals feel, but having been depressed in the past I wouldn't want to make my animals quiet by having them so depressed they didn't move.

                        Had a horse on 2 stints of stall rest of 6 months each. A big, bouncy, active horse. We managed with clicker training and lots of company all the time. After about the 3rd week, he did settle on his own. NO GRAIN or other high energy food. But lots of low grade hay to nibble free choice, helped a lot.
                        "The Threat of Internet Ignorance: ... we are witnessing the rise of an age of equestrian disinformation, one where a trusting public can graze on nonsense packaged to look like fact."-LRG-AF

                        Comment


                        • #13
                          I've given about fifty zillion prolixin decoanoate shots to HUMANs over the course of a 30 yr nuring career. Many of my patient were folks I knew and took care of in inpatient and outpatient settings for years and years at a stretch. I have never seen an abcess at an injection site, rarely seen an adverse reaction, and very very often have seen the medication vastly improve the lives of the people taking it. Havent seen increase in seizure activity either. It helps if you use the minimum dose that gives the desired effect.

                          Having said that, horse owners, like people, often decide that if you did A before B happened that A caused B. The chicken crowed and the sun came up. Did the chicken MAKE the sun rise?

                          All drugs have side effects, and all individuals vary in their reaction to and tolerance of drugs.
                          When psychotic people clear up they can maintain without psychotic symptoms on lower doses of medicine than what it took to get them clear. I expect a horse that became habituated to stall rest, for instance, could manage on less or no medicine once they got used to a new routine...

                          Comment


                          • #14
                            Originally posted by judybigredpony View Post
                            I have one long term lay-up a colt who is on Reserpine w/ little to no bad side effects. I was advised to pre-treat him w/ Banamine due to the stomache upset. But it has taken him a bit of time to wind down and be tractable and not harm himself being strong. No droppy penis or eyes no sweats.
                            The other guy is on your questioned product. He had nasty wet droppings intially but now they are a bit to tight. He is calm unless there is a sudden commotion or he gets startled then he will get wound up sharply, react, then calm down.

                            Have you tried a smaller stall? Stall toys, a friend he can see thru grill in ajoining stall, a radio w/ soft music (it does work)
                            There are cocktails your vet can mix for him, but all have backlash plus his penis runs a risk especially w/ ACE. anyone have thoughts on Rompum, dermosidan, torb??? yeah I can't spell the stuff.
                            Xylazine-Rompum, dormosedan and torb are all very short acting as in 30 minutes max. I can't see giving a horse an IV shot every 30 minutes for weeks. Torb isn't even a tranq that is why its used in the cocktail as opposed to by itself. The chances of penile paralysis are infintely minute. When contrasted with the very high probability of an injury without it should make the decision fairly easy.
                            McDowell Racing Stables

                            Home Away From Home

                            Comment


                            • #15
                              I've given about fifty zillion prolixin decoanoate shots to HUMANs over the course of a 30 yr nuring career. Many of my patient were folks I knew and took care of in inpatient and outpatient settings for years and years at a stretch. I have never seen an abcess at an injection site, rarely seen an adverse reaction, and very very often have seen the medication vastly improve the lives of the people taking it. Havent seen increase in seizure activity either. It helps if you use the minimum dose that gives the desired effect.
                              Geez you've done your work well and are an expert at injections. Alas, as the former medical director and chief psychiatrist at a 1200 bed chronic mental hospital 20-30 years ago when these meds were still in common use, I've encountered all of the side effects and problems I mention in my post, as well as reading the research that confirms the problems. Your anecdotes nothwithstanding of course.
                              "The Threat of Internet Ignorance: ... we are witnessing the rise of an age of equestrian disinformation, one where a trusting public can graze on nonsense packaged to look like fact."-LRG-AF

                              Comment


                              • #16
                                I used it with no ill effects, but no positive effects either. I only gave him one 5mL dose, and since I saw no change and it really scared the crap out of me giving my horse an anti-psychotic, I was all set with ever using it again. I think there are better options out there and would only use it in extreme cases. For example, my gelding was jumping 4 1/2 foot fences and galloping around the farm EVERY DAY on a still healing leg injury. Keeping him inside was not an option.

                                Comment


                                • #17
                                  I had my horse on fluphenazine after stem cell therapy on his torn SI ligament. He had 5 shots spaced out over 6 months, and it made a huge difference. I could tell when it was wearing off because he started rearing, striking, and generally being unpleasant to everyone who came near him. Another shot, and he was back to happily hand-walking, going on the treadmill, etc.

                                  Comment

                                  • Original Poster

                                    #18
                                    If you can think of another option I can discuess with my GP please enlighten mes, I feel in a rock and a hard place! Any ideas greatly appreciated!

                                    Comment


                                    • #19
                                      Originally posted by jeano View Post
                                      I've given about fifty zillion prolixin decoanoate shots to HUMANs over the course of a 30 yr nuring career...
                                      How many horses have you administered fluphenazine to?
                                      There are significant differences among species in terms of response to medications of any sort.
                                      "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

                                      ...just settin' on the Group W bench.

                                      Comment


                                      • #20
                                        Originally posted by Fharoah View Post
                                        If you can think of another option I can discuess with my GP please enlighten mes, I feel in a rock and a hard place! Any ideas greatly appreciated!
                                        You are between a rock and a hard place.
                                        Have you upped the reserpine dose to see if that works, or are you at the upper limits?

                                        You may have to take a deep breath and hope your guy isn't one of the horses who reacts poorly to fluphenazine.
                                        "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

                                        ...just settin' on the Group W bench.

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