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Help with Pain Management

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  • Help with Pain Management

    Have a wonderful horse with some shifting lameness issues.

    History in a nutshell:

    Race horse retired sound, PPE was clean but did have 2 small set splints.
    Horse lame less than a year later in front end. Radiographed feet and thin soles. Took year to resolve.
    Brought back into work. Hind end lameness. More rads - nothing seen. Resolved with no treatment.
    Front end lameness - splint - cryo and rest. Resolved - sound.
    Front end lameness again - another splint - cryo and resolved - sound.
    Hind end lameness - chronic hind end abcess. (on and off for 2 months) - Resolved.
    New splint - no lameness - front end. DMSO treatment, splint never went away but was sound.
    More front end lameness - maybe old splint acting up? Radiographed. Rest - resolved.
    Hind end lameness again, hoof issues? Shod, resolved. Sound.

    TODAY: Hind end lameness - small splint (dime size)?? Could be causing problem?
    Sore back?
    Sore muscles?

    Got massage people out a year ago - hes VERY sensitive but they dont think there is any "area" in particular making him sore.
    Unsure if he has a sore back, or if its just a bad luck string of splnts/abcesses and bruises - unsure if I want to try a chiropractor?? Ive heard mixed reviews.
    Currently, he goes from feeling GREAT one day, OK another day, dead lame, then back to great - all within a month.

    Poor guy just cant cut a break. He is sound then off, then sound, then off. He's 9 years old - in light work. His radiographs all look good with the exception of the splints (he likes to collect those apparently).

    Hes a pleasure horse, treated like royalty but I cant justify radiographs/full workup every time he takes a lame step. After my 500th vet visit, my vet mentioned just putting him on a general pain management program. I would talk to my vet, but has left for 2 months. Im sure I could talk to another vet (and will) but his history is so strange.... (edited to say, going to call in another vet to come see new splint)

    Even though we were fairly certain there was no arthritis, we tried adequan with no results. The omega alpha suff (Antiflam) didnt work at all. CBC run several times to rule out infections. Tried a short course of steroids to rule out an immune mediated disease. Vet doesnt think its Lyme (not really in the area, and the horse isnt consistently lame enough) No joint pain. No fever, horse is always dull (thats his personality, most laid back guy EVER), wondeful appetite. Serum chemistries are normal. Horse seems to be very healthy.

    Im assuming at this point, he just has bad luck, soft feet an bones that like to create splints.

    Any "pain" program out there suitable for him long term? Other than bute, I cant think of anything. Would 1g/day be suitable for such a young horse??

    Thanks for reading, sorry so long!
    Last edited by RPSIPony; Apr. 11, 2010, 11:54 PM.

  • #2
    You saw he has a switching leg lameness with sore back I would consider his feet as a possible cause and sore back as secondary.

    1 gram of bute five days a week has been seggested to me. Apparently you give them that two day break they can do Other option is previcox.


    • #3
      Ohh...post just disappeared!!

      I would think if your horse didnt respond to adequan, he wouldnt respond to previcox. I would also think 1g of bute daily would be ok in an older horse, but that seems really young to start that regime for life....???

      Actually, now that I think about it, thats a REALLY good question!

      What "pain management" options are there for horses, that DONT involve arthritis treatments?


      • #4
        I've had good success with Devil's Claw supplements for daily chronic pain relief. I've variously used SmartFlex Senior, Smart TLC, Devil's Claw Plus and DC-Y (liquid) and found them all to be effective. Not as effective as bute, of course, but effective enough that daily bute is not necessary.


        • #5
          Alot seems to be in foot.
          Is he turned out for a lengthy period & maybe gets ramming around making himself sore or even lame?
          Have you tried shoes with pads?
          Those OTTBs can have notoriously thin soles, shelly hooves.Easily bruised

          Just a thought.


          • Original Poster

            Yep, tried shoes with pads. Front feet seem to be happy now, its been a few years since a bruise. Hind feet could be the culprit, but farrier thinks unlikely that there is bruising there (out in soft paddock, hind shoes, indoor arena work) plus its so GREAT one day and Off another, doesnt really act like a bruise.

            Horse isnt "faking" either - when he feels good, he really feels good. Even when lame, he has his heart in it and wants to work for you - of course he gets the day off if he isnt feeling great.

            Although it could be one, or seven of MANY things, but I hope to rule out intermittent back pain...whats the best way for this? Also, I am starting to wonder if he has some 1 in a 1000000 disease which causes him to have sore muscles some days? My vet is stumped. He's a little OTTB who has had thousands of dollars in diagnostics. I financially cant keep hunting, my budget is tapped. He's a pleasure horse, doesnt show, mostly rides around at home and sometimes goes out on the trails. I love him more than anything in the entire world - but I think there just becomes a point where diagnostics just have to stop. If he was sore one day a week, I would certainly persue further diagnostics but he's on average "off" 2 days a month, "NQR" 4-5 days a month and "great" the rest.

            Would a low dose bute trial be risky for him? No signs of ulcers, and all current bloodwork is normal. Adequan and cosequin have not really done anything to change his monthly offness.


            • #7
              I don't usually suggest them, but what about getting a really good chiro to take a look at him?
              Horse Show Names Free name website with over 6200 names. Want to add? PM me!


              • #8
                Ask your vet about Previcox. Might be a good option, safer on the belly than Bute. My horse has been on it about a year now for arthritis and doing great.


                • #9
                  I'm wondering if he's mildly tying up or muscle spasming. What are his Selenium levels like?

                  If he were mine, I'd get that tested (straightforward blood test) and if he's in the normal to low range, I'd put him on an Se adn E supplements, and most decidedly anyway put him on magnesium, maybe Quiesscence, and see if that helps.


                  • Original Poster

                    OK, so with a careful go-over today, it looks like he has a new small splint. Not hot to the touch, but its definately new so that probably caused some discomfort the other day. Today, he was significantly better (just loose trot, no riding) but not 100%. Will give the vet a call tomorrow to have a feel. I dont think radiographs will be needed (crossing fingers). Poulticed and wrapped for tonight.

                    I am also going to have a chiropractor come out to look at him. The splint certainly hasnt caused all his off days (but I wish it had). I talked with a few people at the barn about it today, and have only heard good reviews. I think I will also book him in for a massage the week following as well.

                    I have also purchased some BL Solution. I figured it might not do anything, but wont do any harm. Its B12, Yucca, Ginsing and Devils Claw. I havent found many reviews on it, but the 4 that I did find all had good reviews.

                    I will get his selenium levels checked as well, but generally in this area horses are receiving enough in their diets that supplimentation is rarely required. Cant hurt to run the test though. I think I will hold off starting him on Selenium until I know his levels. That is not something my vet has recomended in his case, but I will ask about it.

                    Also, question for any vets (or human doc's out there) - is Calcium/Vit D similar in horses as to people? I find at NINE years old, he should not still be popping splints. He is in VERY light work and cant think of any trauma to cause them (white legs, no bruising, no cuts). I know impaction can cause them in younger horses...but would it be possible to have a bone disorder causing them to be soft enough to keep popping splints?


                    • #11
                      Originally posted by Fharoah View Post
                      You saw he has a switching leg lameness with sore back I would consider his feet as a possible cause and sore back as secondary.

                      1 gram of bute five days a week has been seggested to me. Apparently you give them that two day break they can do Other option is previcox.
                      I like all of Fharoah's advice for this horse.

                      I'd also add a couple of other things. First, speak to your vet about Robaxin-- muscle relaxant-- if you think your horse has gotten into holding his back wrong and he's tight. But what else do you see? Has his posture changed? Does he roll? Roll as he always did? Move and choose to use his body while being free lunged as he always did?

                      Platinum Performance makes this stuff, Osteon, that is useful for healing fractures. You could try that for a while if you think he has a splint that needs healing, and the traditional DMSO.

                      Best of luck with your horse. But do pay attention to changes in muscle, posture and behavior in addition to your formal lameness exams. You probably know more about this horse and figuring out where he hurts than anyone else.
                      The armchair saddler
                      Politically Pro-Cat


                      • #12
                        With intermittent and roaming lameness I would suspect lyme disease and maybe even do a neuro workup for EPM.
                        Also, you might want to have a second farrier look over his feet.
                        "The mighty oak is a nut who stood its ground"

                        "...you'll never win Olympic gold by shaking a carrot stick at a warmblood..." see u at x


                        • Original Poster

                          Vet is positive its not lyme - no joint pain, no fever.

                          75% of the time, he is absolutley normal. Playing in the field, rolling, absolutley joe cool about anything.

                          20% of the time...he's just not right in the hind end (its been about a year since he has had a front leg lameness). Mostly hind left, recently hind right. I can "feel" it, but its not noticible to anyone on the ground - horse still wants to work.

                          5% of the time, he is off, like not an abcess limp, but something bothering him limp.

                          He NEVER has a hunched back, never stops rolling even if he is a little off in a leg. However, he has always been SUPER sensitive to groom and move away from a hard curry. I chalk it up to thin skin (doesnt like anywhere really being brushed unless its a soft brush), but he does have a long back so Im certainly not ruling OUT back pain.

                          Im also not too worried about his feet at the moment either. He will walk/trot on any surface, soft, hard or gravel without any issues. He wears shoes though.

                          Poulticed the splint tonight, gonna have the vet come take a feel of it tomorrow and get the ok to start DMSO. This will be his 7th splint (uuuuugh). Maybe these have been the problem all along? May go ahead and re-radiograph both hind legs distal to the hock to see whats going on with the splint bones...


                          • #14
                            Originally posted by SquishTheBunny View Post
                            Ohh...post just disappeared!!

                            I would think if your horse didnt respond to adequan, he wouldnt respond to previcox. I would also think 1g of bute daily would be ok in an older horse, but that seems really young to start that regime for life....???

                            Actually, now that I think about it, thats a REALLY good question!

                            What "pain management" options are there for horses, that DONT involve arthritis treatments?
                            Previcoxx and Adequan are completely different. Adequan is essentially injectible glucosamine. Previcoxx is essentially, I believe, an anti-inflammatory and pain reliever.
                            There are some vets who will not do Previcox, will only suggest Equioxx. Equioxx is too expensive on a daily basis, but if you get previcoxx (dog version), it's only about 25 cents a day- I can't remember exact amount, I did the math last year for another horse.

                            I agree with what someone else said- get another farrier's opinion on his feet. Get the chiro out, as you are doing. Robaxin might also be something to try.
                            Good luck!


                            • Original Poster

                              My vet did mention previcox a while back, I cant remember exactly why we didnt try it, but basically he thought it to be better for joint pain. Although at that price its worth a try if his splint is not the culprit or I dont see results with the BL solutions.

                              Also, can someone fill me in on a low dose for robaxin (ie mg/day) he is a 500kg thoroughbred. Can you keep them on it long term?

                              With the money Ive put into this guy, he's now officially considered my $50,000 horse LOL!!!!


                              • #16
                                Originally posted by RPSIPony View Post
                                I have also purchased some BL Solution. I figured it might not do anything, but wont do any harm. Its B12, Yucca, Ginsing and Devils Claw. I havent found many reviews on it, but the 4 that I did find all had good reviews.
                                BL gave my mare ulcers where bute didn't. Previox is AMAZING!!!


                                • Original Poster

                                  Hmmm... decisions decisions. But.... (just did a bit of reading on Previcox), it really seems to be a product for JOINT pain.

                                  Im not against trying it...and probably end up WILL trying it...

                                  I have a dog who is on previcox. After his first surgery (abdominal sx) he was on metacam for 5 days - day 1 post op surgery he was feeling soooo good it was like he never had surgery. He loved his metacam!!! Had a second surgery (cruciate, torn meniscus) Post surgery pain he was on metacam for the 5 days again, did great!!! After the week he was put on Previcox for long term pain management. The metacam in my opinion was far superior but there were more long term risks, so we opted for the previcox.

                                  I guess what I am trying to say, is if your horse was smucked by a truck and was just ouchy all over, previcox probably wouldnt be the drug of choice to go to (lol, im sure morphine or fentanyl would)...I figured a bute type drug for generalized pain would be better??

                                  I wish metacam/meloxicam came in horse form!!

                                  Can you give previcox with robaxin?


                                  • #18
                                    I think you'll find that the previcox actually acts as a general anti-inflammatory, so will help the "hit by a truck" pain, too.

                                    It's also one of those "can't really hurt much, might well help" things.

                                    The other thing you might investigate is Smartflex Senior--it'g got anti-inflammatories as well as joint stuff and a butt-load of MSM in it. And it is cheap. But you can't show on it.

                                    I know you think it isn't joints, but there may be some minor grumbly thing going on that is hard to pinpoint.

                                    (I've got a horse a bit like yours--no splints to blame, though... Every time one thing heals up, another falls apart.)


                                    • #19
                                      Originally posted by atr View Post
                                      I think you'll find that the previcox actually acts as a general anti-inflammatory, so will help the "hit by a truck" pain, too.
                                      Ditto what it has done for a false ringbone gelding I take care of is nothing short of miraculous where bute did nothing.

                                      Vet said it is better than bute but nothing will make Kahlua sound... owner has just put him back under saddle for the first time in 2 years and he has been a maniac out in the field where previously he couldn't even walk without a significant limp.


                                      • Original Poster

                                        (Off to order some more previcox for the D....o....g.... )

                                        I read the horse dosage somewhere - can anyone remind me? I know its different than in dogs.

                                        Safe to give with robaxin?