United States Equestrian Federation

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Drugs and Medications Corner: A Healthy Respect

Release: May 13 2009

Author: severs

This special section, Drugs and Medications Corner, will feature a series of articles from the USEF’s Drugs and Medications Program and the veterinary community to communicate the latest news to better educate the equine community.

By Richard D. Mitchell, DVM, Fairfield Equine Associates, P. C., Newtown, CT, and Wellington, FL

Many years ago, I was called to see a show hunter discovered to have a “big knee.” I found the horse to have moderate heat and swelling with pain on flexion of the left knee. He demonstrated a 3/5 lameness to trot in hand (AAEP scale, head bobbing). The trainer’s suspicion was the horse got cast in the stall as it was normal the day before when schooled. I suspected a severe contusion (bruise). I suggested radiographing the knee, but the owner and trainer declined. I administered a 500mg dose of Banamine® (flunixin meglumine), a newer drug at the time, and a 20 mg dose of Azium® (dexamethasone), told them to ice and poultice the knee and hand walk him only for exercise. I dispensed four packages of Banamine granules for the horse to receive over the next two days (one package twice daily).

Two days later, the swelling in the carpal region (knee) had subsided remarkably, and the horse was trotting soundly. He was, of course, still getting Banamine orally, so I instructed the trainer to stop with that morning’s dose. I told them to be patient about working the horse. I did not have a comfortable feeling about the analgesic potency of the medication the horse was receiving. I was probably being over cautious, but they agreed to my request. I asked for an update the next day. Thursday afternoon I received a call; he was again lame. I recommended continuing ice and keep him confined, and I would return Friday morning to examine and radiograph him (they agreed).

Upon examination, I again found some heat and mild swelling in the upper left carpus and again 3/5 lame. We performed radiographs and recommend again putting the horse on Banamine orally and continuing supportive care. I suggested the horse be confined with no exercise until the radiographs were developed. I expected a small chip or just a lot of edema under the skin. To my surprise, the radiographs showed a spiral fracture of the radius (forearm) from the radial-carpal joint at the knee to the elbow! This horse was sound on a USEF legal level of Banamine (although being split into twice daily doses). Had I allowed that horse to work on Wednesday when it appeared normal or had allowed it to just remain on medication, a serious disaster would have occurred. As things turned out, following consultation with Dr. Bud Fackleman at Tuft’s University, we confined the horse for 3 months and all healed well with no surgical intervention.

Needless to say, I was left with a healthy respect for the analgesic potency of Banamine.

Banamine (flunixin meglumine) is a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation and pain by suppressing the chemical mediators of the inflammatory reaction. It is one of several NSAIDS for use in horses. Inflammation can occur from acute trauma or more chronic wear and tear. Suppressing inflammation may have a disease modifying effect and be good for the patient. These drugs do not work on the central nervous system and suppress sensation or perception. Horses on NSAIDS are not really “doped.” The USEF has long supported a therapeutic medication rule to protect the welfare of the horse by allowing horses in competition to receive medication for specific medical conditions that will not seriously affect performance or be a threat to their welfare. This good rule has allowed for suddenly sick horses to be appropriately treated with specific medications, recover and still compete. Mildly arthritic horses have still had a useful purpose when made comfortable. Under this rule such horses are not in violation of medication regulations. It has been the opinion of the USE

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