Common Equine Medications and Their Effects Matt Kornatowski, DVM

Outline Sedatives NSAIDs Antibiotics Gastroprotectants Topicals (Non-steroidal Anti-inflammatories) Antibiotics Gastroprotectants Topicals Miscellaneous

Talking Points Appearance Uses Administration routes Side Effects

Non-Talking Points Doses Steroids (Too much) Reproduction drugs Dr. Stanford’s talks Dewormers A whole different talk! Supplements Controlled drugs

Abbreviations PO = Per Os = Orally IV = Intravascularly IM = Intramuscularly PR = Per rectum = enough said

Sedatives Acepromazine Detomidine Romifidine Xylazine Use caution!

Acepromazine (Ace) Affects dopamine receptors Light yellow appearance Oral tablets/paste Used for mild calming effect Not strong analgesic/sedative Given PO, IM, IV Lasts 3-4 hrs Side effects: Sedation, ataxia, hypotension, persistent penile prolapse (paraphimosis)

Detomidine (Dormosedan, Dorm) Alpha 2 agonist Clear in appearance Used for heavy sedation, mild analgesia Dentals, wound repair, etc Given IM, IV Lasts 45 min – 1 hr Side effects: Ataxia, swaying, diuresis Occasional hyperresponsiveness Rarely recumbency Reversal agents

Romifidine (Sedivet) Alpha 2 agonist Clear in appearance Used for moderate sedation Wound repairs, oral exams Given IM, IV Lasts 1 – 1 ½ hrs Side effects: Ataxia, sweating Rarely facial edema

Xylazine (Rompun) Alpha 2 agonist Clear in color, shortest acting Used for mild sedation, mild analgesia Given IM, IV Lasts app. 30 min Effects: Sedation, mild analgesia Occasional hyper-responsiveness

NSAIDs (Non-Steroidal Anti-Inflammatories) Phenylbutazone Banamine Firocoxib Aspirin Piroxicam Meloxicam

NSAIDs (Non-Steroidal Anti-Inflammatories)

Phenylbutazone (Bute) Large white tablets, white paste, flavored powder Used for musculoskeletal pain Mild anti-pyretic effect Given PO, IV Lasts 12-24 hrs Side effects: GI ulceration (high dose) Renal papillary necrosis (dehydration) Bone marrow suppression (anemia) Long term use IM injections cause tissue necrosis (death) Use caution in pregnant mares “Bute Babies”

Flunixin Meglumine (Banamine) White paste, clear liquid Used for GI pain, fever reduction Given PO, IV, (IM??) Lasts 12 hrs Side effects: GI ulceration Renal ischemia (papillary necrosis) AND….

Result of IM injections Clostridial Myositis Result of IM injections

Aspirin White powder Used for hypercoagulable states, Equine Recurrent Uveitis Given PO Side Effects: Same as above (less common), platelet inhibition, tinnitus (overdose)

Firocoxib (Equioxx, Previcox) Cox 2 specific Used for musculoskeletal pain Given PO Lasts 24 hrs Side effects: Less common but similar to other NSAIDS GI ulceration, renal injury, oral erosions

Piroxicam Cox 1 Used for Squamous Cell Carcinoma Given PO, IV (less common) Side effects: Same as above

Meloxicam (Metacam) Cox 2 specific, considered quite safe Used in Europe Coming soon??

Antibiotics SMZs Penicillin G Gentamicin Ceftiofur Doxycycline Metronidazole Enrofloxacin Chloramphenicol

Resistance When a microorganism has the ability of withstanding the effects of antibiotics Genetic mutation within the bacteria Due to overuse or improper use underdosing Multi-drug resistant superbugs MRSA (Methicillin Resistant Staph. Aureus)

SMZs Trimethaprim Sulfadiazine (Veterinary) SMZs, Uniprim, Tucoprim Trimethoprim Sulfamethoxazole (Human) Tribrissen 160 mg Trimethoprim 800 mg Sulfa Main difference: Urine concentration Metabolization

SMZs Paste, powder, white tablets Given PO, IV (Rare) Used for variety of infections Mainly skin, uterine, urinary Side effects: Colitis, Anemia (long term)

Penicillin G “G” = Gold Standard White liquid Limited spectrum of activity Used commonly for Staphylococcus/Streptococcus - Skin, “strangles” Given IM only! Other forms of penicillin can be given IV Side effects: Soft tissue reaction, Allergic reaction, anemia (long term use)

Gentamicin (Gentocin) Clear liquid, ophthalmic ointment Synergistic with penicillin Gentomicin is poor against Streptococcus Given IV, IM, Ocular Side effects: Nephrotoxic (Kidneys) Rare ototoxicity (ears) Neurotoxicity

Ceftiofur (Naxcel, Excede) White powder reconstituted to yellow liquid Excede is brown, thick liquid Used for respiratory infections, internal disease, surgery Given IV, IM (Excede IM ONLY) Side effects: Colitis & anemia (high doses)

Doxycycline Small, orange tablets Used for various issues Given PO Penetrates tissues very well Given PO Oxytetracycline given IV Side effects: Congenital malformations GI disruption Relatively safe

Metronidazole (Flagyl) Oblong white tablets Used for diarrhea, thrush, canker (anaerobic infections) Given PO, PR, topically Side effects: Neurotoxicity (rare) Disruption of GI protozoa

Enrofloxacin (Baytril) Liquid or oral paste Used for variety of infections Less resistance Given PO, IV Side effects: Colitis Neurotoxicity Tissue irritation (Oral lesions) Cartilage damage in young

Chloramphenicol Yellow pills, oral liquid, eye ointment Used for variety of infections “Big gun” antibiotic Given PO, IV, Ocular Side effects: Diarrhea, inappetance bone marrow suppression Relatively safe Aplastic anemia in humans Wear gloves!

Gastroprotectants Gastrogard Ulcergard Ranitidine

Omeprazole (Gastrogard/Ulcergard) Oral, white paste Treat/prevent gastric ulcers Proton pump inhibitor Decreases acid secretion Given PO Side Effects: No adverse effects listed

Ranitidine (Zantac) Small, circular yellow or white tablets Treat gastric ulcers Inhibits H2 receptors Decreases acid secretion Given PO, IV Side effects: Very rare

Topicals Triple Antibiotic Ointment Silver Sulfadiazine Furazone Surpass DMSO

Triple Antibiotic Ointment (Neomycin, Polymyxin, Bacitracin) Clear gel comprised of 3 antibiotics Topical antibiotic Used for variety of issues Eye ulcers (Ophthalmic), wounds, mild to moderate skin infections Side effects: Contact dermatitis

Silver Sulfadiazine (SSD) Thick, white cream Anti-bacterial, anti-fungal Used for burns, eye ulcers, wounds Side Effects: Skin irritation

Nitrofurazone (Furazone) Yellow gel Can be mixed with DMSO Antibacterial Good for burns, skin infections Scratches Side effects: Contact dermatitis Renal impairment

Diclofenac (Surpass) White gel Topical NSAID (Non-specific Cox 1 & 2) Control of joint pain & inflammation Side effects: Well tolerated Dermatitis (Let dry) Possible weight loss, gastric ulcers, diarrhea

DMSO (Di-Methyl Sulf-Oxide) Clear gel “Topical application to reduce acute swelling due to trauma” Used in many other ways Topical carrier agent Some anti-inflammatory properties Side effects: “Burning” (erythema) Garlic odor Relatively safe Teratogenic properties in humans (Gloves!)

Miscellaneus Meds Pergolide Isoxsuprine Marquis

Pergolide Dopamine agonist Used to treat Cushing’s Disease Decreases release of certain proteins Used to treat Cushing’s Disease Side effects: Few (Well tolerated) In humans: Neuroses (hallucinations), nausea, vomiting, rhinitis

Isoxsuprine White tablets Used for laminitis & navicular Given PO Dilates blood vessels Questionable efficacy Given PO Side effects: Unlikely Tachycardia, hypotension Hyperexcitability

Ponazuril (Marquis) Paste formulation EPM treatment ONLY Given PO Equine Protozoal Myelitis Anti-protozoal Affects organelle specific to protozoa! Given PO Side effects: At 10x the dose, some soft manure Very safe!

Key Points Sedatives NSAIDs Antibiotics Ataxia, sweating, urination NSAIDs Gastric ulcers, kidney problems Antibiotics Resistance Potentially cause colitis Call your vet before administering any drugs!

Questions?