Ask the Vet – Long-term use of Equioxx in horses

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DAN: “What are your thoughts
regarding long term Equioxx use in riding horses? Assuming blood work indicates
no areas of concern, is there any benefit to doing
a two day per week break, or any other intimate
breaks from the drug if a horse is on it for an
extended period of time?” This is the third month
in a row that Emma has submitted this exact question. So Emma is dedicated,
and she really would like to know the answer. And good job sticking with it. DR LYDIA GRAY: I get it,
because one of my horses is retired now, and he
is going on Equioxx. Yeah, first of all–
how did you say it? DAN: I said Equioxx. DR LYDIA GRAY: OK,
I said Equioxx. Well, I called the
company that makes it. The original
manufacturer was Merial. They got purchased or acquired
by Boehringer Ingleheim. So I called tech services at BI. DAN: Yes. DR LYDIA GRAY: They say Equioxx. So I think it’s a– DAN: Let’s all move
forward saying Equioxx. DR LYDIA GRAY: I think we’ve
been saying it wrong, Dan. All right, so it’s Equioxx. So it’s an NSAID, which is a
non-steroidal anti-inflammatory drug. And it’s cool, because
it’s a COX-2 only. So it’s supposed to be safer. They did a ton of
safety studies. The label says–
this is why she’s– I think her terms are–
she mentioned two weeks. The label says 14 days. So their first safety
test was 14 days. DAN: After 14
days, take a break? DR LYDIA GRAY: Stop. Stop using it. And then they also
did 35 days, 42 days. I think they went out as far
as 150 days on safety studies. And they also used 1x dose,
like 3x, 5x, and 12 and a 1/2 x. DAN: Wow. DR LYDIA GRAY: Yeah, and I
won’t go through all of it, but the important thing is
in 14 days at the 1x dose, no adverse events were seen. All right, so it’s safe. When they began to go
longer, or they used more than the 1x dose, they began
to see adverse effects. DAN: So going longer than
14 days without a break, is that what you’re– DR LYDIA GRAY: Well, and you
say break, and I mean stop. Now, I’ll tell you this– DAN: Just using the
words that she was using. DR LYDIA GRAY: Yeah,
yeah, yeah, yeah. And here’s what I can say. All that we can say on a
video that is going public is what’s on the label. DAN: Fair, fair. DR LYDIA GRAY: Right? Yeah, the company– I mean, they go
to a lot of money, like millions of dollars,
to get that label approved. This is a question she
should ask her vet. Because her vet can do what
I did, and call tech services at BI. And they actually have a
protocol for long term use to monitor safety. It says on the label
to do blood work. And she mentioned
that, so that’s good. But there are other things
that owners can look for. The first thing that happens
for when a horse is having an adverse reaction
to this, is they have “erosions and ulcers of the
gums, tongue, lips, and face.” So if you see those, then it’s
time to stop, contact your vet, probably do blood
work, and rethink. They said there are some horses
that just cannot tolerate this at all. DAN: Which happens
with medications. DR LYDIA GRAY: Exactly, yeah. But other things that
could happen with this are weight loss, colic,
diarrhea, icterus– jaundice, so yellowing of the
whites of the eyes and skin– yeah, so here’s all
the safety data. So there is a protocol. It’s one that your veterinarian
should be involved in. And also, this drug
is not innocuous. I mean, 14 days at 1x
dose, yes, but if you want to use it long
term, you really need to have your
veterinarian involved in it. I know there’s bottles of
Equioxx sitting in barns and people are just
giving it out like candy. It’s not candy. It’s not. You could do some serious,
permanent, lethal damage to a horse’s kidneys with this
that you can’t come back from. DAN: Well, I was going to say,
I know I ride stock horses, and we have a lot
of navicular, and so it has become very popular
amongst this group to– because it does. It’s very effective. But to your point
is, not just a– DR LYDIA GRAY: It’s not candy. It’s not gummy
bears or something. So any horse that’s on this
for more than the 14 day label claim needs to be working
with a veterinarian to make sure that the
protocol they’re on is safe, and that they know
the signs to look for in their horse, the
first signs of maybe it’s been too long. But the label does
recommend blood work. I just did blood work on Newman. It came back great. Because there was a little
ulcer, and I was like, oh my god, he’s dying. And it was just an ulcer from
like a weed or something, so it wasn’t the product. So I’m going to
keep him on longer. But yeah, she needs to involve
the vet and work with that vet to get a protocol that’s
appropriate for her horse and her situation. DAN: Perfect. Well, Emma, I hope that
was helpful, and thank you for your commitment trying
to get that question answered the last couple of months.

 

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