Tuesday, May 9, 2017

More Vet Bills For Ben

Ben's been on a daily dose of phenylbutazone ("bute") for several years to relieve arthritis, primarily in his hocks -- a not-uncommon problem in ageing horses. An unfortunate side-effect of this NSAID given long term can be gastric problems like ulcers, and for several months Ben's had runny fecal discharge soiling his hind end. Other remedies for this having failed, I discontinued his bute a couple of weeks ago, and sure enough, the discharge has dwindled away to almost nothing. He's seemed comfortable without the bute, too, in terms of idling around his paddock.

So far so good, eh? But Hilly has noticed a little stiffness lately, and when I had Ben's long-time vet out to assess his soundness yesterday, his flexion tests went badly. The underlying arthritis, while not overtly crippling him, hasn't gone away, and while he can move around reasonably freely, the vet worries about his ability to get up from lying down -- a real problem he had previously, before his last round of hock injections (analgesic and steroid) and some management changes relieved that.

So what to do? We could do another round of hock injections (his last set were in 2015), which would be good for some number of months but eventually the effect wears off. He could go back on the bute, which does a good job of controlling the arthritis but clearly is doing harm to his digestive system.

Or we can switch him to a new pain control medication, which is the course we're trying. He's being put on an NSAID called meloxicam, which as the linked article explains is less likely to cause gastric upset. The downsides are (a) his dose is 18 pills twice a day, more of a pain in the butt to dispense than one scoop of powdered bute, and (b) it's also more costly -- the several bottles of the pills I picked up at the vet's office today are enough for 15 or 16 days and cost me 50 bucks. On the other hand, hock injections would run me several hundred dollars.

So we'll see how this new med works, and hopefully it will keep him moving freely without chewing up his gut.

A study of meloxicam versus bute: http://www.thehorse.com/articles/31454/meloxicam-vs-phenylbutazone-effects-on-horses-gastric-mucosa-studied

A good summary of flexion tests: https://en.wikipedia.org/wiki/Flexion_test

An excellent article on hock injections: http://www.doctorramey.com/how-long-do-joint-injections-last/

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