Anti inflammatory drugs such as Bute and Banamine can be very helpful when dealing with a situation like Freedom’s where we’re working to reduce the swelling in his leg. 
The downside is that these Cox-1 inhibitors can cause gastric ulcers.
As an alternative, horse owners are looking at drugs that inhibit Cox-2 pathways such as Equioxx, where the active ingredient is fibrocoxib. In clinical studies fibrocoxib showed fewer gastric side effects than the other NSAIDs (bute, banamine), which makes it preferable when using long term or in horses prone to gastic problems.
Unfortunately, Equioxx is expensive (about $9/dose) and comes as an oral paste. Anyone who has wormed their horse knows that dosing a paste can be messy and wasteful.
Which is why some people are looking long and hard at Previcox, the canine equivalent. Previcox comes in chewable tablets and at a fraction of the cost. A bottle of 60 57-mg tablets costs just $75 ($1.25/tablet). You can feed a tablet to your horse disguised in a treat or a handful of grain.
The problem is that Previcox for horses is an off-label usage, not because fibrocoxib hasn’t been tested in horses (it has) but because it is illegal to prescribe for horses because there is an equine approved form on the market. FDA regulations prevent off-label use of drugs when the same drug exists for that species.
I first learned about Previcox from a friend who is a vet. She had used it for her own horse when she needed long-term NSAIDs. I use Previcox for my elderly dog who is arthritic, so I had a supply on hand. Instead of putting Freedom on 10 days of Bute, I opted to dose Freedom with Previcox instead. Funnily enough the dosage for the typical horse is just 57 mg; the dosage for my dog (who weighs 30 lbs) is half of one of those tablets and most of the time I feed him just a quarter of a tab.
What do you think about the cost of drugs for horses? Do you feel that the drug companies are taking advantage of horse owners?
Do you think vets should be able to prescribe Previcox instead of Equioxx? Judging by equine bulletin boards it seems that many horse owners (and their vets) are already going this route.
I’m so glad you mentioned the dosage issue in off-label use of Previcox. Horses need MUCH less Previcox than dogs. It’s my understanding that it processes through the liver differently in horses, and what you’d give a small dog could seriously injure a horse.
That said, I’ve seen it used a few times, and believe it should be available for rx in horses. One older gelding responded beautifully to it, one middle aged mare it seemed to make no dicernable difference. Hard to know why? Was she simply in more pain, and more stoic? Was it not an inflammation issue as dx’d, but another unknown factor that was making her “off”?
My single concern for off-label use is humans who think “more is better”, and don’t believe (saw this) a horse would need less than a dog. The horse made it, luckily!
Having just adopted a “well mannered, 24+ year old mare in excellent health; has mild arthritis but needs no meds except the occasional bute on cold winter days”…NOT! Talk about needing a lot of something for the arthritis.
The first option I was given was steroid shots to both front knees (with synthetic joint fluid) at a cost of $500 EACH TIME. It may not work, may only work a short time and is extremely painful. I’d love a more cost effective option like Previcox. In fact, my vet had suggested it after I recovered from the shock of the cost of the injections. Right now, we’ll be sedating my mare for her upcoming farrier visit as the arthritis makes her demonstrate a truly wicked (and impressive) cowkick should anyone be stupid enough to ask her to lift her feet more than an inch off the ground.
Once her way overdue hoof trimming is caught up, we will re-evaluate her for something like Previcox. We’ll bute her the night before and the morning of her farrier visit. I also plan to start her on MSM for inflammation.
I know my vet was going to perscribe Previcox to me, as he already does for several horses.My horse also gets a lot of Omega 3 and MSM for inflammation. Sometimes I do think we get taken advantage of because we are horse owners.
I have a friend in vet school and our joke is that by putting a picture of the horse on the label, the price increases tenfold. It’s the myth that all horse owners are rich.
Seriously. I’ve had many people say to me “Oh, so you’re rich?” when I say I have two horses. I usually respond with “Well I might be if I didn’t have two horses.”
I tell people a horse is the land equivalent of a boat. Definition of a boat: a hole in the water into which you pour money. I also tell people that horse ownership would be cheaper if I could just feed my horse dollar bills.