Long term use of anti-inflammatories?

Discussion in 'Horse Management' started by Pacqio, May 13, 2009.

  1. Pacqio

    Pacqio New Member

    Hi everyone,

    I'm new and I hope you will take the time to read my story, and hopefully you guys can help out. I'm located near Wagga Wagga, NSW. A mixture of Aust. Riding Pony x Arab, pure Arab, standard breds, welshies, minis and shetlands make up our funny little licorice allsorts herd (oh, plus one donkey - how could I forget the donkey!). The larger ponies and horses are used for stock work, we drive the smaller ones just for pleasure. Also breed almost all of them.

    The reason I'm here asking questions is actually for a goat, not a horse. Charlotte (the harlot) is 2 yrs old and I've been battling with her for the last week or so with a pretty severe problem. She had a caesarian about 6 mths ago which she recovered from without any more problems. About a week ago I noticed she was having difficulty passing urine. Basically, after A LOT of vet visits we have established that for some reason or another, the urethra has become constricted which is why she struggles to urinate. After speaking with a goat specialist, surgery is not an option.

    She is currently on Flunixil (flunixin meglumine) and that has worked wonders! She is a normal goat while she is on it - passes urine without problems, eats, drinks, plays etc. I've been outside doing fences all day with her tagging along helping me, munching on grass and running around and kicking her feet up like a little kid. she feels so good she came into season the other day, and was tarting up and down parading along the buck fence.

    The problem is that Flunixil is known to cause stomach ulcers and kidney failure, and so my vet is reluctant to prescribe more than a few days worth of it. And after about 36 hrs off the Flunixil, she starts going downhill rapidly again.

    The way I see it, I have four options:

    1) Keep her on the Flunixil (not good due to the stomach ulcer/kidney failure deal)
    2) Take her off the Flunixil (not good cos she'll rupture her bladder and die)
    3) Find an alternative anti-inflammatory which is safer for long term use
    4) Euthanase

    Option (3) is where you guys come in. Basically, my way of thinking is that there has to be an anti-inflammatory drug used long-term in horses, dogs or cats, that might help out my girl. I'm not sure how long term we are looking at, it may be that she will need it for the rest of her life, which could be 8 to 10 years.

    A friend has suggested bute but I dont know much about anti-inflammatories, I'm open to all suggestions. What I'd like to know is any possible drugs which could be used, the relative safety of them for long term use, how you administer them, whether you can breed with the animal while using the drug, etc.

    I am reluctant to euthanase, because I know she can be normal while on the drug, and I can see the potential if only I can find another drug that will do the same, while being safer. money and time is not an issue with this animal.

    Here's my girl:

    [​IMG]

    [​IMG]

    Thank you in advance for any advice you can give me :)
     
  2. beagle

    beagle Well-known Member

    wow pacgio what a great history!
    although i'm not a goat vet,my initial thoughts would be that bute might be a viable alternative as has less gastrointesitnal ulceration potential than flunixil.however,goats are ruminants nonetheless so would expect to metabolise along similar lines to cattle & sheep,so it might be worth your while to contact your local vet med uni to ask the question.in my notes i can only ever find dosage short term,which does not help you.good luck.
    ps my favourite goat friend on here, nannygoat, may have had experience with long term bute on goats....
     
  3. Pacqio

    Pacqio New Member

    hi beagle, thank you very much for your input. I will definitely be discussing possible alternatives with my vet, she will be re-evaluated on Saturday. In the meantime I'm trying to dig up as much information as possible.

    My vet isnt a goat vet either - but she does her best and that is all I ask of her. She does a fantastic job, and often spends time researching my problems. We have been in contact with Sydney Uni as they have a goat specialist team, and we can ask them about the bute also.

    My gut feeling is that there wont be many recorded cases of long term bute use in ruminants ... given that ruminants more often than not are viewed as livestock not as companion animals, and so most owners and vets would go for the euthanasia option. Most people wouldnt have even gone as far as I have. To me she is livestock but also more than that - I have a stud and many goats, and not all of them would get this treatment (not many of them actually) but she is my first registered doe, the first of my own breeding, my first truly successful show goat, and a real pet also. She's a bit special.

    I forgot to mention in that first post, I also train goats to drive in harness, and carry packs! (I'm leading these guys here we were giving rides at a vet open day, but they do actually drive just like minis)

    [​IMG]

    [​IMG]

    But, I'm getting side tracked here - back to the original question! :D
     
    Last edited: May 13, 2009
  4. astraia

    astraia Guest

    There are many newer generation non-steroidal anti-inflammatories used in cats and dogs which are much safer to use long term. They are mostly not used in horses because they are cost-prohibitive (and for that reason they have not been widely studied in that species). However, they are slowly emerging, especially in the US. It would probably not be that expensive to use these ona goat but I guess you need to have some idea of their safety margin in goats.

    Getting in touch with universities (in Australia and overseas) as well as maybe drug companies may be a good option to find out more info. There is a great websites that vets have access to (for a $500 annual fee) called "Veterinary Information Network". They usually have the latest info on there. I will try and have a look for you next time I'm at work.

    I know at Murdoch they use Sheep to study arthritis so I imagine they probably use pain relief for them. Maybe get in touch with them also.

    Also, are you sure it is the urethra that is the problem? Ie. have you had an ultrasound done? Cats get lower urinary problems where they get spasms in the urethra and inflammation in the bladder and have similar signs. There is a variety of treatments utilised in cats that may be worth a try.
     
  5. Claireb

    Claireb Well-known Member

    Alternatives

    Raw devils claw root

    German Chamomile Essential oil

    Both are good anti inflamatories, german chamomile is expensive but highly effective.

    Devils claw root is also a digestive aid and doesn't have the effect on the stomach. But don't buy the liquid form, research and buy the dried root form.

    Cx
     
  6. Pacqio

    Pacqio New Member

    astraia, when the problem first appeared, we took urine samples and sent them off, lab analysis confirmed there was no infection. We then ultrasounded the bladder for stones, because that is a pretty big deal in goats (though more so in males). Couldnt find any stones. We were trying to catheterise her simply to drain the bladder and buy ourselves some more time to figure out what was wrong. But we couldnt pass the catheter, it would go in about an inch then hit something and bend. We even tried a tom cat catheter with no success. When we consulted the goat specialist he agreed that it was likely scar tissue from the caesar - she also had some pretty nasty uterine and vaginal tears.
     
  7. Raw Prawn

    Raw Prawn Well-known Member

    Another option may be Meloxicam. A new version registered for foals has just been released.

    Im in the same boat as beagle....not a goat vet, but Meloxicam would certainly have a lower risk of causing GI ulceration and renal failure.

    In these situations where animals have a severe condition my theory is which is the worse evil?? IMHO the long term effects of NSAIDS are definitely the lesser evil in her situation.

    Good luck with your gorgeous goat!
     
  8. Pacqio

    Pacqio New Member

    Thank you VERY much **)

    More questions, sorry :eek: with NSAIDS from my quick research (which is nothing more than googling at this point) seems the common side effects are gastrointestinal and liver and kidney problems. How common are these side effects ... what percentage of animals on the drugs long term will get these problems ... or what probability is there that they will develop these problems? Sorry I'm not wording that very well but I hope you understand what I mean ...

    Also, what sort of time frame would you expect those things to occur? What are the symptoms to watch out for? And is there something you can give along with the NSAIDS to prevent it?

    can some of the drugs be used for breeding animals?

    What sort of cost are involved (ballpark figure)? I'd be hoping to use a paste for oral dosing, or injections would be another option (doesnt bother her really, she's very well behaved for the flunixil injections, just stands there. The TetraVet she was on earlier was a WHOLE different story lol)

    I know these are very broad questions, and dont worry they will definitely all be discussed with my vet, I just appreciate having a wide range of opinions (particularly when until I found this board, alot of friends and family members were just telling me to euthanase her).

    The pictures of her in my first post were taken today, after 24hrs on Flunixil, after having been off the Flunixil for 48 hrs. You probably cant tell because you dont know her, but her eyes are just so much brighter here and her face is her normal, happy go lucky self. I didnt get a photo when she was off the Flunixil but it certainly wasnt like this.
     
  9. Raw Prawn

    Raw Prawn Well-known Member

    Most of the animals I have been treating who have had side effects are older animals who probably had a degree of renal insufficiency to start with. The two I can think of were both offered blood screening prior to starting NSAIDS but the owner declined #(

    Came across two horses during my internship who developed right dorsal colitis (permenant ulceration/thickening of the right dorsal colon) after a 5 day course of bute.

    Have only had one dog who started vomitting blood after being on medium term NSAIDS (had a fractured pelvis). He was treated and was just fine **)

    HOWEVER....this is dogs and cats... goats are a completely different kettle of fish.

    As far as price. Generally, the safer the NSAID the higher the cost. Bute and flunixin being the least safe and cheapest, Previcox/Deramaxx being the most safe and most expensive.
     
  10. EVP

    EVP Gold Member

    Would a uretheral extension help you think?
    I know they do them in horses and correct alot of things by extending the tubing and removing some lacerations that might have happened during foaling. It also stops urine pooling or running back towards the uterous.

    Or Utheral graft?

    Also common asprin might help. Its a good anti-inflammatory and with a smaller maintenance dose might be more gentle on the stomach lining?

    Also it might help to do the cathater while she is doing well on the meds...might have better chances of getting it in while there is no inflamation?

    Would love you to keep us posted!@)
     
  11. Raw Prawn

    Raw Prawn Well-known Member

    Asprin is one of the most harsh anti-inflammatories on the stomach, its up there with flunixin and bute
     
  12. Pacqio

    Pacqio New Member

    Sorry EVP I'm not familiar with the urethral extension or graft ... not sure what these processes are or whether they would help. When we spoke to the goat specialist at Sydney Uni, he said surgery wasnt an option and to try the anti-inflammatories. And trust me, if there is the slightest chance it can be done, Sydney Uni will do it. They are a fantastic goat specialist vet (among other animals as well) and we did consider referral to Sydney if they could do anything. I know of one very very good buck who got urinary calculi, was treated at Sydney Uni for months and had several operations, that put 5 years onto his life before he passed away last year.

    Raw prawn ... are flunixil and bute roughly the same in terms of stomach irritation? If that is the case I'm thinking there's not much point swapping from flunixil to bute ...

    Also, I was speaking to a goat friend this morning, several years ago she was advised by a vet to NEVER give bute to goats ... seems like they'd had some bad reactions to it ... so bute now has a question mark next to it, on my list.

    The meloxicam does sound interesting, I've used it (Metacam) short term on pedigree cats (we breed Siamese, Oriental and Singapura). I'm thinking its probably going to get pricey given that she's a whole lot heavier than a cat, but then again they use it for dogs as well, dont they, and she's 70kg, basically like a giant dog ...

    I'm just sort of mulling things over at the moment ...

    I'm keeping her in a stall in the barn overnight, rugged, with a heap of food (grain and hay and livamol and a few other yummies), and during the day she goes out into a day yard with hay and grass, without the rug on. Well, I put her out about an hour ago, normally she is very well behaved and stands to take the rug off, well she DID NOT want to stand still - she just wanted to go out! Thats always a good sign lol
     
  13. astraia

    astraia Guest

    I'm pretty sure the reason bute is not used in production animals is because it is not allowed to be used in 'food animals' for human consumption. That's why I think we use ketoprofen in cattle, etc?? But don't quote me on this, I'm just dusting off some very old brain cells from vet school.
    I would be fidning out what they use in the US and europe as anti-inflammatories for goats. They are usually years ahead of Australia.
     
  14. Pacqio

    Pacqio New Member

    hmm ... I know that you can get bute for cattle, I was under the impression the do not use on goats thing was because there was some sort of reaction, but I dont really know :confused:

    A goat friend in US has suggested prednisone ... she's only used it short term though, not long term ... any thoughts on that?
     
  15. Raw Prawn

    Raw Prawn Well-known Member

    Im pretty sure bute and flunixin are about on par as far as side effects. Both are very primitive anti-inflammatories.

    The reason bute gets more of a bad rep is because horses are more often on bute long term. However flunixin is used mostly for tx of colic.

    As far as corticosteroids....wouldnt have a clue in goats! Have a chat to Helen Chapman at Murdoch University. She knows everything there is to know about sheep and goats **)
     
  16. EVP

    EVP Gold Member

    Wow, our vet (or the "leg man" as we call him) prescribed Asprin for our old girls multiple joint ailments and she was on 8grams every second day for 2 years. Didn't seem to hurt her, she carried 2 foals to term and we stopped giving 3 weeks prior to delivery. This was used over using long term Bute.
    She's now 22 but is on Pentasan monthyl so no need for either.

    I was thinking that if the uretha was damaged or scarred they could graft or lengthen like they do with mares....sort of creating extra tubing....but if the team at the uni said no to surgery options then your best bet would be to keep looking for those antiflammatory drugs.

    Wonder about anti-inflammatory creams? Where they might be able to be inserted like a suppository....that way they might work more topically rather than thru the gut? Like they make Nurofen gel for humans?

    Am just throwing out anything I can think of here....lolol
    Cause it sure sounds like you are going to have to look right outside the box on this one.....

    I know having to choose the lesser of the evils is going to come at a price but it would be great if you didn't have to make the euthanasia call.

    Poor goaty.....she sure is cute. :)*
     
  17. Anna E

    Anna E Guest

    Not a goat vet, but I do sheep which is close...I managed a pet sheep in the UK for a client who was on bute at a low dose for 4 and a half years... No issues, and I can't see why a goat should be any different. That was in the days before even Finadyne (showing my age...).
    Don't forget that goats are ruminants - their stomach is (sorry, their stomachs are..!) pH neutral and full of bacteria, so they actually tolerate anti-inflammatories quite well as they don't have an acid bath in there so are less prone to gastric ulceration. Same rules as for any other NSAID - get the dose as low as you can while still keeping her comfortable. Oral bute (sachets) should be fine.
    Metacam should also be OK but is a lot more expensive.
    Another option I would look at would be to place an indwelling Foley catheter into her bladder. Inflate the cuff and let her wee through that for a LONG period (2 weeks +) while on the anti-inflammatories to let all the damage settle down and stop actively trying to stenose the urethra. Then deflate the cuff, take it out, and see if she stenoses again. If she does, back on the bute...
    Lastly, consider marsupialising the bladder... Basically you make an artificial hole in the bladder and suture it to her skin at the the underneath of her belly.. The regular outflow of urine keeps the hole open. Means she'll wee from the bottom of her belly (like a boy goat only no willy LOL) and she'll dribble all the time rather than having regular wees, but it may be an option. I could foresee issues with urine scalding her tummy though so I would only do it as an option of last resort.
    Long term bute definitely the lesser of the several evils here if it works... Only issue I can see is that bute is not licensed in goats so some vets will balk at prescribing it. Then again I don't think any of the NSAIDs are so you should be in the clear under the cascade regs... Sounds like you have a vet who wants to help, so good luck!
     
  18. Raw Prawn

    Raw Prawn Well-known Member

    A little off topic.... but I remember back in the early days of stockies I had a long winded argument with someone on here (no idea who) who insisted that horses are ruminants and have 4 stomachs.... I dont think they ever ended up believing me!!

    Gotta wonder....
     
  19. Anna E

    Anna E Guest

    Well, they have a caecum.... And sometimes they can be as dumb as sheep :p
     
  20. nannygoat

    nannygoat Gold Member

    sent you a wee pm Pacqio...
     

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