Using Anti-Inflammatory Medications at USEF Competitions

For all those who have taken an Advil or an aspirin to make it through a weekend of athletic activity, the concept of giving a horse an anti-inflammatory medication to help ease the aches that certainly occur over the course of a multi-day horse show will come as no surprise.

USEF, the United States Equestrian Federation, in recognizing this reality allows the use of anti-inflammatory medications called NSAIDs, non-steroidal anti-inflammatory medications, on a limited basis. Starting for the 2012 show season you may only use one NSAID at a USEF show. The commonly used NSAIDS include as Bute, Banamine, Ketofen, Naproxen, Surpass and Equioxx .

Equioxx

What is new is information regarding Equioxx or firocoxib. Equioxx differs from medications like Bute, Banamine, and Ketofen in that when used as I am about describe it can provide 24 hour anti-inflammatory effects vs. 12 hours for the other drugs and still comply with USEF medication rules. The advantages of this should be clear. You can obtain anti-inflammatory effects you want during the show. With Bute and Banamine which must be used 12 hours prior to showing and whose effects lasts about that long, the medication’s benefits wane just as you are about to compete.

The key to using Equioxx is that the first day you use it; you need to use it at three times the regular dose. An injectable version of Equioxx is now available and ideally that is how I would give the triple dose. If not Equioxx is also dispensed in paste form and you would give three pastes all at the same time the afternoon of the first day of treatment. Then each afternoon of the show give an additional dose of the medication based on your horse’s weight. As the diagram shows, in this way you will maintain a blood level that is above the therapeutic level but below the USEF maximum allowable level.

Why using the triple dose is important is that Equioxx will basically not have the 24 hour effectiveness without it. Used at the standard dose of 1 tube/day for a full sized horse it takes 8 days to reach the steady state of blood levels that will be achieved by using the triple dose on day one. Of course if your horse has already been getting Equioxx for many days prior to the competition you do not need to give the triple dose on the first day.

Another compelling reason for using Equioxx paste is the nature of the drug itself. It is a COX-2 selective inhibitor. Why this is important is that all the other NSAIDS currently permitted, like Bute and Banamine block both the COX-1 and COX-2 pathways when administered. Blocking the COX-2 pathway is what you want; it relieves pain and reduces inflammation. Blocking the COX-1 pathway can potentially harm your horse resulting in increases risks of side effects such as gastric ulcers, intestinal inflammation and kidney disease. Equioxx blocks only the COX-2 pathway and not the COX-1 pathway.

Previcox

Many have asked why not use Previcox, the small animal pill version of firocoxib instead. The reason I recommend using Equioxx paste at horse shows at this time is that the protocol I just described has been well tested in horses. The research is clear. On the other hand absolutely no one has tested the Previcox pills in horses. It may be that they work exactly as well in the horse as the Equioxx paste or it may be that they are poorly absorbed or cause a high spike in blood levels of firocoxib which will exceed USEF limits. No one knows because no one has done the research. At least for now I would stick to the Equioxx injectable and paste at the horse shows. By using the paste you also know for sure that your horse got all of his medicine in the right amount.

FEI Competitions

What makes Equioxx very useful for USEF horse shows makes it important to monitor if you are competing in international level competitions governed by the FEI’s more restrictive medications rules. Because Equioxx will be cleared very slowly from your horse for FEI competitors it is recommended that you not use Equioxx for 30 days prior to a competition.

Enjoy the shows.  I will see you out there with my horse.