Dear SmartPak: How safe is long-term Bute use?

Answer: Not very. Dr. Lydia Gray suggests some Phenylbutazone alternatives for helping manage your horse’s arthritis.

From the SmartPak Blog:

Is it safe to give my 15yr TB Phenylbutazone long term? He has arthritis in the coffin joint. He also had a steroid injection and is on Adequan. He gets 2 grams of bute each day. Thanks! – Dori

Dori,

“Bute” or phenylbutazone, is a prescription medication that should only be given for short periods of time. Phenylbutazone is classified as a non-steroidal anti-inflammatory drug, or NSAID, for short, and it has harmful effects on both the GI system and the kidneys. So let’s look at other methods to help control pain in your horse and keep his arthritis from getting worse that will keep you in the saddle for as long as possible!

First, make sure you’re managing him correctly: light daily exercise, little repetitive activities such as lunging, long warm-ups and cool-downs, as much turnout as possible, corrective shoeing, and an ideal body condition score so he’s not packing unnecessary pounds. If you jump, ride upper level dressage, or participate in other high demand sports like western reining or endurance, you may want to cut back on the difficulty.

Next, consider some non-prescription ingredients to help manage the discomfort associated with your horse’s condition such as MSM, omega-3 fatty acids, the omega-9 fatty acid cetyl myristoleate, and herbs such as devil’s claw, yucca and boswellia. Note: if you compete, you need to check your organization’s drugs and medications rules. Some ingredients are restricted or even outright prohibited. Don’t forget to supplement with as many of the joint’s natural building blocks (glucosamine, chondroitin sulfate and hyaluronic acid) as you can afford. These ingredients have not only been shown to help in the normal production of cartilage and joint fluid, they may also inhibit enzymes that cause tissue breakdown and destruction.

It sounds like your veterinarian already has your horse on a regimen of joint injections (steroids) and intramuscular injections (Adequan). Ask if a hyaluronic acid product like Legend might also be helpful, and if other treatments such as acupuncture, shock wave therapy, passive range of motion exercises or magnetic therapy might help your horse. Hopefully by combining a variety of treatments, you might need “bute” or some other NSAID (as well as some traditional cold therapy) only occasionally if his arthritis flares up.

-Dr. Lydia Gray