Horse owners’ confidence with common analgesia medications

It is common that you see everyday pets, like dogs and cats, visiting the veterinarian with their owner and maybe leaving with a prescription. What about larger animals? How do they obtain their prescriptions safely?

Researchers from the Department of Veterinary Clinical Sciences at Washington State University published results of an online survey¹ conducted to discover horse owners’ confidence in acquiring and administering analgesic medications to their horses. Technically, owners’ prescriptions should only acquire analgesic medications through a licensed veterinarian with a veterinarian-client-patient relationship (VPCR). This means that the veterinarian engages in follow-up care with the patient and confirms that the owner agrees to follow prescription instructions for optimal safety and effectiveness. Around 96% of responders reported being confident accessing and administrating analgesia to their horses, but the researchers were interested in their training levels.

Horse owners (N = 389) reported using non-steroidal anti-inflammatories (NSAIDs) and alpha 2 agonists more than other medications. The most commonly owned NSAID (reported by 87% of respondents) was oral phenylbutazone, followed by intramuscular flunixin (60%). These medications, especially flunixin, can have adverse effects. Flunixin has been associated with clostridial necrosis, which commonly results in horse mortality. In a clostridial necrosis study, 17 of 37 participants with clostridial necrosis were given flunixin before clinical symptoms were visible.¹

The most common alpha 2 agonists were detomidine and xylazine.¹ Veterinarians have monitored xylazine more closely with the increase in prevalence of illicit xylazine use. On the other hand, detomidine, was associated with a veterinarian death after the individual spilled the medication (combined with butorphanol), and transdermal exposure on the hands resulted in intoxication.

Even in the most common classes of analgesics, there are complications. Although most horse owners are confident with their ability to administer medications, keeping a proper VPCR is vital for horse safety.

The researchers also identified a relationship between non-compliant VPCRs and the demographics of the study. Most study participants were both older and female, but the younger, male owners reported obtaining medications in other ways. They acquired analgesia at feed stores and local businesses more than other non-compliant VPCRs, but with the rise in technology, younger owners tend to use the Internet. When using non-compliant VPCR techniques, owners lose the opportunity for safety follow-ups with a veterinarian.

The researchers concluded that, regardless of horse owners’ confidence and the choice of analgesia, the relationship between veterinarian, client, and patient should be most important. Veterinarians ensure the health and safety of client’s animals, so it is best for clients to use their veterinarians to acquire analgesia products.

Dylan Decandia is a 2023 PharmD candidate at the University of Connecticut

Reference

Sellon, D., Sanz, M., and; Kopper, J. J. (2022). Acquisition and use of analgesic drugs by horse owners in the United States. Equine Veterinary Journal. https://doi.org/10.1111/evj.13564