It’s become popular to combine different NSAIDs when treating lameness and inflammatory conditions. However, doing this may not be wise. A report in the Journal of the American Veterinary Medical Society compared changes in blood protein levels, an indicator of intestinal-tract damage, in control horses getting no drugs, horses on low doses of phenylbutazone (1 mg/lb. orally twice a day), or horses getting that dose of phenylbutazone in combination with 0.55 mg/lb. of intravenous flunixin meglumine (Banamine). Horses were treated for the manufacturer’s recommended maximum of five days.
One horse in the combination group had to be euthanized after developing a severe drop in blood protein levels and colitis. Blood protein levels in the rest of the horses in the combination-drug group were also found to be significantly lower than in the control or the phenylbutazone-alone group. Four of the horses in the combination treatment had substantial gastric ulcers. The authors concluded that the risks of combination NSAID therapy likely outweigh any possible benefits. We agree.
NSAIDs have a narrow margin of safety and may do as much harm as good. Dose based on an accurate body weight. If there’s no significant response within three days, call your veterinarian. If the NSAID isn’t sufficiently controlling an acute inflammatory response, don’t increase the dose or add another drug. Instead, roll up your sleeves and start working on the horse with cold water or icing.
For leg problems, try soaking leg wraps with witch hazel or rubbing alcohol and cooling in the freezer for an hour or more. These won’t freeze like water-soaked wraps will and remain easy to apply. They’ll hold the cold for up to half an hour. You may also prefer the convenience of an ice wrap, which will also work well.