Elite Equine

Bute vs. Banamine: What’s the Difference? 🐴💊

One of the most common questions we get is, “Should my horse get Bute or Banamine?” While both medications are non-steroidal anti-inflammatory drugs (NSAIDs), they work a little differently and are best suited for different conditions.

🐎 Phenylbutazone (Bute) is our go-to medication for musculoskeletal pain and inflammation. It works exceptionally well for conditions involving the bones, joints, muscles, ligaments, and tendons. Horses with arthritis, laminitis, soft tissue injuries, or general orthopedic soreness often respond better to Bute because it provides excellent pain relief for the musculoskeletal system.

🐎 Flunixin Meglumine (Banamine) is generally our first choice for visceral pain—pain originating from the internal organs. This makes it the preferred medication for horses experiencing colic, as it is very effective at controlling intestinal pain. Banamine also has strong anti-endotoxic effects, making it an important part of treating serious infections, pneumonia, pleuropneumonia, colitis, endotoxemia, and severe inflammatory conditions. It can also be helpful for certain eye conditions, such as uveitis.

While there is some overlap between these medications, we typically choose Bute for orthopedic pain and Banamine for colic, fever, and systemic inflammatory disease. They should not be given together unless specifically directed by your veterinarian, as combining NSAIDs significantly increases the risk of stomach ulcers, right dorsal colitis, and kidney injury.

Every horse and every condition is different. Choosing the right medication—and using the correct dose for the appropriate length of time—is an important part of keeping your horse safe while providing the best possible pain relief. As always, consult your veterinarian for medication guidance and instructions!

We are thankful everyday that we get to serve the equine community!

Sweet faces like this remind us daily how lucky we are to do what we do!

Equine Protozoal Myeloencephalitis (EPM) is a neurologic disease most commonly caused by Sarcocystis neurona and spread through contamination of feed, water, or pasture by opossum f***s. Clinical signs can vary widely but often include muscle atrophy, weakness, incoordination, stumbling, asymmetrical gait abnormalities, and poor performance under saddle. Because the signs can mimic many other conditions, a thorough neurologic examination and diagnostic testing are essential.

Early recognition and treatment are critical for the best outcome. Diagnosis is often supported by blood and cerebrospinal fluid testing in combination with clinical findings. Fortunately, many horses respond well to antiprotozoal medications when therapy is initiated promptly. If your horse develops unexplained weakness, imbalance, or changes in performance, a veterinary evaluation is recommended to determine whether EPM could be the underlying cause.

Did you know that 1 opossum can shed up to 250 million Protozoa in its f***s during its life? That’s 30-600k Protozoal eggs shed per day, that can survive up to a year in the environment!

Protazil is an FDA approved medication for EPM that comes in a pelletized form. Recent studies show that 1 dose will reach therapeutic levels in CSF fluid within 12 hours after administration. Compared to the other FDA approved medication that can take 24-48 hours!

Protazil can also be used for maintenance dosing for horses that were severely affected with EPM or at risk for flare ups at once a week dosing.

🐴 Pythiosis in Horses: More Than Just a Skin Lesion

Pythiosis is an uncommon but important disease caused by Pythium insidiosum, an aquatic organism found in warm, stagnant water environments. Horses are typically exposed when skin wounds come into contact with contaminated water.

🔹 Where do lesions occur?
Cutaneous pythiosis most commonly develops on the distal limbs, ventral abdomen, chest, and lower portions of the body—areas frequently exposed to standing water. Lesions are often rapidly progressive, ulcerative, and intensely pruritic, producing abundant granulation tissue and characteristic firm necrotic masses known as “kunkers.”

🔹 An overlooked clinical sign
Some horses affected with pythiosis may also exhibit a persistent cough that fails to respond to conventional therapies, including antibiotics, anti-inflammatories, or allergy medications. While not the primary presentation, a chronic unresponsive cough can be an important clue in horses with concurrent suspicious skin lesions.

🔹 How is it treated?
Treatment often involves a combination of surgical debulking and immunotherapy using a pythiosis vaccine (Pythium immunotherapeutic vaccine). This vaccine stimulates the horse’s immune system to recognize and eliminate the organism, and many horses experience significant lesion regression and eventual resolution following treatment.

Early recognition is critical, as prompt diagnosis and immunotherapy can greatly improve outcomes and help horses return to comfort and function.