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HorseAdvice.com » Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » Dexamethasone » |
Discussion on Dex pulsing | |
Author | Message |
Member: jamie111 |
Posted on Monday, Apr 27, 2009 - 10:38 pm: I've had no luck with treating my horse for seasonal allergies/headshaking. He's at his worst right now (I'm guessing because of the high tree pollen), and after trying many different 'natural' treatments, he's still miserable and definitely unrideable. He can't be outside. I've read information about high dose dex pulsing for a short period of time. Do you have any experience or information on this treatment? Thanks for any thoughts on the subject. |
Moderator: DrO |
Posted on Tuesday, Apr 28, 2009 - 8:01 am: No Ami I have not though if this is a allergy to an inhaled allergen it would not surprise me if it would help. I don't why the doses would have to be that high though. Dex is a powerful drug at regular doses. In humans antihistamines are more effective at combating the itchy sneezy feelings in the nose however.Have you read our article on the diagnosis and treating of head shaking in horses? Check out Training & Conditioning Horses » Behavioral Problems » Head Shaking for a list of rule outs and treatment of the most common seasonal form of head shaking. DrO |
Member: jamie111 |
Posted on Tuesday, Apr 28, 2009 - 10:00 am: Hi, Dr. O. Thanks for your quick response. Yes, I've read your article on HS. I've read every bit of information that I've been able to find over the last year or so, and have joined the yahoo headshakers group, where there is a lot of good information shared. I wanted to get your opinion on dex pulsing, because it does seem a bit scary to me. Below is the actual recommended treatment. According to the woman whose web site this came from, the lower doses of steroids don't work for headshakers (as many of us have tried low doses of steroids without success). I've tried all other commonly recommended treatments, without success (my horse coliced on cypro after 3 days).2) Dexamethasone Pulse Therapy: Suggested dose is 30 mg liquid dexamethasone (oral is best, double the dose to 60 mg), for three consecutive days. Then decrease the amount to 20mg (40mg orally) for one day. Some mood changes may be seen during the first week after the pulse but they will go away quickly. This should be repeated every 25 days. If no symptoms have been seen in 6 months then the dexamethasone can be reduced to 30 mg orally for three days. Please follow veterinarian’s advice on this. Not recommended if any infections are suspected or if the horse is in any way immunocompromised even though the immune system is not compromised much with the short duration of pulsing (see reference). Do not use in horses with pituitary pars intermedia dysfunction. Low doses with tapering are not effective! The effect is dose-dependant. |
Moderator: DrO |
Posted on Tuesday, Apr 28, 2009 - 8:38 pm: These are not what I would consider that high a dose Ami. Though the listed label doses in the article are lower you will notice in the article we recommend (and I give) higher doses. Doses ten times higher than the ones you have discussed are used to suppress the immune system without ill effects, other than the suppressed immune system of course. Contraindications are listed in the article but a much more complete discussion of the side effects of corticosteroid use is discussed in the general article on glucocorticoids.As suggested you should run this by your veterinarian and keep us informed as to how this works for you. DrO |
Member: jamie111 |
Posted on Tuesday, Apr 28, 2009 - 11:49 pm: Thanks very much for your reply. I've given him 16 mg dex (orally) for the past two days with absolutely no results. That was what my vet told me was the max that she'd recommend. Obviously, they're nervous about a larger dose. I'm at my wit's end with my horse's condition. He's a fantastic horse, and his allergies/hs are extremely hard on him and me. I will consider a much higher dose of dex. Also, I'm going to try a Chinese herbal formula. Thanks, again. I'll let you know how it goes. |
Moderator: DrO |
Posted on Wednesday, Apr 29, 2009 - 6:58 am: Your veterinarian needs to read a recent veterinary drug reference and I am not much for Chinese herbal therapies that have not been investigated but hey the Chinese herb harvesters have to eat too.Rereading your post, you have read the article and he is worse right now: have you considered it may not be the pollen but the increased intensity of sunlight? If so what have you done to test this hypothesis? DrO |
Member: jamie111 |
Posted on Wednesday, Apr 29, 2009 - 9:47 am: Hi, Dr. O. I agree -- I wish my vets were more knowledgeable about the use of dex. My horse does not react from being in the light, and when I've tried keeping a guardian fly mask on him for an extended length of time, he shows no improvement. I might be wrong about the photosensitivity issue, but I just don't think that's his problem.Here's a link to the study that discusses the herbs I'd like to use. Let me know what you think. (I'll be back on line Saturday) https://www.acupuncturetoday.com/mpacms/at/article.php?id=30254 Thanks for your advice and any other thoughts you may have. Amy |
Moderator: DrO |
Posted on Thursday, Apr 30, 2009 - 4:49 am: If you continue to come up empty reconsider the cyproheptadine. We know that humans can have gi upset and nausea with antihistamine use but these tend to be transient so perhaps if you start with lower doses and gradually increase it you might find your horse adapts to the medication. Alternatively you could consider other antihistamines.DrO |
Member: jamie111 |
Posted on Saturday, May 2, 2009 - 11:21 pm: Thanks. I'll keep that option open. |