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Discussion on Dex combined with bute

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LL
Member
Username: frances

Post Number: 871
Registered: 3-2004
Posted on Thursday, May 14, 2009 - 7:55 am:   Edit PostPrint Post

Does anyone know why it is that dexamethasone is sometimes given concurrently with bute? I would have thought one type of anti-inflammatory would be enough, but maybe one potentiates the other? Just curious....
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22973
Registered: 1-1997
Posted on Friday, May 15, 2009 - 8:08 am:   Edit PostPrint Post

Hello LL,
Though both are antiinflammatory they have significantly different mechanisms of action at a number of points of the antiinflammatory cascade. You have to remember that inflammation is not a single event but hundreds of different events. While glucocorticoids have a much broader effect on inflammation, NSAIDs have fever reducing properties and some pain relief properties that glucocorticoids don't have.

There is significant overlap of the two class of drugs at the point of suppressing cyclooxygenase (COX-1, COX-2, COX-3?) activity and prostaglandin production. And while you are right they potentiate each other at this point this is also a problem. This is the same system that when suppressed leads to gastro-intestinal ulcers. And this is the reason they should only be used together with great care.
DrO
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LL
Member
Username: frances

Post Number: 872
Registered: 3-2004
Posted on Saturday, May 16, 2009 - 8:54 am:   Edit PostPrint Post

Many thanks, DrO, for the clear and detailed reply. Really interesting. I suppose for a 3-day period in a horse with no history of GI problems, it should normally be ok?
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22983
Registered: 1-1997
Posted on Sunday, May 17, 2009 - 9:20 am:   Edit PostPrint Post

What were the dosage rates? If low to moderate I would not expect problems in all but the rare case of a horse with increased sensitivity.
DrO
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LL
Member
Username: frances

Post Number: 873
Registered: 3-2004
Posted on Sunday, May 17, 2009 - 12:33 pm:   Edit PostPrint Post

The injectible bute was 10 ml daily for the 3 days. The dexamethasone was 10 ml for day 1, and 5ml for days 2 & 3.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22990
Registered: 1-1997
Posted on Monday, May 18, 2009 - 6:32 am:   Edit PostPrint Post

Assuming usual concentrations this would be moderate dosages.
DrO
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LL
Member
Username: frances

Post Number: 874
Registered: 3-2004
Posted on Monday, May 18, 2009 - 9:35 am:   Edit PostPrint Post

Thank you DrO.
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