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Questions and Answers
A 600 kg horse with chronic osteoarthritis is prescribed phenylbutazone at a maintenance dose of 2.2 mg/kg PO SID. If the available phenylbutazone tablets are 1 gram each, and the owner misinterprets '1.3 tabs' as '1 and a half tabs', what is the approximate percentage overdose the horse is receiving?
A 600 kg horse with chronic osteoarthritis is prescribed phenylbutazone at a maintenance dose of 2.2 mg/kg PO SID. If the available phenylbutazone tablets are 1 gram each, and the owner misinterprets '1.3 tabs' as '1 and a half tabs', what is the approximate percentage overdose the horse is receiving?
- Approximately 15% (correct)
- Approximately 50%
- Approximately 25%
- Approximately 35%
A 600 kg horse is receiving phenylbutazone for osteoarthritis. Which clinical sign, if observed by the owner, would be the MOST indicative of a potential gastric ulcer and warrant immediate veterinary consultation, even if the horse otherwise appears comfortable?
A 600 kg horse is receiving phenylbutazone for osteoarthritis. Which clinical sign, if observed by the owner, would be the MOST indicative of a potential gastric ulcer and warrant immediate veterinary consultation, even if the horse otherwise appears comfortable?
- Increased water consumption without changes in urination frequency.
- Slightly reduced energy levels during exercise, but normal behavior at rest.
- Mildly decreased appetite, still consuming hay but leaving some grain. (correct)
- Occasional teeth grinding, particularly after eating.
A 200 kg pony post-colic surgery is prescribed flunixin meglumine at 1.1 mg/kg IV BID. The available concentration is 50 mg/mL. If the veterinary technician accidentally administers half the calculated dose for the morning administration, what volume in mL did the pony receive and what is the resulting mg/kg dose?
A 200 kg pony post-colic surgery is prescribed flunixin meglumine at 1.1 mg/kg IV BID. The available concentration is 50 mg/mL. If the veterinary technician accidentally administers half the calculated dose for the morning administration, what volume in mL did the pony receive and what is the resulting mg/kg dose?
- 2.2 mL, resulting in a 0.55 mg/kg dose. (correct)
- 4.4 mL, resulting in a 1.1 mg/kg dose.
- 2.2 mL, resulting in a 1.1 mg/kg dose.
- 4.4 mL, resulting in a 0.55 mg/kg dose.
In a 200 kg pony receiving flunixin meglumine post-operatively, which change in clinical pathology results would be MOST concerning for NSAID-induced renal compromise, assuming pre-operative values were within normal limits?
In a 200 kg pony receiving flunixin meglumine post-operatively, which change in clinical pathology results would be MOST concerning for NSAID-induced renal compromise, assuming pre-operative values were within normal limits?
A 450 kg horse with severe equine asthma is started on dexamethasone at 0.05 mg/kg IV SID. After 4 days, there is minimal improvement. According to the provided information, what is the MOST appropriate next step in adjusting the dexamethasone dosage?
A 450 kg horse with severe equine asthma is started on dexamethasone at 0.05 mg/kg IV SID. After 4 days, there is minimal improvement. According to the provided information, what is the MOST appropriate next step in adjusting the dexamethasone dosage?
When monitoring a horse receiving dexamethasone for equine asthma, which clinical parameter would be the MOST sensitive early indicator of potential steroid-induced laminitis, especially in a predisposed horse?
When monitoring a horse receiving dexamethasone for equine asthma, which clinical parameter would be the MOST sensitive early indicator of potential steroid-induced laminitis, especially in a predisposed horse?
A 450 kg horse is treated with dexamethasone for severe equine asthma. The owner is instructed to monitor for signs of infection. Which of the following clinical signs would be MOST concerning for infection in this horse, considering the immunosuppressive effects of dexamethasone?
A 450 kg horse is treated with dexamethasone for severe equine asthma. The owner is instructed to monitor for signs of infection. Which of the following clinical signs would be MOST concerning for infection in this horse, considering the immunosuppressive effects of dexamethasone?
Comparing phenylbutazone and flunixin meglumine, which statement accurately describes a key difference in their typical clinical application in horses based on the provided text?
Comparing phenylbutazone and flunixin meglumine, which statement accurately describes a key difference in their typical clinical application in horses based on the provided text?
Considering the monitoring guidelines for phenylbutazone and flunixin meglumine as described, which diagnostic test would be MOST useful for early detection of renal insult in a horse receiving either of these NSAIDs?
Considering the monitoring guidelines for phenylbutazone and flunixin meglumine as described, which diagnostic test would be MOST useful for early detection of renal insult in a horse receiving either of these NSAIDs?
A client is administering phenylbutazone to their 600 kg horse for chronic osteoarthritis at 2.2 mg/kg PO SID. They report the horse is 'doing well' but question if they can reduce the dose to prevent potential side effects. Based on the information provided, what is the MOST appropriate initial recommendation?
A client is administering phenylbutazone to their 600 kg horse for chronic osteoarthritis at 2.2 mg/kg PO SID. They report the horse is 'doing well' but question if they can reduce the dose to prevent potential side effects. Based on the information provided, what is the MOST appropriate initial recommendation?
Considering the information about dexamethasone for equine asthma, which factor would MOST significantly increase the risk of laminitis as a complication of dexamethasone therapy?
Considering the information about dexamethasone for equine asthma, which factor would MOST significantly increase the risk of laminitis as a complication of dexamethasone therapy?
In the context of monitoring a horse on phenylbutazone for osteoarthritis, a urine specific gravity (USG) reading of 1.015 would be interpreted as:
In the context of monitoring a horse on phenylbutazone for osteoarthritis, a urine specific gravity (USG) reading of 1.015 would be interpreted as:
For a 200 kg pony requiring analgesia post-colic surgery, if flunixin meglumine (50 mg/mL) is unavailable, which of the following would be the MOST appropriate alternative NSAID, considering the provided information and general equine pharmacology principles?
For a 200 kg pony requiring analgesia post-colic surgery, if flunixin meglumine (50 mg/mL) is unavailable, which of the following would be the MOST appropriate alternative NSAID, considering the provided information and general equine pharmacology principles?
A 450 kg horse with severe equine asthma is initially treated with dexamethasone at 0.05 mg/kg IV SID. After 3 days, the cough is slightly improved, but still present. The owner is concerned about potential steroid side effects. What is the MOST judicious approach to managing this horse's medication at this stage?
A 450 kg horse with severe equine asthma is initially treated with dexamethasone at 0.05 mg/kg IV SID. After 3 days, the cough is slightly improved, but still present. The owner is concerned about potential steroid side effects. What is the MOST judicious approach to managing this horse's medication at this stage?
Considering the impact of NSAIDs on equine patients, which of the following monitoring parameters is MOST crucial to assess specifically due to the shared mechanism of action between phenylbutazone and flunixin meglumine?
Considering the impact of NSAIDs on equine patients, which of the following monitoring parameters is MOST crucial to assess specifically due to the shared mechanism of action between phenylbutazone and flunixin meglumine?
In a 600 kg horse treated with phenylbutazone for chronic osteoarthritis, if renal insult is suspected based on clinical signs and initial bloodwork, what is the MOST appropriate FIRST step in managing the phenylbutazone therapy?
In a 600 kg horse treated with phenylbutazone for chronic osteoarthritis, if renal insult is suspected based on clinical signs and initial bloodwork, what is the MOST appropriate FIRST step in managing the phenylbutazone therapy?
For a 450 kg horse with severe equine asthma receiving dexamethasone, the veterinarian decides to transition from IV to oral medication for longer-term management. Which oral corticosteroid would be the MOST pharmacologically comparable and appropriate switch from dexamethasone, considering typical equine formulations?
For a 450 kg horse with severe equine asthma receiving dexamethasone, the veterinarian decides to transition from IV to oral medication for longer-term management. Which oral corticosteroid would be the MOST pharmacologically comparable and appropriate switch from dexamethasone, considering typical equine formulations?
When calculating medication dosages for horses, especially with drugs like phenylbutazone and flunixin meglumine, what is the MOST critical reason to use weight-based dosing (mg/kg) rather than a fixed dose for all horses?
When calculating medication dosages for horses, especially with drugs like phenylbutazone and flunixin meglumine, what is the MOST critical reason to use weight-based dosing (mg/kg) rather than a fixed dose for all horses?
If a 200 kg pony is prescribed flunixin meglumine at 1.1 mg/kg IV BID, and the owner only administers it once daily (SID) at the correct dose, what is the MOST likely consequence regarding the pony's post-operative pain management?
If a 200 kg pony is prescribed flunixin meglumine at 1.1 mg/kg IV BID, and the owner only administers it once daily (SID) at the correct dose, what is the MOST likely consequence regarding the pony's post-operative pain management?
Flashcards
Phenylbutazone
Phenylbutazone
A common medication for osteoarthritis (OA) in horses, typically dosed at 2.2-4.4 mg/kg.
Monitoring NSAID Therapy
Monitoring NSAID Therapy
Monitor demeanor, attitude, and appetite, look for signs of gastric ulcers (decreased appetite) or renal insult.
Flunixin meglumine
Flunixin meglumine
An anti-inflammatory drug used post-operative colic, administered intravenously twice daily at 1.1 mg/kg.
Reducing Flunixin Dose
Reducing Flunixin Dose
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Dexamethasone
Dexamethasone
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Monitoring Steroid Therapy
Monitoring Steroid Therapy
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Laminitis Risk
Laminitis Risk
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Normal USG Range
Normal USG Range
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Osteoarthritis (OA)
Osteoarthritis (OA)
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Study Notes
- Anti-inflammatory therapy are administered to horses using steroids an NSAID therapy
Phenylbutazone for Osteoarthritis
- Phenylbutazone is effective for osteoarthritis (OA) in horses
- For a 600 kg horse, the phenylbutazone dosage is typically between 2.2-4.4 mg/kg
- Normally administer 2.2 mg/kg PO SID
- For a 600 kg horse this is 1320 mg
- 1320 mg / 1000 mg = 1.3 tabs, where each tab is 1 gram
- Administer 1.5 gram tabs by mouth once or twice daily
- In cases of severe pain, the dosage may increase to 4.4 mg/kg PO once or twice daily
- For a 600 kg horse, this equates to 2640 mg
- 2640 mg / 1000 mg tabs = 2.64 tabs
- The dosage is interpreted as 2.5 tabs PO SID
- Monitor the horse's demeanor and attitude when administering Phenylbutazone
- An alert and responsive attitude indicates the horse is doing well
- Gastric ulcer or renal insult is possible if problems arise
- Appetite is important to monitor when checking for ulcers
- Reduced food intake may indicate gastric irritation
- Renal distress might not be clinically obvious, so checking the horse's chemistry to see increases in creatinine and possibly BUN is a good idea
- Reduced concentrating ability is possible, collect urine to check
- Normal USG = 1.018 – 1.025
- Reduced concentrating ability is indicated if lower than this range
Flunixin Meglumine for Post-Operative Colic
- Flunixin meglumine (Banamine 50 mg/mL) is an appropriate therapeutic approach for a 200kg pony with post-operative colic
- Administer 1.1 mg/kg IV BID
- This is 200 x 1.1 = 220 mg / 50 mg/mL = 4.4 mL IV BID
- Administer 1.1 mg/kg dose for post operative colic as an analgesic therapy
- This is the highest end of the dosing range
- This dose is appropriate for a few days following surgery
- Once the patient is stable and starts eating again, the dosage may be reduced to 0.5 mg/kg IV BID or SID
- This is 200 kg x 0.5 mg/kg = 100 mg / 50 mg/mL = 2 mL
- Monitor similarly to how NSAIDs are monitored in equine patients
Dexamethasone for Chronic Cough
- Dexamethasone is a therapeutic approach for a 450 kg horse with chronic cough diagnosed as severe equine asthma
- A typical starting dose is 0.05 mg/kg IV SID
- 450 kg x 22.5 mg / 2 mg/mL = 11.3 mL IV SID is how this is administered
- It is possible to consider a higher dose of 0.1 mg/kg IV if this is not effective = 450 x 0.1 = 45 / 2.2 = 22.5 mL IV
- Monitor overall demeanor for appropriate monitoring
- Steroids are immune suppressive
- Check temperature twice a day (N=100 F) as well as foot temperature, digital pulses and other changes in gait
- Secondary infection or laminitis are complications from steroid therapy
- Laminitis can occur in horses that are predisposed with insulin dysregulation due to equine metabolic syndrome
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