To Bute or Not to Bute
A short analysis of Bute, a pain-relieving medication, for equines.
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Soon after I became involved with horses, I came in contact with trainers and other horse enthusiasts, who constantly sang the praises of a wonder drug, capable of relieving the pain associated with either injury or disease in equines. This miracle rug was reported to have miraculous effects in alleviating pain, therefore minimizing the down-time which a horse must endure before he can perform again. This drug seemed to enable a horse to continue to be used in showing, racing, or whatever discipline he had previously been involved in. It seemed to be a wonderful thing, but a lingering doubt caused me to investigate the matter, and I discovered some very alarming information.
What is Bute?
Environment, work and genetic background can make a horse susceptible to stress and/or injury. When an injury occurs, inflammation and the pain associated with it causes the horse’s nutrient system to become overloaded with cellular debris. This causes his stomach to produce more acid. As more acid is produced, the body manufactures certain chemicals to coat the stomach so as to prevent harm to delicate tissues. These chemicals, in turn, cause inflammation and pain in the injured areas.
Bute (tradename) (chemical names: Phenylbutazone and
Butazolidin) acts by blocking the formation of these chemicals. Because these chemicals are needed to protect the stomach lining and the lining of the digestive tract, the result over the long-term can be ulcers in the mouth, stomach and intestines. Over an extended time period, the horse may become uninterested in food and may subsequently lose weight, plus a host of other detrimental effects. In addition, the use of Bute can eventually cause decreased blood flow to the brain, resulting in decreased brain activity, disorientation and eventually death from shock. Some horses also exhibit other symptoms, such as teeth grinding, diarrhea and swelling under the jaw, chest and belly.
Case One: The Foundered Mare
A friend of mine owned a very high-strung mare, who had recently foundered. For those who are ignorant, founder is a situation where the hoof wall softens and separates from the underlying bone structure, causing lameness, pain and inflammation. This mare was unable to walk and spent most of her time lying down. At the advice of her trainer, my friend placed the mare on 3-4 Bute tablets per day. After a few days of treatment, the mare was once again on her feet. This enabled the mare to continue jumping, by relieving the pain and inflammation associated with the founder.
After two weeks of Bute treatment, the mare began to refuse food and had lost about 200 pounds of body weight. She began to become uncontrollable and disoriented, and it appeared that euthanasia was the only alternative for my friend. The cost of the Bute (about $30.00 a week), in addition to other medications, x rays, special shoes and a larger-than-normal amount of shavings to prevent bed sores, was beginning to take its toll on my friend’s bank account. The horse was starting to cost more than she was worth. After reading an article on the effects of Bute, I suggested that she discontinue the drug and see what happened. She really had very little to lose at this point, except the financial drain on her pocketbook. It appeared the horse would have to be put down eventually. She agreed to try the experiment, and stopped the Bute treatments. She attempted to alleviate the pain using only Tylenol. Within two weeks of the discontinuation of Bute, the mare began to gain weight and eat better. She even began to trot around a little. My friend consulted her vet, who prescribed Inflamex, which is a far better pain reliever, with none of the disastrous side effects of Bute. This experiment sold me (and my friend) on the severe effects that Bute can have on an animal.
Case Two: The School Horse
While boarding my own horses at a prominent stable, I became aware that many of the school horses used for riding lessons were being given Bute on a regular basis to maintain their usefulness. The majority of these horses were 20 years and older, and many had recurring leg problems due to the fact that they were retired polo ponies, whose legs had suffered the effects of their trade. The stable manager/owner, trying to avoid putting too much money into these old horses, kept them on a constant diet of Bute, so they could still be used in the lesson program. When asked what one should do for an ailing horse, she would invariably reply, “Bute it.” Except when under saddle, these horses were very irritable souls, ate very little (which also saved her on food) and had constant bouts of watery diarrhea. They were thin, emaciated animals that had very little spirit and appeared to be very unhappy in their existence.
One old nag in particular suffered from splints and bowed tendons, which kept her in constant pain. She also suffered from fainting spells, which I knew from my studies were related to the use of Bute. Luckily, she never fainted while being ridden, but several times I noticed her lying down in her stall in the middle of the day and at feeding times, she had very little interest in her hay. Eventually, she just died one day, and I believe that the underlying cause of her death was related to the over-use of Bute.
Many performance horses suffer sprains, torn ligaments and the like from the stress of competition, as well as from overuse as they get older. Their owners, who have a great deal of time and money tied up in them, want to minimize the amount of down-time associated with whatever injury they have. When a horse can’t be used, they are losing money. Bute is their savior. Bute relieves the pain that a horse experiences when he performs, thus allowing owners to continue to use them. But is this really such a good idea?
Sprains, torn ligaments and other injuries require rest for the affected area in order for proper healing to take place. Continuing to use the affected part can actually prevent the injured areas from healing properly, thereby causing a chronic and life-long condition, which requires still more Bute. Horse owners must realize that Bute and other pain-relievers do not cure the underlying cause of the pain and inflammation. They only mask the symptoms. The use of Bute and other medications for pain and inflammation can become a vicious cycle, until finally the animal must be put down due to ulcers, weight loss and/or circulatory shock.
Justified Under Certain Conditions
I must agree with my critics that Bute is justified under certain conditions. First, the horse must be in a critical, life-threatening state, with the certainty that he will not recover within a short time. Secondly, if the animal is in constant pain at this point, then Bute might be used to alleviate the pain, so that his final days can be spent in relative peace. However, under no circumstances, should the drug be used if there is a chance that the animal can eventually recover from his affliction.
Some of my critics might point out that Bute can still be used for injuries of short duration to ease the suffering until the injury heals. I would much prefer to see another type of pain reliever, such as Inflamex, used which does not have the serious side effects of Bute.
It is evident that Bute is not the so-called “miracle drug” it is believed to be. It is in reality a killer. I must agree with my critics that at times, Bute can serve a very valuable service. But, I believe there is only one time in a horse’s life when Bute could possibly be of any use: to alleviate pain and make his final days bearable. If it appears that the horse is going to die and nothing can be done to save him, then and only then, is Bute an effective treatment.
Bute is entirely too accessible to the common horse-owner. Some vets dispense it like candy. In addition, it can be purchased at feed stores which carry vaccines and other horse supplies. It is my personal opinion (and I am not a vet) that this drug should be available only to vets and that they should not be so quick to dispense it to their patients. Vets who do prescribe the drugs should inform their clients regarding the side effects of the drug, and allow the owner the option of declining the treatment, or demanding that another medication be used. The average horse-owner, who is usually uninformed on the actual effects of the drug, may unknowingly be sentencing their horse to a slow (albeit pain-free) death.
Since there are better and far safer alternatives to Bute, which do not have its disastrous side effects, it is clear that there really is no question regarding the use of Bute on equines. If there is, then the answer is a resounding NO!