So are Bute and Banamine® the same? Not exactly… Banamine® has been shown to be more effective in relieving gastrointestinal, soft tissue and systemic inflammation and pain. Think colic, eye pain, sepsis. Bute on the other hand is more commonly used for musculoskeletal inflammation and pain (muscle pain, arthritis, tendon/ligament injury).
Both Bute and Banamine® are prescription medications and should be obtained from your veterinarian to treat a specific problem on a specific horse. That being said, we all know it lives in every medicine chest of every farm out there. Bute comes in an injectable solution that should only be given intravenously (IV) by an experienced person, namely your veterinarian. It is very irritating and if it gets outside of the vein or in the muscle it can cause severe inflammation, necrosis and sloughing of the tissue.
The safer formulations for laypeople to use are the oral forms, powder or paste. Make sure you read the label to know how many grams are in one scoop of powder or one turn of the dial on the paste tubes (its usually 1g). Banamine® also comes in injectable and oral formulations. The injectable form can be given IV (again make sure you have an experienced hand giving the injection) or intramuscularly (IM). I tend to discourage people from giving Banamine® IM because it has been closely associated with Clostridial myositis, a severe and often life threatening bacterial infection in the muscle. You can also give the injectable formulation orally! Yes, draw the same amount from the bottle that you would have giving IV or IM and squirt it in their mouth! It has similar oral bioavailability, which means its absorbed just as well. NB Injectable Banamine® is VERY bitter (trust me, I’ve accidentally gotten some sprayed in my face) and your horses will appreciate it if you mix it with applesauce or molasses before giving it orally. Banamine® also comes in a paste and granules to be given orally.
The label dose of Banamine® is 1.1mg/kg BID which is a fancy way of saying that a 1000lbs horse should get ~500mg (10cc or a 1000bls dose of paste) no more than once, every 12 hours. Bute’s label dose is 4.4-8.8mg/kg BID. Translation: a 1000lbs horse should get between 2 and 4 grams no more than once every 12 hours. It is very important to note that these volumes are based on body weight and are for a ONE THOUSAND POUND horse!!! If your horse weighs more or less than 1,000lbs, then these doses are not right for you! Example, a 500lbs pony is half the weight of a 1,000lbs horse (get out your calculator and check if you don’t believe me, but my mother will tell you I did very well in math as a child), therefore a 500lbs pony should receive HALF the dose of a full sized horse. I know, I know “But human medicine gives every adult the same amount of pills whether you’re a 90lbs gymnast or a 300lbs sumo-wrestler.” This doesn’t make sense to me, and I hope someday an MD will give me a good explanation as to why. And notice how I say “no more than once every 12 hours?” I didn’t say “twice in a day” because to some people that means, once, and then if it doesn’t work, another dose 20min later. And giving your 1000lbs horse 10cc of Banamine® and then another 10cc an hour later is the same as giving them 20cc at once, and you have overdosed your horse.
It’s not that we should never use these medications; we just need to know the appropriate doses and dosing intervals to make their use as safe and effective as possible.
Believe me, Sunday will not be the last time I reach for the ibuprofen (only at the labeled dose and I’ll keep hydrated with plenty of water) but I do so cautiously (and swear to myself I will never run down Walnut St in 4” heels in freezing temperatures again!). And the safest, most cautious way to administer NSAIDs to your horses is to do so under the direction of your veterinarian. Only he or she knows the right type and the right dose of NSAID for your horse based on the specific problem at the time.