The Money Barrel: Trevor Jeffers on Bute vs. Banamine and Why Not to Stack Them

Trevor Jeffers of XactRx talks with a woman holding a bottle in an alley between arena pens
Trevor Jeffers of XactRx | Photo courtesy of XactRx

Bute for muscle, Banamine for bone. Or bute for bone, Banamine for gut, depending on who is telling it. Kayla Jones brought up the rule, and Trevor Jeffers of XactRx said he has heard it his whole life. The pharmacist went looking for the research behind it and could not find any.

Jeffers came back on The Money Barrel for a second episode, this time on pain management. He is a pharmacist, not a veterinarian, and Jones says so on the episode. This is education on how the drugs work, and the plan for any specific horse belongs with its vet.

Don’t stack bute and Banamine

If listeners take one thing from the episode, Jeffers said, it should be this. He said bute and Banamine hit the same target in the horse, so giving them together adds risk to the stomach and kidneys without adding relief, and he cited two studies in which the bloodwork got worse and the pain relief did not improve. Put a steroid like dexamethasone on top, he said, and the same pathway gets hit a third time.

It’s like you would never take Aleve and Advil at high doses. It’s like they’re hitting the same target and they’re hitting it harder when you’re stacking them together.

-Jeffers puts stacking in human terms.

Listen

Build the plan with a vet

Jeffers also questioned the habit of copying what works for somebody else’s horse, because that clinical picture may not fit another one. He said the point of the episode is to give owners enough to have an educated conversation with their vet and come up with the best plan for that horse.

Just because Susie and Judy and Julie down the road are doing something for their horses doesn’t necessarily mean that same clinical picture is fitting your horse.

-Jeffers on building a plan with a vet instead of copying the barn aisle.

Pain is hard to measure in a horse

Jeffers said pain is subjective, and a horse cannot rate it on a scale of one to 10. Lameness and heart rate are more objective. Jones, going back to something Jeffers said earlier, said owners can put their own feelings on the horse. They get out of the truck with a sore back, take an aspirin and bute the horse too. Jeffers said to be careful using these drugs just because a horse is probably hurting.

So the hard thing is we’re not going to ask our horse, how’s your pain today on a scale of one to 10?

-Jeffers on judging pain in a horse.

One question before anything leaves the vet box

Jeffers said bute and Banamine are not bad things to reach for, and he is not discounting the soreness a long haul can cause. What he wants is a reason and a short course worked out with a vet, not aimless use. Jones asked for one rule to leave owners with, and he answered with a question.

Why am I using this? And if we can answer why we’re using it and we can defend it to someone that doesn’t know anything about it, and we’ve also, prior to that, worked up with our vet a specific reason of why those things are even being reached for, then I think we’re on the right path.

-Jeffers on the last question of the episode.

Inside the episode

  • How COX-1 and COX-2 work, and why the side effects come with the relief
  • How feed changes how long bute stays in the horse
  • Why bute and Banamine never go in the muscle
  • Lasix, withholding water and Banamine on the same day
  • Dexamethasone and steroids, and when Jeffers would call the vet
  • Firocoxib for longer-term use and topical diclofenac for one area
  • Creams vs. ointments and absorption
  • Misoprostol and the link to the ulcer episode
  • Ketoprofen, gabapentin and nerve pain

Sponsor: Martin Saddlery

This episode is brought to you by Martin Saddlery. Their iconic line of barrel saddles continues to help riders of all levels gain confidence and security in today’s tough competition. Find your perfect fit and competitive edge at martinsaddlery.com.

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