Alternatives to bute for long term inflammation+pain relief?

Soooo my girl Lacey has ERU, as some of you are aware.
It has come to my attention over the last couple of weeks (it just got sunny here about then, before that, rain rain rain) that she seems to be having a low pain constantly and right now her level of pain is pretty high since she's in the midst of another attack.

Anyway, the vet advised 2g of bute for two days after an attack starts, then 1g a day after that as long as she's in pain.
However, Miss L turns into an absolute fruitloop on bute. Basically, like someone who's in a maniac stage/super high.
Since the first rule of business with an ERU attack is to get inflammation in the eye down asap, a high dose of bute for the first couple of days, until the swelling goes down, seem reasonable.
But, after that initial high dose, when I start tapering off the bute (I'm trying to keep her at a .25g/day dose since that seems to help her usual level of pain without making her nuts) she acts extremely depressed for a few days, then she's fine. I don't thiiiink it's pain making her depressed because when her eyes hurt and I take her flymask off, she'll do whatever she can to get the mask back on. When she's acting like this, she doesn't care of the mask is on or off, acts like she doesn't want to eat - I have to hold her feed bucket to get anything into her, she's unbelieveably cranky, etc etc. It's just weird.
It happened the last time she had an attack and I was tapering her bute off and it's happening now, as I'm tapering the bute off.

Also, before I continue, about the above, the vet and I have talked about it and we're both a stumped. So I am working in conjunction with a vet and Lacey was thoroughly checked out (bloodwork, physical exam, the whole 9 yards) with no out of the ordinary results.

However, after reading up more on the side effects of bute -even in low doses (I wasn't aware that a low dose could do as much harm as a big one!) and just seeing how she is coming off it, I don't think I want to keep her on bute longterm, if at all possible. Seems reasonable to use it in the midst of an attack but I'd like to get it out of her system as quickly as possible.

However, the internets has not been helpful as to what the "best" supplement is and what the correct doseages would be. I'm not made of money so I can't just try a bunch of things and I don't think it's really fair to play around with her pain, yknow?
I've heard that devil's claw is good (no doseage info though!), asprin (same deal - baby or adult? What's the correct doseage??), "No-Bute", "Bute-Less", etc etc.

For you "anti-herbal/whatever" people out there, I'm skeptical too. However, we're a little desperate over here to find something that works and so far the prescribed thing isn't doing so hot.



Sorry for the novel but I just don't know what to do. It's making me a little nuts (and depressed too! Haha) seeing her like this and knowing that this is just going to keep happening in the years to come.
I thought we had such a good lil' regimen all figured out and then bam, back to square one.

If you read it all, you're the best! Hugs and cookies for you!

Wallaby I feel your frustration. T also has ERU, and I'm struggling to keep her from pain/inflammation as well as help her adjust to loss of sight.

Like you, I've combed the internet for info, and as I'm sure you've found, there isn't much in the traditional protocol of handling ERU for being proactive and avoiding that next "flare-up".

So, I went the non traditional path, homeopathagy. I started with ones that were written by DVM's and then searched to "back-up" the info they suggested. I've found a few sites that are very helpful. But, there are no guarantees about anything truly working.

Right now, according to mhwf. Website, the formula to aid in the treatment of ERU (which as you know is an auto-immune disease) is:
Riboflavin (vit b2)
Vit A or BetaCarotene
Thiamine (Vit b1)
Aspirin
Vit C
And no, the amounts were not given.

I found a site that lead me to "whole horse" and I am currently using a mixture of Chinese herbs blended for T as well as tablets from Standard Process called Oculotrophen. The Oculotrophen acts like a "decoy" on behalf of the eye tissue when the antigens attack, caused by a flare-up.

Gloria , from whole horse was very helpful and gave me as well as confirmed the info I have about ERU. One of the ingreds is tumeric which is an anti-inflammatory and pain killer. My vet is also very supportive about going the homeopathic route.

One thing that several people I've chatted with recommend for those days the eye (s) look a bit off, as well as when they are inflamed is to make a poultice using 5 drops hypericum tincture and 5 drops of calendula tincture diluted with 1 ounce of warm water or saline solution (for contact wearers). Dip a gauze in this and place over the eye for as long as she'll let you , do this 4 - 6 x's a day.

Something else you might want to consider, is the anti-inflammatory abilities of MSM at 30,000 a day. Most joint compound contain this ingred, or you can purchase that alone. T is already on a joint compound, though I do need to check the amount of MSM.

I think the least expensive thing to try is the hypericum and calendula tincture , and you can probably purchase these at a health food store. Most tinctures contain alcohol, so I'm getting just the solutions of these herbs. I'll let you know how well it works on T.

Best of luck to you and Lacey, it is so frustrating dealing with the constant ups and downs of this devastating disease. It's bad enough that with each flare-up more sight is lost until it's eventually gone, but the thought that they are in pain , for me, is the worst part.

Devil's claw?

Thank you Walka for taking the time to write that all out for me! Though it's a bummer that we're both going through this with our girls, it's reassuring to hear what you've learned + to feel like I'm less alone. :) You're the best!
I definitely copied all that into a Word document so it wouldn't get lost.
Lacey is on MSM for her joints (amazingly, that's all she needs to not be creaky!), but she's only been getting 14,000/day so I'll try upping that to see if that helps at all with the inflammation.
I ended up buying 2 different products, one with yucca+devils claw+all those other natural anti-inflammatories, and the other just horse asprin.
I decided that I might as well expirement a little because, like you said, the vision loss is bad enough but the idea that she's in so much pain is a billion times worse. I think I could probably come to terms with it if there was no pain involved but the facts that I know my dear lady hurts, can't tell me how badly she hurts, and I can do very little to alleviate her pain just kill me so many times over.

I will seriously look into that poultice idea. That sounds really promising! She hates having her eyes/around her eyes touched as a general rule these days (I'm sure it has to do with eyesight loss and not being sure where the next touch will occur) but I'm sure she'd let me do it if she felt better post-eye area touching.

I think along with the unknown pain levels, she thinks I can "help" her feel better and when she doesn't feel good, she looks to me to make it better. But, when I don't have a way to make her feel better, it's the most heartwrenching thing in the world, as I'm sure you're famliar with.

Thanks you for that list of things to get up in her diet, as well! I believe FeedXL includes those things in its checks, I'll go check out her levels and see what I need to add.

Thank you again Walkamile! You've helped me feel so much more empowered about dealing with this. :)
And, best of luck to you and T as well. She's lucky to have a carer that's as devoted to her well-being as you are.
Also, randomly, I don't know if this might help you at all with T but it's something I've recently discovered with Lacey- I've started wearing my keys on a carabiner attached to a belt loop on my pants and she LOVES it. They're just loud enough that she can hear me from some distance, she can keep track of my whereabouts, and the sound changes depending on the kind of terrain we're covering. It's VERY interesting. But handy that something that simple makes her feel that much better - I'm not much of an "all the time talker" so talking to her constantly was getting super exhausting. Thank goodness for keys that do the "talking" for me! Haha

Devils claw really shouldn't be fed longterm to horses (no more than one week) as Devil's Claw has also been shown to have analgesic, sedative and diuretic properties on horses...

However you're quite right it's been proven to work as well as steroids for horses...

I had an old mare that could not tolerate any kind of bute or banamine but she occasionally needed something for arthritis.
What worked for her was giving a small dose of Ulcergard an hour before the bute. It made all the difference. One tube would give about 12 pre-treatments. My vet didn't advise me to try it but I did it on my own & as it worked my vet said to keep doing it.

Is your horse getting any kind of eye ointment?

Out of curiosity do you think/know if this could have been because of the magnesium/calcium which could be a preperatory agent for anti inflammitories and glucosamine making it more easily absorbed? Also (possibly) triggering a mucous to form on the linning of the digestive track which keeps its safe from caustic burn associated with some anti inflamatories and electrolyte administration?

Good question.
Ulcergard/omeprazole is a proton pump inhibitor which works at the cellular level to prevent gastric acid production, making the gastic lining less irritated by things like bute. So yes, it can protect the stomach lining as the gastric acids are what causes irritation or ulcers. It doesn't trigger the lining to form as much as it allows it to.

Thank you very much I really appreciate it!!!

A lot of the supplements I've seen that have Devil's Claw in them say that they are safe for longterm use... Can you point me in the direction of some documentation of that^^? [I don't disbelieve you, I'm just trying narrow down "the best" of the worst, you know?]
Maybe it has to do with doses+time frame?
I'll show you one of the things I found that's supposedly "safe" for longterm use, maybe you know something about the other ingredients too... :)
Med-Vet DC-Y - Horse.com

But then again, I supposed it doesn't actually say "safe for longterm use", it says "can be continously fed at this rate"...two different things. Haha


Interesting! I'll get a tube of that then! There's no way Miss L will be able to not get bute during an attack so making it a less crazy expierence would probably be good.

I do have eye ointment but it's steroid based and due the high risk of ulcers, she advised me to use the ointment with caution. I asked her about prescribing an ointment or drops that weren't steroid based but she was unsure about going that route (we were talking over the phone and neither of us are really "phone people") and I didn't catch her reasoning.
Personally, I love my vet but I think this all is a little out of her depth. However, she's the best in the area (the other vet in the area didn't even catch Lacey's ERU a year and a half ago when I called them out specifically to check for any eye abnormalities because I felt like something was wrong) so we're a wee bit stuck that way...