Ins And Outs Of Transdermal NSAID In Horses

If you're fighting tooth and nail to administer oral medications, the introduction of a transdermal option often pleases horses and handlers alike. Transdermal medications are applied to the surface of the skin, typically in the form of an ointment or gel, so as to allow gradual absorption into the body. Are you considering transdermal medications, especially anti-inflammatories? If so, it's important to understand how these drugs are absorbed and eliminated, particularly if your horse is involved in competition and subject to stringent drug withdrawal times.

In the U.S., a transdermal formulation of the nonsteroidal anti-inflammatory (NSAID) diclofenac sodium, sold under the brand name Surpass, is approved for use in horses. Recently, a transdermal product containing flunixin meglumine was approved in cattle and is therefore available for off-label use in horses. Flunixin meglumine is often called by the common brand name Banamine.

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To assess how transdermal delivery of flunixin meglumine behaves in the body compared to other routes of administration (e.g., oral, intravenous, intramuscular), researchers applied a 10-mL dose of transdermal flunixin meglumine along the midline of the horse's back, from the withers to the tailhead. This was equivalent to a standard 500-mg dose of flunixin meglumine per horse. *

Blood and urine samples were intermittently collected for up to 96 hours after administration to measure the intricacies of how the medication is absorbed and cleared, a science known as pharmacokinetics.

“Transdermal application was well tolerated in all six study horses, with no horse showing any negative dermal effects,” said Peter Huntington, B.V.Sc., M.A.C.V.Sc., director of nutrition at Kentucky Equine Research.

In terms of the drug's behavior, here's what the research team found:

  • The maximum concentration of flunixin meglumine in blood was only an average of 515 ng/mL, which is much lower than oral and intramuscular concentrations. Oral administration of a comparable dose of flunixin meglumine results in average concentrations ranging from 3,340 to 7,200 ng/mL. Intramuscular flunixin meglumine reaches average concentrations of 1,799-3,269 ng/mL.
  • Transdermal absorption into the horse's bloodstream was slow, an average of 8.76 hours. Oral flunixin meglumine requires less than an hour to be absorbed.
  • Elimination (clearance) of transdermal flunixin meglumine was also much slower than other routes of administration. It took 22 hours for half of the drug to be eliminated from the bloodstream (called the half-life) when the transdermal formulation was used. In contrast, the intravenous half-life is 3.38-9.68 hours.
  • The data also showed that transdermal flunixin meglumine has unique pharmacokinetics called “flip-flop kinetics” in which the rate of absorption is actually slower than the rate of elimination.

“Based on this data, it is not surprising that flunixin meglumine and a metabolite were still detectable in urine 96 hours after application. This means that the withdrawal time for transdermal flunixin meglumine would be longer than for any other route of administration,” said Huntington.

He added, “Even though the blood concentrations of flunixin meglumine were lower compared to those achieved by other routes, the slow, variable absorption and 'flip- flop kinetics' indicate the medicine applied transdermally persists in the body longer than if given by other routes of administration. More excretion studies in exercising horses are needed before safe withholding periods before competition can be established.”

Despite the low circulating drug concentrations, transdermal flunixin meglumine still elicited an anti-inflammatory effect for up to 72 hours after application.

In terms of safety, Huntington warned, “Considering that transdermal flunixin meglumine is indeed absorbed systemically, this means that horses are at risk of the common side effects associated with NSAIDs administered by other routes: gastric ulceration, dorsal colitis, and disruption of the intestinal microbiome.”

Horses treated with any type of NSAID by any route of administration, including transdermal, would therefore benefit from a digestive tract supplement containing antacids, stomach-coating agents, and a hindgut buffer.

“These supplements reduce the risk of damage to the gut lining or change in the microbiota resulting from NSAID use,” Huntington advised.

*Knych, H.K., R.M. Arthur, S.R. Gretler, D.S. McKemie, S. Goldin, and P.H. Kass. 2021. Pharmacokinetics of transdermal flunixin meglumine and effects on biomarkers of inflammation in horses. Journal of Veterinary Pharmacology and Therapeutics:12993.

Reprinted courtesy of Kentucky Equine Research. Visit ker.com for the latest in equine nutrition and management, and subscribe to Equinews to receive these articles directly.

 

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Veteran Rider Luis Quinonez Approaching Remington Park Milestone Held By Retired Don Pettinger

Veteran jockey Luis Quinonez needs three more wins to move into second place in the all-time rider standings at Remington Park, ahead of the retired Don Pettinger.

Pettinger finished his career with 1,419 Remington Park victories, 706 behind all-time leader Cliff Berry, who had 2,125. All three riders are in the Oklahoma Horse Racing Hall of Fame. Quinonez, 54, came into this meet with 1,416 and has one win in the first four days. He needs 101 more wins to reach 4,000 trips to the winner's circle overall in his career.

“I used to think, 'I'd really like to get to 4,000,' but the last couple of years, it's gotten a little tougher,” said Quinonez, who makes his home in Jones, Okla., just outside of Oklahoma City. “Now it's, 'If I get to 4,000 that would be great. I'm not going to sweat it.'”

He said he will celebrate if and when he moves into second place.

“I got my first win at Remington Park on my very first mount in 1989 when I was about 22 or 23 years old,” he said. “I had just gotten my riding license. I was just galloping horses in 1988, the first year here. The next year, I won on the first horse I rode – New Writer.”

His horse went off at odds of 22-1 for trainer Cliff Darnell and came home with Quinonez's patented late run on the turf. He beat such riders as Berry, the late Pat Steinberg (winner of nine riding titles in the early days of the track and an Oklahoma Horse Racing Hall of Famer), Dale Cordova (10th all-time here and regular rider for Silver Goblin), and Tony McNeil, now the paddock judge at Remington Park.

“Second place would be great, fantastic,” said Quinonez. “I have so many memories at Remington Park, some good and some bad.”

He said one horse almost broke his neck after finishing second in the race.

“He jumped the tracks at the wire and I tried to grab his mane but I came off,” he said. “We still ran second because it was after the finish, but I came back with a bloody nose.”

Was he injured badly?

“Hey, I came back and won the very next race,” he said.

A jockey doesn't win almost 4,000 times without a few X-rays in his life. He said he's had several concussions at Remington Park in his career, but nothing major. And then there are the good memories.

He made it to the Kentucky Derby once aboard Suddenbreakingnews, the 2016 winner of the Southwest Stakes at Oaklawn Park for trainer Donnie Von Hemel. The best trivia question to come out of that win has to do with who ran second. It was none other than Whitmore, who went on to win the 2020 Breeder's Cup Sprint. Suddenbreakingnews won the Clever Trevor Stakes at Remington Park and finished second in the Springboard Mile in the fall of 2015 before moving to Oaklawn. After winning the Southwest, he ran second to Creator in the Arkansas Derby. Whitmore was third.

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“Suddenbreakingnews has to be my all-time favorite because he got me to the Big Dance (Kentucky Derby),” said Quinonez. “Shotgun Kowboy ($1,548,648 earner) and Alternation ($1,064,727) were right up there and Brownie Points ($957,230), but going to the Kentucky Derby was awesome.”

It might have been awesome, but it was a nightmare for him early on.

“We drew the 2-hole and we almost got dropped twice before we went under the wire the first time,” he said. “I really thought we had a chance to win the Derby. I always wanted another chance. I'd been on horses that finished 22nd and 23rd in the Kentucky Derby list (top 20 get in) a few times, but this was my only chance. When I finally got going on him (with clear sailing) the horses on the final turn came out, off the rail, so I took it. We were closing fast and I thought I was going to finish third.”

Suddenbreakingnews finished fifth, less than five lengths behind the 2016 Derby winner Nyquist. Quinonez was within a head and a nose from running third. Exaggerator was second, Gun Runner (2017 Horse of the Year) third and Mohayem fourth.

“I thought we'd catch Gun Runner, but he just had enough left,” Quinonez said.

Quinonez said he still loves riding and competing.

“I still am in pretty good shape,” he said. “I'm not as young now, but this will be fun trying to catch Pettinger for second. I don't think I can catch Cliff, but that's OK. He's my brother from another mother. We've been roommates before and we always play golf together. I don't think I can, but you never know.”

Times have certainly changed. Quinonez won only four races that first year at Remington Park.

“And Cliff only won two, I think,” he said. “He won his first one early and then he ran second about 60 times before winning one more.”

Quinonez, going into Wednesday night's race card at Remington, has had 26,803 starts in his career with 3,899 wins, 3,690 seconds and 3,532 thirds for $76,805,803 from his horses' earnings. At Remington Park, he has ridden 9,719 times with 1,417 wins; 1,344 seconds, and 1,225 thirds for earnings in excess of $25 million.

With a little luck, he could tie the record Wednesday night. He has only two mounts – My Baby Blue (10-1) in the fifth race and Alternative Slew (5-2) in the eighth.

This is the first week Remington Park moves into a four-night racing week, with cards scheduled Wednesday through Saturday, Sept. 1-4. First post nightly is 7:07pm-Central.

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Tapit Colt Takes it to the Bank in With Anticipation

Coinage (c, 2, Tapit–Bar of Gold, by Medaglia d'Oro) switched to grass in style with a wire-to-wire upset victory at 6-1 in Wednesday's GIII With Anticipation S. at Saratoga. The chestnut, drawn widest of all in post six, was sent to the front by Junior Alvarado. The New York-bred showed the way through fractions of :25.66 and :50.65, and had plenty left for the stretch to win going away by two lengths. Saratoga debut winner Portfolio Company (Kitten's Joy), a handful for Irad Ortiz, Jr. throughout the 1 1/16-miles journey, ran well to finish second after making a bold bid at the top of the stretch. Favored Limited Liability (Kitten's Joy) was third.

Coinage, a runaway second out maiden winner against state-breds going 5 1/2 furlongs downstate June 17, entered off a disappointing third-place finish as the favorite in the six-furlong Rick Violette S. at the Spa July 21.

“I told my wife Tina this morning, 'We'll see if they can catch him,'” winning trainer Mark Casse said. “I seldom say this, but I told Junior [Alvarado] to take no prisoners and go. He's a good horse. He has a high-cruising speed. We breezed him over the turf a couple of times as we like to do. Training horses is like putting a puzzle together. You have to keep trying the pieces until figuring out where they fit. We figured it out today.

He continued, “I thought he was an underachiever. I told Mr. [Chester] Broman and the Greens that this horse was something, and I said that four or five months ago. We got up here and he won, but never showed the same as what I thought I had seen before. I'll probably keep him around two turns. There's a lot of options. I have four or five pretty good horses for the Greens that are possible other turf horses. We'll see. I may send him to California, but we'll see what the owners want to do, too.”

Pedigree Notes:

Coinage becomes the 149th stakes winner/92nd graded winner for leading sire Tapit. This is the 41st stakes winner/15th graded winner for broodmare sire Medaglia d'Oro. Millionaire Broman homebred Bar of Gold famously upset the 2017 GI Breeders' Cup Filly & Mare Sprint at 66-1. She is also responsible for a Justify colt of 2020, who brought $825,000 from David Hudson (Travis Durr, agent) at this summer's Fasig-Tipton Saratoga Sale, and a Tapit colt of 2021. She was bred back to Quality Road.

Wednesday, Saratoga
WITH ANTICIPATION S.-GIII, $150,000, Saratoga, 9-1, 2yo,
1 1/16mT, 1:43.69, fm.
1–COINAGE, 120, c, 2, by Tapit
                1st Dam: Bar of Gold (GISW, $1,551,000), by Medaglia d'Oro
                2nd Dam: Khancord Kid, by Lemon Drop Kid
                3rd Dam: Confidently, by Storm Cat
1ST BLACK TYPE WIN, 1ST GRADED STAKES WIN. ($450,000
Ylg '20 KEESEP). O-D. J. Stable LLC and Chester & Mary
Broman; B-Chester & Mary Broman (NY); T-Mark E. Casse;
J-Junior Alvarado. $82,500. Lifetime Record: 4-2-0-2,
$144,750. Click for the eNicks report & 5-cross pedigree.
Werk Nick Rating: A+++ *Triple Plus*.
2–Portfolio Company, 122, c, 2, Kitten's Joy–Iteration, by Wild
Again. ($125,000 Ylg '20 FTKSEL). O-Klaravich Stables, Inc.;
B-Kenneth & Sarah Ramsey (KY); T-Chad C. Brown. $30,000.
3–Limited Liability, 122, c, 2, Kitten's Joy–Hold Harmless, by
Blame. O/B-Stuart S. Janney, III LLC (KY); T-Claude McGaughey.
$18,000.
Margins: 2, 3HF, 4. Odds: 6.90, 2.10, 0.85.
Also Ran: Gooch Go Bragh, Kavod, Silipo. Scratched: Ready to March. Click for the Equibase.com chart, the TJCIS.com PPs or the free Equineline.com catalogue-style pedigree. VIDEO, sponsored by TVG.

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