General Question RE Dex

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buckI
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General Question RE Dex

Post by buckI » Mon May 23, 2016 2:37 am

Reading through the posts on here and dealing with some pig health issues recently got me to thinking about Dex. It is often advised to give in a variety of situations as a supportive treatment in combination with an antibiotic.

I have a pretty good handle on how and why dex works but I know I do not understand the total picture of how this drug works. So in an effort to better understand what's going on I have some questions:

What exactly does dex do? And how?

What situations typically would dex be expected to really aid in healing?

When would you definitely not use dex?

What are some major points to know or be aware of when using dex?

buckI
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Re: General Question RE Dex

Post by buckI » Tue May 24, 2016 10:40 pm

I really hoped this would stimulate some discussion that would benefit everyone.

I, like many people, come here when I have a specific problem, looking for a specific answer.

My motivation here was to foster some general discussion so that a deeper understanding of something we all tend to use would come to light.

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HogDoc
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Re: General Question RE Dex

Post by HogDoc » Wed May 25, 2016 8:00 am

Dexamethasone is a corticosteroid antiinflammatory.
There are parts of the mechanism of action that are well understood and other parts that despite its long history we do not have a precise answer.
The main side effect that people get concerned about is suppression of the immune system. That is why people generally give it with an antibiotic.
Any condition with inflammation is where it has potential benefit.
In any species other than swine you should not use it in pregnant animals. I also tend to go with NSAIDs like banamine or aspirin if I suspect viral disease or near the time we administer vaccine.
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buckI
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Re: General Question RE Dex

Post by buckI » Wed May 25, 2016 11:18 am

Thanks HogDoc. Appreciate your input.

I started this when I read that Baytril can damage cartilage if used repetitively. Baytril is an antibiotic that we have had and used in pigs for the past few years but I had no idea about this potential damaging side effect. Got me to wondering about other drugs. I tend to have a fair understanding of most drugs I use but I thought I would try to learn more and maybe others could as well.

I know about some of the side effects of Dex and about decreasing the adrenal function of the animal, suppressing immune function etc. I know dex is suggested when there is damage or injury to aid in healing. I also know that dex can be used to aid an animal that is under a great deal of stress. I was wondering what other side effects might result from the use of dex?

What does repeated treatments of dex do to performance? Appetite?

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Re: General Question RE Dex

Post by mtbkmom » Thu May 26, 2016 9:47 am

There is a risk for gastric irritation which is why I am hesitant to use it when my pig is completely off feed. If I do use it in this situation I also administer it also with Prilosec.

It does have an effect of "increased appetite" but I question if my pig starts to eat again because they are feeling better or feel like eating more.

Like when I farrow....some of my pigs--especially gilts will get a huge tear at the opening to their vulva and a hematoma/swelling results. I'm not worried about pooping, but sometime they actually have trouble peeing through their vulva opening being so swollen. So I give these girls dexamine for swelling and banamine for pain along with some Prilosec (make sure they don't develop gastric irritation) to keep em peeing easily and eating. I also run cool water at low speed on their vulva while they are up/eating and sometimes I even take my fingers and gently spread their vulva open with the water running and then they pee a bunch. What helps the most...I don't know.

BUT the bottom line for me is I use Dexamathasone for inflammation only, not to treat appetite because it is not labeled for that. So uses for inflammation...trauma (joint or tissue), viral illness (especially respiratory--irritated/inflamed airways and/or lung tissue secondary to viral toxins---we do the same with people who have asthma and a viral illness---antibiotics and steroid burst...not exactly the same from a physiologic aspect, but doesn't surprise me that pigs respond in a similar fashion).

It does affect immune response so I also consider administering with antibiotics, but I also have my sows on the Tru Guardian supplement to keep em headed in the right direction all along. My piglets I do have them on Tru Glo CR for same reason.

I would say that prolonged, repeated dosing might have some issue with adrenal suppression from a textbook viewpoint, but not sure if this is a real issue with pigs.....
Hog Doc... when do you repeat a dose of Dex and what is the interval and what is the max number of doses for a particular situation would you consider...1) trauma and 2) respiratory illness.
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Re: General Question RE Dex

Post by HogDoc » Fri May 27, 2016 10:06 am

mtbkmom wrote:There is a risk for gastric irritation which is why I am hesitant to use it when my pig is completely off feed. If I do use it in this situation I also administer it also with Prilosec.


I would say that prolonged, repeated dosing might have some issue with adrenal suppression from a textbook viewpoint, but not sure if this is a real issue with pigs.....
Hog Doc... when do you repeat a dose of Dex and what is the interval and what is the max number of doses for a particular situation would you consider...1) trauma and 2) respiratory illness.
The first sentence is a very common misperception. Non Steroidal antiinflammatories like aspirin or banamine are culprits for gastric irritation side effects but corticosteroids like dexamethasone or pre def do not pose a risk when it comes to gastric irritation. They should be the drug class of choice if you are looking at a pig off feed that needs antiinflammatories.

In terms of repeat dosages using dexamethasone over a three day course of treatment poses little additional risk than a single dose. I've used it longer in the case of some injuries.
Long term use does increase the immunosuppression and pose the risk of adrenal suppression.
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mtbkmom
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Re: General Question RE Dex

Post by mtbkmom » Fri May 27, 2016 10:34 am

Wow. That is good to know. My local vet is so hesitant to use Dex along with banamine because he thinks this doubles their risk of possible gastric irritation. Will have to time an opportunity to talk about this medication.
"Your present circumstances don't determine where you can go; they merely determine where you start."--I Am Second.

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Re: General Question RE Dex

Post by ddwil » Thu Feb 21, 2019 12:20 pm

So in an anti-inflammatory issue such as respiratory disease, what is typically better to use(for safety and effectiveness) with an antibiotic, predef or dex?

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