Although the Food and Drug Administration approval process ensures that a new drug meets efficacy and safety standards, “real world” usage often reveals even more about its most useful applications. Although the bisphosphonates have been widely available in this country for only a short time, veterinarians are already integrating these medications into their treatment plans.
“Tildren is what I have the most experience with,” says Courtney Wittich, DVM, of Hagyard Equine Medical Institute in Lexington, Kentucky. “I started using it when it had to be imported.”
Wittich, like many veterinarians, often uses Tildren in an “off-label” way not described in the product literature. “I’ll give it to horses with axial skeletal issues, like back and neck bone-related pain,” she says. “And when I’m using it for navicular, I’ll typically give it as part of a regional limb perfusion.” A technique that delivers a high concentration of a medication through an intravenous injection below the level of a tourniquet, regional limb perfusion is also commonly used for targeting antibiotic treatments.
Whether Tildren is administered systemically or locally, Wittich and her