Equine & Livestock Product & Promotions Guide

BetaVet ® Use in Equine Athletes IMPORTANT SAFETY INFORMATION (continued) WARNINGS: Do not use in horses intended for human consumption. Clinical and experimental data have demonstrated that corticosteroids administered orally or parenterally to animals may induce the first stage of parturition when administered during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. Additionally, corticosteroids administered to dogs, rabbits and rodents during pregnancy have resulted in congenital anomalies. Before use of corticosteroids in pregnant animals, the possible benefits should be weighed against potential hazards. HUMAN WARNINGS: Not for use in humans. Keep this and all medications out of the reach of children. PRECAUTIONS: Corticosteroids, including BetaVet ® , administered intra-articularly are systemically absorbed. Do not use in horses with acute infections. Acute moderate to severe exacerbation of pain, further loss of joint motion, fever, or malaise within several days following intra-articular injection may indicate a septic process. Because of the anti-inflammatory action of corticosteroids, signs of infection in the treated joint may be masked. Due to the potential for exacerbation of clinical signs of laminitis, glucocorticoids should be used with caution in horses with a history of laminitis, or horses otherwise at a higher risk for laminitis. Use with caution in horses with chronic nephritis, equine pituitary pars intermedia dysfunction (PPID), and congestive heart failure. Concurrent use of other anti-inflammatory drugs should be approached with caution. Consider appropriate wash out times prior to administering additional NSAIDs or corticosteroids. ADVERSE REACTIONS: Adverse reactions reported during a field study of 239 horses of various breeds which had been administered either BetaVet ® (n=119) or a saline control (n=120) at five percent (5%) and above were: acute joint effusion and/or local injection site swelling (within 2 days of injection), 15% BetaVet ® and 13% saline control; increased lameness (within the first 5 days), 6.7% BetaVet ® and 8.3% saline control; loose stool, 5.9% BetaVet ® and 8.3% saline control; increased heat in joint, 2.5% BetaVet ® and 5% saline control; and depression, 5.9% BetaVet ® and 1.6% saline control. SHAKE WELL IMMEDIATELY BEFORE USE. For additional safety information, please see accompanying Full Prescribing information. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. 2 The equine sports industry is under scrutiny due to horses suffering catastrophic injury during high-profile events. 2 Use of intra-articular corticosteroids close to competition is a concern due to their ability not only to decrease inflammation and pain, and reduce potential overloading of other limbs, but also for their ability to mask pain resulting from ongoing joint deterioration or injury that would otherwise prohibit a horse from competing. 2,3 Indiscriminate use of medication in equine sports has led to significant oversight and monitoring with the ultimate goal of assuring the health and welfare of both animal and human participants. In an effort to promote national uniformity with respect to medication regulations, the Association of Racing Commissioners International (ARCI) and Racing Medication and Testing Consortium (RMTC), as well as the Federation Equestre Internationale (FEI) and United States Equestrian Federation (USEF), have established regulatory thresholds and withdrawal time guidance for a limited number of therapeutic medications, including intra-articular corticosteroids. 3 However, racetrack and sport horse veterinarians face the unique challenge of administering appropriate treatment at therapeutic levels, while adhering to withdrawal time guidelines. The potential for positive tests in serum or plasma creates added pressure and responsibility as veterinarians make medical decisions. Practitioners who need to treat more than one joint, or large joints, are faced with the knowledge that using increased doses of drug and/or combination therapy for a therapeutic purpose may lead to withdrawal violations. 3 In 2015, BetaVet ® , a combination of betamethasone sodium phosphate and betamethasone acetate, gained FDA approval for intra-articular use in horses for control of pain and inflammation associated with osteoarthritis. 4 The following information is presented to assist practitioners in the use of BetaVet ® within a regulated equine sports environment. Use in Equine Athletes (continued)

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