NSAID Choices for Horses Reviewed at Vet Conference

There is no "one-size-fits-all" non-steroidal anti-inflammatory drug (NSAID) therapy for horses; therapy should be tailored to the animal and situation, said Cornell University's Thomas J. Divers, DVM, Dipl. ACVIM, ACVECC, at the 2010 Western Veterinary Conference, held Feb. 14-18 in Las Vegas, Nev.

NSAIDS are used to relieve pain, reduce fever, alleviate endotoxemia (bacterial toxins in the blood) and inflammation, and reduce excessive blood clotting.

Before prescribing an NSAID, veterinarians should consider the reason for the medication, its effectiveness, potential side effects, and cost, as well as how the drug should be given, said Divers in a lecture on choosing appropriate NSAIDs for equine use.

The choice of NSAID is not "straightforward," he added, because the benefits of treatment need to be weighed against the potential side effects of these medications.

There are several NSAIDS used in horses, including phenylbutazone ("bute"), firocoxib (Equioxx), flunixin (Banamine), ketoprofen (Ketofen), carprofen, meclofenamic acid (Arquel) meloxicam, metamizole sodium (Dipyrone), and aspirin. Each has its pros and cons, said Divers.

NSAIDS block the enzyme cyclooxygenase (COX). There are at least two cyclooxygenase enzyme systems, COX-1 and COX-2. Although these enzymes cause inflammation, they also have protective properties that are important to maintain the health of the horse. Safety is a matter of weighing the balance.

For instance, certain prostaglandins can help protect the horse's gastrointestinal tract and kidney function. But when NSAIDs block the inflammation caused by prostaglandins, they can also block these protective properties, putting the horse at risk for developing ulcers and kidney disease.

The veterinarian might prescribe an anti-ulcer medication like omeprazole if a COX-1 selective inhibitor is needed. Divers also reiterated the need to keep horses taking NSAIDs hydrated to minimize the risk of kidney disease.

About the Author

Marie Rosenthal, MS

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