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Topic:Anti-inflammatory
Anti-inflammatory agents are substances used to reduce inflammation in horses, often employed in the management of various equine conditions. These agents can be categorized into non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, among others. NSAIDs, such as phenylbutazone and flunixin meglumine, work by inhibiting cyclooxygenase enzymes, which play a role in the inflammatory process. Corticosteroids, like dexamethasone, modulate the immune response and reduce inflammation through their effects on gene expression. The use of anti-inflammatory agents is common in equine veterinary practice to alleviate pain and improve the quality of life in horses suffering from musculoskeletal disorders, colic, and other inflammatory conditions. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, efficacy, and safety of anti-inflammatory agents in equine medicine.
Ophthalmic cyclosporine in equine keratitis and keratouveitis: 11 cases. Topical cyclosporine A was safely used in a series of 11 cases of equine keratitis and keratouveitis and appeared to be an effective anti-inflammatory agent in 9 cases. The clinical diagnoses included interstitial keratouveitis, endotheliitis, multifocal punctate keratopathy and a melting stromal ulcer. In most cases, the presence or absence of insidious bacterial infection was not conclusively determined. Topical cyclosporine A had no deleterious effects in this series of cases. The authors suggest that topical cyclosporine in both aqueous and lipid base vehicles should be investigated and ev...
Plasma and synovial fluid kinetics, disposition, and urinary excretion of naproxen in horses. Naproxen (+6-methoxy-[alpha-methyl]-2-naphthalene acetic acid) is a nonsteroidal anti-inflammatory drug that is used for the treatment of inflammatory conditions in horses. We developed a model that describes the drug's disposition and renal excretion, including synovial fluid disposition and elimination after IV administration in horses. The plasma disposition, after IV administration of 5 mg/kg of body weight, was described by a two-compartment model; mean +/- SD distribution and elimination half-lives were 1.42 +/- 0.42 and 8.26 +/- 2.56 hours, respectively. Plasma concentration of naproxen...
Effects of ketoprofen and phenylbutazone on chronic hoof pain and lameness in the horse. The analgesic effects of the nonsteroidal anti-inflammatory drugs, ketoprofen (2.2 and 3.63 mg/kg bwt) and phenylbutazone (4.4 mg/kg bwt) were compared in 7 horses with chronic laminitis. Hoof pain was quantified objectively by means of an electronic hoof tester and lameness was subjectively graded on a modified Obel scale. Ketoprofen at a dose of 3.63 mg/kg bwt (phenylbutazone equimolar dose) reduced hoof pain and lameness to a greater extent than the 2.2 mg/kg dose and phenylbutazone. These effects were still present at 24 h in 3 of the 4 pain tests, including lameness grade. These data sugg...
Comparison of the anti-inflammatory actions of flunixin and ketoprofen in horses applying PK/PD modelling. A comparative study in horses of the pharmacokinetics (PK) and pharmacodynamics (PD) of 2 extensively used nonsteroidal anti-inflammatory drugs (NSAIDs), flunixin (FXN) and ketoprofen (KTP), was carried out applying PK/PD modelling. To evaluate the anti-inflammatory properties of these drugs a model of acute inflammation, comprising surgically implanted subcutaneous tissue cages stimulated by intracaveal injection of carrageenan, was used. FXN elimination half-life (T1/2 beta) in plasma was 3.37 +/- 1.09 h. However, in exudate a much longer T1/2 beta was obtained (15.99 +/- 3.80 h). Apparent v...
Acute laminitis. Laminitis is an inflammation of the sensitive laminae along the dorsal aspect of the digit and is considered to be a secondary complication of several predisposing or primary factors. Affected horses are usually very lame, have increased digital pulses, are painful to hoof testers along the toe of the foot, and have evidence of downward rotation or distal displacement of the distal phalanx present on radiographs. Treatments for acute laminitis include anti-inflammatory drugs, anti-endotoxin therapy, vasodilators, antithrombotic therapy, corrective trimming and shoeing, and surgical procedures....
Anti-inflammatory and immune support in endotoxemia and septicemia. Endotoxemia and septicemia are encountered frequently in equine veterinary practice. The deleterious effects of endotoxin are related to the severity of the response of the host's inflammatory system. Consequently, it is imperative that appropriate steps be taken to identify animals at risk of developing endotoxemia or septicemia, and to initiate treatments that will reduce the inflammatory response. This article discusses the anti-inflammatory and immune support of horses and foals with endotoxemia and septicemia.
Screening of non-steroidal anti-inflammatory drugs, barbiturates and methyl xanthines in equine urine by gas chromatography-mass spectrometry. A gas chromatographic-mass spectrometric (GC-MS) screening procedure for 23 acidic drugs in equine urine is described. With the GC-MS method fifteen anti-inflammatory drugs, five barbiturates and three methyl xanthines can be detected with good sensitivity and selectivity. The method consists of alkaline hydrolysis, extraction with organic solvent using salting-out, clean-up extraction, methylation and screening with GC-MS in selected-ion monitoring mode. The limit of detection is 10 micrograms 1(-1) or lower, for most drugs.
Models for assessing the relationship between drug concentration and drug effect in performance horses. The actions of most drugs are dependent upon achieving adequate plasma concentrations. Plasma concentrations are influenced by the degree to which a drug is absorbed, distributed, metabolized and excreted. Pharmacokinetic assessment reflects changes in these variables as a function of time. Pharmacodynamics refers to specific drug effects or mechanisms of drug action. Individual drug pharmacokinetics provides information on which to base a therapeutic dose, route of administration and dosing interval. However, not all drug actions temporally correlate with plasma kinetics. To resolve this disc...
[Doping problems in horse sports–pharmacokinetics of selected antiphlogistics/analgesics relevant to doping]. Drug treatment of horses which are used in horse-racing is restricted by the regulations of the anti-doping control. Veterinarians and anti-doping control commissions are faced with the problems resulting from the discrepancy between the demand "no drugs in blood/urine of horses at the time of competition" and the need for treatment. The pharmacokinetic data of important antiphlogistics/analgetics (NSAID) for horses given in this article shall facilitate the decision of the veterinarians and commissions whether a horse having been treated with NSAID may participate in a competition or not. Fur...
Comparison of the effects of ketoprofen and flunixin meglumine on the in vitro response of equine peripheral blood monocytes to bacterial endotoxin. The purpose of this study was to investigate the in vitro effects of flunixin meglumine, a cyclo-oxygenase inhibitor, and ketoprofen, a reported cyclo-oxygenase and lipoxygenase inhibitor, on the synthesis of cyclo-oxygenase end-products thromboxane B2 and prostaglandin E2, lipoxygenase derived 12-hydroxyeicosatetraenoic acid, tumor necrosis factor and tissue factor. Six adult horses were each randomly administered flunixin meglumine (1.1 mg/kg) or ketoprofen (2.2 mg/kg) intravenously every 12 hours with the drug treatments separated by two weeks. Blood samples were obtained prior to initiatin...
Clinical use and characteristics of the corticosteroids. Corticosteroids possess potent anti-inflammatory activity and are commonly injected intra-articularly for local relief of inflammatory lesions in performance horses. However, the suppression of anabolic activity in the joint may lead to an increased rate of joint breakdown. Complications associated with intra-articular corticosteroid therapy include septic arthritis, which is usually due to inadvertent joint contamination at the time of corticosteroid injection, and steroid arthropathy, which is characterized by an accelerated rate of joint destruction and radiographic evidence of severe degen...
Effects of concurrent administration of phenylbutazone and flunixin meglumine on pharmacokinetic variables and in vitro generation of thromboxane B2 in mares. Flunixin meglumine and phenylbutazone are nonsteroidal anti-inflammatory drugs commonly used for the management of colic, endotoxemia, and musculoskeletal disorders in equids. Although it is not usually recommended, there appears to be an increasing trend to use nonsteroid anti-inflammatory drugs in combination to enhance or prolong their effects. Therefore, we studied the effect of concurrent administration of flunixin (1.1 mg/kg of body weight, IV) as flunixin meglumine and phenylbutazone (2.2 mg/kg, IV) on the pharmacokinetics of each drug and on in vitro thromboxane B2 production. Pharmaco...
Postoperative analgesia using phenylbutazone, flunixin or carprofen in horses. Horses undergoing surgery were randomly assigned to one of three groups to receive phenylbutazone at 4 mg/kg (n = 72), flunixin at 1 mg/kg (n = 68) or carprofen at 0.7 mg/kg (n = 63) by slow intravenous injection at the end of surgery, just before they were disconnected from halothane. Pain was assessed by either of two resident surgical clinicians (who did not know which non-steroidal anti-inflammatory drug had been given) when the horses first stood up, two and four hours later and the next morning. If repeated doses of analgesic drugs were given the time was recorded and taken as an end poi...
The disposition of suxibuzone in the horse. A high performance liquid chromatographic method is described to determine the anti-inflammatory drug suxibuzone (SXB) and its major metabolites phenylbutazone (PBZ) and oxyphenbutazone (OPBZ) in equine plasma and urine. When suxibuzone (6 mg/kg) was administered intravenously (i.v.) or orally (p.o.) no parent drug was detected in plasma or in urine. The disposition of the metabolite PBZ (i.v.) could be described by a 2 compartment model with a beta half-life varying from 7.40 to 8.35 h. Due to severe side effects the use of i.v. suxibuzone should not be encouraged in the horse. PBZ and OPBZ w...
Transoral axial division, under endoscopic guidance, for correction of epiglottic entrapment in horses. Transoral axial division was performed, using endoscopic guidance, in 20 horses with epiglottic entrapment. Mean age of affected horses was 3 years (range, 2 to 5 years), and there were 18 Standardbreds and 2 Thoroughbreds. Standardbreds and female horses were significantly overrepresented when compared with a reference population. Upper respiratory noise prompted endoscopic examination before surgery in 16 horses, but noise was not heard in 4 horses. Ten horses had entrapment by thin tissue without ulceration, 6 horses had entrapment by thin tissue with small, partial-thickness ulceration, 3 ...
Hepatic lobe torsion as a cause of colic in a horse. A 14-year-old Arabian gelding was examined for colic. An exploratory celiotomy was subsequently performed and the left lobe of the liver was found to be twisted. The lobe was resected using a TA-90 surgical stapling instrument. Histologic examination of the resected liver indicated portal vein and sinusoid dilation and congestion with blood. There were focal areas of necrosis and bacterial cocci and rods throughout the section. The histologic findings were consistent with hepatic lobe torsion. After surgery, the horse was treated with broad spectrum antibiotics, anti-inflammatory drugs, hepari...
Pulmonary edema associated with transient airway obstruction in three horses. Pulmonary edema associated with transient airway obstruction was detected in 3 horses. The cause of obstruction was different in each horse, but after relief of the obstruction, clinical signs and radiographic abnormalities were indicative of pulmonary edema. In 2 of the 3 horses, pink frothy fluid was evident in the airways. The horses were treated with furosemide, nasal insufflation of O2, anti-inflammatory agents, and anti-biotics. Of the 3 horses examined, 1 horse died acutely, 1 horse recovered fully, and 1 developed pleuritis and was subsequently euthanatized.
Principles of therapeutics. Topical administration of drugs is the treatment of choice for diseases of the anterior segment. Drug levels attained by this means are usually of short duration, however, necessitating frequent therapy or continuous perfusion if prolonged drug levels are required. A drug-delivery device (collagen shield or contact lens) or subconjunctival injections can be used to augment topical therapy if frequent treatment is not possible. Subconjunctival injections are recommended for drugs that have low solubility and, hence, low corneal penetration. Retrobulbar injections are seldom indicated, except fo...
Idiopathic, aseptic, effusive, fibrinous, nonconstrictive pericarditis with tamponade in a standardbred filly. A Standardbred filly was admitted for evaluation of pleuritis and pneumonia. Heart rate was 80 to 120 beats/min, and the pulse was barely palpable. Thoracic and abdominal ultrasonography and echocardiography revealed substantial pericardial effusion with cardiac tamponade, fibrinous pericarditis, pleural effusion, and ascites. Initial electrocardiography revealed normal sinus rhythm with decreased amplitude of the QRS complexes consistent with pericardial effusion. Following thoracentesis, echocardiogram-guided pericardiocentesis was performed. Bacterial culture yielded no growth from any of t...
[Diagnosis and therapy of tendinitis exemplified by the athletic horse].
Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin
This paper reviews the literature and describes our experiences in the diagnosis and treatment of tendinitis in horses. Ultrasonography provides a sensitive tool to diagnose tendinitis and quantitate the degree of damage to the tendon; as well as provide differential diagnoses such as peritendinitis. The principles in therapy of acute tendinitis are: Immediate reduced exercise or rest, physical therapy to reduce inflammation and administration of local and systemic antiinflammatory drugs. The goal is restoration of the tensile strength of the tendon without peritendinous granulation tissue and... Bioavailability of two ibuprofen oral paste formulations in fed or nonfed ponies. The bioavailability and pharmacokinetics of ibuprofen, a nonsteroidal antiinflammatory drug, was studied in healthy Shetland ponies. Ibuprofen was administered IV, as a suspension, and as a solid solution oral paste to ponies from which food was withheld. The suspension paste was also administered to ponies that received hay and water ad libitum. Both formulations had an absolute bioavailability of about 80%. Bioavailability was not influenced by feeding.
[The surgical therapy of equine recurrent uveitis]. Equine recurrent uveitis (ERU) is the most frequently encountered cause of eye problems and blindness in horses. Classic treatment of ERU includes mydriatics, corticosteroids and nonsteroidal anti-inflammatory drugs. Despite vigorous topical and systemic treatment, however, in many cases, the prognosis for preserving vision remains poor. Experiences with surgical treatment of chronic endogenous uveitis in human patients have shown that vision-impairing axial opacities in the vitreous body can be removed by pars plana vitrectomy, and that a considerable decrease in the frequency and severity of...
Studies of meclofenamic acid and two metabolites in horses–pharmacokinetics and effects on exercise tolerance. The pharmacokinetics and the effects on treadmill exercise of the anti-inflammatory drug meclofenamic acid were studied in seven Standardbred horses after single intravenous and/or oral doses. The decline in plasma concentration after a single intravenous dose of meclofenamic acid (2.2 mg/kg b.wt) was described by a two-compartment open model. The average elimination half-life was 1.4 h, the apparent volume of distribution 0.14 l/kg and the plasma clearance 0.12 l/h kg. Absorption was the rate-limiting step after oral administration. Non-compartmental analysis showed a mean absorption time of ...
Eltenac, a new anti-inflammatory and analgesic drug for horses: clinical aspects. Two controlled studies to determine efficacy in the horse were performed with eltenac, a new injectable, non-steroidal anti-inflammatory drug (NSAID). Clinical trials were carried out with a dose rate of 1 mg/kg body weight in a randomized, placebo-controlled, double-blind design to assess therapeutic efficacy in acute inflammatory disorders and in animals with orthopaedic conditions. In a preliminary pharmacokinetic investigation in six horses mean elimination half-life was 1.7 h after i.v. administration. In the first clinical study, analgesic activity on pain-related lameness was determined...
Pharmacodynamics and pharmacokinetics of miloxicam in the horse. The novel non-steroidal anti-inflammatory drug (NSAID) miloxicam was administered intravenously to six New Forest ponies at a dosage rate of 0.6 mg/kg in a two-part cross-over study. In each part, three horses received miloxicam and three were given a placebo preparation. The actions of miloxicam, compared to placebo, were assessed in a carrageenan-sponge model of acute inflammation. The rise in skin temperature over the site of the acute inflammatory reaction was less in treated ponies, but differences were not statistically significant. Concentrations of the enzymes acid phosphatase (AP) and...
Effects of flunixin meglumine on endotoxin-induced prostaglandin F2 alpha secretion during early pregnancy in mares. The role of prostaglandin F2 alpha (PGF2 alpha) in embryonic loss following induced endotoxemia was studied in mares that were 21 to 44 days pregnant. Thirteen pregnant mares were treated with a nonsteroidal anti-inflammatory drug, flunixin meglumine, to inhibit the synthesis of PGF2 alpha caused by Salmonella typhimurium endotoxin given IV. Flunixin meglumine was administered either before injection of the endotoxin (group 1, -10 min; n = 7), or after endotoxin injection into the mares (group 2, 1 hour, n = 3; group 3, 2 hours, n = 3); 12 pregnant mares (group 4) were given only S typhimurium...
Poisoning with equine phenylbutazone in a racetrack worker. Phenylbutazone is a potent nonsteroidal, anti-inflammatory drug often used by veterinarians to treat racetrack animals. Its use in human beings is limited because of significant adverse effects and the availability of newer, safer drugs. We report the case of a 24-year-old man who ingested 17 g of equine phenylbutazone over a 24-hour period to treat the pain of a toothache. He developed grand mal seizures, coma, hypotension, respiratory and renal failure, and hepatic injury. Serum phenylbutazone concentration obtained approximately eight hours after presentation was 900 micrograms/mL. The pati...
