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Topic:NSAID
Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medications commonly used in horses to manage pain and inflammation. These drugs work by inhibiting enzymes involved in the inflammatory process, specifically cyclooxygenase (COX) enzymes, which play a role in the production of prostaglandins. NSAIDs are frequently administered for conditions such as musculoskeletal disorders, colic, and post-surgical pain. Common NSAIDs used in equine medicine include phenylbutazone, flunixin meglumine, and ketoprofen. While effective, the use of NSAIDs in horses requires careful management due to potential side effects, such as gastrointestinal ulceration and renal impairment. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, therapeutic applications, and safety considerations of NSAIDs in equine practice.
Quantifying the Equine Pain Response to Paracetamol Administration in Horses With Chronic Lameness Already Receiving Non-Steroidal Anti-Inflammatories. Paracetamol is used in horses alongside non-steroidal anti-inflammatories (NSAIDs) for multi-modal analgesia; however to date there are few studies published which have investigated its analgesic effect in the horse. Horses were recruited to this study from a population of geriatric horses at The Horse Trust. Horses were selected based on the following inclusion criteria; documented naturally occurring chronic lameness and being treated with an NSAID at the licensed dose and dosing interval. This population was assessed with a five-point subjective lameness grading system performed live by two...
Cryopreserved umbilical allograft (equicenta® CTM) improves clinical outcomes compared with clinician-selected standard of care in performance horses: a pragmatic prospective controlled trial. This multicenter, prospective, controlled clinical study and client survey evaluated the safety and effectiveness of an equine umbilical tissue suspension (equicenta® CTM; eCTM, 2:1) compared with clinician-selected standard of care (SOC) for treating lame performance horses. Unassigned: This pragmatic, real-world, open-label study enrolled horses diagnosed with appendicular musculoskeletal conditions affecting the joints, tendons, or ligaments under owner consent and an intention-to-treat design with an optional crossover after no improvement at 12 weeks and per-protocol analyses at 26 ...
Nonsteroidal anti-inflammatory drug administration alters crypt distribution of the peroxisomal marker acyl-coenzyme A oxidase 1 in the equine right dorsal colon. To characterize and compare the distribution of peroxisomal markers in the right dorsal colon (RDC) and left ventral colon (LVC) of healthy horses and horses treated with NSAIDs. Unassigned: Archived colonic tissues were evaluated from 10 horses (n = 5/group) administered phenylbutazone (4.4 mg/kg, PO, twice daily for 10 days) or placebo prior to euthanasia. Samples from the RDC and LVC were analyzed using immunofluorescence to assess peroxisomal biogenesis factor 14 (PEX14) and acyl-coenzyme A oxidase 1 (ACOX1) distribution. Marker abundance was quantified within colonic crypts and compared b...
Gastroscopic Evaluation of Gastric Mucosa in Horses Treated With Flunixin Meglumine or High-Dose Firocoxib: A Descriptive Pilot Study. Equine Gastric Ulcer Syndrome (EGUS) is common in horses, and nonsteroidal anti-inflammatory drugs (NSAIDs) are a known risk factor for gastrointestinal ulceration. Although COX-2 selective NSAIDs such as firocoxib theoretically offer a better safety profile, endoscopic evidence for their mucosal safety at high off-label doses is lacking. Objective: To compare the effects of label-dose flunixin meglumine and high-dose firocoxib on the gastric mucosa of a small selected group of horses using serial gastroscopy and histopathology in a descriptive pilot study. Methods: Twenty mixed-breed horses w...
Correction: Phenylbutazone concentrations in synovial fluid following administration via intravenous regional limb perfusion in the forelimbs of six adult horses. [This corrects the article DOI: 10.3389/fmed.2026.1810077.].
Risk factors for post-partum colic in a population of UK and Irish Thoroughbred broodmares. Broodmares are at increased risk of gastrointestinal colic. However, colic risk factors specific to this population have not been investigated. Objective: To investigate horse- and management-level risk factors for post-partum colic in a cohort of Thoroughbred broodmares in the United Kingdom and Ireland. Methods: Prospective, nested case-control study. Methods: Twenty-nine Thoroughbred stud farms in the United Kingdom and Ireland were recruited, and 1044 mares were followed over the 2021 and/or 2022 foaling seasons. Data were collected on signalment, medical and management history for post-pa...
Topical betulinic acid for treatment of equine melanoma and sarcoid. Betulinic acid, a natural pentacyclic triterpenoid, has demonstrated anti-inflammatory and anti-tumor properties in vitro, including activity against equine melanoma and sarcoid. However, there is limited in vivo evidence evaluating its clinical efficacy. The objective of this study was to assess the safety and efficacy of a compounded 1% betulinic acid cream for the treatment of equine cutaneous melanoma and sarcoid. Unassigned: This prospective, randomized, double-blinded, placebo-controlled clinical trial enrolled client-owned horses with melanoma or sarcoid tumors. Horses received either a...
Retained fetal membranes in light breed mares hospitalized for attended parturition. Retention of fetal membranes (RFM) is well described in draft breeds, whereas data on light breed mares remains limited and inconsistent. Objective: This retrospective study aimed to describe the frequency, associated factors, treatments, and consequences of RFM in light breed mares hospitalized for attended parturition. Methods: Medical records of 321 light breed mares hospitalized for attended parturition at the Veterinary Teaching Hospital, University of Bologna, were retrospectively reviewed. Data collected included: breed, previous history of RFM, age, parity, assisted reproductive techni...
Overview of the Current Osteoarthritis Treatment in Veterinary Medicine and Future Directions. Osteoarthritis (OA) is a chronic and progressive joint disease that can cause permanent loss of joint function. OA is highly prevalent in horses, dogs, and cats, affecting different joints and leading to reduced mobility and chronic pain. Different risk factors for animal OA have been identified, including trauma and breed. Inflammation is a hallmark of the disease, with various underlying mechanisms such as cyclooxygenase and metalloproteinase activation, nerve growth factor, cytokine, and prostaglandin upregulation, among others. Although disease complexity makes OA difficult to treat, eno...
Long-term clinical outcome of maxillofacial fractures in horses: A retrospective study of 30 cases (2020-2024). To assess long-term outcome, complications, and return to function in horses with maxillofacial fractures. Methods: Retrospective observational study. Methods: A total of 30 horses with skull fractures (2020-2024). Methods: Clinical records were reviewed for signalment, fracture characteristics, imaging, treatment, and hospitalization. Long-term outcome was obtained via structured owner questionnaires addressing healing, complications, cosmetic appearance, and performance. Descriptive statistics were applied. Results: A total of 29 of 30 horses received treatment (25 surgical, 4 conservative);...
Survey describing the perspectives and practices of Australian veterinarians to pain management in horses. To describe Australian practices and attitudes regarding equine analgesia. Methods: Cross-sectional anonymous, voluntary survey of Australian veterinarians treating equine patients. Methods: Australian veterinarians in equine or mixed practices completed a six-section, 60-question survey between November 2019 to August 2020. Information was gathered on demographics, analgesia prescription, pain assessment and attitudes surrounding specific analgesics. Respondents assigned a pain score ranging from 0 to 10 for various conditions; these were averaged to give each respondent an "average pain scor...
Chronic spasmodic colic management in a thoroughbred horse: A case report from Bangladesh. Equine colic refers to severe abdominal pain caused by gastrointestinal tract dysfunction. A clinical case of equine colic was reported from a riding school in the Chattogram coastal area of Bangladesh. The animal was a 10-year-old gelding thoroughbred horse with a body weight of 500 kg. Unassigned: Visible clinical signs included anorexia, bruxism, restlessness with rolling side to side and pawing by the front leg on both sand and hard surfaces, dehydration, looking at the flank, abdominal distension, and increased intestinal motility detected via rectal palpation. The case was treated using ...
Horses diagnosed with pituitary pars intermedia dysfunction do not have shorter life expectancies but experience more medical events during their lifetime. The frequency of comorbidities in horses with pituitary pars intermedia dysfunction (PPID) in first-opinion practice is unknown. It is hypothesized that horses with PPID would have more frequent medical events and be euthanized at a younger age. Unassigned: This was a case-control retrospective study. Medical records ranging from 1996 to 2024 including 132 horses diagnosed with PPID and 274 controls matched by age and breed were reviewed. Variables associated with PPID were evaluated with a Fisher exact or Mann-Whitney U test followed by conditional logistic regression. Results were reported a...
A Meta-Analysis of International Flunixin Pharmacokinetics in Horses: Toward Regulatory Harmonization and Individualized Detection Times Using Bayesian Paradigm. Flunixin meglumine is widely used to manage pain and inflammation in horses, and its regulation requires robust pharmacokinetic analysis for harmonization. In this study, we conducted a meta-analysis of flunixin disposition using plasma and urine concentration data from 65 horses across four countries to robustly estimate pharmacokinetic parameters in setting screening limits (SLs) for controlling medications in horses. A population (POP) model was developed using nonlinear mixed-effects model analysis. The irrelevant plasma concentration (IPC) and irrelevant urine concentration (IUC) were det...
In Vitro Effects of PRP, Ozonized PRP, Hyaluronic Acid, Paracetamol, and Polyacrylamide on Equine Synovial Fluid-Derived Mesenchymal Stem Cells. Musculoskeletal disorders are a major cause of lameness in horses, often necessitating innovative regenerative strategies to restore joint function and improve quality of life. This study investigated the effects of platelet-rich plasma (PRP), ozonized PRP, hyaluronic acid, paracetamol, and polyacrylamide hydrogel (NOLTREX) on the behavior of mesenchymal stem cells (MSCs) derived from equine synovial fluid. Synovial fluid samples were collected under strict cytological criteria to ensure viability, followed by in vitro expansion and phenotypic characterization of MSCs. Cultures were supplement...
Differential effects of flunixin meglumine and meloxicam on TNF- α production in LPS-stimulated equine neutrophils in vitro. Systemic inflammatory response syndrome (SIRS) induced by endotoxemia is usually secondary to colitis and is a major cause of high morbidity and mortality in horses. Non-steroidal anti-inflammatory drugs (NSAIDs), such as flunixin meglumine (FM) and meloxicam (MX), are used to improve clinical outcomes in SIRS/endotoxemia. These NSAIDs suppress tumor necrosis factor-alpha (TNF-α) levels; however, the underlying mechanisms remain unclear. The aim of this study was to investigate the inhibitory effects of FM and MX on TNF-α in lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear ce...
Autologous conditioned serum IRAP efficacy for tendon and ligament injuries in horses: An observational study. Tendon and ligament injuries in equine athletes pose significant challenges, often leading to prolonged recovery, reduced performance, and increased risk of reinjury. Current treatment strategies, including conservative and surgical approaches, have shown limited success in fully restoring tendon integrity. Autologous blood derivatives, such as autologous conditioned serum (ACS), have emerged as potential regenerative therapies. However, the clinical efficacy of ACS in the treatment of equine tendinopathies remains under investigation. Unassigned: This study aimed to compare the clinical outco...
Description and Complications of a New Modified Semi-Closed Castration Technique in Horses. Castration remains a common surgical procedure in equids, yet postoperative complications such as hemorrhage, infection, and eventration persist, influencing surgical outcomes. This retrospective study introduced a novel modified semi-closed castration technique aimed at minimizing these complications. Eighty-five sexually intact mature male equids (including horses, ponies, and donkeys) underwent the described inguinal castration procedure under general anesthesia. The technique involved a carefully managed opening and subsequent secure closure of the parietal vaginal tunic, enabling direct i...
Phenylbutazone treatment of mares does not reduce embryo production via intracytoplasmic sperm injection. Production of embryos via intracytoplasmic sperm injection (ICSI) is a common clinical procedure in equine practice. A recent study indicates that treatment of mares with phenylbutazone paste significantly lowers blastocyst production after ICSI of recovered oocytes. The current study was conducted to determine the effect of different methods of phenylbutazone administration on in vitro embryo production of recovered oocytes in mares. Unassigned: In study 1 (July 29 through September 18, 2024), 14 mares received either oral liquid phenylbutazone once daily for 10 days or no treatment. On the l...
The Confidential Enquiry into Perioperative Equine Fatalities: phase 4 (CEPEF4) – a worldwide observational, prospective, multicentre cohort study in 2025. To report on the Confidential Enquiry into Perioperative Equine Fatalities 4 (CEPEF4). Methods: Confidential, observational, prospective, multicentre, cohort study. Methods: 47,396 horses/ponies undergoing general anaesthesia (GA). Methods: Characteristics of each GA (249 variables) were collected. Outcomes after seven days were ALIVE (or discharged), EUTHANASIA or DEAD. Logistic regression analysed patient demographics and the anaesthetic drugs (p < 0.05). Results: Data were collected from 47,396 GAs in 93 centres in 28 countries. Death rates were 1.2% overall, 0.6% for cases classified as...
Headshaking associated with a unique presentation of guttural pouches infection and otitis media in a Quarter Horse stallion: diagnosis, medical treatment and outcome. A 3-year-old Quarter Horse stallion was referred for headshaking (HS) syndrome of one month duration. The horse underwent complete HS workup. Physical examination revealed up-and-down head movements associated with nose snorting during lunging and riding, in the absence of other abnormalities at rest or in motion. Lameness, neurologic and behavioural evaluations were unremarkable. Endoscopic examination of the upper respiratory tract showed bilateral guttural pouches (GPs) inflammation. The mucosal surface was altered by the presence of areas of microbullous appearance coalescing into some bul...
Long-Term Firocoxib Use in Horses. Many horses receive firocoxib over multiple years, and studies evaluating hematologic and biochemical values in these animals are lacking. Objective: To describe the hematologic and biochemical values of horses receiving long-term firocoxib. Methods: A total of 79 horses receiving long-term firocoxib and 153 horses not receiving long-term firocoxib and not presenting for a specific medical problem. Methods: Retrospective study comparing horses receiving firocoxib (F group) and no firocoxib (NF group). Signalment, hematologic, and biochemical values were compared between the two groups. Simple ...
Survey on 9 years of anti-doping controls in horse races in Italy. Doping in racehorses is a threat to horse welfare and the integrity of the sport. Despite its relevance, the literature on the prevalence of anti-doping violations worldwide is limited. Objective: To analyse anti-doping violations in racehorses in Italy. Methods: Retrospective observational study. Methods: Data on horse races, anti-doping testing, and confirmed violations between 2014 and 2022 were collected and analysed. Positivity rates, most common drug classes and parent drugs, and differences between trotting and galloping horses were investigated. Results: During the considered 9-year ti...
In Vivo Metabolic Studies of 2-Hydroxyethyl Salicylate in Horses. 2-Hydroxyethyl salicylate (2HES), a nonsteroidal anti-inflammatory drug (NSAID), is a medication to treat musculoskeletal injuries and inflammation swelling of humans and horses. Its misuse could affect the performance of horses and mask injuries, which could pose significant health risks. In horseracing, it is reported as an adverse finding once detected in competition. The metabolism of 2HES in either human or horse has not been reported, and therefore, little is known about its metabolic fate. This paper describes the in vivo metabolism of 2HES in horse with an objective to identify the mo...
Effect of Phenylbutazone Administration on Insulin Sensitivity in Horses With Insulin Dysregulation. Phenylbutazone is prescribed to manage pain caused by hyperinsulinemia-associated laminitis. Phenylbutazone reduces glucose and insulin concentrations in horses with insulin dysregulation (ID) but the underlying mechanism of action is unknown. Objective: Investigate the effect of phenylbutazone on tissue insulin sensitivity in horses. It is hypothesized that the reduced glucose and insulin concentrations in horses with ID receiving phenylbutazone are mediated by a higher tissue insulin sensitivity. Methods: Fifteen light breed horses, including seven with ID. Methods: Randomized cross-over stu...
Assessing omeprazole and flunixin meglumine co-administration in treating equine gastric ulcer syndrome in Mongolian horses. Flunixin meglumine (FM) is commonly used in painful conditions in horses; however, it may contribute to equine gastric ulcer syndrome (EGUS). Some veterinarians combine omeprazole (OME) and FM to reduce EGUS risk. However, the efficacy and safety of this combination in Mongolian horses with chronic lameness remain unknown. Objective: To investigate the changes in lameness and EGUS scores in Mongolian horses through the comparison of three treatment strategies: FM, FM + OME and placebo treated control (CON) and to assess the effects of these treatments on gastric fluid pH, serum total prote...
Streptococcus hillyeri isolated from septic pleuritis in a horse. Here we report the isolation of Streptococcus hillyeri from a thoracic sample from a horse. A 17-y-old Hungarian Sport Horse mare was referred to the equine clinic of the University of Veterinary Medicine Budapest, Hungary, with suspected pleuritis. Upon arrival, the horse was febrile and had tachycardia, severe inspiratory dyspnea, and tachypnea. Thoracic ultrasonography revealed severe bilateral pleural effusion, and a large area of lung consolidation. After sampling of both hemithoraces, 66 L of turbid exudate were drained. Based on these findings, a tentative diagnosis of septic pleuritis ...
Analgesic efficacy of tapentadol in chronic joint disorders in horses: plasma serotonin concentration and adrenocortical response as biomarkers of pain-induced stress. The study aimed to evaluate the analgesic efficacy of tapentadol in horses, by determining plasma serotonin concentration and adrenocortical response, as biomarkers of pain stress in chronic joint disorders. Thirty-six horses (20 females and 16 males) were divided into three groups of 12 subjects each: group A, osteoarthritis (OA), grade 3-4 lameness; group B, OA, grade 5 lameness; and group C, no OA, no lameness, were enrolled. The orthopedic examination included flexion tests, and radiological and ultrasound examinations. The degree of lameness has been estimated from 0 to 5 according to the...
Effect of phenylbutazone administration on the enteroinsular axis in horses with insulin dysregulation. Phenylbutazone is prescribed for laminitis-associated pain and decreases glucose and insulin responses to an oral glucose test (OGT) in horses with insulin dysregulation (ID). Objective: Investigate the effect of phenylbutazone administration on the enteroinsular axis in horses. Methods: Sixteen horses, including 7 with ID. Methods: Randomized cross-over study design, with horses assigned to treatment with phenylbutazone (4.4 mg/kg IV q24h) or placebo (5 mL 0.9% saline). On Day 9 of treatment, an OGT was conducted, followed by a 10-day washout period, administration of the alternative trea...
