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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.
Use of firocoxib for the treatment of equine osteoarthritis.
Veterinary medicine (Auckland, N.Z.)    November 4, 2014   Volume 5 159-168 doi: 10.2147/VMRR.S70207
Donnell JR, Frisbie DD.This review presents the pathogenesis and medical treatment of equine osteoarthritis (OA), focusing on firocoxib. Inhibition of prostaglandin E remains a fundamental treatment for decreasing clinical symptoms (ie, pain and lameness) associated with OA in horses. Nonsteroidal anti-inflammatory drugs (NSAIDs), which inhibit the production of prostaglandin E from the arachidonic acid pathway, continue to be a mainstay for the clinical treatment of OA. Firocoxib is a cyclooxygenase (COX)-2-preferential NSAID that has been shown to be safe and to have a 70% oral bioavailability in the horse. Three ...
Selective and simultaneous determination of NSAIDs in equine plasma by HPLC with molecularly imprinted solid-phase extraction.
Bioanalysis    October 22, 2014   Volume 6, Issue 16 2147-2158 doi: 10.4155/bio.14.79
Meucci V, Minunni M, Vanni M, Sgorbini M, Corazza M, Intorre L.Detection of nonsteroidal anti-inflammatory drugs (NSAIDs) in equine plasma is a significant analytical problem in veterinary anti-doping controls. Results: A new HPLC method coupled to selective extraction with molecularly imprinted polymers was developed for the simultaneous determination in equine plasma of the NSAIDs phenylbutazone, flunixin, oxyphenbutazone, ketoprofen and naproxen. The analytical performances of the method have been evaluated both in standard solutions and equine plasma samples. Recovery: Molecularly imprinted polymers solid-phase extraction for all NSAIDs was >94% with ...
Orally administered phenylbutazone causes oxidative stress in the equine gastric mucosa.
Journal of veterinary pharmacology and therapeutics    October 7, 2014   Volume 38, Issue 3 257-264 doi: 10.1111/jvp.12168
Martínez Aranzales JR, Cândido de Andrade BS, Silveira Alves GE.Phenylbutazone (PBZ) is widely used in equine medicine, and its side effects on the gastrointestinal tract are well known. The inhibition of prostaglandins and the oxidative stress induced by nonsteroidal anti-inflammatory drugs (NSAIDs) are described as mechanisms of gastric mucosal injury in humans. In horses, only the secondary effect of changes in cyclooxygenases is related to gastric mucosal injury. The objective of this study was to evaluate the effect of PBZ on certain antioxidative/oxidative parameters of the gastric mucosa. The concentrations of antioxidants and oxidants (superoxide d...
Prospective survey of veterinary practitioners’ primary assessment of equine colic: clinical features, diagnoses, and treatment of 120 cases of large colon impaction.
BMC veterinary research    July 7, 2014   Volume 10 Suppl 1, Issue Suppl 1 S2 doi: 10.1186/1746-6148-10-S1-S2
Jennings K, Curtis L, Burford J, Freeman S.Large colon impactions are a common cause of colic in the horse. There are no scientific reports on the clinical presentation, diagnostic tests and treatments used in first opinion practice for large colon impaction cases. The aim of this study was to describe the presentation, diagnostic approach and treatment at the primary assessment of horses with large colon impactions. Methods: Data were collected prospectively from veterinary practitioners on the primary assessment of equine colic cases over a 12 month period. Inclusion criteria were a diagnosis of primary large colon impaction and posi...
Effects of meloxicam and phenylbutazone on renal responses to furosemide, dobutamine, and exercise in horses.
American journal of veterinary research    June 25, 2014   Volume 75, Issue 7 668-679 doi: 10.2460/ajvr.75.7.668
Raidal SL, Hughes KJ, Charman AL, Nielsen SG, Phillips JK, Noble GK.To compare the effects of 2 NSAIDs (phenylbutazone and meloxicam) on renal function in horses. Methods: 9 Thoroughbred or Standardbred mares (mean ± SD age, 5.22 ± 1.09 years [range, 2 to 12 years]; mean body weight, 470 ± 25 kg [range, 442 to 510 kg]). Methods: A randomized blinded placebo-controlled crossover study was conducted to examine the effects of treatment with phenylbutazone, meloxicam, or a placebo (control solution) on renal responses to the administration of furosemide, dobutamine, and exercise (15 minutes at 60% of maximum heart rate). Renal function was assessed by use of bi...
Pain control in horses: what do we really know?
Equine veterinary journal    May 15, 2014   Volume 46, Issue 4 517-523 doi: 10.1111/evj.12265
Sanchez LC, Robertson SA.Currently, approaches to pain control in horses are a mixture of art and science. Recognition of overt pain behaviours, such as rolling, kicking at the abdomen, flank watching, lameness or blepharospasm, may be obvious; subtle signs of pain can include changes in facial expression or head position, location in the stall and response to palpation or human interaction. Nonsteroidal anti-inflammatory drugs (i.e. phenylbutazone, flunixin meglumine and firocoxib), opioids (i.e. butorphanol, morphine and buprenorphine) and α2 -adrenergic agonists (i.e. xylazine, detomidine, romifidine and medetomid...
In vivo effects of phenylbutazone on inflammation and cartilage-derived biomarkers in equine joints with acute synovitis.
Veterinary journal (London, England : 1997)    April 1, 2014   Volume 201, Issue 1 51-56 doi: 10.1016/j.tvjl.2014.03.030
de Grauw JC, van Loon JP, van de Lest CH, Brunott A, van Weeren PR.Although phenylbutazone (PBZ) is commonly used in equine orthopaedic practice, little is known about its in vivo effects on joint inflammation and cartilage turnover. This study investigates the effects of PBZ on inflammatory parameters, matrix metalloproteinase (MMP) activity and cartilage biomarkers in equine joints with acute synovitis. In a two-period cross-over study, transient synovitis was induced at T = 0 h in the middle carpal joint of seven ponies by lipopolysaccharide (LPS) injection. Ponies received PBZ (2 mg/kg PO twice daily) or placebo for 1 week, starting at T = 2 h. Ar...
Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions.
Equine veterinary journal    February 18, 2014   Volume 46, Issue 4 427-434 doi: 10.1111/evj.12224
Naylor RJ, Taylor AH, Knowles EJ, Wilford S, Linnenkohl W, Mair TS, Johns IC.Ex vivo evidence suggests that cyclo-oxygenase (COX) 2-preferential inhibitor nonsteroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, have a less detrimental effect on intestinal healing than flunixin meglumine (FM). Whether this translates to a beneficial effect in horses with naturally occurring strangulating small intestinal (SSI) lesions is unknown. Objective: To compare the clinical outcome of horses with naturally occurring SSI lesions treated with meloxicam or FM. Methods: Randomised prospective study. Methods: Cases presenting to the Royal Veterinary College Equine Referral H...
Nonthyroidal illness syndrome in adult horses.
Journal of veterinary internal medicine    January 13, 2014   Volume 28, Issue 2 609-617 doi: 10.1111/jvim.12274
Hilderbran AC, Breuhaus BA, Refsal KR.This study was performed to determine whether sick horses have thyroid hormone (TH) alterations similar to those observed in nonthyroidal illness syndrome in other species. Objective: Horses suffering from systemic diseases have decreased THs and inappropriately low thyroid-stimulating hormone (TSH). Methods: Seventy-one clinically normal horses; 380 hospitalized horses. Methods: Total thyroxine (TT4), free thyroxine by equilibrium dialysis (fT4D), total triiodothyronine (TT3), free triiodothyronine (fT3), and TSH were measured in normal and hospitalized horses. Disease severity was categorize...
Carprofen inhibits the release of matrix metalloproteinases 1, 3, and 13 in the secretome of an explant model of articular cartilage stimulated with interleukin 1β.
Arthritis research & therapy    January 1, 2014   Volume 15, Issue 6 R223 doi: 10.1186/ar4424
Williams A, Smith JR, Allaway D, Harris P, Liddell S, Mobasheri A.Arthritic diseases are characterized by the degradation of collagenous and noncollagenous extracellular matrix (ECM) components in articular cartilage. The increased expression and activity of matrix metalloproteinases (MMPs) is partly responsible for cartilage degradation. This study used proteomics to identify inflammatory proteins and catabolic enzymes released in a serum-free explant model of articular cartilage stimulated with the pro-inflammatory cytokine interleukin 1β (IL-1β). Western blotting was used to quantify the release of selected proteins in the presence or absence of the cyc...
Evaluation of the safety of a combination of oral administration of phenylbutazone and firocoxib in horses.
Journal of veterinary pharmacology and therapeutics    December 20, 2013   Volume 37, Issue 4 413-416 doi: 10.1111/jvp.12097
Kivett L, Taintor J, Wright J.Simultaneous administration of a nonselective COX inhibitor and a COX-2 specific NSAID has not been previously reported in horses. The goal of this study was to determine the safety of a 10-day dosage regimen of phenylbutazone and firocoxib, both at their standard dosages, in horses. Six horses were administered 2.2 mg/kg of phenylbutazone and 0.1 mg/kg of firocoxib by mouth, daily for 10 days. Horses were assessed daily for changes in behavior, appetite, fecal consistency, signs of abdominal pain, and oral mucous membrane ulceration. Horses were assessed prior to and on the last day of treatm...
Naproxen in the horse: pharmacokinetics and side effects in the elderly.
Research in veterinary science    December 14, 2013   Volume 96, Issue 1 147-152 doi: 10.1016/j.rvsc.2013.12.007
Della Rocca G, Di Salvo A, Cagnardi P, Marchesi MC, Conti MB.It is well-known that old animals show physiologic and/or pathologic variation that could modify the pharmacokinetics of drugs and the related pharmacodynamic response. In order to define the most appropriate therapeutic protocol in old horses, pharmacokinetic profile and safety of naproxen were investigated in horses aged over 18 years after oral administration for 5 days at the dose of 10 mg/kg b.w./day. After the first administration, the maximum concentration (Cmax 44.21 ± 9.21 μg/mL) was reached at 2.5 ± 0.58 h post-treatment, the harmonic mean terminal half-life was 6.96 ± 1.73 h, AU...
Efficacy of intramuscular meperidine hydrochloride versus placebo in experimental foot lameness in horses.
Equine veterinary journal. Supplement    December 1, 2013   Issue 45 48-53 doi: 10.1111/evj.12168
Foreman JH, Ruemmler R.There are no peer reviewed, blinded controlled studies regarding the skeletal analgesic efficacy of intramuscularly administered meperidine in horses. Objective: Using an adjustable heart bar shoe model of equine foot pain, the objective of this study was to test the hypothesis that meperidine (pethidine) administered intramuscularly would prove more efficacious in alleviating lameness than a saline placebo. Methods: Crossover pharmacodynamic experiment. Methods: Eight healthy adult Thoroughbred horses randomly underwent weekly i.m. treatments 1 h after lameness induction: saline placebo (1â...
Equine deep stromal abscesses (51 cases – 2004-2009)–Part 1: the clinical aspects with attention to the duration of the corneal disease, treatment history, clinical appearance, and microbiology results.
Veterinary ophthalmology    October 17, 2013   Volume 17 Suppl 1 6-13 doi: 10.1111/vop.12103
de Linde Henriksen M, Andersen PH, Thomsen PD, Plummer CE, Mangan B, Heegaard S, Toft N, Brooks DE.To study the equine deep stromal abscesses (DSA) with focus on the duration of the corneal disease, medical treatment, season of presentation, clinical appearance, and the degree of corneal vascularization. Methods: Equine DSA diagnosed, biopsied, and surgically treated at the University of Florida Veterinary Medical Center (UFVMC) from 2004 to 2009 were identified. The medical record, clinical photographic images, and microbiology results for each case were evaluated. Frequency and prevalence calculation as well as qualitative data analysis was performed for clinical and microbiological data....
Disposition of firocoxib in equine plasma after an oral loading dose and a multiple dose regimen.
Veterinary journal (London, England : 1997)    September 4, 2013   Volume 198, Issue 2 382-385 doi: 10.1016/j.tvjl.2013.07.035
Cox S, Villarino N, Sommardahl C, Kvaternick V, Zarabadipour C, Siger L, Yarbrough J, Amicucci A, Reed K, Breeding D, Doherty T.The objective of this study was to determine if a single loading dose (LD), 3× the label dose of firocoxib oral paste, followed by nine maintenance doses at the current label dose achieves and maintains near steady state concentrations. Six healthy, adult mares were administered 0.3mg/kg of firocoxib on Day 0, and 0.1 mg/kg 24 h later on Day 1, and at 24 h intervals from Day 2 to Day 9, for a total of 10 doses. Blood samples were collected throughout the study. The mean firocoxib maximum plasma concentration and standard deviation was 199±97 ng/mL, 175±44 ng/mL and 183±50 ng/mL after the L...
Quantification of several acidic drugs in equine serum using LC-MS-MS.
Journal of analytical toxicology    August 27, 2013   Volume 37, Issue 8 600-604 doi: 10.1093/jat/bkt069
Heffron B, Taddei L, Benoit M, Negrusz A.The use of nonsteroidal antiinflammatory drugs in racehorses is allowed under most jurisdictions. Furosemide is administered to treat exercise-induced pulmonary hemorrhage. To help distinguish between therapeutic and illegal uses, racing regulatory bodies have set thresholds in serum for several drugs. The method for the simultaneous detection and quantification of furosemide, flunixin, ketoprofen, phenylbutazone and oxyphenbutazone using 500 µL of serum, and liquid extraction using diethyl ether : hexanes : dichloromethane followed by liquid chromatography tandem mass spectrometry quantitati...
Phase I dose escalation of doxorubicin chemotherapy in tumor-bearing equidae.
Journal of veterinary internal medicine    July 26, 2013   Volume 27, Issue 5 1209-1217 doi: 10.1111/jvim.12145
Théon AP, Pusterla N, Magdesian KG, Wilson WD.There is no information on the use of doxorubicin in horses with tumors. Objective: To determine dose-limiting toxicosis (DLT) and maximum tolerated dose (MTD) of doxorubicin in tumor-bearing horses. Methods: Seventeen horses with 34 localized or multicentric advanced tumors. Methods: Two-stage dose-ranging design involving intrapatient and interpatient dose escalation. Treatment protocol included 6 treatment cycles given at 3-week intervals with dosages ranging from 40 to 85 mg/m(2). Clinical signs, hematologic, and nonhematologic changes were evaluated. Results: Total doses ranged from 1,127...
Efficacy of cyclo-oxygenase inhibition by two commercially available firocoxib products in horses.
Equine veterinary journal    July 16, 2013   Volume 46, Issue 1 72-75 doi: 10.1111/evj.12095
Barton MH, Paske E, Norton N, King D, Giguère S, Budsberg S.Two firocoxib preparations for oral use are approved for use in animals in many countries: a chewable canine tablet and an equine paste. In order to reduce costs, many veterinarians use the canine product in horses even though this is an off-label use of the preparation. Objective: To determine the relative efficacy of 2 commercially available firocoxib products to inhibit prostaglandin E₂ (PGE2) synthesis after oral dosing in horses. Methods: A crossover design using 8 adult horses (n = 4 for each preparation during each treatment period). Body weight range 532-614 kg. Methods: Horses recei...
Pharmacokinetics, pharmacodynamics, metabolism, toxicology and residues of phenylbutazone in humans and horses.
Veterinary journal (London, England : 1997)    May 27, 2013   Volume 196, Issue 3 294-303 doi: 10.1016/j.tvjl.2013.04.019
Lees P, Toutain PL.The presence of horse meat in food products destined for human consumption and labelled as beef has raised several concerns of public interest. This review deals solely with one aspect of these concerns; samples of equine tissue from horses destined for the human food chain have tested positive for the non-steroidal anti-inflammatory drug, phenylbutazone. The safety of some or all such foods for human consumers is a major concern, because it was shown many years ago that phenylbutazone therapy in humans can be associated with life threatening blood dyscrasias. As an initial basis for assessing...
Shutting the stable door after the horse (on phenylbutazone) has bolted.
Veterinary journal (London, England : 1997)    May 23, 2013   Volume 196, Issue 3 273-274 doi: 10.1016/j.tvjl.2013.05.001
Higgins A.No abstract available
Corneal ulcers in horses.
Compendium (Yardley, PA)    March 28, 2013   Volume 35, Issue 1 E4 
Williams LB, Pinard CL.Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems all...
Synovial distribution of “systemically” administered acetylsalicylic acid in the isolated perfused equine distal limb.
BMC veterinary research    March 26, 2013   Volume 9 56 doi: 10.1186/1746-6148-9-56
Friebe M, Schumacher S, Stahl J, Kietzmann M.This study investigated synovial concentrations of acetylsalicylic acid (ASA) and its metabolite salicylic acid (SA) in the equine fetlock joint following systemic administration of ASA. Salicylates were chosen because SA is the only nonsteroidal anti-inflammatory drug for which threshold levels exist for plasma and urine in equine sports. To avoid animal experiments, the study was conducted using an ex vivo model of the isolated perfused equine distal limb in combination with plasma concentrations obtained from literature.Salicylate concentrations in the joint were determined using microdialy...
Acute encephalopathy with concurrent respiratory and metabolic disturbances in first known parenteral human administration of flunixin meglumine and acepromazine maleate.
The Journal of emergency medicine    March 20, 2013   Volume 45, Issue 2 206-209 doi: 10.1016/j.jemermed.2012.11.088
Kamali MF, Wilson AC, Acquisto NM, Spillane L, Schneider SM.Flunexin is a nonsteroidal anti-inflammatory drug approved for veterinary use in horses and cattle. Acepromazine is a phenothiazine derivative used in horses, dogs, and cats. Human exposure to these substances is rare. Methods: We report a case of a human injection of two equine medications, flunixin and acepromazine, which resulted in altered mental status, respiratory alkalosis, gastrointestinal bleeding, and elevation of liver transaminases in a 43-year-old woman who worked as a horse trainer. The patient intentionally self-injected these medications and subsequently presented to the Emerge...
Use of a soluble epoxide hydrolase inhibitor as an adjunctive analgesic in a horse with laminitis.
Veterinary anaesthesia and analgesia    March 7, 2013   Volume 40, Issue 4 440-448 doi: 10.1111/vaa.12030
Guedes AG, Morisseau C, Sole A, Soares JH, Ulu A, Dong H, Hammock BD.A 4-year old, 500 kg Thoroughbred female horse diagnosed with bilateral forelimb laminitis and cellulitis on the left forelimb became severely painful and refractory to non-steroidal anti-inflammatory therapy (flunixin meglumine on days 1, 2, 3 and 4; and phenylbutazone on days 5, 6 and 7) alone or in combination with gabapentin (days 6 and 7). Methods: Pain scores assessed independently by three individuals with a visual analog scale (VAS; 0 = no pain and 10 = worst possible pain) were 8.5 on day 6, and it increased to 9.5 on day 7. Non-invasive blood pressure monitoring revealed severe hyper...
Attitude of Brazilian veterinarians in the recognition and treatment of pain in horses and cattle.
Veterinary anaesthesia and analgesia    March 6, 2013   Volume 40, Issue 4 410-418 doi: 10.1111/vaa.12025
Lorena SE, Luna SP, Lascelles BD, Corrente JE.The objective of this study was to assess the use of analgesics, describe the attitudes of Brazilian veterinarians towards pain relief in horses and cattle and evaluate the differences due to gender, year of graduation and type of practice. Methods: Prospective survey. Methods: Questionnaires were sent to 1000 large animal veterinarians by mail, internet and delivered in person during national meetings. The survey investigated the attitudes of Brazilian veterinarians to the recognition and treatment of pain in large animals and consisted of sections asking about demographic data, use of analge...
Dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 17-20 doi: 10.1111/j.2042-3306.2012.00655.x
Foreman JH, Bergstrom BE, Golden KS, Roark JJ, Coren DS, Foreman CR, Schumacher SA.There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM). Objective: The objective of this experiment was to compare the efficacy of various dosages of FM with a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose-dependent manner when tested in a reversible model of foot lameness. Methods: Ten horses shod with adjustable heart bar shoes had weekly modified AAEP grade 4.0/5.0 lameness induced by tightening a set screw against the heart bar. Heart rate (HR) and lameness score...
Effect of ketoprofen treatment on the uterine inflammatory response after AI of jennies with frozen semen.
Theriogenology    February 28, 2013   Volume 79, Issue 7 1019-1026 doi: 10.1016/j.theriogenology.2013.01.006
Vilés K, Rabanal R, Rodríguez-Prado M, Miró J.Artificial insemination (AI) involving the placing of frozen-thawed semen directly into the jenny uterine body is associated with very low pregnancy rates. This might be because of an exacerbation of the acute response of the endometrium to sperm, as seen in mares with persistent induced mating endometritis. Pregnancy rates can be increased in such mares, however, by including anti-inflammatory treatments in the insemination protocol (Bucca S, Carli A, Buckley T, Dolci G, Fogarty U. The use of dexamethasone administered to mares at breeding time in the modulation of persistent mating induced e...
Pharmacokinetics and safety of oral administration of meloxicam to foals.
Journal of veterinary internal medicine    February 20, 2013   Volume 27, Issue 2 300-307 doi: 10.1111/jvim.12045
Raidal SL, Edwards S, Pippia J, Boston R, Noble GK.The pharmacokinetics, efficacy, and safety of meloxicam have been evaluated in adult horses, but not foals. Physiologic differences between neonates and adults might alter drug pharmacokinetics and therapeutic index. Objective: The pharmacokinetics of meloxicam will be different in foals compared with adult horses, and foals could be at increased risk for adverse drug effects. Methods: Twenty lightbreed foals less than 6 weeks of age at commencement of the study. Methods: Single and repeated oral dose pharmacokinetics were determined for meloxicam (0.6 mg/kg) in 10 foals. The safety of the d...
[Vigilance for veterinary medicinal products: reports of adverse reactions in the year 2011].
Schweizer Archiv fur Tierheilkunde    November 29, 2012   Volume 154, Issue 12 513-519 doi: 10.1024/0036-7281/a000400
Müntener CR, Bruckner L, Kupper J, Althaus F, Caduff-Janosa P.167 adverse reactions of Swissmedic-authorized veterinary medicinal products were reported during the year 2011 (2010: 160). Species and drug classes remain comparable with previous years: most of the reactions occurred following the use of antiparasitic products (39 %), antiinfectives (20 %) or non-steroidal antiinflammatory drugs (11 %) in companion animals (85 dogs and 27 cats) followed by cattle/calves (37). We received 15 cases of adverse reactions following reconverted use, 8 of them in treated cats. Additionally the Swiss Toxicological Information Centre in Zürich processed 84 enquirie...
Systemic or intrasynovial medication as singular or as combination treatment in horses with (peri-)synovial pain.
The Veterinary record    October 23, 2012   Volume 171, Issue 21 527 doi: 10.1136/vr.100811
Brommer H, Schipper P, Barneveld A, van Weeren PR.Records of lame horses (2004-2007) with (peri-)synovial pain of the metacarpophalangeal joint (MCPJ, n = 53), digital flexor tendon sheath (DFTS, n = 20), and distal interphalangeal joint (DIPJ, n = 31) were evaluated (n = 104). Cases were grouped according to the following treatments: (1) systemic administration of NSAIDs (n = 40); (2) intrasynovial administration of glucocorticosteroids (n = 30); (3) combination treatment (n = 34). Outcome was defined as successful when the owner reported that the horse had returned to its previous level of performance within a period of up to six months aft...
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