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Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions.
Abstract: 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 Hospital and Bell Equine Veterinary Clinic during 2010 and 2011 in which an SSI lesion was identified at exploratory laparotomy were eligible for inclusion. Horses received either 1.1 mg/kg bwt FM or 0.6 mg/kg bwt meloxicam i.v. q. 12 h. Clinical outcomes and clinical and laboratory parameters associated with endotoxaemia were compared between groups. Results: Sixty cases were enrolled, 32 horses received FM and 28 received meloxicam. There was no difference in signalment, physical examination or surgical factors between groups. The overall survival to discharge was 81%; there was no difference in survival (P = 0.14) or incidence of post operative ileus (P = 0.25) between groups. There was no significant difference between the plasma lipopolysaccharide (LPS) concentrations at 0 h (P = 0.18) or 48 h (P = 0.60); however, there was a significant difference between neutrophil count at 48 h (P<0.05) and at 96 h (P<0.01) with significantly greater cell numbers in horses receiving meloxicam compared with FM. Blinded pain score evaluation showed that more horses receiving meloxicam showed gross signs of pain than those treated with FM (P = 0.04). Conclusions: Nonsteroidal anti-inflammatory drug choice did not affect major clinical outcomes in horses with SSI lesions but had some effects on signs of pain. This study provides no evidence to recommend one NSAID treatment above another based on survival or the incidence of ileus; however, evaluation of a larger number of cases is required.
© 2013 EVJ Ltd.
Publication Date: 2014-02-18 PubMed ID: 24372991DOI: 10.1111/evj.12224Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Multicenter Study
- Randomized Controlled Trial
- Research Support
- Non-U.S. Gov't
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research article investigates the comparative use and effects of two drugs, flunixin meglumine and meloxicam, for the post-operative treatment of horses with small strangulating intestinal lesions. The study aimed to identify if there was a difference in outcome based on the choice of drug.
Methodology and Objectives
- The research was conducted as a randomized prospective study on horses presenting to the Royal Veterinary College Equine Referral Hospital and Bell Equine Veterinary Clinic during 2010 and 2011.
- The horses selected for the study had all identified with strangulating small intestinal (SSI) lesions during exploratory laparotomy.
- The doses administered were either 1.1 mg/kg of flunixin meglumine or 0.6 mg/kg of meloxicam every 12 hours.
- The study’s primary objective was to understand and compare the clinical outcomes of the horses treated with either drug.
- The researchers also compared clinical and laboratory parameters associated with endotoxemia between the two groups.
Results
- A total of sixty cases were enrolled, with 32 horses receiving flunixin meglumine and 28 receiving meloxicam.
- No significant difference was observed in crucial factors like age, physical condition, or surgical factors between the two groups.
- The overall survival rate was 81%, with no statistically significant difference in survival or incidence of post-operative ileus between the groups.
- For plasma lipopolysaccharide (LPS) concentrations at both initial and 48 hours, there was no significant difference.
- However, there was a significant difference in neutrophil counts at both 48 and 96 hours, indicating more significant cell numbers in horses receiving meloxicam compared to those receiving flunixin meglumine.
- Blinded pain score evaluation revealed more horses receiving meloxicam showing visible signs of pain than horses treated with flunixin meglumine.
Conclusions
- The study concluded that the choice of nonsteroidal anti-inflammatory drug (NSAID), either meloxicam or flunixin meglumine, did not majorly impact clinical outcomes in horses with SSI lesions.
- However, some effects on signs of pain were observed, with horses receiving meloxicam showing higher signs of pain.
- The study recommended no preference for one NSAID treatment over the other based on survival or incidence of ileus.
- The researchers also suggested the need for a larger case study for a more definitive understanding and conclusion.
Cite This Article
APA
Naylor RJ, Taylor AH, Knowles EJ, Wilford S, Linnenkohl W, Mair TS, Johns IC.
(2014).
Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions.
Equine Vet J, 46(4), 427-434.
https://doi.org/10.1111/evj.12224 Publication
Researcher Affiliations
- Equine Referral Hospital, Royal Veterinary College, Hatfield, Hertfordshire, UK.
MeSH Terms
- Animals
- Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
- Clonixin / analogs & derivatives
- Clonixin / therapeutic use
- Endotoxins / blood
- Female
- Horse Diseases / drug therapy
- Horse Diseases / etiology
- Horses
- Inflammation / veterinary
- Intestinal Obstruction / surgery
- Intestinal Obstruction / veterinary
- Intestine, Small / pathology
- Intestine, Small / surgery
- Male
- Meloxicam
- Postoperative Complications / drug therapy
- Postoperative Complications / veterinary
- Thiazines / therapeutic use
- Thiazoles / therapeutic use
Citations
This article has been cited 13 times.- Griessel TS, Muñoz Morán JA, Byaruhanga C, Smit Y. A single-centre retrospective study of surgical site infection following equine colic surgery (2013‒2021). Vet Rec 2025 May 17;196(10):e5227.
- Mushtaq S, Das YK, Aksoy A. Comparison of the Inhibitory Effects of Flunixin Meglumine and Meloxicam on the Smooth Muscles Motility of the Gastrointestinal Tract of Cattle. Vet Med Sci 2025 Jan;11(1):e70190.
- Citarella G, Heitzmann V, Ranninger E, Bettschart-Wolfensberger R. Analgesic Efficacy of Non-Steroidal Anti-Inflammatory Drug Therapy in Horses with Abdominal Pain: A Systematic Review. Animals (Basel) 2023 Nov 8;13(22).
- Mercer MA, Davis JL, McKenzie HC. The Clinical Pharmacology and Therapeutic Evaluation of Non-Steroidal Anti-Inflammatory Drugs in Adult Horses. Animals (Basel) 2023 May 10;13(10).
- Gandini M, Cerullo A, Franci P, Giusto G. Changes in Perioperative Antimicrobial and Anti-Inflammatory Drugs Regimens for Colic Surgery in Horses: A Single Center Report. Vet Sci 2022 Oct 4;9(10).
- Lemonnier LC, Thorin C, Meurice A, Dubus A, Touzot-Jourde G, Couroucé A, Leroux AA. Comparison of Flunixin Meglumine, Meloxicam and Ketoprofen on Mild Visceral Post-Operative Pain in Horses. Animals (Basel) 2022 Feb 21;12(4).
- Hellstrom EA, Ziegler AL, Blikslager AT. Postoperative Ileus: Comparative Pathophysiology and Future Therapies. Front Vet Sci 2021;8:714800.
- Ziegler AL, Blikslager AT. Sparing the gut: COX-2 inhibitors herald a new era for treatment of horses with surgical colic. Equine Vet Educ 2020 Nov;32(11):611-616.
- Mendoza Garcia FJ, Gonzalez-De Cara C, Aguilera-Aguilera R, Buzon-Cuevas A, Perez-Ecija A. Meloxicam ameliorates the systemic inflammatory response syndrome associated with experimentally induced endotoxemia in adult donkeys. J Vet Intern Med 2020 Jul;34(4):1631-1641.
- Ziegler AL, Freeman CK, Fogle CA, Burke MJ, Davis JL, Cook VL, Southwood LL, Blikslager AT. Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction. Equine Vet J 2019 May;51(3):329-335.
- Gitari A, Nguhiu J, Varma V, Mogoa E. Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya. Vet World 2017 Oct;10(10):1255-1263.
- Ziegler A, Fogle C, Blikslager A. Update on the use of cyclooxygenase-2-selective nonsteroidal anti-inflammatory drugs in horses. J Am Vet Med Assoc 2017 Jun 1;250(11):1271-1274.
- Banse H, Cribb AE. Comparative efficacy of oral meloxicam and phenylbutazone in 2 experimental pain models in the horse. Can Vet J 2017 Feb;58(2):157-167.
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