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Home / Equine Research Bank / Equine Vet Educ / Sparing the gut: COX-2 inhibitors herald a new era for treat...
Equine veterinary education2019; 32(11); 611-616; doi: 10.1111/eve.13189

Sparing the gut: COX-2 inhibitors herald a new era for treatment of horses with surgical colic.

Abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage a wide variety of conditions in horses, including management of colic. Flunixin meglumine is by far the most commonly used drug in the control of colic pain and inflammation and has become a go-to for not only veterinarians but also horse-owners and nonmedical equine professionals. NSAID use, however, has always been controversial in critical cases due to a high risk of adverse effects associated with their potent cyclo-oxygenase (COX) inhibition. There are two important COX isoenzymes: COX-1 is generally beneficial for normal renal and gastrointestinal functions and COX-2 is associated with the pain and inflammation of disease. Newer selective NSAIDs can target COX-2-driven pathology while sparing important COX-1-driven physiology, which is of critical importance in horses with severe gastrointestinal disease. Emerging research suggests that firocoxib, a COX-2-selective NSAID labelled for use in horses, may be preferable for use in colic cases in spite of the decades-long dogma that flunixin saves lives.
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Publication Date: 2019-10-04 PubMed ID: 34305336PubMed Central: PMC8297937DOI: 10.1111/eve.13189Google Scholar: Lookup
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  • Journal Article

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.

The research article explores the safer use of selective NSAIDs, specifically firocoxib, compared to flunixin meglumine, in treating horses with colic. The paper emphasizes the significant decrease in adverse side-effects due to the selective targeting of COX-2, a cyclo-oxygenase enzyme related to pain and inflammation, without disturbing the COX-1 enzyme, which is crucial for renal and gastrointestinal functions.

Overview of NSAIDs in Managing Horse Conditions

  • The paper begins by highlighting the common use of Nonsteroidal anti-inflammatory drugs (NSAIDs) in managing a variety of conditions in horses, most notably colic. The most widely used NSAID for this purpose is flunixin meglumine due to its effective control of colic pain and inflammation.
  • Despite the effectiveness of flunixin meglumine and NSAIDs in general, their use has always been controversial, especially in significant cases, due to a high risk of adverse effects arising from their strong inhibition of cyclo-oxygenase (COX).

Deciphering the Role of COX Isoenzymes

  • The study explains that there are two crucial COX isoenzymes: COX-1 and COX-2. COX-1 is generally beneficial as it facilitates normal renal and gastrointestinal functions, while COX-2 is associated with pain and inflammation of disease.
  • The inhibition of COX-1 by NSAIDs can compromise the renal and gastrointestinal functions, which, in turn, can trigger adverse effects in the treated horses.

Selective NSAIDs: A New Therapeutic Approach

  • Newly developed NSAIDs can selectively target COX-2-driven symptoms of disease, without interfering with COX-1, thereby maintaining its beneficial functions.
  • This article emphasizes the therapeutic potential of firocoxib, a COX-2-selective NSAID, arguing that it may be preferable for use in colic cases over flunixin meglumine, contradicting the long-standing belief that flunixin is the best treatment.
  • The targeted approach of firocoxib minimizes the risk of adverse effects linked with COX inhibition, making it a promising choice for treating horses with severe gastrointestinal disease.

Cite This Article

APA
Ziegler AL, Blikslager AT. (2019). Sparing the gut: COX-2 inhibitors herald a new era for treatment of horses with surgical colic. Equine Vet Educ, 32(11), 611-616. https://doi.org/10.1111/eve.13189

Publication

Equine veterinary education
ISSN: 0957-7734
NlmUniqueID: 9885274
Country: England
Language: English
Volume: 32
Issue: 11
Pages: 611-616

Researcher Affiliations

Ziegler, A L
  • Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
  • Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA.
Blikslager, A T
  • Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA.

Grant Funding

  • K01 OD028207 / NIH HHS
  • L40 OD028437 / NIH HHS
  • P30 DK034987 / NIDDK NIH HHS
  • T32 DK007737 / NIDDK NIH HHS

Conflict of Interest Statement

Authors’ declaration of interests No conflicts of interest have been declared.

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