The use of nonsteroidal anti-inflammatory drugs in critically ill horses.

Abstract: To review the physiology of the cyclooxygenase (COX) enzymes with reference to the beneficial effects of nonsteroidal anti-inflammatory drugs (NSAIDs) related to their analgesic and antiendotoxic properties as well as the mechanisms responsible for adverse gastrointestinal, renal, and coagulation effects. Methods: Human and veterinary peer reviewed literature Results: NSAIDs are frequently administered to critically ill horses for their analgesic and anti-inflammatory effects. However, NSAIDs have significant side effects principally on the gastrointestinal mucosa and kidneys. These side effects may be exacerbated in critically ill horses if they have gastrointestinal damage or are volume depleted Conclusions: This review provides important information for equine veterinarians and criticalists on the advantages and disadvantages of using traditional NSAIDs and newer equine COX-2 selective NSAIDs for the management of different conditions in critically ill horses.
Publication Date: 2014-12-17 PubMed ID: 25521286DOI: 10.1111/vec.12271Google Scholar: Lookup
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This research article provides a comprehensive review of the benefits and potential drawbacks of using nonsteroidal anti-inflammatory drugs (NSAIDs) for critically ill horses. It focuses particularly on how these drugs interact with cyclooxygenase (COX) enzymes, and their effects on pain relief, inflammation, and potentially negative impacts on the gastrointestinal tract and kidneys.

Background and Purpose

  • This research aims to bring to light the complex physiological interactions of NSAIDs, specifically as they relate to critically ill horses.
  • By presenting a clear and detailed overview of the advantages and drawbacks of NSAIDs, the authors intend to help veterinary practitioners make more informed decisions when it comes to managing conditions in ill horses.


  • The authors of the research article examined and reviewed a wide array of peer-reviewed human and veterinary literature pertaining to NSAIDs and their effects.

Use of NSAIDs in Ill Horses

  • NSAIDs are frequently employed in the treatment of critically ill horses due to their potent pain-relief and anti-inflammatory properties.
  • The analgesic benefits of NSAIDs come from their ability to inhibit COX enzymes, which play a significant role in the inflammatory response within the body.
  • These drugs also possess antiendotoxic properties, making them effective in combating endotoxins released by dying bacteria that can cause inflammation and other health issues.

Potential Side effects of NSAIDs

  • While NSAIDs have notable benefits, their use can also lead to significant side effects centered primarily on the gastrointestinal mucosa and the kidneys.
  • In the gastrointestinal tract, NSAIDs can lead to ulcers and other disorders due to their hindrance of COX enzymes, which are important for gut health and integrity.
  • NSAIDs can also harm the kidneys since they rely on prostaglandins (which are reduced by NSAIDs) to regulate blood flow, especially in conditions of shock or dehydration.
  • The research brings attention to the fact that such side effects may be amplified in critically ill horses already suffering from gastrointestinal damage or volume depletion.


  • The paper concludes by underlining the importance of discerning use of NSAIDs in therapy for critically ill horses.
  • It emphasizes that veterinarians and critical care specialists need to understand the potential benefits and risks in order to manage conditions in such animals effectively.
  • The authors suggest that newer COX-2 selective NSAIDs may offer a safer alternative as these may limit the negative impact on the gut and kidneys while still providing analgesic benefits.

Cite This Article

Cook VL, Blikslager AT. (2014). The use of nonsteroidal anti-inflammatory drugs in critically ill horses. J Vet Emerg Crit Care (San Antonio), 25(1), 76-88.


ISSN: 1476-4431
NlmUniqueID: 101152804
Country: United States
Language: English
Volume: 25
Issue: 1
Pages: 76-88

Researcher Affiliations

Cook, Vanessa L
  • From the Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI (Cook); and.
Blikslager, Anthony T

    MeSH Terms

    • Animals
    • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
    • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
    • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
    • Critical Care
    • Critical Illness
    • Cyclooxygenase 2 / administration & dosage
    • Cyclooxygenase 2 / adverse effects
    • Cyclooxygenase 2 / therapeutic use
    • Gastrointestinal Tract / drug effects
    • Horse Diseases / drug therapy
    • Horses
    • Humans
    • Kidney / drug effects
    • Pain / drug therapy
    • Pain / veterinary
    • Veterinary Medicine


    This article has been cited 11 times.
    1. 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).
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    5. Jacobs CC, Schnabel LV, McIlwraith CW, Blikslager AT. Non-steroidal anti-inflammatory drugs in equine orthopaedics.. Equine Vet J 2022 Jan 25;54(4):636-48.
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    6. 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.
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    7. Canisso IF, Segabinazzi LGTM, Fedorka CE. Persistent Breeding-Induced Endometritis in Mares - a Multifaceted Challenge: From Clinical Aspects to Immunopathogenesis and Pathobiology.. Int J Mol Sci 2020 Feb 20;21(4).
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    8. Mendoza FJ, Serrano-Rodriguez JM, Perez-Ecija A. Pharmacokinetics of meloxicam after oral administration of a granule formulation to healthy horses.. J Vet Intern Med 2019 Mar;33(2):961-967.
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    9. Martin EM, Schirmer JM, Jones SL, Davis JL. Pharmacokinetics and ex vivo anti-inflammatory effects of oral misoprostol in horses.. Equine Vet J 2019 May;51(3):415-421.
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    10. Martin EM, Jones SL. Inhibition of microsomal prostaglandin E-synthase-1 (mPGES-1) selectively suppresses PGE(2) in an in vitro equine inflammation model.. Vet Immunol Immunopathol 2017 Oct;192:33-40.
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    11. 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.
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