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Equine Health Resource

NSAIDs, Non-Steroidal Anti-Inflammatories, Generally



Non-steroidal anti-inflammatory drugs, (NSAIDs) are used extensively in equine veterinary practice. As a class of drugs, their therapeutic value improves quality of life and healing for thousands of horses every year.

The NSAIDS most commonly used in equine veterinary practice, in order of frequency of use are: phenylbutazone, flunixin meglumine (Banamine), firocoxib, salicylic acid (aspirin), ketoprofen, and meclofenamic acid.

Generally, drugs in this class block the inflammatory cascade by blocking enzymes that are required for the formation of certain prostaglandins. In doing this, they reduce pain, fever and swelling. In lameness cases, the lameness improves. But there are costs to this. Some prostaglandins have “housekeeping” protective roles in the body (particularly in the kidney and intestinal tract). Many NSAIDS eliminate these “good prostaglandins” as well as the “bad prostaglandins of inflammation”, exposing these organs to injury.

Understand the effectiveness and potential dangers of NSAID’s in horses, and consult with your vet regarding their role in your horse’s health. Ask your vet how to evaluate the condition that you are treating, so that you know how much this treatment is helping.

Your vet’s role is to select the right NSAID for the situation, and to follow up with you to ensure that the medication is having the desired effect, without obvious side-effects.

This Treatment Might be used for a horse exhibiting these signsRelated Observations

Related DiagnosesThis Treatment Might Be Used for these Diagnoses

Laminitis, Acute
Laminitis, Chronic
Pneumonia, Pleuropneumonia & Pleuritis, Generally
Bone Spavin, Distal Hock Arthrosis
Osteoarthritis, OA, Generally
Trauma as Cause, Generally
Laminitis, Support-Limb
Endotoxemia, Endotoxic Shock
Duodenitis-Proximal Jejunitis, DPJ
Equine Recurrent Uveitis, ERU
Pigeon Fever
Salmonella Colitis (in Growing Foal or Adult)
Proximal Suspensory Ligament Injury, Front Limb
Vaccination Reaction
Fracture of Carpal Bone Chip & Slab
Carbohydrate or Grain Overload
Eastern, Western & Venezuelan Equine Encephalomyelitis
West Nile Virus, WNV
Equine Herpes Myeloencephalitis, EHM
Hoof Pain After Trimming or Shoes Pulled
Aging Changes, Generally
Intra-Muscular Injection Site Reaction
Coffin Joint Arthritis, Low Ringbone
Fracture of Withers
Jugular Vein Thrombosis
Abscess on Sheath
Flexor Tendon Injury, Tendinitis, Bowed Tendon
Navicular Syndrome
Poisonous Snake Bite, Rattlesnake or Pit Viper
Corneal Ulcer, Scratch or Abrasion
Sole, Foot, Corn or Heel Bruise
Cholangiohepatitis, Cholelithiasis
Sole, Foot or Hoof Abscess
Degenerative Suspensory Ligament Disease, DSLD
Capped Hock
Tying-Up, Recurrent Exertional Rhabdomyolysis
Shoe Boil, Olecranon Bursitis
Clostridial Muscle & Fascia Infection (Myonecrosis)
Brucellosis, Poll Evil, Fistulous Withers
Coronavirus Entero-Colitis
Navicular Bursa Penetrated by Foreign Body
Splints, Splint Exostosis
Suspensory Ligament Body Injury
Proximal Suspensory Ligament Injury, Hind Limb
Coffin Joint Collateral Ligament Injury
Sacro-Iliac Strain & Pain
Liver Disease, Acute Hepatitis
Lameness, Undiagnosed
Equine Influenza, EI
Rope Burn, Uncomplicated Pastern Abrasion
Vulvar Area Trauma
Nail or Other Foreign Body Punctures Foot, Sole or Frog
Suspensory Ligament Branch Injury
Older Horse Ataxia & Weakness
Fracture of Skull, Not Involving Sinus
Retained Placenta
Back Pain, Generally
Inferior Check Ligament Strains or Tears
Pastern Arthritis, High Ringbone
Liver Abscess
Conjunctivitis, Generally
Eyelid Trauma
Insect Stings, Centipede, or Spider Bites
Meningo-Encephalitis, Meningitis
Arytenoid Chondritis & Epiglottiditis
Bucked Shins
Fracture of Neck Vertebrae
Colic, Sand Accumulation or Impaction
Equine Anaplasmosis
Fracture of Coffin Bone, Generally
Overriding Dorsal Spinous Processes
Internal Ear Infections
Purpura Hemorrhagica, PH
Blister Beetle Toxicity
Burn, Chemical, Toxin, Caustic Substances Ingested & Irritating Mouth, Lips, Tongue
Equine Herpesvirus 1 & 4, Rhinopneumonitis
Metritis, After Foaling
Vasculitis, Photoactive
Vasculitis, Generally
Wound or Laceration to Cornea
Acute Respiratory Distress Syndrome, ARDS
Fracture of Splint Bone
Lymphedema, Chronic Progressive
Fracture of Extensor Process P3
Curb, Strain of Tarsal Plantar Ligament
Wound involving Abdominal or Thoracic Cavity
Wound or Laceration to Head
Bucked Shins
Wound or Laceration to Armpit or Groin Area
Puncture Wound of Head, Jaw & Upper Neck
Sleep Deprivation
Collateral Ligament Injury or Rupture, Generally
Smoke Inhalation, Pneumonitis
Subchondral Bone Cyst, Generally
Nerve Paralysis, Traumatic
Viral Upper Respiratory Tract Infections, Generally
Vesicular Stomatitis, VS
Muscle Strain of Back
Foal or Newborn, Fractured or Broken Ribs
Recto-Vaginal Tear or Fistula
Peroneus Tertius Rupture
Aorto-Iliac Thrombosis
Calcific Band Keratopathy
Hypoxemic-Ischemic Encephalopathy
Seasonal Pasture Myopathy
Fibrotic Myopathy
Dislocated Hip, Coxo-Femoral Luxation
Upward Fixation of Patella, Locking Stifle or Patella
Intermittent Upward Fixation of Patella
Bone Bruise
Quittor, Infected Collateral Cartilage
Fracture of Sacrum
Fracture of Accessory Carpal Bone
Fracture of Tail
Small Strongyle Infestation
Temporohyoid Osteoarthropathy
Exhausted Horse Syndrome, EHS
Carpal Tunnel Syndrome, Carpal Canal Tenosynovitis
Fracture of Femur & 3rd Trochanter Fracture
Wound or Laceration to Mouth, Lips & Muzzle
Infection of Extensor Tendon Sheath
Extensor Tenosynovitis, Non-Infectious
Fractured or Broken Ribs (in Adult)
Fluoroquinolone Induced Tendinopathy
Fracture of Navicular Bone
Trochanteric Bursitis, Whorlbone
Choke, Esophageal Feed or Foreign Body Obstruction
Equine Rhinitis A & B Viruses
Carpal Hygroma, Synovial Hernia, Ganglion
Biceps Brachii Tendinitis, Bicipital Bursitis
Windpuffs or Windgalls
Pancreatic Diseases, Generally
Infarcted Intestine or Colon
Headshaking Syndromes, Generally
Front Tooth or Incisor, Fractured or Broken
Equine Herpesvirus 1, Abortion
External Ear Infections
Facial Nerve Paralysis

Consider Potential Side Effects & Complications

Sadly, these drugs are misused throughout the equine competitive world.

Misuse or overuse of NSAIDs can cause intestinal ulcers or kidney damage. These effects can be life-threatening.

When you choose to administer these drugs to your horse, understand that you are masking the body's natural pain response. When you do that and then ask your horse to perform, they may overload a structure that is already damaged, risking severe injury. Even when you are treating your horse with NSAID's under the guidance of a veterinarian, do not forget this serious risk.

Ask yourself this question: If one of your car tires had 5 broken lug bolts and only one left holding the tire on, would you be willing to patch it together with duct tape and drive 180 miles per hour?

Generally, multiple NSAID's are not used simultaneously, because the danger of side effects often outweighs any additional benefits.

Consider Reasons Not To Use This Treatment

Used very cautiously in foals, in horses with kidney or intestinal disease, or in horses that are dehydrated. Some NSAIDS are safer than others in these patients.

It is illegal in many competitive disciplines for there to be detectable levels of NSAID's in blood samples.

Is It working? Timeframe for effect

Minutes to hours. The onset and length of effect depends on the particular NSAID and on route of administration, oral, IM, IV.

Questions To Ask My Vet

  • What level of performance is in the best interests of my horse's long-term health?
  • Which of the NSAIDS is the most appropriate for my horse?
  • What are the precautions for use of that particular NSAID?
  • How can I judge the effectiveness of this treatment?

Helpful terms & topics in HSVGWritten, Reviewed or Shared by Experts in Equine Health

Author: Doug Thal DVM Dipl. ABVP


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