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NSAIDs, Non-Steroidal Anti-Inflammatories, Generally

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