Are NSAID Painkiller Medications Helpful or Harmful to Horses?

Horses can develop many injuries in life that leave them in high levels of pain and discomfort. As a horse owner, this can be extremely difficult to see, and you will naturally want to do anything that you can to help alleviate their symptoms. This is where NSAIDS come in for many owners.

NSAIDs stand for non-steroidal anti-inflammatory drugs and are often used to help manage a horse's pain levels and inflammation due to a number of different health conditions. However, due to the strength of some of these medications, they can do some damage if taken long term. There are a number of NSAIDs that are commonly used to treat medical conditions in horses including, Ph*nylbutazone (Bute), fl*nixin meglumine (B*namine), K*toprofen (Ketofen), and fir*coxib (Eq*ioxx).


Note: due to Google policies many of these terms are ‘banned’ on unauthorised medical websites and as such, to allow us to discuss the specific medication we have replaced a letter within the medication with a star!

The drugs work by blocking the enzyme known as cyclooxygenase, commonly referred to as COX, which is produced by the body in response to inflammation, effectively giving pain relief. But are NSAIDS the best solution for your horse? Are the rumours true that they can cause more harm than good? We've done the research, so you don't have to – let's jump into it.

Which NSAIDs Are Usually Given to Horses?

There are four main NSAIDS that are commonly given to horses, each being used to treat a number of different conditions. Let's take a closer look.

Ph*nylbutazone

Commonly known as Bute, this non-selective COX inhibitor is used to best treat several acute musculoskeletal pain such as bone bruising, laminitis and tears in the soft tissue. The drug does have some severe side effects, such as jugular vein thrombus and kidney damage, as well as right dorsal colitis and gastric ulcers.

Fl*nixin Meglumine

A non-selective COX inhibitor, often known as B*namine. This treats smooth muscle pain such as colic and pneumonia, as well as endotoxemia. This needs to be administered carefully, however, as if injected intramuscularly, it can cause clostridial myositis. Other side effects are similar to Ph*nylbutazone and include gastric ulcers, right dorsal colitis and kidney damage.

K*toprofen

This non-selective COX inhibitor is also known as Ketofen, treats many of the same conditions as B*namine but is often used as an alternative as it comes with fewer side effects -mainly gastric ulcers and kidney damage. Many horses develop a sensitivity to B*namine or Bute, and so this is a great alternative.

Fir*coxib

Also commonly known as Eq*ioxx, this COX-2 selective inhibitor is often used to treat chronic bone injuries, osteoarthritis, chronic laminitis and small intestine colic. It has minimal side effects, however, in some occasional cases, it can lead to right dorsal colitis.

What Are The Side Effects of NSAIDs?

Now that you know a little bit about the different types of NSAIDs, let's look at their side effects. While NSAIDs are great at helping to manage inflammation and painful conditions in horses, such as orthopaedic joint pain or colic, they can be used too often or not used properly. It is important to listen to advice from vets as they understand these side effects and can ensure that you use them carefully. Experts warn of using NSAIDs often, almost like supplements, as over time, they can have an impact on the body. Therefore, if you are considering medicating your horses, consult veterinary experts to ensure you are using them correctly. Let's take a closer look at some of the issues that occur when using NSAIDs.

NSAIDs Can Be Wrongly Administered

NSAIDs given to horses are usually given via an injection, which can lead to pain for the horse and potential disfigurement if administered wrongly. For example, one common NSAID used in animals is Ph*nylbutazone. When injected, it is meant to be administered into the vein through intravenous methods. If, however, the drug touches tissue or skin outside of the vein, it can cause it to slough, leading to a blood clot that can stop blood from travelling from the brain to the heart via the jugular vein. Therefore, blood can build up in these veins, causing the veins in the neck to bulge significantly.

NSAIDs Can Lead To Ulceration

As well as being injected, NSAIDS can be given to horses via ground-up tablets or as a paste which can be used topically. In these forms, the medication can lead to ulcers in the horse's mouth or lips. Additionally, they can also cause ulcers within the stomach, which is more serious and difficult to treat.

Gastric ulcers are common in horses on courses of NSAIDs. This is because of the make up of a horse's stomach. The stomach is made up of two parts – the glandular part and the squamous mucosa part. These parts are split by the margo plicatus, which is a line of tissues. The glandular part of the stomach produces gastric acid, however frequent use of NSAIDs can lead to lower pH levels within in stomach and a reduction in the production of mucous – both of which can lead to ulcers in the stomach. You may first identify these ulcers as your horse will stop eating due to the discomfort they are in. In an effort to combat this, if your horse needs to be on this medication for a period of time, it may also be taking gastro protectants.

NSAIDs Can Lead To Right Dorsal Colitis

As previously mentioned above, the use of NSAIDs over time can lead to ulcers in both the mouth and the stomach, but it can also lead to ulcers within the large intestine, particularly within the upper right dorsal part of the colon. The drug most linked to this is Ph*nylbutazone, but other NSAIDs can also cause this.

The best way to try and avoid this ulceration is to try and use as low a dose of the non-steroidal medication as possible over a short period of time, as this will minimise its impact on the colon. Additionally, using a medication that is a COX-2 inhibitor will help reduce the likelihood of this condition.

Any ulcers within the colon can lead to a loss of protein in the horse's body which can have serious repercussions. Therefore, vets should be monitoring blood work for blood protein levels to detect any ulcers early. Another clue that your horse may have developed ulcers in the colon is through loose and soft stool. Early identification is vital, as the survival rate for those with this condition is less than 50%. If the issue is identified rapidly, vets may be able to intervene, administering misoprostol which can help return prostaglandin levels to normal, getting rid of the ulcers.

NSAIDs Can Damage The Kidneys

Many horses who are not feeling themselves struggle to eat their food or drink enough water, meaning that they may be dehydrated. Horses that have not drunk enough water may develop kidney damage if taking NSAIDs before rectifying the hydration issues. As NSAIDs reduce the levels of prostaglandin, which help regulate blood flow in the body, including to the kidneys. When this blood flow is impacted, oxygen is not properly delivered to the kidneys leading to issues such as renal papillary necrosis or death of the kidney tissue. If the kidney tissue is damaged, the kidneys will not be able to work properly, leading to even more complications.

One way to spot potential kidney issues within horses is if they are urinating far more often than normal. If you do notice this, then contact your vet immediately for tests. Before administering any NSAIDs, get your vet to test the horse's hydration levels to try and rule this issue out entirely. If the hydration levels are low, rectify this before using the medication.

When Is It Appropriate To Use NSAIDs?

Having looked at the uses of NSAIDs and the possible side effects, when is it safe to use them on your horse? Experts suggest that the drugs are a good choice to tackle a number of different musculoskeletal conditions and can actually save horses lives. It is, however, important to have them administered by a professional who is aware of the risks and how to best avoid them.

If your horse is suffering from issues with its internal organs, such as pneumonia or colic, it is best for the vet to prescribe fl*nixin meglumine. This NSAID is also an excellent anti-endotoxemic, meaning that it helps stop bacterial sepsis within the bloodstream. This can occur with a number of conditions like colic.

Ph*nylbutazone is a better alternative if you are looking to treat pain in the muscles or joints due to the fact it is a stronger option. If your horse has injuries such as tears in the connective tissue, laminitis or bruising of the bones, your vet will probably suggest this option.

If the joint pain is even more severe or is likely to last a long time, your horse will most likely be prescribed Eq*ioxx. This drug is great at treating conditions such as laminitis that is chronic, osteoarthritis or severe injuries to the bone. This is because Eq*ioxx, while not being as strong as other options, is less likely to lead to serious side effects if consumed consistently over a longer period.

Whatever the type of NSAID that your vet chooses, it is important to ask why they have selected that particular type in order to ensure that it is the right decision, taking on board the potential side effects. Be aware of the complications in order to help identify them quickly if they do occur, making sure that your horse gets medical treatment sooner if needs be.

It may also be a good idea to let the vet test your horse's blood before administering NSAIDs and throughout the course of the treatment. This is because quite often, any adverse side effects can be identified by blood work early on, leading to early intervention.

When Is It A Bad Idea To Use NSAIDs?

There are some instances where using NSAIDS would be detrimental. Firstly, if there is a chance of other complications, rather than just the symptom that you are trying to treat, then you should consult a vet before administering any medication. Additionally, if your horse is hydrated, it is important to rehydrate it before using NSAIDs. This is because using NSAIDS can lead to increased chances of toxicity in animals that are not eating correctly and are dehydrated. Additionally, horses that already have issues such as pre-existing gastrointestinal disease can easily react to NSAIDs.

Therefore, many experts recommend that before starting any treatment with NSAIDs, you should complete basic blood work on the horse to monitor any levels that may be off. Suppose you do begin a course of NSAIDs for your horse and notice any complications. In that case, it is important to contact your vet quickly, who may recommend stopping the course of treatment and administering a different type of drug.

Our Final Take on NSAIDS

There are many benefits to non-steroidal anti-inflammatory drugs as they help horses in pain and reduce inflammation. They are important in the treatment of many conditions and are used regularly by vets and horse owners to help treat them. Like most drugs, however, NSAIDs can react differently depending on the horse and can be used improperly, leading to complications. Therefore, it is important to be aware of these side effects and how to identify them in order to keep your horse safe. Always follow the advice of trained veterinarians to ensure that they are used effectively, and most importantly, use them for as short a term as possible.

Although biased, we would highly recommend investigating the use of Advanced Magnetic products to work alongside prescribed anti-inflammatory medications and treatments. 

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