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The researchers found that in their study, approximately 40% of the horses receiving NSAID treatment began to develop bowel wall thickening on the third day of treatment.

Published by Christa Lesté-Lasserre, Massachusetts | September 21, 2021 | Colitis, gastrointestinal problems, diseases and conditions, horse care, medicine, veterinarians and professionals

Non-steroidal anti-inflammatory drugs (NSAIDs)—even flunixin meglumine and meloxicam—can cause indigestion in horses, sometimes within 48 hours of administration. A group of European researchers stated that although this effect is usually mild, caregivers should monitor horses that have been treated and assess whether the benefits of pain relief outweigh the potential digestive discomfort.

"NSAIDs are very important drugs because controlling pain and inflammation is essential in veterinary medicine, but like any drug, they are not without risks," said DVM PhD Gaby van Galen. ECEIM and ECVECC of the Large Animal Teaching Hospital, Department of Large Animal Science, University of Copenhagen, Denmark.

"Every time you treat a patient with medication, you need to ask yourself whether the benefits of this treatment outweigh the possible problems, including non-steroidal anti-inflammatory drugs," Van Gaalen said. "Many times, the answer is yes, because horses need that kind of relief. But strict monitoring should be carried out to ensure that any side effects are detected as quickly as possible. When side effects occur, this may change the balance between strengths and weaknesses and may lead to Adjust the horse's treatment plan."

Phenylbutazone (Bute) is a non-steroidal anti-inflammatory drug that is known to cause colitis-inflammation of the colon in the right back. Van Galen said that veterinarians understand that horses seem to be better able to tolerate flunixin meglumine (Banamine) and meloxicam. She noticed that perhaps because of this, the horses in the hospital did not receive much gastrointestinal monitoring while receiving these medications. Therefore, she conducted a study to determine the extent to which non-steroidal anti-inflammatory drugs affect the digestive tract of horses.

In this study, van Galen and her colleagues monitored 22 horses in university hospitals, including those who were hospitalized for reasons other than gastrointestinal problems and received or did not receive non-steroidal anti-inflammatory drugs (for at least four days) Horses, and healthy control horses. Eight horses receiving NSAIDs received intravenous flunixin meglumine; four received intravenous injections followed by oral flunixin meglumine; four received intravenous flunixin meglumine, Meloxicam was followed by oral administration; one received oral meloxicam followed by intravenous flunixin meglumine.

Scientists conduct daily physical examinations on animals — especially for signs of colic, depression, decreased appetite, and loose stools — ultrasound, fecal occult blood test, and blood chemistry.

Van Galen said that they found that about 40% of horses receiving NSAID treatment developed thickening of the intestinal wall, especially in the right dorsal colon, which started as early as the third day of treatment.

"We can see clinically and statistically significant thickening of the right dorsal wall on the ultrasound examination," she said. "Edema (liquid swelling) accumulates, so there is actually water on the wall."

Some horses under treatment also showed relatively uncomfortable signs of loss of appetite and depression, and had thin stools, which is unlikely to be related to their main illness. Blood tests and fecal occult blood tests also confirmed that some horses had mild colitis.

However, untreated horses basically did not show these signs, she said.

Van Galen said that because colitis is mild and reversible-meaning that the colon wall becomes thinner within a few days after stopping taking the NSAID-these findings do not necessarily mean that practitioners need to stop treatment immediately. Rather, it shows that they need to monitor these horses closely to ensure that they get more benefits than disadvantages from the NSAID.

She said that hospitalized horses should receive regular ultrasound monitoring while taking non-steroidal anti-inflammatory drugs. Horses treated at home can benefit from other types of monitoring, such as checking stool consistency and loss of appetite. The stool occult blood test can detect blood in the stool, which indicates early colitis. She added that regular monitoring from day 1 is particularly useful because it allows people to see how the horse’s condition has changed from a normal base level.

In general, van Galen said she wants practitioners and owners to remember that flunixin meglumine and meloxicam are not without risks and should still be used with caution.

"When developing a plan to use non-steroidal anti-inflammatory drugs, ideally, people should develop a strategy that uses as few drugs as possible in the shortest time possible," she said.

The study titled "Colon Health of Hospitalized Horses Treated with Non-Steroidal Anti-inflammatory Drugs: A Preliminary Study" was published in the June 2021 issue of the Journal of Equine Veterinary Medicine.

Christa Lesté-Lasserre has been passionate about horses and science since she rode her first Shetland pony in Texas, and she has written scientific research that helps to better understand all equine animals. After completing her undergraduate studies in science, journalism and literature, she received a master's degree in creative writing. She lives in France and aims to showcase the most fascinating aspect of equine science: the stories it creates. Follow Lesté-Lasserre on Twitter @christalestelas.

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