As a horse owner or caretaker, it’s only a matter of time before your farm’s veterinarian hands you an NSAID prescription. Whether it’s bute for lameness, Banamine for colic, or Equioxx for creaky, arthritic joints, non-steroidal anti-inflammatory drugs (NSAIDs) truly are staples of the horse owner’s medicine box. Fast-acting, easy-to-use, and effective, NSAIDs are often our first line of defense for injured, feverish, and colicky horses.
As all drugs do, these anti-inflammatory and pain medications carry potential risks and side effects. To learn how to use NSAIDs for horses safely and responsibly, we turned to Lidia Bizhenka, DVM. She’s a veterinarian who is currently pursuing further education in veterinary anesthesia and analgesia through the University of Edinburgh’s postgraduate program in Scotland.
Which NSAIDs Do Equine Vets Usually Prescribe?
In equine medicine, the four most commonly used NSAIDs are:
- Phenylbutazone (bute).
- Flunixin meglumine (Banamine, Prevail).
- Firocoxib (Equioxx).
- Diclofenac (Surpass), a topical NSAID.
What Are the Risks of NSAIDs for Horses?
If you have a headache, you can purchase ibuprofen from the local drug store at your leisure. All NSAIDs for horses in the United States, however, require a veterinary prescription. The Food and Drug Administration (FDA) put this law in place to safeguard our domestic animals from inappropriate or excessive use of NSAIDs.
“Gastrointestinal ulcers, colitis (inflammation of the large colon), kidney damage, and blood clotting problems are the main concerns with long-term use of NSAIDs,” cautions Bizhenka. Kidney and liver damage can occur because these organs are responsible for processing, metabolizing, and eliminating drugs. Ulceration of the stomach and colon, along with disrupted blood clotting, are caused by the very mechanism of action of NSAIDs—something called cyclooxygenase inhibition.
Bute and Banamine are “non-selective cyclooxygenase (COX) inhibitor” NSAIDs. There are two types of COX enzymes. COX-1 protects the stomach mucosa and intestinal wall and maintains healthy kidney function and blood clotting. COX-2 is the enzyme of inflammation: It releases prostaglandins that contribute to pain, swelling, and fever. Bute and Banamine block both COX types, making them double-edged swords in equine pain management.
Tips for Safe NSAID Use
As we’ve established, NSAIDs have both positive and negative effects on the horse’s body. You and your veterinarian must determine the risk-benefit ratio for each individual scenario. If you do decide to add that scoop of bute powder to your horse’s next grain meal, here are six helpful tips to keep him as safe and healthy as possible:
- Use a COX-2 selective inhibitor whenever possible, meaning an NSAID that primarily suppresses COX-2 while minimally impacting COX-1. Equioxx (firocoxib) is the equine FDA-approved NSAID that fits the bill. “A recently published study showed that using firocoxib for 14 days straight does not cause any changes in the stomach mucus layer,” says Bizhenka. According to its manufacturer, Equioxx is labeled for use for up to 14 continuous days at a time.
- Use gastroprotectants when your horse is taking NSAIDs for extended periods. “With NSAIDs, we generally see short-term, three- to seven-day treatment courses,” explains Bizhenka. “Sometimes, this can be extended up to 14-21 days with caution.” Administering omeprazole (or another medication that protects the stomach lining from ulceration, as recommended by your vet) can minimize damage to your horse’s gut.
- Ask your veterinarian if applying the topical NSAID diclofenac (Surpass) externally, directly to the site of injury, is appropriate in your horse’s particular case. A good example is a bandage bow or bee sting. A localized application of diclofenac might reduce absorption into the bloodstream. This minimizes the risk of whole-body negative effects compared to oral or injectable bute or Banamine.
- Follow your veterinarian’s instructions for dosage and duration of treatment. Do not give more than one NSAID at a time, even through different routes of administration. For example, don’t combine intravenous (IV) Banamine with oral bute or topical Surpass.
- Keep your horse hydrated throughout the NSAID treatment period to reduce the drug’s impact on the kidneys.
- Closely monitor your horse for signs of gastrointestinal upset (colic, diarrhea, loss of appetite, etc.). Report any changes to your veterinarian.
NSAIDs for horses very much have a role to play in equine pain management. They are effective, fast-acting, relatively easy to administer, and affordable. To keep your horse safe and healthy, treat them like the Advil you take for the occasional headache rather than a long-term solution for a chronic, painful condition.
Watch: How To Give a Horse an Oral Medication
Lucile Vigouroux, MSc, holds a master’s degree in Equine Performance, Health, and Welfare from Nottingham Trent University (UK) and an equine veterinary assistant certification from AAEVT. She is a New-York-based freelance author with a passion for equine health and veterinary care. A Magnawave-certified practitioner, Lucile also runs a small equine PEMF therapy business.
Are you enjoying this content? Sign up for My New Horse’s FREE newsletter to get the latest horse owner info and fun facts delivered straight to your inbox!
