The acronym NSAIDs, stands for non-steroidal anti-inflammatory drugs. It includes; Bute, Banamine, Equioxx, Asprin, and DMSO, to name a few, and are arguably the most commonly used drugs in equine medicine.
In ancient times, willow bark was used to relieve pain (analgesic) and reduce fevers (antipyretic), and willow bark is still used today in some holistic remedies. In the 1820s, the active ingredient was discovered to be salicylic (sal-i-sillic) acid. A specific form of salicylic acid is marketed today and is known as aspirin.
HOW NSAIDs WORK
NSAIDs reduce pain by reducing inflammation. They are our most valuable way of managing pain associated with injuries, including chronic issues such as arthritis.
NSAIDs work by reducing the production of prostaglandins, a hormone that perpetuates inflammation and signals pain. It is important to note that there are many forms of prostaglandins in the body, and some are vitally important in protecting organs such as the stomach and kidneys. Some even play a role in reproductive systems. There is a danger of blocking the good prostaglandins when using NSAIDs, resulting in gastric ulcers and kidney disease. One class of NSAIDs selectively blocks only the prostaglandins associated with inflammation, and Equioxx is the equine NSAID in that group.
NSAIDs not only reduce inflammation they are also effective at reducing fevers.
DANGERS OF NSAIDs
NSAIDs are vitally important in helping manage pain and improving our patients’ quality of life. However, we must never lose sight of the potential for severe, even life-threatening side-effects. The recent death of the famed racing horse, Kaldero, was due to fatal colitis he developed while on a course of Bute.
CLINICAL SIGNS OF NSAIDs TOXICOSIS
Clinical signs of toxicosis can occur within days to weeks of commencing NSAID treatment. Clinical signs vary depending on the location of the ulceration but can also be difficult to differentiate as many symptoms overlap:
- Oralulceration – difficulty in prehension and mastication
- Esophageal ulceration – excessive salivation, pain behaviors (stretching neck, groaning) when swallowing
- Gastric ulceration – slow consumption of feed, loss of appetite, anorexia
Colonic ulceration can occur acutely and cause severe rapid onset colitis; however, the course of the disease is typically more deceptive, with clinical signs such as intermittent colic, sometimes diarrhea, and sometimes weight loss.