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Safe NSAID Use For Horses - How To Reduce Side Effects

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Lindsay Butzer, DVM
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Almost every horse owner has or will use non-steroidal anti-inflammatory drugs (NSAIDs) at some point. Whether used for chronic conditions like osteoarthritis or for acute injuries, NSAIDs help keep your horse comfortable while reducing the effects of uncontrolled inflammation.
The most commonly used NSAIDs for horses are phenylbutazone, flunixin meglumine (Banamine), Diclofenac sodium (Surpass cream) and firocoxib (Equioxx).

How Do NSAIDs Work?
NSAIDs block the production of an enzyme called cyclooxygenase (or COX) that the body uses to produce prostaglandins. Prostaglandins are hormone-like chemicals that are released at the site of an injury to control pain, inflammation, and blood clotting.
Pain and inflammation are normal bodily reactions to illness and injury. You’ll see swelling and inflammation when blood rushes to the injury site to deliver infection-fighting white blood cells and starts the healing process. Pain signals to your horse that they must slow down and avoid further injury.
By inhibiting COX production, NSAIDs reduce pain that may be affecting your horse’s quality of life. In some cases, NSAIDs are also necessary to prevent tissue damage caused by excessive inflammation.
There are different types of COX enzymes produced within the body. COX-1 is responsible for protecting the digestive tract. COX-2 is produced at the site of injury or inflammation. Selective NSAIDs (also known as COX-2 inhibitors) are more gentle on the digestive system because they target COX-2 enzymes.

Common Side Effects of NSAIDs for Horses
While NSAIDs are highly efficient at controlling pain, they can interfere with the body’s natural healing process. It’s best to keep dosages as low as possible while still maintaining efficacy and to avoid prolonged use.
One of the biggest concerns with NSAID use is their harmful effects on the gastrointestinal tract. Prostaglandins aid blood flow and production of mucus in the digestive tract, protecting against damage from stomach acid. Horses can develop ulcers in the mouth and on the tongue, stomach ulcers, right dorsal colitis (RDC), and kidney failure.

Monitor For Symptoms of NSAID Side Effects
NSAIDs can cause ulcers on the tongue and other soft tissues in the mouth. Oral ulcerations can cause drooling, reluctance to eat, and visible blisters or sores. Gastrointestinal symptoms include reduced appetite, diarrhea, unexplained weight loss, and recurring colic. Also watch out for increased drinking and urination, which can indicate kidney damage.

Preventing Side Effects with NSAID Use
Your veterinarian will prescribe NSAIDs that are appropriate for your horse’s condition and medical history. Administering pain medication without veterinary guidance increases your horse’s risk of adverse effects.
For horses at an increased risk for gastrointestinal side effects, for example, if they have a history of colic or require long-term use for a chronic condition like osteoarthritis, they may need a COX-2 inhibitor. Even COX-2 inhibitors, though, carry some risk of gastrointestinal effects.
Horses that are ill or dehydrated are at greater risk for kidney damage. If your horse has not been eating or drinking, do not administer NSAIDs without the guidance of your veterinarian.
Never administer a higher dose than directed, or stack different types of NSAIDs, even through different routes of administration. For example, if you apply a topical NSAID, it would be unsafe to follow it with an oral medication.

Alternatives To NSAIDs for Horse Pain Management
Used properly NSAIDs are a safe way to manage your horse’s pain. That said, they should be used sparingly. Natural forms of pain management can sometimes be used in place of or in conjunction with medications. Vet-recommended T-Relief tablets is a plant-based pain reliever that’s been used for over 50 years for both humans and animals.
Always consult your veterinarian before trying a new supplement or remedy, as even natural preparations can have contraindications.
Cold therapy is a natural, easy, and affordable way to reduce pain and inflammation. Apply an ice pack or hose the affected area with cold water for around twenty minutes at a time, up to four times per day. Overuse can damage the already-injured tissue, causing frostbite or an ice burn.
Above all else, give your horse time to rest and recuperate. By giving your horse time to heal, rather than masking signs of pain, you can give them the best chance at making a full recovery.