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Sparing the gut: COX ‐2 inhibitors herald a new era for treatment of horses with surgical colic
Author(s) -
Ziegler A. L.,
Blikslager A. T.
Publication year - 2020
Publication title -
equine veterinary education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 31
eISSN - 2042-3292
pISSN - 0957-7734
DOI - 10.1111/eve.13189
Subject(s) - medicine , nonsteroidal , horse , disease , adverse effect , inflammation , cyclooxygenase , intensive care medicine , gastroenterology , enzyme , paleontology , biology , biochemistry , chemistry
Summary Nonsteroidal anti‐inflammatory drugs ( NSAID s) are commonly used to manage a wide variety of conditions in horses, including management of colic. Flunixin meglumine is by far the most commonly used drug in the control of colic pain and inflammation and has become a go‐to for not only veterinarians but also horse‐owners and nonmedical equine professionals. NSAID use, however, has always been controversial in critical cases due to a high risk of adverse effects associated with their potent cyclo‐oxygenase ( COX ) inhibition. There are two important COX isoenzymes: COX ‐1 is generally beneficial for normal renal and gastrointestinal functions and COX ‐2 is associated with the pain and inflammation of disease. Newer selective NSAID s can target COX ‐2‐driven pathology while sparing important COX ‐1‐driven physiology, which is of critical importance in horses with severe gastrointestinal disease. Emerging research suggests that firocoxib, a COX ‐2‐selective NSAID labelled for use in horses, may be preferable for use in colic cases in spite of the decades‐long dogma that flunixin saves lives.