Non‐steroidal anti‐inflammatory drugs in equine orthopaedics

Abstract

Orthopaedic disorders are one of the most common complaints that will be managed by the equine practitioner and one which plays a significant role in the loss of use and wastage of horses within multiple equine disciplines. [1][2][3][4][5] Orthopaedic disease can be acute or chronic, is accompanied by inflammation and often manifests as lameness. Following injury or disruption to one or multiple musculoskeletal tissues, the inflammatory cascade is activated, leading to local increased recruitment of proinflammatory cells that release an array of cytokines and prostanoids. Production of prostanoids, importantly prostaglandin E2 (PGE2), through metabolism of arachidonic acid by cyclooxygenase (COX), is an important component of the inflammatory reaction. Prostanoids contribute to pain and hyperalgesia by increasing the sensitivity for signalling by peripheral nociceptive terminals. 6 Tissue injury also stimulates release of neurotransmitters from central terminals of nociceptors and augments production of PGE2 in the spinal cord. This leads to additional excitation and disinhibition of dorsal horn neurons and generates abnormal responses to sensory signals from the periphery. 7One of the main goals in management of orthopaedic disease in horses is reduction of inflammation and, as a result, reduction in associated pain and lameness. Another goal is to minimise disease progression and long-term deterioration of tissues.Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most readily available and cost-effective methods to inhibit the inflammatory response and, as a result, these drugs continue to be a mainstay of management of equine orthopaedic injury and lameness. In cases of acute orthopaedic disease, such as septic arthritis, NSAIDs are important in blunting the initial inflammatory response in order to decrease pain and to prevent further propagation of inflammation. These drugs also play important roles in modulating chronic disease, such as that seen with osteoarthritis (OA), by controlling persistent inflammation and slowing the progression of disease. Clinicians need to be cognisant of the potential gastrointestinal and renal side effects associated with the administration of NSAIDs.Gastrointestinal effects include oral and gastric ulceration and right

Equine Gastric Ulcer Syndrome: An Update on Current Knowledge

“…At an experimental level, multiple studies have shown the ulcerogenic capacity of NSAIDs at high doses in horses [ 50 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ]. Most of these studies, however, use NSAID doses in excess of what is typically recommended for clinical use [ 98 ]. The ability for fed-fasted NSAID models to cause both ESGD and EGGD at normal therapeutic doses has also been demonstrated [ 92 , 97 ].…”

The Optimal Period of Staged Bilateral Total Knee Arthroplasty Procedures under Enhanced Recovery: A Retrospective Study

“…Additionally, one aspect of ERAS is multimodal pain management. This can reduce opioid consumption, which can potentially lessen the incidence of hospital adverse events such as nausea and vomiting and urinary retention 17,18 …”

“…This can reduce opioid consumption, which can potentially lessen the incidence of hospital adverse events such as nausea and vomiting and urinary retention. 17,18 However, the perioperative risks based on the timing of the second-stage TKA under the ERAS protocol are not known. Our purpose was: (i) to determine whether the interval to the second stage influences the clinical outcomes; and (ii) to evaluate the optimal interval of staged bilateral TKA under the ERAS protocol.…”

Pharmacokinetics of meloxicam in pigeons after single intravenous, oral, and intramuscular administration

“…They are available in various types such as aspirin, acetamido, ibuprofen, and meloxicam, which differ in chemical structure but are effective in relieving pain, reducing inflammation, and inhibiting the synthesis of central prostaglandin. Veterinarians have also adopted NSAIDs in treating a wide range of animals, including mammals ( Jacobs et al, 2022 ), birds ( Castineiras et al, 2021 ), and fish ( Stancová et al, 2015 ), with positive therapeutic outcomes.…”