GASTROENTEROLOGY
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NSAIDs are ubiquitous. Despite the risk of adverse
Courtesy of Dr. Rebecca Bishop
gastrointestinal and renal effects, more than 40% of equids are prescribed nonsteroidal anti-inflammatory drugs during veterinary treatment, according to a 2019 study in the Equine Veterinary Journal. Although COX-2 inhibitors—or coxibs—were developed to reduce unwanted effects, traditional NSAIDs like flunixin meglumine and phenylbutazone are still the predominant choice in most clinics.
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COX Recap
NSAIDs rely on inhibition of the COX pathways, which are responsible for constitutive functions in gastroprotection, renal homeostasis and platelet func-
Issue 2/2022 | ModernEquineVet.com
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tion (COX-1), and inducible functions, including pain, fever and inflammation (COX-2). “Traditional NSAIDs are non-specific, in that they work both at the level of COX-2, which affects the therapeutic effects, but they also impact COX-1 production, which results in delayed mucosal healing, increased intestinal permeability, right dorsal colitis, gastric ulceration and kidney damage,” said Rebecca Bishop, DVM, MS, resident in equine surgery at the University of Illinois, College of Veterinary Medicine. To avoid the negative effects, COX-2 specific inhibitors—such as firocoxib—were devel-
