NSAIDs for Horses Vet Guide 2025 – Dr Duncan Houston 🐎💊

By Dr Duncan Houston, BVSc – Your trusted veterinary guide to safe and effective use of NSAIDs in horses.

Introduction

As a professional veterinarian and founder of Ask A Vet, I know how important it is to manage equine pain with both precision and compassion. This 2025 guide outlines everything you need to know about non‑steroidal anti‑inflammatory drugs (NSAIDs) in horses—from the most commonly used options to dosing, side effects, monitoring, and best practices for safe use. 🏇❤️

What Are NSAIDs?

NSAIDs are medications that reduce inflammation, pain, and fever by blocking cyclooxygenase (COX) enzymes—specifically COX‑1 and COX‑2—in the body. While COX‑2 is involved in inflammatory pathways, COX‑1 protects the stomach and kidneys. Most NSAIDs used in horses impact both, which is why side effects like gastrointestinal ulceration and kidney damage may occur if used improperly. 🔬💥

Why We Use NSAIDs in Horses

• Pain management: essential for colic, musculoskeletal injuries, and lameness.
• Inflammation control: after injuries, surgery, or in arthritis.
• Fever reduction: supportive care during infections or systemic illness.

Main NSAIDs Used in Equine Practice

1. Flunixin Meglumine (“Banamine”) 💉

A prescription anti‑inflammatory and analgesic used especially for colic and visceral pain. It also helps reduce fever. Often included in emergency kits—but only with veterinary guidance due to potential gut and kidney side effects. :contentReference[oaicite:3]{index=3}

2. Phenylbutazone (“Bute”) 🦴

Highly effective for musculoskeletal pain and lameness—long a staple in equine orthopedics. However, long‑term or high‑dose use can cause serious side effects like gastric ulcers, kidney issues, and bone marrow suppression. :contentReference[oaicite:4]{index=4}

• Dosing: Typically 2.2–4.4 mg/kg/day, sometimes higher under vet supervision.
• Warnings: Don’t stack with other NSAIDs or corticosteroids; monitor closely.

3. Firocoxib (“Equioxx”) – COX‑2 selective 🧬

Designed for chronic pain management and arthritis, firocoxib focuses on COX‑2 to reduce inflammation while sparing some COX‑1, lowering GI side effect risk. Only use vet‑approved equine formulations—off‑label use of canine versions is prohibited. :contentReference[oaicite:5]{index=5}

Dosing accuracy is vital: overdosing loses selectivity and raises risk. Avoid combining with other NSAIDs. :contentReference[oaicite:6]{index=6}

Comparing NSAIDs

Side Effects & Monitoring

Common NSAID side effects include:

• Gastrointestinal ulcers and colitis
• Right dorsal colitis
• Renal papillary necrosis & kidney failure
• Bone marrow suppression (noted with phenylbutazone)

Best practice: Use the lowest effective dose for the shortest time, schedule regular vet check‑ups and blood tests, ensure proper hydration, and avoid NSAID stacking. :contentReference[oaicite:7]{index=7}

Additional Strategies & Alternatives

Topicals (e.g., Diclofenac)

Apply locally to affected joints to limit systemic intake—but are most effective for mild conditions. :contentReference[oaicite:8]{index=8}

Orthobiologics & Joint Injections

Options include:

• Adequan (polysulfated glycosaminoglycan): injectable to protect cartilage. :contentReference[oaicite:9]{index=9}
• IRAP (autologous conditioned serum): anti‑inflammatory cytokines tailored to individual horses. :contentReference[oaicite:10]{index=10}
• Pentosan polysulfate, hyaluronic acid, platelet‑rich plasma injections—often used alongside NSAIDs.

Supportive Care

Holistic strategies to boost outcomes:

• Physical rehab & controlled exercise
• Weight management to reduce joint stress
• Proper nutrition and balanced turnout
• Comfortable footing and stalls
• Regular dental and hoof care

Best Use Practices

1. Vet consult before use
2. Accurate weight‑based dosing
3. Short cycles; reassess frequently
4. No stacking
5. Protect stomach & kidneys (hydrate, feed buffers)
6. Regular blood work

Conclusion

When used correctly under veterinary guidance, NSAIDs are invaluable tools for managing equine pain and inflammation. Choose the right drug based on the condition, monitor carefully, and always prioritize your horse’s overall wellness. If you have questions or need support, visit AskAVet.com or download the Ask A Vet app for expert advice anytime 🐴📱.