💊 Vet Guide to NSAID Use and GI Side Effects in Horses | 2025 Pain Relief & Colitis Risk Management 🐴

By Dr Duncan Houston, BVSc

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications in equine medicine. They’re effective at reducing pain, swelling, and fever—but they’re not without risk. Emerging research shows that even short-term NSAID use can cause subtle but measurable damage to the gastrointestinal (GI) system. 🧠💥

This 2025 guide explains how NSAIDs work, which ones are most commonly used, what GI signs to watch for, and how to manage NSAID use responsibly. 🐴🌿

🧪 What Are NSAIDs and Why Are They Used?

NSAIDs reduce inflammation by blocking enzymes called **cyclooxygenases (COX)**. These enzymes play a key role in producing prostaglandins—chemicals that cause pain and swelling. Blocking these enzymes is how drugs like **bute (phenylbutazone)**, **Banamine® (flunixin meglumine)**, and **Equioxx® (firocoxib)** provide relief. 💊⚡

🔹 Common NSAIDs for Horses:

• 💊 **Phenylbutazone (Bute)** – Often used for musculoskeletal pain
• 💉 **Flunixin meglumine (Banamine®)** – Effective for colic, fever, and soft tissue pain
• 🧪 **Firocoxib (Equioxx®)** – A COX-2 selective NSAID considered safer for long-term use

But these benefits come with side effects—particularly in the GI system. 📉

🌡️ What the Latest Research Says About GI Risk

In a recent university study of 22 horses, none of which were admitted for GI issues, researchers found a startling result. After just **3 days** of NSAID use, **40%** of treated horses developed visible GI changes. 🧪🔍

🧬 Study Highlights:

• 🔬 Thickening of the gut wall was seen via ultrasound in the upper right colon
• 💧 Edema (fluid buildup) in the intestinal wall was identified
• 🥱 Horses exhibited signs like decreased appetite, depression, and loose stools
• 💩 Fecal occult blood testing showed signs of **mild colitis** in treated horses
• 🧾 Untreated horses showed none of these signs

While the symptoms were mild, this study makes it clear: **NSAID use is not risk-free**, even over short periods. ⚠️

⚠️ GI Side Effects of NSAIDs

Here are the most common gastrointestinal risks associated with NSAID use in horses: 🩺

• 💥 **Right dorsal colitis** – inflammation and ulceration of the colon
• 📉 **Loss of appetite and lethargy**
• 💩 **Soft stools or diarrhea**
• 💧 **Edema** in the intestinal wall, leading to discomfort or fluid imbalance
• 🩸 **GI bleeding** (often detected only via fecal occult blood tests)

Most horse owners may not notice these symptoms early, making **routine monitoring** during NSAID treatment essential. 🔍📋

🩺 How to Use NSAIDs Safely

NSAIDs are important tools, but the key is **cautious, informed use**. Here’s how to minimize the risks: 🧠⚖️

✅ Vet-Backed NSAID Safety Tips:

• 📅 **Use for the shortest time possible** to achieve pain relief
• ⚖️ Use **the lowest effective dose**—don’t increase without vet approval
• 🚫 **Never combine NSAIDs** unless explicitly instructed by your vet
• 🧪 Monitor appetite, manure consistency, and demeanor daily
• 🩸 Ask your vet about **fecal occult blood testing** if symptoms arise

Using Equioxx® or other **COX-2 selective NSAIDs** may reduce some GI risk, but all NSAIDs require respect and vigilance. 🧪⚠️

🌿 Alternatives to Long-Term NSAID Use

If your horse requires chronic pain management, it may be time to consider alternatives to NSAIDs: 🧬

• 🦴 **Joint injections** (e.g. corticosteroids, hyaluronic acid)
• 🔋 **Shockwave therapy** for soft tissue injuries or arthritis
• 🧬 **Regenerative medicine** – PRP, stem cells
• 🍃 **Nutritional joint supplements** (e.g. omega-3s, MSM, glucosamine/chondroitin)
• 📦 **Topicals** or **localized cold/heat therapies**

Ask your vet to develop a long-term plan that minimizes reliance on NSAIDs while keeping your horse comfortable. 🐴💡

📲 Use Ask A Vet for Medication Monitoring

The Ask A Vet app helps horse owners stay on top of pain management and medication side effects:

• 📊 Log medication start/end dates and monitor for side effects
• 📸 Share stool photos or appetite notes with a licensed vet
• 🧾 Learn when to stop, switch, or taper your horse’s NSAID
• 📱 Ask about safer alternatives to routine bute or Banamine® use

It’s your digital assistant for smarter medication management. 🐴📲

✅ NSAID Safety Takeaways

• 💊 NSAIDs like bute, Banamine®, and Equioxx® are effective—but not without risks
• 🩺 Recent research shows GI damage can occur in just a few days
• 📉 Monitor horses closely for appetite, depression, and soft manure
• 📦 Use the lowest effective dose, and never combine NSAIDs
• 📱 Use Ask A Vet to manage medication use safely and efficiently

📲 Final Thoughts from Dr Duncan Houston

NSAIDs remain a key part of equine pain control—but they must be used with care. What looks like a harmless daily dose may quietly contribute to gut inflammation or colitis. With monitoring, moderation, and medical guidance, we can keep horses comfortable **and** protected. 🧠💙

Download the Ask A Vet app to get support managing NSAID use, side effects, and alternative options—all in one place. 🐎📱