Retrospective Analysis of the Use of Tiludronate in Equine Practice: Safety on 1804 Horses, Efficacy on 343 Horses.
Authors: Tischmacher Adeline, Wilford Sophie, Allen Kent, Mitchell Richard D, Parkin Tim, Denoix Jean-Marie
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Tiludronate Safety and Efficacy in Equine Practice Between 2006 and 2019, researchers retrospectively analysed 2,497 tiludronate administrations across 1,804 horses treated at two equine veterinary centres, with a subset of 343 horses receiving documented clinical follow-up beyond one year. The bisphosphonate was administered intravenously at 1 mg/kg using slow infusion protocols, with systematic recording of concurrent medications, preceding non-steroidal anti-inflammatory drug use, and adverse events. Safety data proved compelling: only 0.9% of injections triggered potential side effects, with mild colic representing the most common reaction, suggesting excellent tolerance across the broader equine population. Among horses with extended follow-up, approximately 80% presented initial lameness grades exceeding 1.5/5; roughly half achieved soundness by 30 days and maintained this improvement through to one year, with mean lameness scores improving by more than one grade from baseline. Performance metrics available for 129 horses demonstrated sustained clinical utility, with 69% remaining in competition one year post-treatment and 82% of those competing at equivalent or improved levels compared to pre-treatment baselines. This represents the first large-scale field study combining safety surveillance across thousands of doses with long-term efficacy data in horses, establishing tiludronate as a well-tolerated option for managing chronic orthopaedic conditions, though practitioners should remain alert to the small risk of post-injection colic.
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Practical Takeaways
- •Tiludronate is a very safe treatment option for lameness in horses, with minimal side effects reported in over 2,400 injections—mild colic is the main concern but occurs in <1% of cases
- •Expect significant lameness improvement within 30 days in approximately half of treated horses, with sustained benefits at one year, making it suitable for performance horses
- •Most competing horses maintain or improve their performance level post-treatment, supporting use in athletic populations seeking to return to sport
Key Findings
- •Tiludronate demonstrated excellent tolerance with only 0.9% of 2,497 injections (1,804 horses) causing potential side effects, with mild colic being most frequent
- •Approximately 50% of horses (343 with 1-year follow-up) achieved soundness within 30 days and remained sound after one year
- •Mean lameness score improved by more than one grade over the follow-up period compared to initial examination
- •One year after treatment, 69% of horses with performance data (129 horses) were still competing, with 82% competing at a similar or better level