Colonic Health in Hospitalized Horses Treated with Non-Steroidal Anti-Inflammatory Drugs - A Preliminary Study.
Authors: van Galen G, Saegerman C, Hyldahl Laursen S, Jacobsen S, Andersson Munk M, Sjöström H, Holm Lindmark S, Verwilghen D
Journal: Journal of equine veterinary science
Summary
# Editorial Summary NSAIDs remain essential tools in equine practice despite well-documented risks to colonic health, yet longitudinal clinical evidence of how often these complications actually develop during routine treatment has been limited. Van Galen and colleagues monitored 17 hospitalised horses receiving NSAIDs for >4 days using serial ultrasonography, faecal occult blood testing, and clinical assessment, comparing findings against 5 untreated control horses. Within two days of starting treatment, NSAID-treated horses began developing right dorsal colon pathology: ultrasonographic wall thickening occurred in 4 of 9 horses, subclinical to mild colitis in 9 of 11 horses, and right dorsal colitis in 4 of 10 horses, with no complications observed in controls. Whilst the severity remained low grade in most cases, the high incidence and early onset suggest that regular ultrasonographic monitoring throughout NSAID courses is prudent clinical practice, and highlight an important gap in non-invasive diagnostic tools for detecting subclinical colon pathology before it progresses—information particularly valuable when advising clients on risks during extended NSAID treatment for musculoskeletal or systemic conditions.
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Practical Takeaways
- •Horses receiving NSAIDs for >4 days should be monitored closely for signs of colitis (depression, reduced appetite, unstructured feces, abdominal pain) starting from day 2 of treatment, as colon pathology develops early and may be subclinical
- •Ultrasonographic measurement of right dorsal colon wall thickness is a useful noninvasive monitoring tool during NSAID treatment, with significant thickening indicating pathology before clinical signs appear
- •Consider implementing routine monitoring protocols (clinical examination, ultrasonography, fecal occult blood testing) for hospitalized horses receiving NSAIDs to detect early colon changes and allow timely intervention
Key Findings
- •NSAID-treated horses (n=17) developed thickened right dorsal colon walls in 4/9 cases and colitis in 9/11 cases, while all 5 control horses remained healthy
- •Pathological changes were identified as early as treatment day 2, indicating rapid onset of NSAID-related colon complications
- •Right dorsal colon wall thickness in treated horses was significantly greater compared to baseline values and control horses, suggesting measurable ultrasonographic pathology
- •Right dorsal colitis was identified in 4/10 NSAID-treated horses with low clinical severity but high incidence, emphasizing need for monitoring during NSAID therapy