Effects of cyclooxygenase inhibitors flunixin and deracoxib on permeability of ischaemic-injured equine jejunum.
Authors: Tomlinson J E, Blikslager A T
Journal: Equine veterinary journal
Summary
# Editorial Summary: COX Inhibitors and Post-Ischaemic Intestinal Recovery in Horses Ischaemic injury to the equine jejunum remains a serious concern in colic cases, and the choice of analgesic and anti-inflammatory medication may significantly influence mucosal healing—yet this relationship had received limited investigation. Tomlinson and Blikslager (2005) used an ex vivo model of ischaemia-reperfusion injury in equine jejunal tissue to examine whether two commonly used cyclooxygenase inhibitors, flunixin (a non-selective COX inhibitor) and deracoxib (marketed as COX-2 preferential), altered intestinal permeability during recovery. Both drugs impaired the restoration of mucosal barrier function following ischaemic injury, suggesting that COX inhibition—regardless of selectivity—may compromise the mechanisms required for normal epithelial repair. These findings carry important implications for clinical colic management: whilst NSAIDs remain valuable for pain relief and systemic inflammation control, their use in cases with suspected or confirmed intestinal ischaemia warrants careful consideration of dosing, duration, and timing relative to the ischaemic insult, and practitioners should weigh analgesic benefits against potential delays in mucosal recovery when selecting pharmacological protocols for these critical cases.
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Practical Takeaways
- •Reconsider routine use of flunixin in colic cases with suspected intestinal ischaemia, as it may impair tissue recovery
- •COX-2 selective inhibitors may not be safer alternatives to non-selective NSAIDs in ischaemic colic; both classes warrant cautious use
- •Consider alternative analgesic and anti-inflammatory strategies in colic patients where intestinal compromise is suspected or confirmed
Key Findings
- •Flunixin prevented recovery of equine jejunum following ischaemic injury
- •Etodolac, a COX-2 preferential inhibitor, also prevented recovery post-ischaemia
- •Both cyclooxygenase inhibitors demonstrated detrimental effects on intestinal healing after ischaemic damage