Update on the Use of NSAIDs and Opioids in the Horse

The presentation will start with evaluating current clinical practice concerning use of NSAIDs and opioids in the horse, as we found in the survey that was performed last year. From the results of this survey we can ask ourselves the question whether there is need for more and newer NSAIDs for the horse. The release of more COX 2-selective NSAIDs like Firocoxib will be performed in the near future and we know that for instance Carprofen is also registered for horses in countries not far from ours. What will these new NSAIDs bring us that we do not currently have? Recent literature describes the efficacy of Firocoxib in orthopaedic (Doucet 2009) and in visceral pain (Cook 2009) in comparison to other NSAIDs.
Results of the survey learned that most of the equine practitioners use butorphanol as their favourite opioid. This probably has to do with the indications for registration: combination with a sedative for standing surgery and premedication and treatment of acute visceral pain. There are still practitioners that use methadone for these purposes, especially in combination with sedatives for small surgical procedures. There are very small numbers of veterinarians that use morphine and epidural techniques with opioids are also encountered very little. This means that opioids do not have widespread use for postoperative analgesia. The options with short acting systemically administered opioids like butorphanol are not very good. At this stage the side effects of opioids come into play. Therefore, local application and other administration techniques need to be used. [...]