The use of nonsteroidal anti-inflammatory drugs in critically ill horses

Objective To review the physiology of the cyclooxygenase (COX) enzymes with reference to the beneficial effects of nonsteroidal anti‐inflammatory drugs (NSAIDs) related to their analgesic and antiendotoxic properties as well as the mechanisms responsible for adverse gastrointestinal, renal, and coagulation effects. Data Sources Human and veterinary peer reviewed literature Veterinary Data Synthesis NSAIDs are frequently administered to critically ill horses for their analgesic and anti‐inflammatory effects. However, NSAIDs have significant side effects principally on the gastrointestinal mucosa and kidneys. These side effects may be exacerbated in critically ill horses if they have gastrointestinal damage or are volume depleted Conclusions This review provides important information for equine veterinarians and criticalists on the advantages and disadvantages of using traditional NSAIDs and newer equine COX‐2 selective NSAIDs for the management of different conditions in critically ill horses.