Horses that receive an extended course or high doses of non-steroidal anti-inflammatories (NSAIDs) seem to be at greater risk of developing right dorsal colitis, an Australian study shows.
NSAIDs are one of the most prescribed pain-relief and anti-inflammatory medications in veterinary medicine. Of these, phenylbutazone is the predominant NSAID associated with right dorsal colitis, though it's unclear whether this is related to increased usage compared with other NSAIDs, a lower safety profile, or unknown pharmacodynamics.
Dr. Jordan Flood, with the University of Queensland, and team members looked retrospectively at 35 cases of right dorsal colitis that presented at seven Australian clinics. The team found NSAID overdose in 21 of the 25 cases where the NSAID dose was known (84 percent of the cases). Of the horses that had NSAID overdoses, 76 percent had received at least 2.2 mg/kg phenylbutazone for a minimum of eight consecutive days.
The right dorsal colon wall was thickened in 77 percent of cases and 43 percent of the horses died. Three of the 35 horses had been treated with “stacked” NSAIDs, meaning that more than one NSAID had been given at a time. Stacking NSAIDs predisposes the horse to right dorsal colitis.
Each of the horses presented to the clinic with an elevated heart rate, diarrhea and colic, all hallmark signs of right dorsal colitis. Flood recommended that horses given NSAIDs be monitored for these symptoms and be taken off the drugs if any appear. Horses with the condition typically have low levels of albumin and calcium in the blood, and elevated levels of lactate. Monitoring of serum albumin concentration is also recommended.
While horses receiving elevated doses of NSAIDs over a long period of time are most likely to develop right dorsal colitis, horses receiving recommended doses of NSAIDs also experienced this issue. The scientists found that horses that had an increased heart rate, packed cell volume, and abnormal appearance of mucous membranes were less likely to survive, even if they received the correct dose and length of NSAID treatment.
The research team concluded that phenylbutazone may not be safe for prolonged use and that other drugs should be considered if longer-term anti-inflammatories or pain relief is needed. The team also suggested that owner education regarding appropriate NSAID use be improved.
Identifying the symptoms of right dorsal colitis could assist veterinarians in identifying the condition, which could lead to more positive outcomes from the disease.
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