15 – Large Animal NSAIDs

Question 1

Equine NSAIDs

Answer 1

• Phenylbutazone
• Flunixin meglumine
• Meloxicam extra-label use in Canada? (approved in other countries)

Question 2

Phenylbutazone

Answer 2

• Oral and injectable
• Variety of musculoskeletal inflammation label indications
• *very good for musculoskeletal PAIN (lameness)

Question 3

Flunixin meglumine

Answer 3

• Injectable solution (IV or IM)
• Indicated for musculoskeletal disorders and visceral pain (ex. COLIC!)
• See label in food animal section

Question 4

Equine no longer used NSAIDs

Answer 4

• Acetylsalicylic acid
• Dipyrone
• Ketoprofen: more $$
• Firocoxib: osteoarthritis, very safe

Question 5

Which NSAIDs are labelled for use in pregnant mares?

Answer 5

• *not determined! We DO NOT know!!
  o Can use it, just know may be risk.
  o Currently do use some
• Phenylbutazone
• Flunixin
• Ketoprofen
• Firocoxib

Question 6

Food animal NSAIDs

Answer 6

• Meloxicam (injectable and oral suspension)
• Flunixin (banamine)
• Ketoprofen

Question 7

Meloxicam (food animals): injectable

Answer 7

• Look at label for withdrawal or withhold time
• Labelling is all over the map
  o Not labeled for castration, BRD, anti[pyretic
  o Used for de-budding calves, C-section, mastitis pain

Question 8

Meloxicam (food animals): oral suspension

Answer 8

• Not in US
• *only labelled for castration!
• Double the dose vs. injectable
• Slightly cheaper

Question 9

Flunixin (food animals): injectable

Answer 9

• Only labeled for pyrexia (fever) and endotoxemia (shock)
• Not labeled for analgesia, but has really good ANALGESIA

Question 10

Flunixin (banamine) tissue lesion

Answer 10

• Injection site necrosis and injury=pain
• *not good for the animal
• **IV USE ONLY IN CATTLE

Question 11

Flunixin (food animals) transdermal

Answer 11

• Pyrexia or BRD and mastitis
• Analgesia (foot got)
• Poor on the back
• *easy to administer

Question 12

Ketoprofen (food animal) injectable

Answer 12

• Lots of label claims (older approval)
• NO MILK WITHDRAWAL period
• Short MEAT withdrawal time
• More expensive
• Not in the STATES

Question 13

Wha is the go to NSAID in food animal (ex. dairy) practice?

Answer 13

• Ketoprofen ‘

Question 14

Aspirin used to be used as a food animal NSAID

Answer 14

• Never approved for use in US
• Approved a long time ago in Canada: no efficacy or safety data
• Very poor bioavailability form the rumen
• *very cheap, you get what you pay for

Question 15

NSAIDs in small ruminants

Answer 15

• Meloxicam (up to 14 days of analgesia, lower clearance and formulation)
  o Alleviation of pain and inflammation
  o SC, no oral formulation approved
  o Worldwide: buccal

Question 16

NSAIDs licensed in pigs

Answer 16

• Ketoprofen (IM)
• Flunixin (IM)
• Acetaminophen (Pracetam)
• Meloxicam

Question 17

Ketoprofen (IM): pigs

Answer 17

• Fever and inflammation due to respiratory disorders

Question 18

Flunixin (IM): pigs

Answer 18

• Pyrexia associated with SRD

Question 19

Acetaminophen (pracetam): pigs

Answer 19

• Pyrexia associated with SRD
  o Medicated water, 3 day withdrawal period

Question 20

Meloxicam (Metacam for swine)

Answer 20

• Injectable solution (IM)
  o 5mg/kg BW: Approved for relief of post-operative pain associated with minor soft tissue surgery (ex. castration)

Question 21

NSAIDs: combination products

Answer 21

• None have data showing they are more effective than the antibiotic alone
• *all have data that show fever decreases

Question 22

NSAIDs: combination products examples

Answer 22

• flunixin (w/florfenicol)=RESFLOR
• Meloxicam + florfenicol=Zeleris
• Tulathromycin+ketoprofen=Draxxin KP

Question 23

What can we draw from NSAID data?

Answer 23

• Should NOT expect uniform results between all trials
• Not appropriate to extrapolate results from a study using one NSAID, dose regimen, indication or outcome measure to different situations
• *generally not “totally useless” or “magic cullet”