Letter to the Editor: Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction

Abstract

Dear Editor, I am concerned about the presentation of data in the paper by Ziegler and colleagues, which suggests a more positive account of the findings than the study actually yielded [1]. This is most evident in the lay press [2]. My major concerns are as follows: the results [1]. In fact the only major statistically significant finding was related to a marker considered a 'poor predictor of clinical endotoxaemia' according to a previous study by coauthors [14].

Sparing the gut: COX‐2 inhibitors herald a new era for treatment of horses with surgical colic

“…These effects in people are thought to be the result of inhibition of COX‐2 (reducing vasodilatory prostaglandin E 2 ) and a lack of inhibition of COX‐1 (permitting thrombogenic thromboxane A 2 ) (Sibbald ; Atukorala and Hunter ). In light of this history, some veterinarians have expressed concern about increased risk of thromboembolic effects in critical, possibly already pro‐thrombotic horses when treated with COX‐2‐selective drugs (Freeman ). However, while horses are similarly susceptible to the gastrointestinal side effects seen in humans, they are not known to be susceptible to these prothrombotic side effects from COX‐2‐selective NSAIDs.…”

“…Importantly, clinical trials testing COX‐2‐selective NSAIDs in critical equine cases reported no differences in thrombotic events such as thrombosed jugular veins (Naylor et al . ; Freeman ; Ziegler et al . ).…”

Medication control of flunixin in racing horses: Possible detection times using Monte Carlo simulations

“…Flunixin meglumine is a one of the most commonly employed NSAIDs in cases of inflammation and pain associated with soft tissue conditions in horses 1‐4 . It is also considered efficacious in controlling abdominal pain, and thus is the standard therapy for equine colic 5‐7 …”

“…[1][2][3][4] It is also considered efficacious in controlling abdominal pain, and thus is the standard therapy for equine colic. [5][6][7] Most horse racing regulatory authorities have distinct frameworks for doping control and medication control. In the case of doping drugs, such as anabolic steroids, the objective is to detect any trace through the most sensitive analytical methods.…”

Letter to the Editor: Bias in statistics or bias in equine veterinary medicine?

“…Please find our point‐by‐point responses to D. E. Freeman's letter to the Editor regarding our article reporting the results of a randomised clinical trial (RCT) comparing flunixin meglumine and firocoxib for the control of postoperative pain and endotoxaemia in horses after surgical correction of small intestinal strangulating obstruction (SISO) .…”