The University of North Carolina has recently completed a study that indicates that one of the best ways to reduce a complication of small intestinal strangulating obstruction (SISO) is by choosing the correct pain medication. Endotoxemia occurs when a bacterial toxin crosses the gut lining, initiating a large immune response and causing shock. This happens more often in SISO because the gut lining is compromised, allowing the endotoxin into circulation more easily.
Dr. Anthony Blikslager created a study that took place over two years and used 56 horses that had surgery for (SISO) at three university clinics. Post-surgery, the horses were given either firocoxib or flunixin. Researchers monitored their pain levels and blood work for signs of endotoxemia: a molecule called soluble CD14 (sCD14) is released by immune cells and is one of the earliest signs of endotoxemia.
The scientists discovered that the pain levels of all the horses was generally the same, but horses that were given flunixin to manage their pain had more than three times the chance of having high sCD14 in their blood. They conclude that flunixin slows gut repair and allows endotoxins to cross the gut lining.
Though flunixin can control pain well, the researchers recommend a COX-2 inhibitor. The next phase of research will study horses given both firocoxib or flunixin and their implications on SISO.
Read more at EQUUS.
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