An introduction to NSAIDs for cattle: recommendations for the veterinary surgeon

Non-steroidal anti-inflammatory drugs (NSAIDs) are increasingly being used in cattle driven by the increased recognition and awareness of pain in cattle by veterinarians and farmers, and also by increasing evidence that treatment with NSAIDs can significantly improve treatment response for key diseases.

As of February 2020, five NSAIDs are authorised for use in cattle in the UK (see Table 1).

Post-partum inflammation/pain

Musculoskeletal disorders

Lameness

Injuries

The literature on the use of NSAIDs in cattle is growing — a quick search using Scopus with search terms ‘NSAID’ and ‘cattle’ identified 228 documents of which half had been published in the last 9 years. However, of those studies only eight had comparisons of NSAIDs, of which four were comparisons in clinical trials of NSAIDs registered for use in cattle in the UK.

Many comparison studies are small and underpowered. For example, the most recent study identified by the search evaluated carprofen and flunixin after calving, but only had 20 cows in each treatment group (Giammarco et al, 2018). Studies are also inconsistent in both results and method — the other three studies identified by the search all evaluated the use of NSAIDs in the treatment of pneumonia, but one study compared single doses of carprofen, flunixin and ketoprofen, one a single dose of carprofen with three of flunixin, and the third a single dose of meloxicam with (depending on response) up to three doses of flunixin. All studies found no difference, but the authors of the first study claimed that one dose of flunixin was as good as one of carprofen and the second that one dose of carprofen was as good as three of flunixin. None of the studies is large enough to provide conclusive evidence in regard to NSAID choice.