Dette er utdrag av artikkel til P. W. Lockwood, J. C. Johnson, T. L. Katz publisert i Veterinary Record (2003) 152, s. 392-394.Gjengitt er hele summary og diskusjon samt tabell 3 i artikkelen.Uthevninger er gjort av oss.

Clinical efficacy of flunixin, carprofen and ketoprofen as adjuncts to the antibacterial treatment of bovine respiratory disease
P. w. LOCKWOOD, J. c. JOHNSON, T. L. KATZ

SUMMARY
Three non-steroidal anti-inflammatory drugs (NSAIDS), flunixin, ketoprofen and carprofen, were used in conjunction with ceftiofur, in the treatment of naturally occurring bovine respiratory disease. Sixty-six mixed-breed beef cattle weighing on average 197 kg met the inclusion criteria of pyrexia of at least 40°C, an illness score indicating at least moderate illness and at least moderate dyspnoea. They were allocated randomly to four treatment groups. All the groups received ceftiofur for three days at a dose rate of 1.1 mg/kg by intramuscular injection, and three groups received, in addition, a single dose of either flunixin (2.2 mg/kg by intravenous injection) or ketoprofen (3 mg/kg by intravenous injection) or carprofen (1.4 mg/kg by subcutaneous injection). During the first 24 hours of the study, the pyrexia of the three groups treated with a NSAID was reduced significantly more than the pyrexia of the group treated with ceftiofur alone, and two and four hours after treatment the reduction in pyrexia was significantly greater in the groups treated with flunixin and ketoprofen than in the group treated with carprofen. There were no statistically significant differences between the four groups with respect to depression, illness scores, dyspnoea or coughing. There was less lung consolidation in the three groups treated with a NSAID than in the animals treated with ceftiofur alone, but the difference was significant only in the group treated with flunixin.

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TABLE 3:
Mean (sd) and median percentage lung consolidation in groups of calves with respiratory disease after treatment with ceftiofur alone or ceftiofur plus carprofen, ketoprofen or flunixin for three days.
Group                                                              Number of calves                               Mean                  Median 
Ceftiofur                                                                    17                                        19.0 (22.3)                   15.3
Ceftiofur plus carprofen                                           16                                        14.5(9.8)                        5.5
Ceftiofur plus ketoprofen                                         16                                        13.7 (20.7)                     6.3
Ceftiofur plus fIunixin                                               17                                          5.2 (13.7)                    1.7*
* Significantly difrerent from ceftiofur(P=0.003)

The data are skewed. Total percentage lung consolidation calculated as 0.1 (lobe 1+2,cranial and caudal segments of left cranial lobe) + 0.27 (lobe 3; left caudal lobe)+ 0.05 (lobe 4, accessory lobe) +0.3 (lobe 5, right caudal lobe) +0.08 (lobe 6, right middle lobe) + 0.2 (Iobes 7 and 8, cranial and caudal segments of right cranial lobe)

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DISCUSSION 
Studies of the pharmacodynamics of flunixin and ketoprofen in calves, using a tissue cage model of inflammation (Landoni and others 1995c), indicate that the two drugs have similar modes of action. The mode of action of carprofen is unknown (Lees and others 1996) but, in contrast with the other two NSAIDs, it may involve mechanisms other than the inhibition of cyclo-oxygenase. The plasma half-lives of the three NSAIDS are different. Ketoprofen and flunixin have short half-lives, 0.42 and 6.87 hours, respectively (Landoni and others 1995a, b), whereas carprofen, when administered subcutaneously as in this study, has a reported plasma half-life of 33.8 hours (Lees and others 1996). However, in inflammatory disease the half-life of the drug in inflammatory exudate may be more relevant than its plasma half-life. Lees and others (1996) reported a half-life for flunixin in inflammatory exudate of 23 hours.

The rapid reduction of pyrexia is one of the main aims in the treatment of bovine respiratory disease. Although all three NSAIDS reduced the calves' pyrexia by more than ceftiofur alone, flunixin and ketoprofen reduced it more quickly and to a greater extent than carprofen. The clinical illness scores, depression scores, the resolution of dyspnoea and the over- all clinical success rates were neither statistically or clinically significantly different among the four treatments. Lung consolidation is an important consequence of bovine respiratory disease. Flunixin reduced the extent of lung consolidation by more than the other two NSAIDS, and by significantly more than ceftiofur alone.