[Use of bisphosphonates in horses - a review].

Systemic administration of tiludronate or clodronate decreases lameness in some horses suffering from navicular syndrome within 2-6 months of treatment. In horses that fail to respond to the first treatment, a follow-up treatment may still improve the lameness. Horses with a lameness duration of less than 6 months have better odds of experiencing improvement in lameness. Bisphosphonate (BP) treatment can result in renal damage, and it is recommended to assess renal function prior to and after treatment. Horses with pre-existing renal compromise should not be treated with BP, as this may promote deterioration of their renal status. Furthermore, BP should not be administered concurrently with non-steroidal antiinflammatory medications or other nephrotoxic drugs. One of the most common side effects of BP treatment in the horse is development of colic signs, which usually resolves with hand walking. In cases where medical treatment is warranted, N-butylscopolamine, xylazine, detomidine or butorphanol should be administered alone or in combination. The treatment with non-steroidal antiinflammatory medications is not recommended. In horses with muscle fasciculations, plasma electrolyte concentrations should be determined. The route of administration for BP should follow manufacturer recommendations, as local applications such as intraarticular injections or administration via regional limb perfusion may not be safe and are thus currently not recommended.