Associate professor in equine surgery National Veterinary School of Toulouse Toulouse, France
Adverse Reactions Identified After Tiludronate Treatment in 442 Horses: A Retrospective Study. Lallemand EA1, Pires O2, Wilford S3. 1Université de Toulouse, INRAE, ENVT, InTheRes, Toulouse, France; 2Université de Toulouse, INRAE, ENVT, Toulouse, France; 3Vet'entrepreneur, Paris, France.
Tiludronate (Tildren®) is a bisphosphonate used since 2002. The main objective of our study was to investigate retrospectively secondary effects observed after tiludronate administrations in adult horses. Data were collected from three equine clinics from 2008 to 2019. A total of 442 horses fit the study selection criteria. Forty percent were mares, 37% geldings, and 23% male horses. Seventy-nine percent were sport horses, 13% were racehorses, and 8% pleasure horses. Median age of the horses at the time of first administration was 9.0 ± 3.6 years. Median follow-up after last administration was 8.0 ± 16.8 months. Regarding observed secondary effects, 0.68% of the horses presented acute renal failure (n = 3) within 13 days following tiludronate administration (7 ± 6 days). This short time interval and published data suggest a causal link. Six fractures in five horses (1.13%) were diagnosed from 71 to 398 days after tiludronate administration (184 ± 114 days). This 1.13% frequency compares favorably to the 12.56% fractures observed in a population of Thoroughbred racehorses (Verheyen K et al, Bone, 2006). The most important imitation of this study is its retrospective nature. Even if acute renal failure was uncommon ( < 1%), careful patient selection should be done; slow IV perfusion over 90 minutes and avoidance of NSAIDs coadministration are clinically relevant. Colic signs were not observed in our study but practitioners involved in this study mostly administered metamizole as a precautionary measure when horses were not sedated. Our study didn’t detect any evidence for increased frequency of fracture after tiludronate administration when administered at the recommended dosage regimen.