Flunixin meglumine and dimethyl sulfoxide (DMSO) both ameliorated endotoxemia in donkeys (Equus asinus), according to a study published online 26 September 2026 in The Veterinary Journal. The research team, led by Maged R. El-Ashker with Haytham Aamer, Eman Nour, Ehab Wafa and Mohamed Youssef, tracked the effect through two renal biomarkers: neutrophil gelatinase-associated lipocalin (NGAL) and beta-2 microglobulin (B2M).

The choice of biomarkers matters for equine practitioners. NGAL and B2M rise early when tubular and glomerular function comes under pressure, and endotoxemia — whether from colic, sepsis or gastrointestinal compromise — drives exactly that kind of renal insult. Donkeys have long sat in the shadow of horses in the clinical literature, and this study addresses that gap directly by measuring how two drugs already common in large-animal practice perform in the species.

Flunixin meglumine, a nonsteroidal anti-inflammatory drug, remains a standard intervention for endotoxemic equids. Its capacity to blunt prostaglandin-mediated inflammation is well documented in horses; the donkey evidence base is thinner. DMSO, a free radical scavenger, has a long history of off-label use in endotoxemia protocols, often paired with fluid therapy. The Veterinary Journal study set out to compare how each agent influenced biomarker dynamics during induced endotoxemia, using NGAL and B2M as readouts of kidney injury rather than relying on creatinine alone, which lags behind acute damage.

For clinicians, the practical question is straightforward: does the standard flunixin protocol, the DMSO adjunct, or the combination best protect renal function when endotoxin is circulating? The authors report that treatment ameliorated the endotoxemic state, with biomarker trajectories providing the evidence. The study design allows NGAL and B2M to serve as early sentinels — a monitoring approach practitioners could adopt at the stall side, since delayed recognition of renal injury in endotoxemic equids carries a poor prognosis.

The donkey-specific angle has real-world weight. Donkeys metabolize some drugs differently from horses, and extrapolated dosing has caused problems in the field. Pharmacokinetic work over the past decade has shown that donkeys are not small horses, and treatment studies in the species help replace extrapolation with data. Any practice serving working donkeys, donkey sanctuaries or mixed equine clientele will recognize the scenario: a colicking or septic animal, endotoxin on board, renal function in question, and a formulary built largely on horse evidence.

Biomarker-guided monitoring also changes the economics of care. NGAL and B2M assays are increasingly accessible through reference laboratories, and serial measurement can flag tubular injury before azotemia becomes established. In a species where owners may present animals late — working donkeys often arrive with advanced disease — earlier detection tools carry outsized value.

Neither drug in the study carries a donkey-specific label; flunixin meglumine is approved by the FDA Center for Veterinary Medicine for horses and cattle, and DMSO has its own regulatory status in the United States, leaving donkey use in both cases as extralabel application under the usual veterinary oversight. Practitioners should weigh that status alongside the published efficacy data when building protocols.

The full paper — including dosing, treatment groups and statistical outcomes — appears in The Veterinary Journal, available online since 26 September 2026. As NGAL and B2M assays become routine in equine medicine, studies like this one give donkey clinicians a species-grounded reference point, and further work will likely establish whether these biomarker findings translate into survival advantage in field cases.