David G. Levine, DVM; Kira L. Epstein, DVM; Dana A. Neelis, DVM; Michael W. Ross, DVM American Journal of Veterinary Research November 2009 70 11 1323-1325 Objective—To determine whether topical application of 1% diclofenac sodium cream would decrease inflammation at sites of IV regional limb perfusion (IVRLP) in healthy horses. Animals—6 healthy adult horses (12 forelimbs). Procedures—Bilateral IVRLP with 2.5 g of amikacin sulfate was performed twice in each horse, with 24 hours between each session. Horses were treated with topical 1% diclofenac liposomal cream (treated limbs) or a placebo cream (control limbs). All injection sites were evaluated before the first IVRLP session and 24 hours after the second session by means of ultrasonographic examination by a trained ultrasonographer who was unaware of the treatment received. Circumferential measurements and subjective visible inflammation scores were recorded by a veterinarian who was also unaware of treatment received. Results—After IVRLP, control limbs had a significantly greater increase in subcutaneous thickness, compared with treated limbs. Ultrasonographic and visual assessment scores were significantly higher in control versus treated limbs. The mean change in limb circumference was greater, but not significantly so, in control limbs, compared with treated limbs. Conclusions and Clinical Relevance—Topical application of 1% diclofenac sodium liposomal cream to sites of IVRLP in healthy horses decreased inflammation as judged by visual assessment and ultrasonography. Decreased inflammation may allow extended use of IVRLP and may result in a reduction in pain in treated horses.