Topic:Analgesia
Analgesia in horses involves the use of medications and techniques to alleviate pain caused by injury, surgery, or chronic conditions. Effective pain management is important for the welfare and recovery of equine patients, as unmanaged pain can lead to complications and prolonged healing. Common analgesic agents used in horses include non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and local anesthetics. These agents work through various mechanisms to reduce pain perception and improve comfort. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, application, and clinical outcomes of analgesic strategies in equine medicine.
Analgesic, hemodynamic, and respiratory effects of caudal epidurally administered xylazine hydrochloride solution in mares. To examine effects of 0.25 mg of xylazine/kg of body weight diluted to a total volume of 6 ml/450 kg with sterile 0.9% NaCl, administered into the epidural space of the sacrococcygeal joint on perineal analgesia, sedation, ataxia, and respiratory and cardiovascular function in standing mares. Methods: Randomized, blinded study, using xylazine (treatment) and 0.9% NaCl (controls). At least 2 weeks elapsed between the treatments. Methods: Eight healthy mares. Methods: Blood samples were drawn. Systemic hemodynamics were determined, including cardiac output and pulmonary arterial, systemic arteri...
A comparison of N-butylscopolammonium bromide and butorphanol tartrate for analgesia using a balloon model of abdominal pain in ponies. The analgesic effect of N-butylscopolammonium bromide (0.3 mg/kg) using a balloon-induced model of colic in ponies was evaluated and compared with butorphanol tartrate (0.1 mg/kg). Eight adult ponies were used and each received both treatments during the two different trials. The order in which the treatment was received was randomly assigned. At the start of each trial, moderate abdominal pain was induced by inflation of a balloon placed in the lumen of the caecum. The ponies were evaluated every 5 minutes, and a cumulative pain score (CPS) was assigned. Two baseline measurements were recorde...
Treatment and outcome of chronic tenosynovitis in three horses. Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for ...
[Intravenous anesthesia in the horse: comparison of xylazine-ketamine and xylazine-tiletamine-zolazepam combinations]. Intravenous anesthesia in the horse: Comparison of xylazine-ketamine and xylaxine-tiletamine-zolazepam combinations. Six healthy adult horses were anesthetized twice at random with following intravenous combinations: 1.1 mg/kg of body weight (BW) of xylazine followed by 2.2 mg/kg BW of ketamine (X-K) and 1.1 mg/kg BW of xylazine followed by 1.65 mg/kg BW of tiletamine-zolazepam (X-TZ). The modifications of some cardiorespiratory parameters and the duration of anesthesia were evaluated and compared for the 2 protocols used. Few significant differences were observed between the 2 protocols in re...
Uterine torsion associated with small intestinal incarceration in a mare at 126 days of gestation. A mare at 126 days of gestation was examined because of signs of abdominal pain. The cause of abdominal pain could not be determined by physical examination. Lack of response to analgesics and small intestinal distention on palpation per rectum prompted exploratory celiotomy. Small intestine was found to be entrapped by the uterus, which had undergone torsion. The uterus was returned to its correct position, and the small intestine was decompressed. After surgery, the mare was treated with orally administered progestin to prevent abortion. The mare recovered and delivered a live foal at 354 da...
Effects of ketoprofen and phenylbutazone on chronic hoof pain and lameness in the horse. The analgesic effects of the nonsteroidal anti-inflammatory drugs, ketoprofen (2.2 and 3.63 mg/kg bwt) and phenylbutazone (4.4 mg/kg bwt) were compared in 7 horses with chronic laminitis. Hoof pain was quantified objectively by means of an electronic hoof tester and lameness was subjectively graded on a modified Obel scale. Ketoprofen at a dose of 3.63 mg/kg bwt (phenylbutazone equimolar dose) reduced hoof pain and lameness to a greater extent than the 2.2 mg/kg dose and phenylbutazone. These effects were still present at 24 h in 3 of the 4 pain tests, including lameness grade. These data sugg...
Total intravenous anaesthesia in ponies using detomidine, ketamine and guaiphenesin: pharmacokinetics, cardiopulmonary and endocrine effects. Pharmacokinetics and some pharmacological effects of anaesthesia induced by a combination of detomidine, ketamine and guaiphenesin were investigated in eight ponies. Cardiopulmonary function was studied and plasma met-enkephalin, dynorphin, beta-endorphin, arginine vasopressin, adrenocorticotrophin, cortisol, 11-deoxycortisol and catecholamine concentrations were measured. The combination produced slight cardiorespiratory depression, hyperglycaemia and a reduction in haematocrit. There were no changes in plasma opioids, pituitary peptides or catecholamines. Plasma cortisol concentration decrea...
Sedative and analgesic effects of detomidine and romifidine in horses. In a double blind study, eight horses were treated intravenously at seven-day intervals with detomidine at doses of 10, 20 and 40 micrograms/kg, or with romifidine at doses of 40, 80 and 120 micrograms/kg, or with a placebo solution. Their sedative and analgesic effects were evaluated by objective measurements and by a clinician at 15-minute intervals for three hours and the horses' instability in stocks, locomotor ataxia and heart rate were recorded simultaneously. The administration of both drugs at all doses resulted in sedation. The sedation achieved with romifidine was significantly shall...
Emergency analgesia and chemical restraint in the horse. Clinical examination of the equine patient with acute abdominal pain should identify the affected body system and yield a provisional diagnosis. Determination of signalment, history, physical examination, and basic laboratory tests should assist in classification of the gastrointestinal disorder and direct the therapeutic plan. Determination of the definitive diagnosis of abdominal pain based on clinical examination is not crucial. For a successful outcome, efforts should be directed toward early recognition of the need for surgery and treatment of cardiovascular compromise in horses with seve...
[Doping problems in horse sports–pharmacokinetics of selected antiphlogistics/analgesics relevant to doping]. Drug treatment of horses which are used in horse-racing is restricted by the regulations of the anti-doping control. Veterinarians and anti-doping control commissions are faced with the problems resulting from the discrepancy between the demand "no drugs in blood/urine of horses at the time of competition" and the need for treatment. The pharmacokinetic data of important antiphlogistics/analgetics (NSAID) for horses given in this article shall facilitate the decision of the veterinarians and commissions whether a horse having been treated with NSAID may participate in a competition or not. Fur...
Caudal analgesia induced by epidural or subarachnoid administration of detomidine hydrochloride solution in mares. Seven adult mares were used to determine the analgesic, CNS, and cardiopulmonary effects of detomidine hydrochloride solution after epidural or subarachnoid administration, using both regimens in random sequence. At least 1 week elapsed between experiments. A 17-gauge Huber point (Tuohy) directional needle was used to place a catheter with stylet into either the epidural space at the first coccygeal interspace or the subarachnoid space at the lumbosacral intervertebral junction. Catheters were advanced so that the tips lay at the caudal sacral (S5 to S4) epidural space or at the midsacral (S3 ...
Nerve supply of the proximal sesamoid bone in the horse. In chronical proximal sesamoid bone lameness it is difficult to localise the exact site of pain. A specific diagnostic analgesia is not available because of a deficiency of detailed information about the nerve supply to the proximal sesamoid bones and surrounding area. A macroscopic study of the nerve distribution to the proximal sesamoid bones of 10 foals and 5 adult horses revealed that these bones are innervated by two branches, in this study called the medial and lateral sesamoidean nerve, respectively, originating from the medial and lateral palmar nerve. Histology of the left forelimbs o...
Proximal suspensory desmitis in the hindlimb: 42 cases. Proximal suspensory desmitis of the hindlimb was diagnosed using local analgesic techniques and ultrasonography in 42 horses. Subtarsal analgesia resulted in substantial improvement in lameness in 36 of 41 horses in which local analgesic techniques were used. In the remaining five horses lameness was improved by perineural analgesia of the tibial nerve (three) or the tibial and fibular nerves. Intra-articular analgesia of the tarso-metatarsal joint produced a similar degree of improvement in two of 24 horses in which lameness had been improved by subtarsal analgesia. Ultrasonographic abnormali...
Narcotics and local anesthetics. The recognition and alleviation of animal pain is a growing veterinary and public concern. Pain can be of an acute or chronic nature with different behavioral manifestations. Physiologically, pain is a dynamic and complex phenomenon that produces changes in the central and autonomic nervous systems as well as in the endocrine system. Horses and other animals appear to possess an endogenous pain-suppressing system involving the brainstem and spinal cord. This system can modulate pain perception and the responses to it. The recently discovered endogenous opioid peptides (endorphins and enkephali...
Postoperative analgesia using phenylbutazone, flunixin or carprofen in horses. Horses undergoing surgery were randomly assigned to one of three groups to receive phenylbutazone at 4 mg/kg (n = 72), flunixin at 1 mg/kg (n = 68) or carprofen at 0.7 mg/kg (n = 63) by slow intravenous injection at the end of surgery, just before they were disconnected from halothane. Pain was assessed by either of two resident surgical clinicians (who did not know which non-steroidal anti-inflammatory drug had been given) when the horses first stood up, two and four hours later and the next morning. If repeated doses of analgesic drugs were given the time was recorded and taken as an end poi...
Forelimb lameness associated with radiographic abnormalities of the cervical vertebrae. Eight horses had forelimb lameness which was considered unrelated to primary forelimb pain, but was associated with radiographic abnormalities of one or more cervical vertebrae. There was no evidence of ataxia or weakness. The degree and character of the forelimb lameness varied between horses. In 4 horses, selective local analgesic techniques were used to rule out lameness associated with pain in the forelimb. In the other 4 horses, radiographic examination of the cervical region was performed on the basis of forelimb lameness seen in conjunction with neck stiffness and/or neck pain. Three ho...
Paravertebral thoracolumbar anaesthesia in 10 horses. The caudal border of the last rib was used as a reliable point of orientation while performing paravertebral thoracolumbar anaesthesia (PTLA) on 10 horses undergoing standing flank laparotomy. The local anaesthetic in all horses was 2% lidocaine. The PTLA procedure was completed in 9.8 +/- 1.8 mins (mean +/- sd). Sedation was provided by a combination of intravenous morphine with xylazine or detomidine. Overall analgesia, provided by the combination of PTLA and sedation, was rated as excellent in 2 horses and good in 6 horses. In the remaining 2 horses, overall analgesia was rated as fair beca...
Clinical effects of detomidine with or without atropine used for arthrocentesis in horses. The effectiveness of detomidine with or without atropine sulfate premedication in producing sedation and analgesia for arthrocentesis was studied in 12 horses. The effects were evaluated by monitoring heart and respiratory rates, borborygmi, distance from the lower lip to the floor, systolic blood pressure, and response to needle insertion. Either atropine or saline (as a placebo) was administered immediately prior to detomidine. All drugs were administered intravenously. Measurements were taken prior to drug injection and at 1, 5, 10, 15, 20, 25, 30, 40, 50, 60, 120, 180 and 240 minutes posti...
Conservative management of femoral diaphyseal fractures in four foals. Femoral fractures in young horses can occur as a result of severe trauma and generally have a poor prognosis despite treatment. Four young horses with femoral diaphyseal fractures were managed with conservative treatment consisting of prolonged rest, analgesics, hind limb support, and corrective farriery. A favorable outcome in the form of pasture soundness with potential for limited athletic usefulness was obtained in 3 out of the 4 cases. This report supports the use of conservative treatment of selected diaphyseal femoral fractures in young horses.
[Pain prevention and pain treatment in small and large domestic animals]. The aim of this article is to emphasize the need for analgesic medication in animals in possibly painful situations, especially in the postoperative period. The two large groups of compounds used as analgesics--the opiates and the nonsteroidal antiinflammatory drugs (NSAIDs)--are described with special reference to their pharmacokinetics, side-effects and toxicity, their mechanism of action, their indications and contraindications. Recommended doses of the different drugs available are given for the dog, the cat, the horse, the swine and the small and large ruminants.
A comparison of responses to analgesia of the navicular bursa and intra-articular analgesia of the distal interphalangeal joint in 59 horses. Analgesia of the distal interphalangeal (DIP) joint and of the navicular bursa was performed independently in the lame or lamer forelimb of 59 horses, in which lameness was significantly improved by perineural analgesia of either the palmar digital or palmar (abaxial sesamoid) nerves. In 3 horses no improvement was detected. Lameness was improved by analgesia of the DIP joint but there was no response to analgesia of the navicular bursa in 3 horses. In 12 horses, lameness was improved by analgesia of the navicular bursa but intra-articular analgesia resulted in no change. Forty-one horses resp...
Analgesic effects of detomidine in thoroughbred horses with chronic tendon injury. This study was undertaken to assess the analgesia provided by detomidine (20 micrograms kg-1 intravenously) in thoroughbred horses. Pain thresholds to a mechanical noxious stimulus were measured before and after a period of mild chronic pain in one foreleg. Detomidine was a good analgesic in control animals; their pain thresholds were significantly elevated for about 60 minutes. After injury, the injured leg had a significantly lower pain threshold and the intensity and duration of analgesia provided by detomidine were significantly reduced. The analgesia in the opposite (sound) leg was also r...
An investigation of injection techniques for local analgesia of the equine distal tarsus and proximal metatarsus. A positive radiographic contrast agent was injected into the tarsometatarsal (TMT) joints of both hindlimbs of 10 horses. Lateromedial radiographic views were obtained at 5, 15 and 30 mins after injection. Injection was successful in 19 of 20 limbs. Communication between the centrodistal (CD) and TMT joints was identified in 7 limbs (35%). Contrast agent extended around the tendons of tibialis cranialis (TC) and fibularis tertius (FT) in 18 limbs, and in 7 limbs some contrast entered the tarsal sheath. Slight to moderate plantar and/or distal extension of contrast agent was identified in 13 li...
Comparison of lidocaine, xylazine, and xylazine/lidocaine for caudal epidural analgesia in horses. Caudal epidural analgesia was achieved in 6 adult horses on 3 successive occasions at weekly intervals by injection of lidocaine, xylazine, and a combination of lidocaine/xylazine through indwelling epidural catheters. Analgesia was defined as a lack of response to pinprick and hemostat pressure in the skin of the perineal area. A significant (P < 0.05) difference was not found for time of onset of analgesia between lidocaine (4.3 +/- 0.8 minutes, mean +/- SEM) and the lidocaine/xylazine combination (5.3 +/- 1.3 minutes). Time to onset of analgesia after administration of xylazine was signi...
Xylazine-ketamine and detomidine-tiletamine-zolazepam anesthesia in horses. Eight horses were anesthetized three times, by intravenous administration of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), detomidine (0.02 mg/kg) and tiletamine-zolazepam (1.1 mg/kg), or detomidine (0.04 mg/kg) and tiletamine-zolazepam (1.4 mg/kg). The sequences were randomized. The duration of analgesia and the times to sternal and standing positions were recorded. Heart rate, arterial pressure, pHa, PaCO2, and PaO2 were measured before and during anesthesia. The duration of analgesia with the two doses of detomidine-tiletamine-zolazepam, 26 +/- 4 minutes and 39 +/- 11 minutes, respectively...
Postpartum partial cystectomy through the vagina in a mare with everted partially necrotic bladder. The bladder of a 750-kg Clydesdale mare had everted through the urethra into the vagina immediately after parturition. The bladder was reinverted into the peritoneal cavity by an attending veterinarian, but 4 days later, the bladder was everted again in the vagina. The mare was able to void urine through both ureters, which could be seen in the mucosal surface of the bladder. The everted bladder had become edematous and could not be reinverted through the urethra. A considerable portion of the fundus was necrotic. The mare was administered xylazine epidurally to induce perineal analgesia, and ...
The influence of surgery and anaesthesia on the pharmacokinetics of pethidine in the horse. The plasma concentration of pethidine was measured in 16 horses, after its administration intravenously (i.v.) at a dose rate of 1 mg/kg bodyweight (bwt). In eight animals studied before surgery, the plasma levels of the drug decreased in a bi-exponential manner with a distributive half life of 3 mins and an elimination half life of 57.7 mins. Total body clearance was 17.7 ml/kg bwt/min. The remaining horses were investigated immediately after a period of anaesthesia and surgery and in these animals the drug exhibited smaller volumes of distribution (V1 cand Vdarea) and a significantly lower c...
Ketamine, Telazol, xylazine and detomidine. A comparative anesthetic drug combinations study in ponies. This study was designed to assess the effects of 5 anesthetic drug combinations in ponies: (1) ketamine 2.75 mg/kg, xylazine 1.0 mg/kg (KX), (2) Telazol 1.65 mg/kg, xylazine 1.0 mg/kg (TX), (3) Telazol 2 mg/kg, detomidine 20 micrograms/kg (TD-20), (4) Telazol 2 mg/kg, detomidine 40 micrograms/kg (TD-40), (5) Telazol 3 mg/kg, detomidine 60 micrograms/kg (TD-60). All drugs were given iv with xylazine or detomidine preceding ketamine or Telazol by 5 min. Heart rate was decreased significantly from 5 min to arousal after TD-20 but only at 60 and 90 min after TD-40 and TD-60 respectively. Respirato...
Identification of detomidine carboxylic acid as the major urinary metabolite of detomidine in the horse. Horse urine was investigated for metabolites by chromatography and mass spectrometry following the oral administration of the large animal analgesic sedative detomidine to two stallions and intravenous administration of [3H]-detomidine to a mare. Detomidine carboxylic acid and hydroxydetomidine glucuronic acid conjugate were identified in the urine after the oral doses. In addition, traces of free hydroxydetomidine were observed. About half of the radioactivity of [3H]-detomidine was excreted in the urine in 12 h after the i.v. dose (80 micrograms/kg). Most of the excretion occurred between 5 ...
Chemical restraint for surgery in the standing horse. Chemical restraint can be a useful pharmacologic tool to assist the veterinarian performing surgery in the standing horse. The agents discussed impose minimal adverse side effects and are considered relatively safe when administered in the doses described. Acetylpromazine, the most widely used tranquilizer, produces mild sedation but no analgesia. The use of tranquilizers for surgical procedures requires the combined use of either a local anesthetic technique or a sedative-hypnotic or opiate to provide analgesia. Sedative-hypnotics such as xylazine and detomidine or opiates such as morphine an...