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.
A comparison of methods for proximal palmar metacarpal analgesia in horses. Three techniques for inducing analgesia of the proximal metacarpal region were evaluated for the frequency of inadvertent injection into the middle carpal and carpometacarpal joints. Using methylene blue solution as a marker dye and 30 fresh cadaver specimens each, three clinicians performed either 30 infiltrations at the origin of the suspensory ligament (method A), 30 palmar and palmar metacarpal nerve blocks at the proximal end of the metacarpus (method B), or 30 palmar and palmar metacarpal nerve blocks at the distal aspect of the accessory carpal bone (method C). The frequency of inadvert...
Narcotic analgesics, their detection and pain measurement in the horse: a review. Narcotic analgesics produce pharmacological effects by interacting with specific opiate receptors. At least five major types of opiate receptors have been recognised. These include mu (morphine) and kappa (ethylketazocine) receptor types. Narcotic analgesics which interact with mu receptors produce locomotor and autonomic stimulation at doses that produce little or no analgesia. Therefore, use of these drugs as analgesics in equine medicine has not been very satisfactory. Theoretical considerations suggested that the role of kappa agonists in equine analgesia be investigated. Using a pure kapp...
A preliminary comparison of lidocaine and xylazine as epidural analgesics in ponies. Xylazine (0.35 mg/kg) or lidocaine (0.35 mg/kg) was injected into the epidural space of six ponies to compare their effectiveness as epidural analgesics. Each pony received both treatments at 1 week intervals with the order of treatments randomized. Xylazine produced analgesia of significantly longer duration (247 +/- 58 minutes) than that produced by an equal dose of lidocaine (135 +/- 22 minutes). Mild transient ataxia of no clinical significance developed in all ponies with both treatments. Spinal cords were removed from two ponies and examined histologically. No discernible pathologic chan...
Epidural injection of xylazine for perineal analgesia in horses. Local anesthetics given in the epidural space of a horse may cause hind limb weakness in addition to analgesia. Because alpha 2 agonists given by epidural injection cause sensory blockade without motor effects in human beings and other species, their use in veterinary anesthesia is appealing. This study was designed to examine the effectiveness of xylazine HCl, an alpha 2 agonist commonly used in horses. Xylazine, 0.9% NaCl, and lidocaine were given by epidural injection to horses subjected to perineal electrical stimulation. Administration of xylazine (0.17 mg/kg of body weight, diluted to a ...
Detomidine (Domosedan) in foals: sedative and analgesic effects. Detomidine was administered twice to six foals (14 to 94 days old) using three different doses (10, 20 and 40 micrograms/kg bodyweight intravenously) in a double blind trial. Sedation, analgesia, heart rate and clinically observed side-effects were recorded. Detomidine showed strong sedative effects at all doses tested. Sedation deepened very little by increasing the dose from 10 to 40 micrograms/kg bodyweight, but the duration of the effect was longer. Analgesia was considered good with the largest dose (40 micrograms/kg), and moderate or non-existent with the lower doses. Detomidine caused a...
Dose-related effects of detomidine on autonomic responses in the horse. 1. Detomidine is a novel veterinary sedative analgesic which is thought to act by stimulation of alpha 2 adrenoreceptors. The present study was undertaken to determine the direction, time course, and dose-response relationship of detomidine on specific autonomic responses in the unanaesthetized horse. 2. Detomidine was administered intravenously to eight adult thoroughbred racehorses at doses of 0.010-0.040 mg kg-1, according to a double-blind Latin square crossover design. Cardiac and respiratory rates, pupil diameter and rectal temperature were monitored for 180 min postinjection. 3. Detomid...
Objective assessment of detomidine-induced analgesia and sedation in the horse. The effects of detomidine, a veterinary sedative analgesic, were studied in the horse. Novel objective techniques were employed to assess the analgesic and sedative potency of this compound. Intravenous doses of 0.010, 0.020 and 0.040 mg/kg were administered to eight adult Thoroughbred racehorses according to a double-blind crossover design. Analgesia was measured by determining the latency to onset of the skin twitch and hoof withdrawal reflexes following noxious thermal stimulation of the withers and fetlock, respectively. Sedation was assessed by quantifying spontaneous locomotor activity i...
Recognition and management of ileus. Ileus may occur in horses of all ages secondarily to drug administration, colic, exhaustion, peritonitis, or metabolic disorders. Ileus most commonly occurs following abdominal surgery for colic and is a significant cause of postoperative mortality in these horses. The most common clinical signs of ileus are decreased or absent intestinal sounds and gastric reflux. Ileus is treated by eliminating the initiating causes, correcting metabolic imbalances, decompressing distended bowel, providing analgesia, stimulating motility with drugs, and regulating exercise and feed and water intake.
Selected aspects of the clinical pharmacology of visceral analgesics and gut motility modifying drugs in the horse. Comparison of the visceral analgesic effects of xylazine, morphine, butorphanol, pentazocine, meperidine, dipyrone, and flunixin in a cecal distention model of colic pain indicated that xylazine produces the most relief from abdominal discomfort. Repeated administration of xylazine may reduce visceral pain so effectively that the seriousness of abdominal disease is obscured. Xylazine decreased propulsive motility in the jejunum and pelvic flexure of healthy ponies. Morphine and butorphanol also gave relief from visceral pain in the cecal distention model. Morphine may inhibit colonic, and buto...
Dose related effects of the kappa agonist U-50, 488H on behaviour, nociception and autonomic response in the horse. Current opiate receptor theory suggests that kappa agonists should provide good analgesia without producing marked central nervous system stimulation. U-50,488H is an experimental narcotic analgesic that is a selective kappa agonist. In the present study, U-50,488H produced good analgesia in horses using both the skin twitch and hoof withdrawal reflex assays. Further, the analgesia was relatively long lasting (120 mins) compared to other mu-agonists tested in horses. The locomotor response to U-50,488H was less than observed with ethylketazocine and butorphanol, and has yielded the smallest lo...
Dental dolorimetry for the evaluation of an analgesic agent in the horse. A monopolar electrode was implanted surgically in the canine tooth dentine layer to evaluate pain threshold responses of horses. A constant-current stimulator was used to deliver a known electrical current to the tooth pulp nerve. A single stimulus of 2-ms duration, repeated at greater than or equal to 20-s intervals, was used to elicit a head lift response. The lowest current level that produced 3 positive head lift responses was recorded as the pain threshold of the horse. The testing technique, dental dolorimetry, was easily performed. Tooth pulp pain thresholds (TPPT) were established on 8...
Comparative analgesia of xylazine, xylazine/morphine, xylazine/butorphanol, and xylazine/nalbuphine in the horse, using dental dolorimetry. Xylazine, morphine, butorphanol, and nalbuphine were evaluated in 5 adult male horses, using dental dolorimetry. Comparisons were made at 30, 60, and 100 minutes after IV drug administration. Peak analgesia and the time to develop peak analgesia also were compared. Xylazine induced a marked increase in the tooth pulp pain threshold measurements as did the xylazine/narcotic combinations. Statistical differences were not detectable between these treatments. Xylazine and xylazine/butorphanol were better analgesics than was butorphanol alone at 30 and 60 minutes. Xylazine resulted in peak analgesi...
Presence of salicylic acid in standardbred horse urine and plasma after various feed and drug administrations. Plasma and urinary levels of salicylic acid were examined in Standardbred mares after administration of various feeds, containing different compositions of hay. In addition, horses were administered acetylsalicylic acid orally and methyl salicylate topically. Elevated salicylic acid levels were observed in horse urine and plasma in animals fed lucerne hay. The plasma and urinary elimination of salicylic acid exhibited a diurnal pattern which was related to the type of feed and the feeding schedule. Within 24 h after oral administration of acetylsalicylic acid, plasma and urine salicylic acid l...
Pelvic fractures in horses: 19 cases (1974-1984). The clinical features of 19 horses with pelvic fractures were reviewed. The most common problem was a grade III or IV unilateral hind limb lameness. The prevalence of fractures was greater in females and horses less than 4 years old. All horses were treated with a combination of analgesic administration and stall rest for 2 to 6 months. Seven of 11 horses (64%) available for long-term follow-up evaluation recovered and 4 of 11 (36%) had no lameness when being ridden. Five of seven (71%) horses with fractures that involved the acetabulum recovered, and 4 (57%) had complete resolution of lamenes...
Radioimmunoassay of detomidine, a new benzylimidazole drug with analgesic sedation properties. A sensitive and specific radioimmunoassay was developed for detomidine, 4(5)-(2,3-dimethylbenzyl)imidazole. The antibodies were raised in rabbits against a conjugate of detomidine and bovine thyroglobulin prepared by diazo reaction. Detomidine was iodinated with chloramine-T and immunoreactive tracer was purified in cation exchange chromatography. The sensitivity of the RIA was 1.6 fmol/tube allowing direct detomidine measurements from minute serum and urine samples (0.1-0.2 microliter) as well as tissue homogenates (10 microliters). For concentrations below 16 pmol/ml chloroform extraction wa...
Beta-endorphin: peripheral opioid activity of homologues from six species. The peripheral opioid activity of six homologous beta-endorphins (beta-EPs) were assayed on the guinea pig ileum and the vas deferens of the mouse, the rat and the rabbit. In the guinea pig ileum assay, human beta-EP (beta h-EP) was less potent than camel, turkey, and ostrich beta-EPs, of the same potency as equine beta-EP and more active than des-acetyl salmon beta-EP. In the rat vas deferens, mammalian beta-EPs showed higher activity than those from the bird and the fish, whereas in the mouse vas deferens assay, beta h-EP is more active than those from other species. In the rabbit vas defere...
[Flunixin and its use in horses]. Flunixin is a non-steroidal anti-inflammatory agent, with a potent analgesic activity and a slight toxicity. It is largely used in horses, in the form of meglumine salt, for the treatment of inflammatory diseases or colics, and often identified in dopage cases. Physical and chemical properties of the drug, its pharmacological and toxicological properties, and its use in equine species are depicted.
Renal toxicity of non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs represent the most heavily prescribed and used class of drugs in human medicine. Most are derivatives of either salicylates, propionic acid, indoleacetic acid, anthranilic acid, pyrazolone, or oxicams. They depress the synthesis of prostaglandins from arachidonic acid by reversible inhibition of the enzyme cyclooxygenase. In the kidney, prostaglandins PGE2 and PGI2 modulate the vasoconstrictor effects of angiotensin II, norepinephrine, and vasopressin. In the presence of volume contraction, anesthesia, or disease states associated with high levels of these...
Dose-related effects of ethylketazocine on nociception, behaviour and autonomic responses in the horse. Sensitive methods for measuring the analgesic, physiological and behavioural effects of opioids in the horse have recently been developed. Fentanyl, a prototypic mu-opiate receptor agonist, has been previously shown to produce a syndrome characterized by marked analgesia and locomotor stimulation as well as tachycardia, tachypnoea and behavioural arousal. To determine whether other opiate receptors mediate some of the actions of the narcotic analgesics in the horse, an agent with activity at kappa- and to lesser extent mu-receptors was studied using a vigorous experimental protocol. Like fenta...
Visceral analgesia: effects of xylazine, butorphanol, meperidine, and pentazocine in horses. The visceral analgesic, cardiorespiratory, and behavioral effects induced by xylazine, butorphanol, meperidine, and pentazocine were determined in 9 adult horses with colic. Colic was produced by inflating a balloon in the horses' cecum. Heart rate, respiratory rate, mean arterial blood pressure, and cardiac output increased after cecal balloon inflation. Xylazine and butorphanol decreased the hemodynamic response to cecal balloon inflation. Meperidine and pentazocine had minimal effects on the cardiorespiratory changes induced by cecal balloon inflation. Xylazine produced the most pronounced ...
Upper respiratory tract obstruction caused by a pharyngeal abscess in a filly. A 3-year-old Thoroughbred filly had a pharyngeal abscess causing obstruction of the upper respiratory tract. Diagnosis was made by a combination of endoscopy, biopsy, cytology, and radiography. Treatment with antimicrobials and analgesics resulted in successful resolution of the abscess.
Comparison of carbonated lidocaine and lidocaine hydrochloride for caudal epidural anesthesia in horses. A double-blind comparison of carbonated lidocaine and lidocaine hydrochloride in caudal epidural anesthesia was performed in 8 horses. Among 5 horses with successfully paired bilateral caudal epidural blockades, no significant differences in onset time, duration, or sensory blockade were demonstrated. In the present study, carbonated lidocaine did not offer an advantage over the hydrochloride salt for caudal epidural anesthesia in the horse.
A method for studying cutaneous pain perception and analgesia in horses. Pain perception and its alteration by analgesic drugs is difficult to measure in the horse. The latency to onset of flexion of a limb in response to a noxious thermal stimulus has been used as a nociceptive end point for analgesic studies in many species. While this method has been employed in the horse, it may be confounded by the spontaneous locomotor activity observed after administration of narcotic analgesics. Consequently, an alternative method of assaying narcotic analgesia that did not involve the equine locomotor apparatus was developed. This report describes the use of the heat-evoke...
Spinal fluid concentrations of mepivacaine in horses and procaine in cows after thoracolumbar subarachnoid analgesia. The CSF concentrations of mepivacaine in 10 Standardbred horses and of procaine in 10 Holstein cows given the drugs by thoracolumbar subarachnoid injection were determined. Mepivacaine hydrochloride was injected into the horses (502 +/- 60.5 kg) at an average dosage of 30 mg (1.5 ml of 20 mg/ml solution). Analgesia was produced 7.5 +/- 4.3 minutes after injection, extended between spinal cord segments T13 and L3 on both sides of the spinal column, and lasted 47 +/- 18.7 minutes at the T18 dermatome. Procaine hydrochloride was injected into cows (614 +/- 51.5 kg) at a dosage ranging between 75 ...
Clinical pharmacology and therapeutic uses of non-steroidal anti-inflammatory drugs in the horse. Weak organic acids possessing anti-inflammatory, analgesic and antipyretic properties--commonly known as aspirin-like drugs--have been used in equine medicine for almost 100 years. These non-steroidal anti-inflammatory drugs (NSAIDs) may be classified chemically into two groups; the enolic acids such as phenylbutazone and carboxylic acids like flunixin, meclofenamate and naproxen. All NSAIDs have similar and possibly identical modes of action accounting for both their therapeutic and their toxic effects. They block some part of the cyclo-oxygenase enzyme pathway and thereby suppress the synthe...