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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.
Pharmacology of the Equine Foot: Medical Pain Management for Laminitis. One of the biggest challenges in managing laminitis in horses remains the control of pain. The best analgesic approach is a multimodal approach, including nonsteroidal anti-inflammatory drugs, opioids, and/or constant rate infusions of α-2 agonists, ketamine, and lidocaine. Recent literature indicates that amitriptyline and soluble epoxide hydrolase inhibitor might be beneficial. Clinically oriented studies will be needed if they have a place in laminitis pain management. The systemic pain control can be combined with local techniques such as long-acting local anesthetics or epidural catheter...
Pharmacokinetics of paracetamol in the Thoroughbred horse following an oral multi-dose administration. Paracetamol is a widely used, non-opioid analgesic and antipyretic drug. Scientific evidence suggests that it is an effective pain treatment in equine medicine. However, there is very little published information about the pharmacokinetics of the drug in the horse. The aim of the research was to determine the pharmacokinetics of paracetamol in equine plasma and urine to inform treatment of Thoroughbred racehorses. In this multi-dose study, paracetamol was administered orally at 20 mg/kg to six Thoroughbred horses. Pre- and post-administration urine and plasma samples were collected and analys...
Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction. While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the ...
Pharmacokinetic Profiles of Metamizole Metabolites after Intramuscular and Intravenous Administration in Healthy Arabian Horses. Metamizole sodium (MT) is an analgesic and antipyretic drug molecule used in humans, horses, cattle, swine, and dogs. Metamizole rapidly hydrolyzes and turns into methylamino antipyrine (MAA), an active primary metabolite of MT. The present study aims to determine the pharmacokinetic (PK) profiles of MT metabolites after intravenous (IV) and intramuscular (IM) administration into sex of Arabian horses (Equus ferus caballus) using a cross-over study design. The plasma samples were extracted by solid-phase extraction (SPE) method, and plasma concentrations of MT metabolites were analyzed by high...
Species Differences in Metabolism of Soluble Epoxide Hydrolase Inhibitor, EC1728, Highlight the Importance of Clinically Relevant Screening Mechanisms in Drug Development. There are few novel therapeutic options available for companion animals, and medications rely heavily on repurposed drugs developed for other species. Considering the diversity of species and breeds in companion animal medicine, comprehensive PK exposures in the companion animal patient is often lacking. The purpose of this paper was to assess the pharmacokinetics after oral and intravenous dosing in domesticated animal species (dogs, cats, and horses) of a novel soluble epoxide hydrolase inhibitor, EC1728, being developed for the treatment of pain in animals. Results: Intravenous and oral adm...
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses. Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would b...
Cryotherapy provides transient analgesia in an induced lameness model in horses. The analgesic effect of cryotherapy in an induced lameness model was evaluated. Lameness was induced with solar pressure from a custom-made shoe in a 10-horse, cross-over study. The degree of lameness was recorded with a commercial non-invasive inertial sensor. The distal limbs were maintained in an ice and water slurry (cryotherapy) or at ambient temperature (control) for 1 hour. Lameness was assessed serially over the following hour. Lameness at each time point was compared to the baseline induced lameness, within and between groups. Lameness had improved significantly in all horses 5 minute...
Pharmacokinetic properties of metamizole active metabolites in Northeastern Brazilian donkeys (Equus asinus). Metamizole (MT), also known as dipyrone, is an analgesic and antipyretic drug labeled for use in humans and domestic animals in some countries. As with other drugs, the administration of MT in donkeys is based on studies carried out with horses. In the present report, we aimed to determine the pharmacokinetics of the two main metamizole active metabolites (N-methyl-4-aminoantipyrine [MAA] and 4-aminoantipyrine [AA]) following 10 (M ) and 25 mg/kg (M ) IV metamizole doses in Northeast Brazilian donkeys (n = 10). Blood was collected at predetermined times within over 48 h; MAA and AA plasma ...
Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both. Standing surgery under sedation reduces anesthetic-related mortality in horses. Medetomidine, alone and combined with morphine in a constant rate infusion (CRI), has been described for standing surgery but their cardiorespiratory, sedative and antinociceptive effects have never been compared. The addition of ketamine could improve analgesia in these procedures with minimal cardiorespiratory consequences. The objectives were to compare the cardiorespiratory effects, quality of sedation, antinociception and ataxia produced by administration of a medetomidine-based CRI with morphine, ketamine or ...
Pharmacokinetics of dipyrone in horses: A multi-dose, dose escalation study. Dipyrone is a non-opioid, nonsteroidal anti-inflammatory drug with antipyretic and analgesic properties commonly used in horses. Dipyrone is rapidly hydrolyzed to the primary active metabolite 4-methylaminoantipyrine (4-MAA). The purpose of this study was to determine the pharmacokinetic profile of 4-MAA following repeated and escalating doses of intravenously administered dipyrone. Twenty-six horses were randomly allocated to five treatment groups (one placebo group and four dipyrone groups [30 mg/kg q8h, 30 mg/kg q12h, 60 mg/kg q8h, and 90 mg/kg q12h]) and treated for nine consecutive da...
Accelerometric Evaluation of the Locomotor Pattern After Administration of Morphine in Conscious Healthy Horses. The objective of the present study was to compare, using accelerometry, the gait changes produced after administration of a dose of 0.2 mg/kg of morphine at the walk in healthy horses. Six mature horses were used, and all animals received two different treatments with, at least, two weeks interval in between. Treatments administered consisted of a single dose of 10 ml of saline solution or a total of 0.2 mg/kg of morphine diluted in 10 ml of saline solution. A three-dimensional accelerometric device was used to collect data continuously while horses were walking. The walking test was performed...
Spontaneous Behaviors of Post-Orchiectomy Pain in Horses Regardless of the Effects of Time of Day, Anesthesia, and Analgesia. This prospective and longitudinal study aimed to identify spontaneous post-orchiectomy pain behaviors in horses regardless of the effects of anesthesia, analgesia, and recording time of day. Twenty-four horses divided into four groups were submitted to: inhalation anesthesia only (GA), or combined with previous analgesia (GAA), or orchiectomy under pre (GCA), or postoperative (GC) analgesia. The data obtained from the subtraction of frequency and/or duration of 34 behaviors recorded during seven 60-min time-points in the 24 h after the anesthesia from those recorded in the mirrored time-points...
Clinical Randomized Comparison of Medetomidine and Xylazine for Isoflurane Balanced Anesthesia in Horses. To assess drug plasma levels, preanesthetic sedation, cardiopulmonary effects during anesthesia and recovery in horses anesthetized with isoflurane combined with medetomidine or xylazine. Prospective blinded randomized clinical study. Sixty horses undergoing elective surgery. Thirty minutes after administration of antibiotics, flunixine meglumine or phenylbutazone and acepromazine horses received medetomidine 7 μg kg (group MED) or xylazine 1.1 mg kg (group XYL) slowly intravenously (IV) and sedation was assessed 3 min later. Anesthesia was induced with ketamine/diazepam and maintained wi...
Analgesic and Cardiopulmonary Effects of Epidural Romifidine and Morphine Combination in Horses. The study aim is to compare the effects of epidural administration of two different doses of romifidine combined with morphine in horses. A prospective crossover blinded experimental design was used. Five adult healthy horses two males and three females with a mean body weight of 380 ± 45 Kg (335-425 kg), were studied. Treatments consisted of romifidine 30 μg/kg (R30) or 60 μg/kg (R60) combined with morphine 0.1 mg/kg with a washout interval of 72 hours, administered through an epidural catheter placed at the first intercoccygeal space. Heart rate (HR) and respiratory rate (f), pH, blood ga...
The pharmacokinetics of a fentanyl matrix patch applied at three different anatomical locations in horses. Matrix fentanyl patches have not been investigated in horses and may represent an effective means of providing analgesia over an extended time period without venous catheterisation. Objective: To describe the pharmacokinetics of a matrix transdermal fentanyl patch in horses. Methods: Randomised experiment, Latin-square design. Methods: Six adult horses were given each of three treatments with a 96-hour washout. For each treatment, two 100 µg/h matrix fentanyl patches were applied to the inguinal region (TXA), metacarpus (TXM) or ventral tail base (TXT) for 72 hours. Blood samples for fentan...
Complications following equine sacroiliac region analgesia are uncommon: A study in 118 horses. Diagnosis of sacroiliac region pain is supported by a positive response to sacroiliac region analgesia (SIRA). Varying techniques have been described for SIRA; with clinician preference often dictating method. Potential complications following SIRA include ataxia and recumbency. No study has specifically evaluated the prevalence of complications. To describe the complication prevalence following SIRA in a referral clinic. Retrospective cohort study. Review of records from horses presented to two of the authors at Rossdales, Newmarket, between January 2014 and December 2018, that underwent SIRA...
Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses. An ideal dexmedetomidine protocol has yet to be determined for standing sedation in horses. It was hypothesized that an IV bolus followed by CRI dexmedetomidine would have a quicker increase in plasma concentrations compared with repeated IM injections. In a crossover design, eight adult, female horses were randomly placed into two groups: the CRI group (IV bolus dexmedetomidine at 0.005 mg/kg followed by a CRI at 0.01 mg/kg/h for 15 min then 0.005 mg/kg/h for 60 min) and the IM group (dexmedetomidine at 0.01 mg/kg, followed by 0.005 mg/kg in 30-min intervals for 60 min). Clearance and...
Comparison of intraoperative cardiorespiratory and behavioral responses to medetomidine combined with tramadol or butorphanol during standing laparoscopic ovariectomy in horses. The purpose of this study was to assess the cardiorespiratory and behavioral responses to the combination of medetomidine and tramadol (M-T) or butorphanol (M-B) in standing laparoscopic ovariectomy in horses. One ovary was removed under M-T and the contralateral ovary was removed under M-B with at least 4 weeks between operations at random. Horses were sedated using intravenous medetomidine (5 µg/kg) followed by tramadol (1 mg/kg) or butorphanol (10 µg/kg) after 5 min. Sedation was maintained through the repeated injection of medetomidine (1 µg/kg) and tramadol (0.4 mg/kg) or medetomidine ...
Antinociceptive effects of levomethadone in standing horses sedated with romifidine. To evaluate the antinociceptive effect of a bolus of intravenous levomethadone administered to horses during romifidine constant rate infusion (CRI). Methods: Prospective, randomized, masked, crossover experimental study. Methods: A group of eight adult Warmblood horses (seven geldings, one mare) aged 6.6 ± 4.4 years, weighing 548 ± 52 kg [mean ± standard deviation (SD)]. Methods: Levomethadone 0.1 mg kg or an equivalent volume of saline (control) was administered intravenously to standing horses 60 minutes after starting a romifidine CRI. Blood samples to quantify romifidine and levomethad...
Towards an improved pain assessment in castrated horses using facial expressions (HGS) and circulating miRNAs. Pain in horses is an emergent welfare concern, and its assessment represents a challenge for equine clinicians. This study aimed at improving pain assessment in horses through a convergent validation of existing tools: we investigated whether an effective analgesic treatment influences the horse grimace scale (HGS) and the concentration of specific circulating microRNAs (miRNAs). Eleven stallions underwent routine surgical castration under general anaesthesia. They were divided into two analgesic treatment groups: castration with the administration of preoperative flunixin and castration with ...
The effect of regional hypothermia on mechanical nociceptive thresholds in the equine distal forelimb. Regional hypothermia has shown promise as analgesic in horses when used to manage painful conditions of the distal limb such as laminitis. In this prospective study, the analgesic effects of regional hypothermia were assessed using mechanical nociceptive thresholds during distal limb cooling. The study population consisted of eight healthy adult Standardbred horses, selected from a teaching herd. A distal forelimb of each horse was cooled using water immersion at the following sequential target water temperatures: 34 °C, 20 °C, 10 °C, 5 °C, 1 °C, 5 °C, 10 °C, 20 °C. Limb surface temper...
Intra-articular use of analgesic/antinflammatory drugs in dogs and horses. Joint pain is a major cause of lameness in animals such as horses and dogs, and it may affect their athletic performance and quality of life. The intra-articular administration of analgesic/antinflammatory drugs is a common practice in veterinary medicine, for both lameness diagnosis and joint pain management. It is used either perioperatively, such as in animals undergoing arthroscopy/arthrotomy, and in osteoarthritic animals. However, evidence regarding efficacy and safety of each drug is limited, and controversies persist in these areas. In particular, it is often uncertain whether a define...
Bayesian-based withdrawal estimates using pharmacokinetic parameters for two capsaicinoid-containing products administered to horses. Capsaicinoids deter horses from chewing on bandages and are applied topically to provide analgesia to musculoskeletal injuries. They are banned during competition due to their nerve blocking properties. The pharmacokinetics of oral (PO) and direct gastric administration via nasogastric tube (NG), or topical (TOP) administration of two capsaicinoid-containing products were investigated, and the withdrawal times required prior to competition were estimated. Capsaicin (CAP) and dihydrocapsaicin (DCAP) were quantified in plasma, and both compounds were best described by a delayed absorption two co...
Pharmacokinetics and pharmacodynamics of meperidine after intramuscular and subcutaneous administration in horses. To describe the pharmacokinetics and pharmacodynamics of meperidine after IM and subcutaneous administration in horses. Methods: prospective, randomized, blinded, crossover trial. Methods: Six adult horses weighing 494 ± 33 kg. Methods: Treatments included meperidine 1 mg/kg IM with saline 6 mL subcutaneously, meperidine 1 mg/kg subcutaneously with saline 6 mL IM, and saline 6 mL subcutaneously and 6 mL IM, with a 7-day washout between treatments. Plasma meperidine concentrations and pharmacodynamic values (thermal and mechanical thresholds, physiological variables, fecal production) were c...
Standing Sedation and Iocoregional Analgesia in Equine Dental Surgery. Procedural sedation has become popular for describing a semiconscious state that allows patients to be comfortable during certain surgical or diagnostic procedures. Sedation may be enhanced by locoregional anesthetic techniques to produce sufficient analgesia and muscle relaxation for surgery to occur. Sedation and local anesthesia for standing diagnostic and surgical procedures on the horse's head circumvents the potential complications of general anesthesia (particularly, complications related to recovery). However, the implementation of a locoregional anesthetic technique requires a thoroug...
Upper body movement analysis of multiple limb asymmetry in 367 clinically lame horses. Compensatory lameness is common in horses and evaluation can be challenging. Objective: To investigate patterns of compensatory movements in clinical cases with fore- or hindlimb lameness before and after diagnostic analgesia. Methods: Retrospective clinical study. Methods: Multiple limb lameness of 367 horses was characterised by type (push-off, impact or mixed), limb (fore- or hindlimb in predominant lameness) and side (ipsi- or contralateral in concurrent lameness) using a body-mounted inertial sensor (BMIS). Diagnostic analgesia was performed until the percentage improvement of the vector ...
Meperidine pharmacokinetics and effects on physiologic parameters and thermal threshold following intravenous administration of three doses to horses. Meperidine is a synthetic opioid that belongs to the phenylpiperidine class and is a weak mu receptor agonist. In horses there are a limited number of published studies describing the analgesic effects of systemically administered meperidine in horses. The objective of this study was to describe the pharmacokinetics, behavioral and physiologic effects and effect on thermal threshold of three doses of intravenously administered meperidine to horses. Eight University owned horses (four mares and four geldings, aged 3-8 years were studied using a randomized balanced 4-way cross-over design. Hors...
Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis. Opioid epidural analgesia has been shown to provide effective analgesia in horses. There is a lack of evidence regarding the effect of opioid epidural analgesia on quality of recovery in horses. Objective: Identify whether opioid epidural analgesia influences quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis. Methods: Single-centre retrospective cross-sectional study. Methods: Data were obtained from the clinical records of horses which had undergone arthroscopic or tenoscopic surgery for management of hindlimb synovial sepsis over...
Objective Assessment of Acute Pain in Foals Using a Facial Expression-Based Pain Scale. Pain assessment is very important for monitoring welfare and quality of life in horses. To date, no studies have described pain scales for objective assessment of pain in foals. Studies in other species have shown that facial expression can be used in neonatal animals for objective assessment of acute pain. The aim of the current study was to adapt a facial expression-based pain scale for assessment of acute pain in mature horses for valid pain assessment in foals. The scale was applied to fifty-nine foals (20 patients and 39 healthy controls); animals were assessed from video recordings (30-6...
