Topic:Pain Management

Is it pain, or is it behaviour?
The Veterinary record    May 3, 2024   Volume 194 Suppl 1 9 doi: 10.1002/vetr.4204
Pearson G.This year BVA Live will, for the first time, feature farm animal and equine CPD. Among the varied topics on offer, Gemma Pearson will be presenting an introduction to equine behavioural medicine, examining the link between emotional and physical health in horses.
Effect of hospitalization on equine local intestinal immunoglobulin A (IgA) concentration measured in feces.
Journal of equine veterinary science    April 30, 2024   105078 doi: 10.1016/j.jevs.2024.105078
May A, Gerhards H, Wollanke B.During hospitalization horses may develop gastrointestinal conditions triggered by a stress-associated weak local immune system. The prospective, clinical trial was conducted to find out whether fecal immunoglobulin A (IgA) concentrations could be determined in hospitalized horses and how they changed during hospitalization and in response to various stressors. Samples were obtained from 110 horses and a control group (n = 14). At arrival in the hospital, horses were categorized into pain grades (1-5), and elective versus strenuous surgery (> 2 hours, traumatic and emergency procedures)...
The pharmacokinetics and pharmacodynamics of fentanyl administered via transdermal patch in horses.
Frontiers in pain research (Lausanne, Switzerland)    March 20, 2024   Volume 5 1373759 doi: 10.3389/fpain.2024.1373759
Reed RA, Berghaus LJ, Reynolds RM, Holmes BT, Krikorian AM, Sakai DM, Ishikawa Y, Knych HK.Understanding the pharmacokinetics and pharmacodynamics of fentanyl in horses is crucial for optimizing pain management strategies in veterinary medicine. Unassigned: Six adult horses were enrolled in a randomized crossover design. Treatments included: placebo, two 100 mcg/h patches (LDF), four 100 mcg/h patches (MDF), and six 100 mcg/h patches (HDF). Patches were in place for 72 h. Blood was obtained for fentanyl plasma concentration determination, thermal threshold, mechanical threshold, heart rate, respiratory rate, and rectal temperature were obtained prior patch placement and at m...
Review of intra-articular local anaesthetic administration in horses: Clinical indications, cytotoxicity, and outcomes.
Equine veterinary journal    November 8, 2023   doi: 10.1111/evj.14027
Webster A, Pezzanite L, Hendrickson D, Griffenhagen G.Equine practitioners frequently inject local anaesthetics (LA) intra-articularly in both diagnosis of lameness and for pain management intra- or post-operatively with synovial endoscopy. Recent reviews of the human and veterinary literature support the concept that chondrotoxicity of LA on joint tissues depends on the type of drug, dose administered, and duration of exposure. The purpose of this review is to summarise the current literature describing intra-articular local anaesthetic use, including both in vitro and in vivo studies, and to draw some comparisons to literature from other specie...
Modified abaxial sesamoid nerve block provides enhanced proximal diffusion compared to basisesamoid block and lower proximal diffusion than traditional low plantar nerve block in equine hind limbs: ex vivo and in vivo study.
Journal of the American Veterinary Medical Association    August 29, 2023   1-6 doi: 10.2460/javma.23.04.0212
Estrada RJ, Alvarado GJ, Vargas A, Vargas J, Vargas D, Chacu00f3n R, Razquin P, Vindas R.To determine the proximal diffusion distance of radiopaque contrast medium and mepivacaine/methylene blue solution and incidence of inadvertent intrasynovial and intravascular injections of modified sesamoid nerve block (MASB) when compared with traditional plantar nerve analgesia techniques of the equine distal hind limb. Methods: Ex vivo model: 18 hind limbs; and in vivo model: 5 horses in a crossover study. Methods: In the ex vivo model, a mepivacaine/methylene blue solution was used to compare the diffusion distance between MASB, basisesamoid block (BSB), and traditional low plantar block ...
Phenylbutazone concentrations in synovial fluid following administration via intravenous regional limb perfusion in the forelimbs of six adult horses.
Frontiers in veterinary science    August 24, 2023   Volume 10 1236976 doi: 10.3389/fvets.2023.1236976
O'Brien M, Mochel JP, Kersh K, Wang C, Troy J.Pain management is critical to equine welfare with non-steroidal anti-inflammatory drugs (NSAID) commonly used in horses. However, systemic NSAID use is limited by harmful gastrointestinal and renal side effects. Intravenous regional limb perfusion (IVRLP) is a technique used in horses that produces high, local antibiotic concentrations while limiting systemic circulation. NSAID-IVRLP would be a novel method of local pain management while limiting systemic NSAID side effects. To date, NSAID-IVRLP administration has not been reported in horses. This study aimed to identify the pharmacokinetics ...
Animal model for tendinopathy.
Journal of orthopaedic translation    August 14, 2023   Volume 42 43-56 doi: 10.1016/j.jot.2023.06.005
Luo J, Wang Z, Tang C, Yin Z, Huang J, Ruan D, Fei Y, Wang C, Mo X, Li J, Zhang J, Fang C, Li J, Chen X, Shen W.Tendinopathy is a common motor system disease that leads to pain and reduced function. Despite its prevalence, our mechanistic understanding is incomplete, leading to limited efficacy of treatment options. Animal models contribute significantly to our understanding of tendinopathy and some therapeutic options. However, the inadequacies of animal models are also evident, largely due to differences in anatomical structure and the complexity of human tendinopathy. Different animal models reproduce different aspects of human tendinopathy and are therefore suitable for different scenarios. This rev...
18F-sodium fluoride positron emission tomography provides pertinent additional information to computed tomography for assessment and management of tarsal pain in horses.
Journal of the American Veterinary Medical Association    August 9, 2023   1-8 doi: 10.2460/javma.23.03.0164
Espinosa-Mur P, Spriet M, Manso-Diaz G, Arndt S, Perez-Nogues M, Roman JL, Garcia-Mata R, Katzman SA, Galuppo LD.To assess the value of 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) for imaging the tarsus and proximal metatarsus and compare it with CT and lameness evaluation. Methods: 25 horses with lameness localized to the tarsal and proximal metatarsal regions that underwent 18F-NaF PET/CT between 2016 and 2021. Methods: 18F-NaF PET and CT images were retrospectively independently evaluated by 3 observers. Standardized uptake values (SUV) were used to characterize 18F-NaF uptake. Correlation between PET and CT findings with subjective and objective maximum (Max-D) and minimum pelvic...
Pharmacokinetic modelling of orally administered cannabidiol and implications for medication control in horses.
Frontiers in veterinary science    August 9, 2023   Volume 10 1234551 doi: 10.3389/fvets.2023.1234551
Eichler F, Pou017aniak B, Machnik M, Schenk I, Wingender A, Baudisch N, Thevis M, Bu00e4umer W, Lischer C, Ehrle A.Cannabidiol (CBD) products gain increasing popularity amongst animal owners and veterinarians as an alternative remedy for treatment of stress, inflammation or pain in horses. Whilst the use of cannabinoids is banned in equine sports, there is limited information available concerning CBD detection times in blood or urine. The aim of this study was to determine the pharmacokinetic properties of CBD following oral administration in the horse to assist doping control laboratories with interpreting CBD analytical results. Part 1: dose escalation study: Single oral administration of three escalatin...
Further comments on: Complications following diagnostic and therapeutic sacroiliac joint region injections in horses: A study describing clinicians’ experience.
Equine veterinary journal    August 8, 2023   Volume 55, Issue 5 927 doi: 10.1111/evj.13970
Gray P.No abstract available
Longitudinal evaluation of fentanyl concentrations in equine plasma and synovial fluid following application of transdermal fentanyl patches over one carpal joint.
Veterinary surgery : VS    August 3, 2023   doi: 10.1111/vsu.13990
Ortega McCormack JJ, Reed RA, Epstein KL, Camus MS, Knych HK.To determine if transdermally delivered fentanyl can achieve greater concentrations of fentanyl in synovial fluid when applied over a synovial structure. Conclusion: Application of fentanyl matrix patches directly over the CMCJ did not result in increased fentanyl concentrations in the synovial fluid of the treated intercarpal joint in normal horses.
Evaluation of frontal and infratrochlear nerve blocks for standing sedated frontonasal sinusotomy in horses.
Veterinary surgery : VS    July 22, 2023   doi: 10.1111/vsu.13997
Elliott SM, Giancola SC, Moorman V.To determine if targeted blocking of frontal and infratrochlear nerves provided anesthesia for the approach to a frontonasal sinusotomy. Methods: Two part study: Part 1 randomized crossover design; Part 2 proof of concept. Methods: N = 12; six each in Parts 1 and 2. Methods: Part 1: Each horse had either frontal and infratrochlear nerve blocks or a line block performed with 2% mepivacaine hydrochloride. Mechanical nociceptive thresholds (MNT) were obtained at five sites along a proposed frontonasal sinusotomy prior to injection, and at 10, 60, and 120 min after blocking. After a 4 day ...
Effect of pony morphology and hay feeding methods on back and neck postures.
Journal of animal physiology and animal nutrition    July 14, 2023   doi: 10.1111/jpn.13861
Bordin C, Raspa F, Harris P, Ellis AD, Roggero A, Palestrini C, Bergero D, Valle E.The application of hay feeding devices, such as the use of hay nets or slow feeders, can help with the management of weight in ponies; however, there is still a lack of knowledge regarding their effect on equine posture. Therefore, the aim of the study was to assess the effect of different feeding devices on the posture of ponies using morphometric analysis. Two different breed types, Shetland type (SH, n = 5) versus Welsh Cob type (WC, n = 4), were fed the same forage in four different ways: on the ground (G), using a fully filled haynet (HF), using a partially filled haynet (HL) and...
Ketoprofen in horses: Metabolism, pharmacokinetics, and effects on inflammatory biomarkers.
Drug testing and analysis    July 13, 2023   doi: 10.1002/dta.3543
Knych HK, McKemie DS, Kass PH, Stanley SD, Blea J.Ketoprofen is an anti-inflammatory drug that is commonly administered to racehorses for the alleviation of musculoskeletal pain and inflammation. This study represents a comprehensive examination of the metabolism (in vivo and in vitro), pharmacokinetics and ex vivo pharmacodynamics, of ketoprofen in horses. The in vitro metabolism as well as specific enzymes responsible for metabolism was determined by incubating liver microsomes and recombinant CYP450 and UGT enzymes with ketoprofen. For the in vivo portion, 15 horses were administered a single intravenous dose of 2.2-mg/kg ketoprofen. Blood...
Post-anesthetic CPS and EQUUS-FAP scores in surgical and non-surgical equine patients: an observational study.
Frontiers in pain research (Lausanne, Switzerland)    July 12, 2023   Volume 4 1217034 doi: 10.3389/fpain.2023.1217034
Reed RA, Krikorian AM, Reynolds RM, Holmes BT, Branning MM, Lemons MB, Barletta M, Quandt JE, Burns CC, Dantino SC, Sakai DM.Equine pain scoring may be affected by the residual effect of anesthetic drugs. Unassigned: To compare pain scores in the hours immediately following anesthetic recovery to baseline pre-anesthetic scores in equine patients undergoing surgical and non-surgical procedures. Unassigned: Clinical observational study. Unassigned: Fifty adult horses undergoing anesthesia for surgical or non-surgical procedures were enrolled. Horses underwent pain scoring using the Composite Pain Score (CPS) and Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) prior to anesthesia (T0) and foll...
Pharmacokinetics of acetaminophen after a single Oral administration of 20 or 40 mg/kg to 7-9 Day-old foals.
Frontiers in veterinary science    July 6, 2023   Volume 10 1198940 doi: 10.3389/fvets.2023.1198940
Gold JR, Grubb T, Court MH, Villarino NF.Acetaminophen is utilized in human infants for pain management and fever. Neonatal foals might benefit from administration of acetaminophen but effective and safe dosage regimens for neonatal foals remains to be determined. Unassigned: The objective was to determine the plasma pharmacokinetics of acetaminophen following oral administration of a single dose of 20 mg/kg or 40 mg/kg to neonatal foals. A secondary objective was to evaluate any changes in hematology and biochemistry profiles. Unassigned: Randomized study. Unassigned: Eight clinically healthy 7-9-day old Quarter Horse foals (3 c...
Response to comments on Complications following diagnostic and therapeutic sacroiliac joint region injections in horses: A study describing clinicians’ experiences.
Equine veterinary journal    June 29, 2023   Volume 55, Issue 5 925-926 doi: 10.1111/evj.13964
Nagy A, Dyson S.No abstract available
Transdermal Flunixin Meglumine as a Pain Relief in Donkeys: A Pharmacokinetics Pilot Study.
Metabolites    June 21, 2023   Volume 13, Issue 7 doi: 10.3390/metabo13070776
McLean AK, Falt T, Abdelfattah EM, Middlebrooks B, Gretler S, Spier S, Turoff D, Navas Gonzalez FJ, Knych HK.Recent approval of transdermal flunixin meglumine (FM) (Banamine®) in cattle has opened the door for the drug's potential application in other species. Transdermal FM could provide a safe and effective form of pain relief in donkeys. In order to evaluate the pharmacokinetics and effects of FM on anti-inflammatory biomarkers in donkeys, a three-way crossover study design was employed. In total, 6 healthy donkeys were administered transdermal (TD) FM at a dosage of 3.3 mg/kg, and oral (PO) and intravenous (IV) doses of 1.1 mg/kg body weight. Blood samples were collected over 96 h to determine t...
Gabapentin: Clinical Use and Pharmacokinetics in Dogs, Cats, and Horses.
Animals : an open access journal from MDPI    June 20, 2023   Volume 13, Issue 12 2045 doi: 10.3390/ani13122045
Di Cesare F, Negro V, Ravasio G, Villa R, Draghi S, Cagnardi P.Gabapentin is an anticonvulsant drug, which presents an established clinical efficacy in human patients for the management of refractory partial seizures, secondarily generalized tonic-clonic seizures, and for the control of chronic neuropathic pain. Gabapentin was synthesized as a structural analogue of the inhibitory neurotransmitter GABA, with GABA-mimetic effects, able to cross the blood-brain barrier. In veterinary medicine, is extra-label used in combination with other treatments to control seizures when other drugs are no longer effective or become toxic or for neuropathic pain treatmen...
The effect of acute equine temporomandibular joint inflammation on response to rein-tension and kinematics.
Frontiers in veterinary science    June 19, 2023   Volume 10 1213423 doi: 10.3389/fvets.2023.1213423
Reisbig NA, Pifko J, Lanovaz JL, Weishaupt MA, Carmalt JL.Although the temporomandibular joint (TMJ) is the major contact point between the reins in the riders' hand, the bit in the mouth, and the rest of the horse under saddle, the role of inflammation of this joint on equine locomotion and rein tension is unknown. Unassigned: To determine the effect of acute TMJ inflammation on rein-tension and horse movement when horses were long-reined on a treadmill. Unassigned: A randomized, controlled, cross-over design. Unassigned: Five horses were trained by one clinician to walk and trot on a treadmill wearing long-reining equipment instrumented with a rein...
Effects of subconjunctival ropivacaine, liposomal bupivacaine, and mepivacaine on corneal sensitivity in healthy horses.
Veterinary surgery : VS    June 18, 2023   doi: 10.1111/vsu.13980
Gonzalez GA, Betbeze C, Wills R, Eddy A, Mochal-King C, Fontenot RL.To evaluate corneal sensitivity and adverse events following subconjunctival administration of three local anesthetics in horses. Methods: Randomized, masked, crossover study. Methods: Twelve healthy adult mares. Methods: The subconjunctival space of the treated eye was injected with 0.2 mL of liposomal bupivacaine (1.3%), ropivacaine (0.5%), or mepivacaine (2%). All horses received each medication once and the contralateral eye received saline (control). Corneal touch threshold (CTT) was measured using a Cochet-Bonnet esthesiometer before sedation, after sedation, and at specified intervals...
Application of the Ridden Horse Pain Ethogram to 150 Horses with Musculoskeletal Pain before and after Diagnostic Anaesthesia.
Animals : an open access journal from MDPI    June 9, 2023   Volume 13, Issue 12 1940 doi: 10.3390/ani13121940
Dyson S, Pollard D.The Ridden Horse Pain Ethogram (RHpE) was developed to facilitate the recognition of musculoskeletal pain. The aim of this study was to document changes in RHpE scores before and after diagnostic anaesthesia was performed to alleviate pain ± when the saddle was changed. One hundred and fifty horses underwent ridden exercise as part of an investigation of poor performance. The RHpE was applied before and after the interventions. Fifty-two (34.7%) horses exhibited a bilaterally symmetrical short step length and/or restricted hindlimb impulsion and engagement. Fifty-three (35.3%) horses had epis...
Pharmacokinetics, clinical efficacy and safety of acetaminophen (paracetamol) in adult horses with naturally occurring chronic lameness.
Equine veterinary journal    June 7, 2023   doi: 10.1111/evj.13959
Mercer MA, Davis JL, McKenzie HC, Byron CR, Kelleher ME, Trager L, Cecere TE, Wilson KE, Council-Troche RM, Werre SR.Acetaminophen is used clinically in horses with musculoskeletal pain; however, no studies have been performed in horses with chronic lameness. Objective: To determine the pharmacokinetics, safety and efficacy of chronic dosing of acetaminophen in horses with naturally occurring chronic lameness. Methods: Longitudinal. Methods: Twelve adult horses with chronic lameness were treated with acetaminophen (30 mg/kg PO) every 12 h for 21 days. Plasma concentrations of acetaminophen were analysed on days 7 and 21 via LC-MS/MS and noncompartmental pharmacokinetic analysis. Lameness was evaluated ...
Gastrojejunostomy as a treatment for gastric outflow disorders in four adult horses.
Australian veterinary journal    May 30, 2023   Volume 101, Issue 8 302-307 doi: 10.1111/avj.13249
Brabon A, Labens R, Ramachandran A, Dart AJ, Dowling BA.Four adult horses with histories of moderate abdominal pain and inappetence were diagnosed with delayed gastric emptying and gastric impaction attributed to pyloroduodenal obstruction (three cases) or duodenitis (one case). A stapled side-to-side gastrojejunostomy was performed on all horses. Two horses returned to work and survived ≥3 years. One horse was euthanased 6 months post-surgery due to recurrent abdominal pain, and one was found dead 5 months postsurgery after an unattended foaling.
Horse Grimace Scale Does Not Detect Pain in Horses with Equine Gastric Ulcer Syndrome.
Animals : an open access journal from MDPI    May 12, 2023   Volume 13, Issue 10 1623 doi: 10.3390/ani13101623
Ferlini Agne G, May BE, Lovett A, Simon O, Steel C, Santos L, Guedes do Carmo L, Barbosa B, Werner LC, Daros RR, Somogyi AA, Sykes B, Franklin S.Equine gastric ulcer syndrome (EGUS) is a highly prevalent and presumptively painful condition, although the amount of pain horses might experience is currently unknown. The aims of this study were to determine if the Horse Grimace Scale (HGS) could identify pain behaviours in horses with and without EGUS and if severity would be positively associated with the HGS score. Horse grimace scale scores were assessed blindly using facial photographs by seven observers and involved evaluation of 6 facial action units as 0 (not present), 1 (moderately present) and 2 (obviously present). Lameness exami...
The Clinical Pharmacology and Therapeutic Evaluation of Non-Steroidal Anti-Inflammatory Drugs in Adult Horses.
Animals : an open access journal from MDPI    May 10, 2023   Volume 13, Issue 10 1597 doi: 10.3390/ani13101597
Mercer MA, Davis JL, McKenzie HC.This review firstly examines the underlying pathophysiology of pain and inflammation associated with orthopedic disease and endotoxemia. Then, it reviews the clinical pharmacology (pharmacokinetics and pharmacodynamics) of both conventional and non-conventional NSAIDs in the adult horse, and finally provides an overview of different modalities to evaluate the therapeutic efficacy of NSAIDs in research.
Critical Care of the Colic Patient: Monitoring, Fluid Therapy, and More.
The Veterinary clinics of North America. Equine practice    May 9, 2023   Volume 39, Issue 2 287-305 doi: 10.1016/j.cveq.2023.03.011
Barton C, Hassel DM.A successful outcome to management of the critical colic patient is highly dependent on how the patient is monitored and treated, particularly, in the perioperative period. In this article, we will provide an update on monitoring techniques, advances in fluid therapy, nutrition management and pharmacotherapeutic agents, inclusive of pain monitoring and management, prokinetics, and management of systemic inflammatory response syndrome and the hypercoagulable state.
Repeat Celiotomy-Current Status.
The Veterinary clinics of North America. Equine practice    April 28, 2023   Volume 39, Issue 2 325-337 doi: 10.1016/j.cveq.2023.03.012
Freeman DE, Bauck AG.Repeat celiotomy can be lifesaving in horses with a surgically treatable postoperative obstruction, although guidelines for its use are lacking, except for uncontrollable postoperative pain. Overdiagnosis of ileus as the cause of postoperative obstruction could delay a second surgery so the disease progresses beyond a manageable level of severity. Although many horses respond favorably to repeat celiotomy, complications can be severe and life threatening, such as incisional infection and adhesions. Repeat celiotomy does not seem to exacerbate postoperative ileus, despite additional surgical ma...
Recurrent Colic: Diagnosis, Management, and Expectations.
The Veterinary clinics of North America. Equine practice    April 28, 2023   Volume 39, Issue 2 399-417 doi: 10.1016/j.cveq.2023.03.014
Mair T, Sherlock C.Most recurrent episodes of non-specific colic are self-limiting, and the results of clinical examinations are unremarkable. Differentiating these cases from serious diseases can be difficult, but repeated evaluations are warranted. Horses presenting with very frequent bouts of colic are more likely to have serious diseases and a higher mortality rate compared to horses presenting with less frequent bouts of transient colic. Horses with recurrent bouts of prolonged colic are more likely to have motility issues or partial intestinal obstruction. Non-gastrointestinal diseases can also cause recur...
Review of the Mechanism of Action and Use of Bisphosphonates in Horses.
Journal of equine veterinary science    April 27, 2023   Volume 127 104503 doi: 10.1016/j.jevs.2023.104503
Yocom A, Contino E, Kawcak C.Bisphosphonates are a group of drugs that can reduce bone resorption by incorporating into the crystal structure of exposed hydroxyapatite where they are taken up by osteoclasts. Bisphosphonates have several other mechanisms of action including reducing pain and inflammation and altering macrophage function. There are two types of bisphosphonates-nitrogenous and non-nitrogenous, the latter of which is used in horses. This article provides a literature-based review of the proposed mechanisms of action and therapeutic uses of bisphosphonates including a brief review of bone response to disease. ...
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