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Topic:Pain Management

Pain management in horses involves various strategies and interventions designed to alleviate discomfort and improve the well-being of equine patients. It encompasses pharmacological approaches, such as the use of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and other analgesics, as well as non-pharmacological methods like physical therapy, acupuncture, and environmental modifications. Effective pain management aims to address both acute and chronic pain conditions, which can result from injuries, surgeries, or diseases such as laminitis and arthritis. This page aggregates peer-reviewed research studies and scholarly articles that explore the mechanisms, efficacy, and safety of different pain management techniques in horses, contributing to the understanding and advancement of equine veterinary care.
The effect of regional hypothermia on mechanical nociceptive thresholds in the equine distal forelimb.
Veterinary journal (London, England : 1997)    January 6, 2021   Volume 269 105607 doi: 10.1016/j.tvjl.2021.105607
Rainger JE, Wardius S, Medina-Torres CE, Dempsey SM, Perkins N, van Eps AW.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.
Research in veterinary science    December 30, 2020   Volume 134 159-170 doi: 10.1016/j.rvsc.2020.12.014
Di Salvo A, Chiaradia E, Nannarone S, Della Rocca G.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...
An Investigation Into the Short-Term Effects of Photobiomodulation on the Mechanical Nociceptive Thresholds of M. Longissimus and M. Gluteus Medius, in Relation to Muscle Firing Rate in Horses at Three Different Gaits.
Journal of equine veterinary science    December 24, 2020   Volume 98 103363 doi: 10.1016/j.jevs.2020.103363
Ahmed W, Elbrønd VS, Harrison AP, Hart JO, Williams RE.Back pain is a common condition in horses, yet despite this, quantitative assessments of the efficacy of treatment are scarce. Mechanical nociceptive thresholds (MNTs) and acoustic myography (AMG) recordings were obtained, both preinterventionand postintervention, from the left and right epaxial muscles in eight healthy general riding horses (mean age 17 ± 6 yrs). Using an algometer, MNT readings were taken at each of the 6 preselected points along the thoracolumbar M. longissimus and M. gluteus medius region. AMG recordings of the M. longissimus and M. gluteus medius were taken while wal...
Outcome following neurectomy of the deep branch lateral plantar nerve and plantar fasciotomy for hindlimb proximal suspensory desmopathy in western performance horses: 21 cases.
Veterinary surgery : VS    December 16, 2020   Volume 50, Issue 2 273-282 doi: 10.1111/vsu.13552
Tatarniuk DM, Hill JA, Modesto RB, Swor TM, Caston SS, Kersh KD.To report the outcome of horses used in western performance disciplines after deep branch lateral plantar neurectomy/fasciotomy surgery for hind limb proximal suspensory desmopathy (PSD). Methods: Retrospective analysis. Methods: Twenty-one client-owned horses. Methods: Medical records were reviewed (2009-2019) for horses involved in western performance disciplines that had been treated with deep branch lateral plantar neurectomy and plantar fasciotomy for lameness due to hind limb PSD. Follow-up was obtained by reexamination and/or verbal interviews with owners >2 years postoperatively. Res...
EEG individual power profiles correlate with tension along spine in horses.
PloS one    December 14, 2020   Volume 15, Issue 12 e0243970 doi: 10.1371/journal.pone.0243970
Stomp M, d'Ingeo S, Henry S, Lesimple C, Cousillas H, Hausberger M.Assessing chronic pain is a challenge given its subjective dimension. In humans, resting state electroencephalography (EEG) is a promising tool although the results of various studies are contradictory. Spontaneous chronic pain is understudied in animals but could be of the highest interest for a comparative study. Riding horses show a very high prevalence of back disorders thought to be associated with chronic pain. Moreover, horses with known back problems show cognitive alterations, such as a lower attentional engagement. Therefore, we hypothesized that the individual EEG power profiles res...
Accelerometric Changes before and after Capacitive Resistive Electric Transfer Therapy in Horses with Thoracolumbar Pain Compared to a SHAM Procedure.
Animals : an open access journal from MDPI    December 5, 2020   Volume 10, Issue 12 doi: 10.3390/ani10122305
Argüelles D, Becero M, Muñoz A, Saitua A, Ramón T, Gascón E, Sánchez de Medina A, Prades M.Capacitive resistive electric transfer (CRET), a radiofrequency at 448 kHz, increases flexibility in quadricep muscles of human athletes. To assess whether CRET would result in clinical and biomechanical improvements in horses with thoracolumbar pain, 18 sport horses were divided into two groups: CRET (n = 9), subjected to four CRET sessions, during two consecutive weeks, and SHAM (n = 9), subjected to the same procedure with the device off. Clinical examination and accelerometry were performed before and after the four sessions. During the study, horses were in training and in active competit...
Clinical assessment and grading of back pain in horses.
Journal of veterinary science    December 3, 2020   Volume 21, Issue 6 e82 doi: 10.4142/jvs.2020.21.e82
Mayaki AM, Abdul Razak IS, Adzahan NM, Mazlan M, Rasedee A.The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objective: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP ...
Development and Validation of an Automated Video Tracking Model for Stabled Horses.
Animals : an open access journal from MDPI    November 30, 2020   Volume 10, Issue 12 2258 doi: 10.3390/ani10122258
Kil N, Ertelt K, Auer U.Changes in behaviour are often caused by painful conditions. Therefore, the assessment of behaviour is important for the recognition of pain, but also for the assessment of quality of life. Automated detection of movement and the behaviour of a horse in the box stall should represent a significant advancement. In this study, videos of horses in an animal hospital were recorded using an action camera and a time-lapse mode. These videos were processed using the convolutional neural network Loopy for automated prediction of body parts. Development of the model was carried out in several steps, in...
Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses.
Animals : an open access journal from MDPI    November 29, 2020   Volume 10, Issue 12 doi: 10.3390/ani10122242
Maskato Y, Dugdale AHA, Singer ER, Kelmer G, Sutton GA.Assessment of the severity of pain in colic cases is subjective. The Equine Acute Abdominal Pain Scale (EAAPS), previously validated using film clips of horses with colic, was tested for feasibility and revalidated in both medical and surgical colic cases in Israel and the UK. Feasibility qualities evaluated were quickness and ease-of-use. Pain in 231 horses, presented for colic, was assessed by 35 participants; 26 in the UK and 9 in Israel. Without prior training, participants assessed the severity of pain using two scales; the EAAPS and a visual analogue scale (VAS). Convergent validity comp...
Nerve growth factor in the equine joint.
Veterinary journal (London, England : 1997)    November 28, 2020   Volume 267 105579 doi: 10.1016/j.tvjl.2020.105579
Kendall A, Nyström S, Ekman S, Hultén LM, Lindahl A, Hansson E, Skiöldebrand E.Nerve growth factor (NGF) is a neurotrophin with many functions. In humans, it is involved in inflammation, nerve growth, apoptosis and pain signalling. Increased concentrations of NGF in synovial fluid has been shown in humans and dogs with osteoarthritis. Despite osteoarthritis being a common problem in horses, no studies have previously been published on NGF in the equine joint. The aim of this study was to quantify NGF in equine synovial fluid from healthy joints, acutely inflamed septic joints and joints with structural changes associated with osteoarthritis. A secondary aim was to identi...
Pharmacokinetics and pharmacodynamics of meperidine after intramuscular and subcutaneous administration in horses.
Veterinary surgery : VS    November 26, 2020   Volume 50, Issue 2 410-417 doi: 10.1111/vsu.13545
Hanafi AL, Reed RA, Trenholme HN, Sakai DM, Ryan CA, Barletta M, Quandt JE, Knych HK.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...
Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses.
Animals : an open access journal from MDPI    November 24, 2020   Volume 10, Issue 12 doi: 10.3390/ani10122195
Haussler KK.The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until...
An assessment of the effectiveness of hyaluronic acid and polyacrylamide hydrogel in horses with osteoarthritis: Systematic review and network meta-analysis.
Research in veterinary science    November 20, 2020   Volume 134 42-50 doi: 10.1016/j.rvsc.2020.11.013
da Silva Xavier AA, da Rosa PP, de Brum Mackmill L, Roll VFB.For several years, hyaluronic acid (HyA) and, more recently, polyacrylamide hydrogel (PHyd) have been used to reduce lameness and pain caused by osteoarthritis. However, there is still a lack of scientific evidence of the efficacy of these substances to allow veterinary experts to make decisions about their use in horses. The objective of this study was to evaluate, through a systematic review and network meta-analysis (NMA), the efficacy of HyA, associated or not with other drugs, and PHyd in relieving lameness in horses with osteoarthritis. The searches for primary studies were conducted on ...
Identification of Body Behaviors and Facial Expressions Associated with Induced Orthopedic Pain in Four Equine Pain Scales.
Animals : an open access journal from MDPI    November 19, 2020   Volume 10, Issue 11 doi: 10.3390/ani10112155
Ask K, Rhodin M, Tamminen LM, Hernlund E, Haubro Andersen P.Equine orthopedic pain scales are targeted towards horses with moderate to severe orthopedic pain. Improved assessment of pain behavior and pain-related facial expressions at rest may refine orthopedic pain detection for mild lameness grades. Therefore, this study explored pain-related behaviors and facial expressions and sought to identify frequently occurring combinations. Orthopedic pain was induced by intra-articular LPS in eight horses, and objective movement asymmetry analyses were performed before and after induction together with pain assessments at rest. Three observers independently ...
Management of Thermal Injuries in Donkeys: A Case Report.
Animals : an open access journal from MDPI    November 17, 2020   Volume 10, Issue 11 doi: 10.3390/ani10112131
Lohse J, Pietrantoni P, Tummers C.Burn injuries are uncommon in large animals and there are no reports of these injuries in donkeys. Burns cause local and systemic effects. Extensive thermal injuries can be challenging to manage and the extent of the burn surface affected will directly impact the severity of the illness and the prognosis. Burns are classified according to the depth of injury into four categories, from first-degree burns, and the least affect to fourth-degree burns, which are the more severely affected patients. This case report describes the medical management of four donkeys that sustained various degrees of ...
Standing Sedation and Iocoregional Analgesia in Equine Dental Surgery.
The Veterinary clinics of North America. Equine practice    November 16, 2020   Volume 36, Issue 3 477-499 doi: 10.1016/j.cveq.2020.08.009
Campoy L, Sedgwick SR.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...
A Comparative Neuro-Histological Assessment of Gluteal Skin Thickness and Cutaneous Nociceptor Distribution in Horses and Humans.
Animals : an open access journal from MDPI    November 11, 2020   Volume 10, Issue 11 2094 doi: 10.3390/ani10112094
Tong L, Stewart M, Johnson I, Appleyard R, Wilson B, James O, Johnson C, McGreevy P.The current project aims to build on knowledge of the nociceptive capability of equine skin to detect superficial acute pain, particularly in comparison to human skin. Post-mortem samples of gluteal skin were taken from men ( = 5) and women ( = 5), thoroughbreds and thoroughbred types (mares, = 11; geldings, = 9). Only sections that contained epidermis and dermis through to the hypodermis were analysed. Epidermal depth, dermal depth and epidermal nerve counts were conducted by a veterinary pathologist. The results revealed no significant difference between the epidermal nerve counts of human...
Equine Facial Action Coding System for determination of pain-related facial responses in videos of horses.
PloS one    November 3, 2020   Volume 15, Issue 11 e0231608 doi: 10.1371/journal.pone.0231608
Rashid M, Silventoinen A, Gleerup KB, Andersen PH.During the last decade, a number of pain assessment tools based on facial expressions have been developed for horses. While all tools focus on moveable facial muscles related to the ears, eyes, nostrils, lips, and chin, results are difficult to compare due to differences in the research conditions, descriptions and methodologies. We used a Facial Action Coding System (FACS) modified for horses (EquiFACS) to code and analyse video recordings of acute short-term experimental pain (n = 6) and clinical cases expected to be in pain or without pain (n = 21). Statistical methods for analyses were a f...
Upper body movement analysis of multiple limb asymmetry in 367 clinically lame horses.
Equine veterinary journal    November 2, 2020   Volume 53, Issue 4 701-709 doi: 10.1111/evj.13367
Phutthachalee S, Mählmann K, Seesupa S, Lischer C.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 ...
Riding Soundness-Comparison of Subjective With Objective Lameness Assessments of Owner-Sound Horses at Trot on a Treadmill.
Journal of equine veterinary science    November 1, 2020   Volume 95 103314 doi: 10.1016/j.jevs.2020.103314
Müller-Quirin J, Dittmann MT, Roepstorff C, Arpagaus S, Latif SN, Weishaupt MA.Lameness is a symptom indicative of pain or injury of the locomotor apparatus. Lame horses generally should not be ridden. However, owners' ability to assess lameness has been questioned. This study's aim was to use subjective lameness assessments and objective gait analysis to generate a descriptive overview of movement and weight-bearing asymmetries of owner-sound riding horses. 235 horses were subjectively assessed in a field study, and the owner's perception of their horse's orthopedic health was recorded through an online survey. 69 horses were re-evaluated by gait analysis at an equine h...
En-bloc Auriculectomy for Removal of a Large Pinna-Based Ear Mass in a Horse.
Frontiers in veterinary science    October 30, 2020   Volume 7 560379 doi: 10.3389/fvets.2020.560379
Silverstone AM, Tatarniuk DM, Durket E, Gillen AM.A 15-year-old Pony of America (POA) gelding presented for evaluation of a large mass present on the right external pinna. Based on gross appearance, the right ear mass was suspected to be neoplastic. The most likely differential diagnosis was that of a fibroblastic sarcoid. Complete auriculectomy via use of a constricting latex-tourniquet performed under multimodal analgesia was proposed as an option to achieve complete resolution of mass growth and improve patient comfort. Benefits of latex tourniquet constriction included immediate lack of bleeding associated with amputation, gradual ischemi...
Bisphosphonates in veterinary medicine: The new horizon for use.
Bone    October 24, 2020   Volume 142 115711 doi: 10.1016/j.bone.2020.115711
Suva LJ, Cooper A, Watts AE, Ebetino FH, Price J, Gaddy D.Bisphosphonates (BPs) are characterized by their ability to bind strongly to bone mineral and inhibit bone resorption. However, BPs exert a wide range of pharmacological activities beyond the inhibition of bone resorption, including the inhibition of cancer cell metastases and angiogenesis and the inhibition of proliferation and apoptosis in vitro. Additionally, the inhibition of matrix metalloproteinase activity, altered cytokine and growth factor expression, as well as reductions in parameters of pain have also been reported. In humans, clinical BP use has transformed the treatment of post-m...
Update on Equine Odontoclastic Tooth Resorption and Hypercementosis.
The Veterinary clinics of North America. Equine practice    October 14, 2020   Volume 36, Issue 3 671-689 doi: 10.1016/j.cveq.2020.08.006
Limone LE.Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive, painful disease, affecting incisors, canines, and cheek teeth. Examination findings include gingival inflammation, gingival recession and/or hyperplasia, subgingival swelling, bulbous enlargement of teeth, associated periodontal disease, pathologic tooth fracture, and/or tooth mobility and loss. Current hypotheses include biomechanical stresses and secondary bacterial involvement. Early recognition allows case management, but it is a progressive disease. Owner education is crucial; horses with complete or multi...
Radiographic findings and anatomical variations of the caudal cervical area in horses with neck pain and ataxia: case-control study on 116 horses.
The Veterinary record    October 8, 2020   Volume 187, Issue 9 e79 doi: 10.1136/vr.105756
Beccati F, Pepe M, Santinelli I, Gialletti R, Di Meo A, Romero JM.Abnormalities of the ventral lamina of the sixth cervical vertebra (AVL-C6) are thought to exert abnormal stress on the articular process joints (APJs) of the cervicothoracic junction. The aim of the study was to investigate the association between AVL-C6 and radiographic findings in the caudal cervical area and between clinical signs of neck pain and ataxia and radiographic findings. Methods: Medical records of horses subjected to cervical radiography were reviewed. Horses were classified into those with neck pain (group C), those with ataxia (group A) and healthy horses (group H). Presence o...
Differential gene expression in skin RNA of horses affected with degenerative suspensory ligament desmitis.
Journal of orthopaedic surgery and research    October 7, 2020   Volume 15, Issue 1 460 doi: 10.1186/s13018-020-01994-y
Haythorn A, Young M, Stanton J, Zhang J, Mueller POE, Halper J.Equine degenerative suspensory ligament desmitis (DSLD) is a systemic connective tissue disorder first identified in Peruvian Paso horses but afflicting other horse breeds as well. Inappropriate accumulation of proteoglycans in connective tissues, most prominently in tendons and ligaments, leads to progressive and debilitating lameness and pain. It is largely unknown what drives the overproduction of proteoglycans, but our previous studies suggest involvement of bone morphogenetic protein 2 (BMP2), a member of the transforming growth factor-β (TGFβ) family, impacting synthesis of proteoglyca...
Meperidine pharmacokinetics and effects on physiologic parameters and thermal threshold following intravenous administration of three doses to horses.
BMC veterinary research    October 1, 2020   Volume 16, Issue 1 368 doi: 10.1186/s12917-020-02564-4
Hamamoto-Hardman BD, Steffey EP, McKemie DS, Kass PH, Knych HK.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...
Functional Electrical Stimulation (FES) and the Effect on Equine Multifidi Asymmetry.
Journal of equine veterinary science    September 28, 2020   Volume 95 103255 doi: 10.1016/j.jevs.2020.103255
Isbell DA, Schils SJ, Oakley SC, Carraro U, Knaeble BR.Asymmetry of the multifidi has been correlated with scoliosis and back pain in humans and has been investigated as a factor in equine back pain as well. The purpose of this study was to determine if FES would affect the symmetry of equine thoracolumbar multifidi when compared to controls. Twelve horses received 24 FES treatments bilaterally over the thoracolumbar region for 8 weeks. Twelve additional control horses received no FES treatments. Ultrasonographic measurements of the cross-sectional area (CSA) of the multifidi of the treatment horses at seven thoracolumbar levels were compared to ...
Adaptation strategies of horses with induced forelimb lameness walking on a treadmill.
Equine veterinary journal    September 24, 2020   Volume 53, Issue 3 600-611 doi: 10.1111/evj.13344
Serra Bragança FM, Hernlund E, Thomsen MH, Waldern NM, Rhodin M, Byström A, van Weeren PR, Weishaupt MA.There is a paucity of research describing the gait pattern of lame horses at the walk. Objective: To describe the changes in motion pattern and vertical ground reaction forces (GRFz) in horses with induced forelimb lameness at the walk and compare those changes with the changes observed at the trot. Methods: Experimental study. Methods: In 10 clinically sound Warmblood horses, moderate forelimb lameness was induced using a sole pressure model followed by trot and walk on a treadmill. Kinematic data were collected using 3D optical motion capture (OMC), and GRFz by an instrumented treadmill. Mix...
Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis.
Equine veterinary journal    September 23, 2020   Volume 53, Issue 4 682-689 doi: 10.1111/evj.13338
Louro LF, Milner PI, Bardell D.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.
Animals : an open access journal from MDPI    September 10, 2020   Volume 10, Issue 9 doi: 10.3390/ani10091610
van Loon J, Verhaar N, van den Berg E, Ross S, de Grauw J.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...
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