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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.
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...
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...
Venous blood gas parameters, electrolytes, glucose and lactate concentration in sick neonatal foals: Direct venipuncture versus push-pull technique.
Equine veterinary journal    September 3, 2020   Volume 53, Issue 3 488-494 doi: 10.1111/evj.13332
Del Prete C, Lanci A, Cocchia N, Freccero F, Di Maio C, Castagnetti C, Mariella J, Micieli F.Blood collection by indwelling intravenous catheter (IVC) avoids repeated venipuncture, which could cause thrombophlebitis risk, anxiety and pain in patients. Objective: To compare blood gas parameters, electrolytes, glucose, lactate and haematocrit concentration obtained from venous blood samples collected via a jugular IVC by push-pull (PP) technique to those obtained by venipuncture in hospitalised foals, at the time of catheter placement (T0) and 24 hours after the beginning of intravenous therapy (T24). Methods: Prospective observational study. Methods: Paired blood samples were drawn fr...
Effects of Equine-Assisted Therapies or Horse-Riding Simulators on Chronic Pain: A Systematic Review and Meta-Analysis.
Medicina (Kaunas, Lithuania)    August 31, 2020   Volume 56, Issue 9 doi: 10.3390/medicina56090444
Collado-Mateo D, Lavín-Pérez AM, Fuentes García JP, García-Gordillo MÁ, Villafaina S.Background and objectives: Chronic pain is a complex global public health problem that affects the health status, quality of life, activities of daily living, and different work-related variables. Riding a horse may lead to some benefits in chronic pain patients through the improvement of postural control and other biopsychosocial processes. Therefore, this systematic review and meta-analysis aimed to evaluate the effects of horse riding (with real or simulated horses) on chronic pain. Materials and methods: A systematic literature search was carried out in accordance with PRISMA guidelines in...
Selection of Potent Inhibitors of Soluble Epoxide Hydrolase for Usage in Veterinary Medicine.
Frontiers in veterinary science    August 26, 2020   Volume 7 580 doi: 10.3389/fvets.2020.00580
Shihadih DS, Harris TR, Kodani SD, Hwang SH, Lee KSS, Mavangira V, Hamamoto B, Guedes A, Hammock BD, Morisseau C.The veterinary pharmacopeia available to treat pain and inflammation is limited in number, target of action and efficacy. Inhibitors of soluble epoxide hydrolase (sEH) are a new class of anti-inflammatory, pro-resolving and analgesic drugs being tested in humans that have demonstrated efficacy in laboratory animals. They block the hydrolysis, and thus, increase endogenous concentrations of analgesic and anti-inflammatory signaling molecules called epoxy-fatty acids. Here, we screened a library of 2,300 inhibitors of the sEH human against partially purified feline, canine and equine hepatic sEH...
Oral Supplementation with Ultramicronized Palmitoylethanolamide for Joint Disease and Lameness Management in Four Jumping Horses: A Case Report.
Animals : an open access journal from MDPI    August 21, 2020   Volume 10, Issue 9 doi: 10.3390/ani10091469
Gugliandolo E, Barbagallo A, Peritore AF, Cuzzocrea S, Crupi R.Background: Four show jumping horses were evaluated for non-responsive lameness, which caused their withdrawal from show jumping competitions. The clinical evaluation was performed by radiographic examination, flexion tests, diagnostic anesthesia and lameness evaluation using the American Association of Equine Practitioners (AAEP) scale. The diagnoses were a case of navicular syndrome, a complicated case of chronic navicular syndrome and arthrosis of the distal interphalangeal joint of the right anterior limb and two cases of distal intertarsal joint arthritis. Nutraceuticals are often an impo...
Standing Arthroscopic Treatment of Temporomandibular Joint Sepsis in a Horse.
Journal of veterinary dentistry    August 20, 2020   Volume 37, Issue 2 94-99 doi: 10.1177/0898756420948269
Elzer EJ, Wulster KB, Richardson DW, Ortved KF.A 15-year-old Thoroughbred gelding was presented for investigation of fever, right temporomandibular region swelling, and progressive pain when opening the mouth. Right temporomandibular joint (TMJ) sepsis was diagnosed based on synovial fluid analysis, sonographic imaging, and standing robotic cone-beam computed tomography. Concurrent otitis media and temporohyoid osteoarthropathy (THO) were also noted. The horse was treated with arthroscopic debridement and lavage during standing sedation followed by local and systemic antimicrobial therapy. There were no complications associated with the su...
Effects of Flunixin Meglumine, Firocoxib, and Meloxicam in Equines After Castration.
Journal of equine veterinary science    August 19, 2020   Volume 94 103229 doi: 10.1016/j.jevs.2020.103229
Gobbi FP, Di Filippo PA, Mello LM, Lemos GB, Martins CB, Albernaz AP, Quirino CR.This study is "aimed" to evaluate and compare the efficacy of flunixin meglumine (FM), firocoxib (FX), and meloxicam (MX) after castration of horses. Thirty horses were submitted to open castration and divided into three groups (n = 10) depending on the anti-inflammatory drug administered: group I (GI) (FM, 1.1 mg kg1, IV, once a day [SID], 5 days); group II (GII) (FX, 0.1 mg kg1, IV, SID, 5 days), and group III (GIII) (MX, 0.6 mg kg1, IV, SID, 5 days). Clinical, behavioral, and hematological parameters and the peritoneal fluid (PF) were evaluated before (day [D] 0) and 1, 2, 3, 5, a...
Can Endocrine Dysfunction Be Reliably Tested in Aged Horses That Are Experiencing Pain?
Animals : an open access journal from MDPI    August 14, 2020   Volume 10, Issue 8 1426 doi: 10.3390/ani10081426
Gehlen H, Jaburg N, Merle R, Winter J.The aim of the present study was to evaluate (i) the effects of different intensities and types of treated pain on the basal concentrations of adrenocorticotropic hormone (ACTH) and cortisol, and (ii) the thyrotropin-releasing hormone (TRH) stimulation test, to determine whether treated pain caused a marked increase of ACTH, which would lead to a false positive result in the diagnosis of pituitary pars intermedia dysfunction (PPID). Methods: Fifteen horses with treated low to moderate pain intensities were part of the study. They served as their own controls as soon as they were pain-free agai...
Mechanical nociceptive assessment of the equine hoof following distal interphalangeal joint intra-articular anesthesia.
PeerJ    August 11, 2020   Volume 8 e9469 doi: 10.7717/peerj.9469
Malacarne BD, Cota LO, Neto ACP, Paz CFR, Dias LA, Corrêa MG, Carvalho AM, Faleiros RR, Xavier ABS.With the hypothesis that equine dorsal lamellar tissue can be desensitized by anesthesia injection into distal interphalangeal joint (DIPJ), the objective was to assess the mechanical nociceptive threshold of hoof dorsal lamellae following intra-articular (IA) administration of lidocaine into this joint. Methods: The DIPJ of the forelimbs of six adult healthy horses were injected with either 5 mL of lidocaine, or 5 mL of lactated Ringer's solution. Treatments were randomly distributed, with each forelimb undergoing a single treatment. The hooves were evaluated pre- and post-injection at pre-se...
Anatomy and Ultrasound-Guided Injection of the Medial Branch of the Dorsal Ramus of the Cervical Spinal Nerves in the Horse: A Cadaveric Study.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    August 10, 2020   Volume 33, Issue 6 377-386 doi: 10.1055/s-0040-1714301
Corraretti G, Vandeweerd JM, Hontoir F, Vanderperren K, Palmers K. The aim of this study was to describe the anatomy of the nerves supplying the cervical articular process joint and to identify relevant anatomical landmarks that could aid in the ultrasound-guided location and injection of these nerves for diagnostic and therapeutic purposes. Methods:  Twelve cadaveric equine necks were used. Five necks were dissected to study the anatomy of the medial branch of the dorsal ramus of the cervical spinal nerves 3 to 7. Relevant anatomical findings detected during dissections were combined with ultrasonographic images obtained in one other neck. Six additiona...
Ketorolac Is Not More Effective Than Flunixin Meglumine or Phenylbutazone in Reducing Foot Pain in Horses.
Journal of equine veterinary science    August 6, 2020   Volume 94 103204 doi: 10.1016/j.jevs.2020.103204
Grady SE, Lescun TB, Moore GE, Cooper BR, Davern AJ, Brunner TJ, Taylor SD.The objective was to compare the analgesic efficacy of ketorolac tromethamine (KT) and two other nonsteroidal anti-inflammatory drugs (NSAIDs), including flunixin meglumine (FM) and phenylbutazone (PB), using a heart bar shoe (HBS) model of reversible foot lameness in horses. Nine adult horses were used in a blinded, randomized, placebo-controlled crossover study. After induction of left front limb lameness using a modified HBS model, one of three NSAIDs (KT, 2.0 mg/kg IV; FM, 1.1 mg/kg IV; PB, 4.4 mg/kg IV) or saline (placebo) was administered IV as a single dose. Lameness was assessed eve...
White line disease in a 19-year-old appendix mare.
The Canadian veterinary journal = La revue veterinaire canadienne    August 4, 2020   Volume 61, Issue 8 895-898 
Ellis L.A 19-year-old appendix mare was presented with severe, acute right forelimb lameness and a history of significant hoof wall defect. The defect began as progressive toe separation affecting the dorsal hoof wall, which was eventually resected by a farrier. Placement of bar shoes by a farrier to stabilize the hoof was ineffective. Radiographs showed hoof wall separation, palmar rotation, and displacement of the coffin bone, consistent with failure of the laminar structures. Treatment included phenylbutazone, radiographic-guided therapeutic farriery consisting of derotation with a wedge shoe, and ...
Effects of High Intensity Laser Therapy in the Treatment of Tendon and Ligament Injuries in Performance Horses.
Animals : an open access journal from MDPI    July 31, 2020   Volume 10, Issue 8 doi: 10.3390/ani10081327
Zielińska P, Nicpoń J, Kiełbowicz Z, Soroko M, Dudek K, Zaborski D.The aim of this study was to evaluate the effects of high intensity laser therapy (HILT) on tendon and ligament injury treatment in horses. Twenty six horses with tendinopathies were randomly assigned to a HILT treated or to a non-treated group. Each horse was subjected to the same rehabilitation programme. Horses from the treatment group underwent a series of fifteen HILT treatments with the same parameters. Clinical and ultrasound assessments were performed by the same veterinarian and were carried out before (day 0), during (day 13-15) and after treatment (day 38-40). Clinical evaluation in...
Analysis of Thoroughbred horse farm workers’ compensation insurance claims in Kentucky: Injury frequency, cost, lost time, and associated occupational factors.
American journal of industrial medicine    July 28, 2020   Volume 63, Issue 10 936-948 doi: 10.1002/ajim.23159
Flunker JC, Clouser JM, Swanberg JE.Thoroughbred horse farm workers self-report a high frequency of work-related injuries and pain. However, an analysis of Thoroughbred horse farm workers' compensation injury claims is absent from the literature, yet may benefit worker safety. We analyzed workers' compensation insurance firm data containing 2276 claims filed between 2008 and 2015. Injury frequency, cost, and lost time per cause, nature, and body part injured were examined qualitatively and via univariate tests. Factors associated with high cost and high duration lost time claims were modeled via multivariable logistic regression...
A retrospective evaluation of the effect of perianesthetic hydromorphone administration on the incidence of postanesthetic signs of colic in horses.
Veterinary anaesthesia and analgesia    July 23, 2020   Volume 47, Issue 6 757-762 doi: 10.1016/j.vaa.2020.06.003
Skrzypczak H, Reed R, Barletta M, Quandt J, Sakai D.To describe the incidence of postanesthetic signs of colic (PASC) in horses and determine if perianesthetic administration of hydromorphone was associated with an increased risk of PASC. Methods: Retrospective, cohort study. Methods: A total of 409 horses. Methods: Anesthesia and clinical records of horses admitted for various procedures from July 2018 to September 2019 were reviewed. Signs of colic and interventions were recorded up to 48 hours after anesthesia. A binomial logistic regression model was used to evaluate the association between the type of surgery, administration of hydromorpho...
Effect of Caudal Traction on Mechanical Nociceptive Thresholds of Epaxial and Pelvic Musculature on a Group of Horses With Signs of Back Pain.
Journal of equine veterinary science    July 23, 2020   Volume 93 103197 doi: 10.1016/j.jevs.2020.103197
Long K, McGowan CM, Hyytiäinen HK.Direct muscular attachment from lumbar vertebrae to the caudal vertebrae of the tail suggests that caudal traction, also described as a tail pull, may affect lumbar vertebral segments and/or associated soft tissues in horses. Traction is a commonly used human manual therapy technique used for pain relief and anecdotally observed to relieve pain in horses. However, research is lacking validating the efficacy of manual caudal traction on the horse. The objective of this study was to determine if caudal traction has an effect on mechanical nociceptive thresholds (MNTs) in a group of horses with c...
Degenerative Lumbar Spinal Stenosis.
Revista brasileira de ortopedia    July 23, 2020   Volume 56, Issue 1 9-17 doi: 10.1055/s-0040-1712490
Hennemann S, de Abreu MR.Degenerative lumbar spinal stenosis is the most frequent cause of low back pain and/or sciatica in the elderly patient. Epidemiology, pathophysiology, clinical manifestations and testing are reviewed in a wide current bibliographic investigation. The importance of the relationship between clinical presentation and imaging study, especially magnetic resonance imaging (MRI), is emphasized. Prior to treatment indication, it is necessary to identify the precise location of pain, as well as the differential diagnosis between neurological and vascular lameness. Conservative treatment combining medic...
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