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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.
Towards Machine Recognition of Facial Expressions of Pain in Horses. Automated recognition of human facial expressions of pain and emotions is to a certain degree a solved problem, using approaches based on computer vision and machine learning. However, the application of such methods to horses has proven difficult. Major barriers are the lack of sufficiently large, annotated databases for horses and difficulties in obtaining correct classifications of pain because horses are non-verbal. This review describes our work to overcome these barriers, using two different approaches. One involves the use of a manual, but relatively objective, classification system for...
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...
Equine “Idiopathic” and Infundibular Caries-Related Cheek Teeth Fractures: A Long-Term Study of 486 Fractured Teeth in 300 Horses. Background: Limited objective information is available on the prevalence of non-traumatic equine cheek teeth fractures, the signalment of affected horses, and the clinical features and treatment of these fractures. Objectives: This study aims to document patterns of idiopathic and infundibular caries-related cheek teeth fractures in a referral population and evaluate associations between fracture patterns and horse age, Triadan position of affected teeth, clinical signs, and deemed necessity for treatment. Study Design: A retrospective case review. Methods: The clinical records at Edinburgh Un...
A study of ultrasound-guided perineural injection of the caudal cervical spinal nerve roots in equine cadavers. To develop an ultrasound-guided cervical perineural injection technique for horses and to evaluate and compare the distribution of contrast agent among perineural, intra-articular and periarticular injections. Methods: Prospective, experimental cadaveric study. Methods: A total of 14 equine cadaveric necks. Methods: Bilateral ultrasound-guided perineural injection technique for the caudal cervical spinal nerve roots (CSNRs 5-7) was developed. Paramagnetic or iodinated contrast was injected and the distribution of contrast was evaluated using magnetic resonance (MR) or computed tomography (CT) ...
Outcomes after cervical vertebral interbody fusion using an interbody fusion device and polyaxial pedicle screw and rod construct in 10 horses (2015-2019). Further development of surgical techniques for equine cervical stabilisation is necessary to make the procedure less technically demanding, reduce complications and improve outcomes. Objective: To describe clinical outcomes and owner reports in horses undergoing placement of an interbody fusion device and polyaxial pedicle screw and rod construct for cervical vertebral fusion in horses with cervical vertebral compressive myelopathy. Methods: Retrospective case series. Methods: Data were retrieved from medical records of 10 horses undergoing cervical vertebral fusion (2015-2019). Records were e...
Retrospective analysis of horses with ultrasound evaluation of the sacroiliac region and response to local corticosteroid injection: 42 cases. Local injection of corticosteroids is commonly performed in horses with sacroiliac (SI) region pain and/or dysfunction, ,and ultrasound findings of normal horses and those with SI pain have also been well described. However, no studies have been performed that have evaluated if ultrasound findings, injection technique, or medications injected affect prognosis for return to function. The objectives of the current study are to determine if findings on ultrasound, injection technique, or medications injected are predictive of return to function in horses with SI region pain and/or dysfunction. Me...
Gastric and Large Colon Impactions Combined With Aggressive Enteral Fluid Therapy May Predispose to Large Colon Volvulus: 4 Cases. To resolve large colon impactions, frequent enteral administration of large volumes of water (8-10 liters in a 500 kg horse) has been suggested. Furthermore, in large colon volvulus, the simultaneous presence of gastric impaction has been described as a possible predisposing factor. To describe the clinical and surgical features of horses with large colon volvulus associated with aggressive enteral fluid therapy performed to resolve an initial large colon impaction. Records of horses that underwent exploratory laparotomy at the Veterinary Teaching Hospital of Turin between 2012-2019 were revie...
Horse-riding simulators in treatment of chronic low back pain: A meta-analysis. The use of horse-riding simulators in the treatment of chronic low back pain has drawn considerable attention for its efficacy and acceptability to reduce chronic low back pain; because of the similarities in movements provided by equine-assisted therapies and the possible accessibility advantages. However, the results are conflicting. This study aimed to perform a meta-analysis of randomised controlled trials to assess the impact of treatments based on horse-riding simulators on chronic low back pain. Methods: A systematic literature search up to January 2021 was performed and 11 studies were...
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...
Perceptions and Attitudes towards Mules in a Group of Soldiers. Mules are essential for pack work in mountainous areas, but there is a lack of research on this species. This study intends to assess the perceptions, attitudes, empathy and pain perception of soldiers about mules, to understand the type of human-mule relationship. For this, a survey was applied with closed-ended questions where the empathy and pain perception tools were included and later analyzed through correlations. Open-ended questions were analyzed through text mining. A total of 73 soldiers were surveyed. They had a wide range of ages and years of experience working with equids. Signifi...
Comparison of sedation quality and safety of detomidine and romifidine as a continuous rate infusion for standing elective laparoscopic ovariectomy in mares. To compare efficacy and safety of a continuous rate infusion of detomidine hydrochloride and romifidine hydrochloride for standing elective bilateral laparoscopic ovariectomy in mares. Methods: Blinded, randomized prospective clinical study. Methods: Eighteen healthy mares presenting for elective bilateral ovariectomy METHODS: Mares were randomly assigned to one of two sedation protocols. Prior to surgery, baseline head height, heart rate, respiratory rate, and postural sway were recorded. An IV loading dose of α2-agonist (46 μg/kg romifidine or 13.9 μg/kg detomidine) was administered. S...
Pharmacokinetics and pharmacodynamics of a high concentration of buprenorphine (Simbadol) in conscious horses after subcutaneous administration. To determine the pharmacokinetics and pharmacodynamics of high-concentration formulation of buprenorphine (1.8 mg mL; Simbadol) following subcutaneous (SC) administration in horses. Methods: Prospective, randomized, crossover trial. Methods: A group of six healthy adult horses weighing 521-602 kg. Methods: On three occasions, Simbadol (0.005 mg kg; treatment S5), (0.0025 mg kg; treatment S2.5) or saline (treatment SAL) were administered SC at least 7 days apart in random order. Electrical nociceptive threshold (ENT) measured on the neck region, physiologic variables, locomotor activity, degree...
Ultrasound-guided erector spinae plane block in horses: a cadaver study. To describe dye distribution and spinal nerve involvement after a simulated erector spinae plane (ESP) block performed on fresh equine cadavers. Methods: Experimental cadaver study. Methods: A group of 11 adult equine cadavers. Methods: The spinal region surrounding the sixteenth thoracic vertebra (Th16) of one cadaver was removed and underwent magnetic resonance imaging. In 10 adult equine cadavers [body weight, 549 ± 58 kg (mean ± standard deviation)], 0.2 mL kg of a 50:1 2% lidocaine/dye solution was injected bilaterally (n = 20 injections) into the fascial plane between the transverse p...
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...
Heat hypersensitivity at a site proximal to a surgically induced osteochondral fracture in horses. To evaluate thermal nociceptive thresholds (TNTs) before and after inducing a standardized radiocarpal bone osteochondral fracture (OCF) in horses. Methods: Prospective, controlled, randomized, masked study. Methods: A group of 10 Thoroughbred fillies aged 2 years. Methods: Skin temperature and TNTs were measured on the skin over the triceps brachii muscle in both the thoracic limbs before (week 0) and weekly (weeks 1-8) after unilateral arthroscopic induction of a radiocarpal OCF (n = 4) or sham surgery (n = 6) followed by a standardized exercise programme. The contralateral, non-operated t...
Effect of Perineural Anesthesia on the Centre of Pressure (COP) Path During Stance Phase at Trot in Sound Horses. This study aimed to examine how short-term loss of proprioception in the equine foot influences the individual COP path during the stance phase of the trot in sound horses. Ten horses were evaluated to be objectively non-lame using the 'Equinosis Q System and subsequently examined using a portable pressure measuring system with pressure foils fixed directly underneath both front hooves prior to and after perineural anesthesia of the palmar digital nerves. The individual COP paths of both forelimbs was assessed prior to and after unilateral and bilateral abaxial sesamoid nerve blocks. COP from ...
Equine Discomfort Ethogram. In recent years, there has been a growing interest in and need for a comprehensive ethogram of discomfort behavior of horses, particularly for use in recognizing physical discomfort in domestically managed horses. A clear understanding of the physical discomfort behavior of horses among caretakers, trainers, and professional health care personnel is important to animal welfare and caretaker safety. This is particularly relevant to pain management for hospitalized equine patients. Various pain scale rubrics have been published, typically incorporating only a few classically cited pain behaviors...
Development, Validation, and Reliability of a Sedation Scale in Horses (EquiSed). The lack of standardization of sedation scales in horses limits the reproducibility between different studies. This prospective, randomized, blinded, horizontal and controlled trial aimed to validate a scale for sedation in horses (EquiSed). Seven horses were treated with intravenous detomidine in low/high doses alone (DL 2.5 μg/kg + 6.25 μg/kg/h; DH 5 μg/kg +12.5 μg/kg/h) or associated with methadone (DLM and DHM, 0.2 mg/kg + 0.05 mg/kg/h) and with low (ACPL 0.02 mg/kg) or high (ACPH 0.09 mg/kg) doses of acepromazine alone. Horses were filmed at (i) baseline (ii) peak, (iii) intermediate,...
Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament. Impinging/overriding dorsal spinous processes (DSPs) of the thoracolumbar vertebrae are a common cause of poor performance in horses. In the last five decades, numerous surgical treatments have been reported on, from transverse transection of the affected DSPs, and endoscopic resection of the affected DSPs, to transection of the interspinous ligament. Until recently, cosmetic outcomes have been reported as good to excellent in studies. However, a previously unreported complication of neurogenic atrophy of the contralateral epaxial muscle following desmotomy of the interspinous ligament has bee...
Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment. Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous s...
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 ...
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 ...
“Feel the Force”-Prevalence of Subjectively Assessed Saddle Fit Problems in Swiss Riding Horses and Their Association With Saddle Pressure Measurements and Back Pain. Ill-fitting saddles can impair the well-being and performance of horses. Saddle fit is generally assessed subjectively by a trained professional or with an electronic saddle pressure mat, but little is known about the agreement between both methods. The study aims were (1) to assess the prevalence of saddle fit issues in a riding sound Swiss horse population, (2) to investigate how well the subjective assessment correlates with objectively measured pressure magnitude and distribution under the saddle during riding, and (3) how well both correlate with back pain of the horse. Only 10% of the sa...
Experimental evaluation of cortical screw placement in lag fashion into the distal phalanx in standing horses. The objectives of this in vivo experimental study were to evaluate the feasibility of cortical screw insertion into the intact distal phalanx in standing sedated horses and to document potential postoperative complications. One cortical screw was randomly inserted in lag fashion into each distal phalanx in 9 horses. The second surgery on the contralateral limbs was performed 2-3 weeks after the first operation, when a 4.5-mm cortical screw was inserted in lag fashion into the distal phalanx of sedated horses following perineural analgesia. Following surgery, the drill hole was filled with an a...
A Review of Methods for Detecting Soreness in Horses During the last century and today, the Tennessee walking horse has been used primarily for pleasure and show competition. Unique and natural to the breed is a smooth four-beat “running walk” gait. In the 1950s the accentuated or exaggerated running walk, known as the “big lick” became popular at high-level competitions. The combination of exaggerated high-action step in front and long stride behind is still considered desirable in today's horse show competitions, and it is often achieved through soring. Soring is the practice of applying a substance or mechanical device to the lower li...
Radiological prevalence of osteoarthritis of the cervical region in 104 performing Warmblood jumpers. Cervical osteoarthritis (OA) has been documented as a potential source of pain and poor performance in sport horses. Objective: To assess the prevalence of cervical OA in a population of Warmblood jumpers and its correlation with age, level of performance, neck pain and mobility. Methods: Descriptive observational study. Methods: Warmblood jumpers free of lameness or neurological disorders were selected. Cervical pain and range of motion of the neck were subjectively assessed. Left to right lateral views were taken at C3-C4, C4-C5, C5-C6 and C6-C7. The presence of OA at the cervical articular ...
The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting. Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a 'normal' pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, usi...
