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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.
Effect of meloxicam treatment on movement asymmetry in riding horses in training.
PloS one    August 13, 2019   Volume 14, Issue 8 e0221117 doi: 10.1371/journal.pone.0221117
Persson-Sjodin E, Hernlund E, Pfau T, Haubro Andersen P, Holm Forsström K, Rhodin M.Quantitative gait analysis has revealed that a large proportion of horses in training, perceived as free from lameness by their owners, show movement asymmetries of equal magnitude to horses with mild clinical lameness. Whether these movement asymmetries are related to orthopaedic pain and/or pathology has yet to be further investigated. Therefore, the objective of this study was to determine whether movement asymmetries in riding horses in training are affected by anti-inflammatory treatment with meloxicam. In a crossover design, horses were treated with meloxicam or placebo for four days res...
Various 3D printed materials mimic bone ultrasonographically: 3D printed models of the equine cervical articular process joints as a simulator for ultrasound guided intra-articular injections.
PloS one    August 6, 2019   Volume 14, Issue 8 e0220332 doi: 10.1371/journal.pone.0220332
Beaulieu A, Linden AZ, Phillips J, Arroyo LG, Koenig J, Monteith G.In the equine racehorse industry, reduced athletic performance due to joint injury and lameness has been extensively reviewed. Intra-articular injections of glucocorticoids are routinely used to relieve pain and inflammation associated with osteoarthritis. Intra-articular injections of pharmaceutical agents require practice for precise needle placement and to minimize complications. Training on simulators or models is a viable alternative for developing these technical skills. The purpose of this study was to compare the qualitative ultrasonographic characteristics of three-dimensional (3D) pr...
Clinical insights: Equine anaesthesia and analgesia.
Equine veterinary journal    August 3, 2019   Volume 51, Issue 5 563-564 doi: 10.1111/evj.13147
Southwood L.No abstract available
Prospective randomized comparison of platelet rich plasma to extracorporeal shockwave therapy for treatment of proximal suspensory pain in western performance horses.
Research in veterinary science    August 1, 2019   Volume 126 38-44 doi: 10.1016/j.rvsc.2019.07.020
Giunta K, Donnell JR, Donnell AD, Frisbie DD.Proximal suspensory desmitis (PSD) is a frequent cause of lameness in the performance horse. Extracorporeal shockwave therapy (EST) and platelet rich plasma (PRP) have become common treatments for PSD yet clinical data on efficacy is limited. The main objective of this randomized, prospective clinical study was to compare long-term effectiveness of EST and PRP in Western performance horses. One hundred horses with lameness localized to the proximal suspensory ligament received treatment with either PRP or EST following baseline ultrasonographic evaluation. A veterinarian and agent evaluated th...
An equine-assisted therapy intervention to improve pain, range of motion, and quality of life in adults and older adults with arthritis: A randomized controlled trial.
Applied nursing research : ANR    July 10, 2019   Volume 49 5-12 doi: 10.1016/j.apnr.2019.07.002
White-Lewis S, Johnson R, Ye S, Russell C.To compare equine-assisted therapy to exercise education on pain, range of motion, and quality of life in adults and older adults with arthritis. Quality of life for adults and older adults is negatively impacted by arthritis pain, stiffness, and decreased function. Equine-assisted therapy provides unique movements to the rider's joints and muscles improving pain, range of motion, and quality of life and has improved outcomes in balance, gait, strength, functional mobility, and spasticity for older adults, stroke, spinal cord injury, and multiple sclerosis patients. No research has investigate...
Intra-articular anaesthesia of the equine stifle improves foot lameness.
Equine veterinary journal    June 27, 2019   Volume 52, Issue 2 314-319 doi: 10.1111/evj.13135
Radtke A, Fortier LA, Regan S, Kraus S, Delco ML.Equine diagnostic anaesthesia can be a useful tool in challenging lameness examinations. However, anaesthetics diffuse over time leading to nonspecific desensitisation of periarticular structures. Nerves that convey sensation from the distal limb to the central nervous system pass in close proximity to the caudal stifle joint capsule. Therefore, diffusion of intra-articular (IA) anaesthetics could cause inadvertent desensitisation of the distal limb resulting in a false diagnosis of stifle lameness. Objective: To determine if IA stifle anaesthesia can alleviate lameness originating in the dist...
Bisphosphonate use in the horse: what is good and what is not?
BMC veterinary research    June 24, 2019   Volume 15, Issue 1 211 doi: 10.1186/s12917-019-1966-x
Mitchell A, Watts AE, Ebetino FH, Suva LJ.Bisphosphonates (BPs) are a family of molecules characterized by two key properties: their ability to bind strongly to bone mineral and their inhibitory effects on mature osteoclasts and thus bone resorption. Chemically two groups of BPs are recognized, non-nitrogen-containing and nitrogen-containing BPs. Non-nitrogen-containing BPs incorporate into the energy pathways of the osteoclast, resulting in disrupted cellular energy metabolism leading to cytotoxic effects and osteoclast apoptosis. Nitrogen-containing BPs primarily inhibit cholesterol biosynthesis resulting in the disruption of intrac...
Prospective randomized investigation of topical anesthesia during unilateral laparoscopic ovariectomy in horses.
Veterinary surgery : VS    June 21, 2019   Volume 49 Suppl 1 O54-O59 doi: 10.1111/vsu.13264
Koch DW, Easley JT, Hatzel JN, Nelson BB, Hendrickson DA, Bruemmer J, Hackett ES.To compare pain-related responses in mares receiving topical or injected anesthesia of the ovarian pedicle prior to standing unilateral laparoscopic ovariectomy. Methods: Prospective randomized, blinded, placebo-controlled study. Methods: Fifteen healthy research mares. Methods: Mares were restrained in stocks and administered sedation. A right or left paralumbar ovariectomy was performed by using a laparoscopic portal and two instrument portals. Mares were divided into two treatment groups, and equal volumes of mepivacaine anesthesia were administered either topically (n = 8) or by injection ...
Comparison of first and second acupuncture treatments in horses with chronic laminitis.
Iranian journal of veterinary research    June 14, 2019   Volume 20, Issue 1 9-12 
Lee D, May K, Faramarzi B.Laminitis is a common but critical disease that causes severe pain and disability in horses. The etiology and pathogenesis of laminitis remain inconclusive and a multimodal therapeutic approach is generally indicated. Acupuncture has been used as a treatment option; however, the required number of treatments is still controversial due to the lack of objective scientific evidence. Objective: The objective of this study was to determine if the response to a second acupuncture treatment differed from the response to the first acupuncture treatment in horses with chronic laminitis. Methods: Fourte...
Pressure algometry for assessment of abdominal wall sensitivity in horses after ventral midline coeliotomy.
Veterinary anaesthesia and analgesia    June 10, 2019   Volume 46, Issue 6 820-828 doi: 10.1016/j.vaa.2019.03.008
Visser EM, Menke ES, van Loon JP.To assess the clinical course of abdominal wall sensitivity after ventral midline coeliotomy in horses by determining mechanical nociceptive thresholds (MNTs) during hospitalization, and to determine the inter-observer reliability of pressure algometry on the abdominal wall. Methods: Observational, cohort study. Methods: A total of 13 horses presenting with signs of abdominal pain/colic undergoing ventral midline coeliotomy and 10 healthy horses without an abdominal incision. Methods: Measurements were performed on days 1, 3, 5, 7 and 9 postoperatively using a pressure algometer. Measurement s...
A “modified Obel” method for the severity scoring of (endocrinopathic) equine laminitis.
PeerJ    June 7, 2019   Volume 7 e7084 doi: 10.7717/peerj.7084
Meier A, de Laat M, Pollitt C, Walsh D, McGree J, Reiche DB, von Salis-Soglio M, Wells-Smith L, Mengeler U, Mesa Salas D, Droegemueller S, Sillence MN.Laminitis is a common equine disease characterized by foot pain, and is commonly diagnosed using a five-grade Obel system developed in 1948 using sepsis-related cases. However, endocrinopathic laminitis is now the most common form of the disease and clinical signs may be mild, or spread across two Obel grades. This paper describes a modified method which assigns scores to discreet clinical signs, providing a wider scale suitable for use in a research setting. Methods: The "modified Obel" method was developed using an iterative process. First, a prototype method was developed during the detaile...
Effect of fentanyl on thermal and mechanical nociceptive thresholds in horses and estimation of anti-nociceptive plasma concentration.
Veterinary journal (London, England : 1997)    May 31, 2019   Volume 249 82-88 doi: 10.1016/j.tvjl.2019.05.012
Echelmeyer J, Taylor PM, Hopster K, Rohn K, Delarocque J, Kästner SBR.There are few investigations relating anti-nociception to plasma concentrations of fentanyl in horses. The study objective was to evaluate analgesic efficacy and duration in horses and determine the minimum anti-nociceptive plasma concentrations. Eight horses were treated with saline (P) and fentanyl (F=2.5μg/kg; F=5μg/kg; F=10μg/kg) given IV over 5min, with a wash-out period of 10 days. To evaluate thermal (°C) and mechanical (N) nociceptive threshold single stimulations were applied prior to (baseline) and 10, 30, 60, 90, 120, 180, 240, 300, 360, 420, 540min and 22.5h after treatment. Pl...
Evaluation of the effect of experimentally induced cartilage defect and intra-articular hyaluronan on synovial fluid biomarkers in intercarpal joints of horses.
Acta veterinaria Scandinavica    May 30, 2019   Volume 61, Issue 1 24 doi: 10.1186/s13028-019-0460-6
Niemelä TM, Tulamo RM, Carmona JU, López C.Inflammatory and degenerative activity inside the joint can be studied in vivo by analysis of synovial fluid biomarkers. In addition to pro-inflammatory mediators, several anabolic and anti-inflammatory substances are produced during the disease process. They counteract the catabolic effects of the pro-inflammatory cytokines and thus diminish the cartilage damage. The response of synovial fluid biomarkers after intra-articular hyaluronan injection, alone or in combination with other substances, has been examined only in a few equine studies. The effects of hyaluronan on some pro-inflammatory m...
Are There Shared Mechanisms in the Pathophysiology of Different Clinical Forms of Laminitis and What Are the Implications for Prevention and Treatment?
The Veterinary clinics of North America. Equine practice    May 22, 2019   Volume 35, Issue 2 379-398 doi: 10.1016/j.cveq.2019.04.001
van Eps AW, Burns TA.Laminitis is a consequence of primary disease processes elsewhere in the body. The key pathophysiologic events are insulin dysregulation in endocrinopathic laminitis, ischemia in supporting limb laminitis, and inflammation in sepsis-related laminitis. These apparently disparate mechanisms converge to cause lamellar attachment failure through epithelial cell adhesion loss and stretch, possibly mediated by common growth factor signaling pathways. Tissue damage through mechanical distraction, inflammation, pain, and a proliferative epithelial healing response are features of acute laminitis regar...
Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligament.
Veterinary journal (London, England : 1997)    May 11, 2019   Volume 249 16-23 doi: 10.1016/j.tvjl.2019.05.004
Derham AM, O'Leary JM, Connolly SE, Schumacher J, Kelly G.Racehorses may perform poorly because of impinging dorsal spinous processes (DSPs) of the thoracolumbar vertebrae. No study has looked objectively at the long-term outcome of racehorses undergoing desmotomy of the interspinous ligament as a treatment for horses with poor performance caused by impinging DSPs. The aim of this study was to examine objectively, by using pre-operative and post-operative racing records, the effectiveness of desmotomy of the interspinous ligament (DISL) in improving the performance of racehorses with impinging DSPs. Medical records of all horses undergoing desmotomy ...
Is There Still a Place for Lidocaine in the (Postoperative) Management of Colics?
The Veterinary clinics of North America. Equine practice    May 7, 2019   Volume 35, Issue 2 275-288 doi: 10.1016/j.cveq.2019.03.003
Freeman DE.Intravenous lidocaine is widely used to prevent or treat postoperative ileus in horses. Clinical studies that support this approach are flawed and contradicted by others. Also, physical obstruction could be more important in causing postoperative reflux than postoperative ileus in the horse. The antiinflammatory properties of lidocaine and the role of inflammation from intestinal handling in the genesis of postoperative reflux are questionable. Because of cost and questionable efficacy of lidocaine, a well-designed clinical trial is required to support its continued use. However, lidocaine cou...
Is Electrical Nerve Stimulation the Answer for Management of Equine Headshaking?
The Veterinary clinics of North America. Equine practice    April 30, 2019   Volume 35, Issue 2 263-274 doi: 10.1016/j.cveq.2019.03.002
Pickles K.Horses with trigeminal mediated headshaking (TMHS) have a decreased activation threshold of the trigeminal nerve and clinical signs are suspected to be a manifestation of trigeminal neuralgia. Electrical nerve stimulation (ENS) is used for management of neuralgia in humans and appears to work via gate control theory. Use of an equine specific percutaneous ENS program in over 130 TMHS horses has resulted in approximately 50% success return to previous work. Electroacupuncture may also be useful in the management TMHS. Optimization of ENS procedures for TMHS is likely to require a greater unders...
Behavioral Signs Associated With Equine Periapical Infection in Cheek Teeth.
Journal of equine veterinary science    March 28, 2019   Volume 77 144-150 doi: 10.1016/j.jevs.2019.03.005
Pehkonen J, Karma L, Raekallio M.No studies have focused on dental pain signs associated with periapical infection in cheek teeth (CT) of horses. Moreover, the ability of owners to recognize signs of dental pain in horses has not been reported. We hypothesized that periapical infection will usually induce pain that manifests in the behavior of the horse. Removing the infected tooth will reduce the expression of such behaviors. Owners of 47 horses whose CT had been removed because of periapical infection participated in this study. They filled an internet-based questionnaire including 23 questions about eating behavior, bit be...
Oral Administration of Meloxicam Suppresses Low-Dose Endotoxin Challenge-Induced Pain in Thoroughbred Horses.
Journal of equine veterinary science    March 21, 2019   Volume 77 139-143 doi: 10.1016/j.jevs.2019.03.001
Urayama S, Tanaka A, Kusano K, Sato H, Nagashima T, Fukuda I, Fujisawa C, Matsuda H.Nonsteroidal anti-inflammatory drugs such as flunixin meglumine have been used to treat signs of systemic inflammatory conditions, but it is also known to have the side effect to small intestine mucosa. It may be considered to be due to inhibition of both cyclooxygenase (COX)-1 and COX-2. On the other hand, meloxicam is widely used in equine clinical practice and an effective nonsteroidal anti-inflammatory drug with the preferential inhibitory effect on COX-2. However, it has not yet been evaluated in equine systemic inflammation. The aim of this study was to evaluate the effect of meloxicam a...
Use of non-contrast-enhanced computed tomography to identify deep digital flexor tendinopathy in horses with lameness: 28 cases (2014-2016).
Journal of the American Veterinary Medical Association    March 20, 2019   Volume 254, Issue 7 852-858 doi: 10.2460/javma.254.7.852
Jones ARE, Ragle CA, Mattoon JS, Sanz MG.To describe the use of non-contrast-enhanced CT to identify deep digital flexor (DDF) tendinopathy in horses with lameness attributed to pain in regions distal to the metatarsophalangeal or metacarpophalangeal joints. Methods: Retrospective case series. Methods: 28 client-owned horses. Methods: Medical records were searched to identify horses that underwent non-contrast-enhanced CT with or without high-field MRI as part of an evaluation for lameness localized to areas distal to the metacarpophalangeal or metatarsophalangeal joint in ≥ 1 limb. Horses were included in the study if they had ≥...
Ground Reaction Forces: The Sine Qua Non of Legged Locomotion.
Journal of equine veterinary science    March 6, 2019   Volume 76 25-35 doi: 10.1016/j.jevs.2019.02.022
Clayton HM, Hobbs SJ.Legged locomotion results from the feet pressing against the ground to generate ground reaction forces (GRFs) that are responsible for moving the body. By changing limb coordination patterns and muscle forces, the GRFs are adjusted to allow the horse to move in different gaits, speeds, and directions with appropriate balance and self-carriage. This article describes the typical GRF patterns in each gait, the adaptations that produce turning, and the GRF patterns used to unload the painful limb when the horse is lame. The intent is to provide information that is of practical interest and value ...
Therapeutic developments in equine pain management.
Veterinary journal (London, England : 1997)    February 28, 2019   Volume 247 50-56 doi: 10.1016/j.tvjl.2019.02.010
Mama KR, Hector RC.Many drugs and non-drug modalities are used to manage pain in horses, but evidence regarding efficacy and safety remains limited. This manuscript will first briefly review tried and tested techniques, e.g. the use of non-steroidal anti-inflammatory drugs, in the management of pain. Newer approaches to administering medications such as oral use of detomidine, which was previously only administered by injection, will also be discussed. Finally, introductory information on newer therapies, for example acupuncture and chiropractic manipulation, that the veterinarian may consider for the management...
Pharmacological Regulation in the USA and Pharmacokinetics Parameters of Firocoxib, a Highly Selective Cox-2, by Pain Management in Horses.
Journal of equine veterinary science    February 21, 2019   Volume 77 36-42 doi: 10.1016/j.jevs.2019.02.007
Rangel-Nava A, Ramírez-Uribe JM, Recillas-Morales S, Ibancovichi-Camarillo JA, Venebra-Muñoz A, Sánchez-Aparicio P.The objective of the study was to conduct a review of the pharmacological regulation and pharmacokinetic parameters of firocoxib when administered orally or intravenously in horses. A search for literature was done in SCOPUS and PubMed for studies that had to evaluate the pharmacological regulation as well as the pharmacokinetic parameters of firocoxib when administered in horses. The nonsteroidal anti-inflammatory drugs have analgesic, anti-inflammatory, antipyretics, and antiendotoxic effects. The newly developed is selective to COX2 characterized by less adverse effects in veterinary patien...
Musculoskeletal problems associated with lameness and poor performance in cutting horses: 200 cases (2007-2015).
Journal of the American Veterinary Medical Association    February 20, 2019   Volume 254, Issue 5 619-625 doi: 10.2460/javma.254.5.619
Swor TM, Dabareiner RM, Honnas CM, Cohen ND, Black JB.OBJECTIVE To describe the chief complaints by owners and the types and prevalences of musculoskeletal problems associated with lameness or poor performance in cutting horses. DESIGN Retrospective case series. ANIMALS 200 client-owned cutting horses examined at the Texas A&M University Veterinary Medical Teaching Hospital between January 1, 2007, and December 31, 2015, because of lameness or poor performance. PROCEDURES Medical records were reviewed, and data were collected regarding signalment, history, findings on physical and lameness examinations, results of diagnostic procedures performed,...
Efficacy, chondrotoxicity and plasma concentrations of tramadol following intra-articular administration in horses undergoing arthroscopy: preliminary findings.
The veterinary quarterly    February 19, 2019   Volume 38, Issue 1 129-137 doi: 10.1080/01652176.2018.1546963
Di Salvo A, Chiaradia E, Della Rocca G, Giorgi M, Mancini F, Marenzoni ML, Conti MB, Nannarone S.Intra-articular administration of analgesics is performed to ensure good perioperative pain management avoiding undesirable systemic effects. To evaluate the effect of intra-articular injection of tramadol on postoperative pain after arthroscopy in horses and to determine whether tramadol had a local effect. Before the in vivo study, an in vitro test was performed aiming to evaluate the viability of equine chondrocytes after exposure to various concentrations of tramadol. The concentration identified as most appropriate was used to treat the horses' joints. Twelve horses affected by osteochond...
Morphine, but not methadone, inhibits microsomal prostaglandin E synthase-1 and prostaglandin-endoperoxide synthase 2 in lipopolysaccharide-stimulated horse synoviocytes.
Biochimie    February 11, 2019   Volume 160 28-33 doi: 10.1016/j.biochi.2019.02.004
Schwarzbach SV, Melo CF, Xavier PLP, Roballo KC, Cordeiro YG, Ambrósio CE, Fukumasu H, Carregaro AB.Osteoarthritis (OA) is one of the main locomotor disorders in horses. Although nonsteroidal anti-inflammatory drugs are the first-line treatment for OA, opioids could also be used. In previous studies, opioids showed promising anti-inflammatory and analgesic effects. In this study, we aimed to investigate the effects of two opioids (morphine and methadone) against inflammation in lipopolysaccharide (LPS)-stimulated synoviocytes by analyzing microsomal prostaglandin E synthase-1 (mPGES-1) and prostaglandin-endoperoxide synthase 2 (PTGS2) expression. Synoviocytes were obtained from the joints at...
Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma.
Veterinary journal (London, England : 1997)    February 10, 2019   Volume 246 85-91 doi: 10.1016/j.tvjl.2019.02.001
van Loon JPAM, Van Dierendonck MC.Objective pain assessment is important to guide and tailor therapy in clinical practice. This study describes the clinical applicability and validity of two pain scales, the Composite Pain Scale (CPS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) in horses with orthopaedic trauma or after orthopaedic surgery. A cohort follow-up study was performed using 77 adult horses (n=43 with orthopaedic trauma or injury; n=34 controls). Composite and facial expression-based pain scores were assessed by direct observations of pairs of two independent observers. All horse...
Clinical insights: Treatment of laminitis.
Equine veterinary journal    February 7, 2019   Volume 51, Issue 2 145-146 doi: 10.1111/evj.13055
Bamford NJ.No abstract available
Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses.
Veterinary anaesthesia and analgesia    February 5, 2019   Volume 46, Issue 3 325-334 doi: 10.1016/j.vaa.2019.01.005
Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S.To determine the required rate of a detomidine infusion (loading dose 5 μg kg; initial rate 12.5 μg kg hour) added to a constant infusion of methadone (0.2 mg kg; 0.05 mg kg hour) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. Methods: Prospective, clinical study. Methods: Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. Methods: At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 ...
Letter to the Editor: Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction.
Equine veterinary journal    February 3, 2019   Volume 51, Issue 3 422 doi: 10.1111/evj.13078
Freeman DE.No abstract available
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