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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.
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
Using Movement Sensors to Assess Lying Time in Horses With and Without Angular Limb Deformities.
Journal of equine veterinary science    January 31, 2019   Volume 75 55-59 doi: 10.1016/j.jevs.2019.01.011
Clothier J, Small A, Hinch G, Barwick J, Brown WY.Chronic musculoskeletal pathologies are common in horses, however, identifying related effects can be challenging. This study tested the hypothesis that movement sensors and analgesics could be used in combination to confirm the presence of restrictive pathologies by assessing lying time. Four horses presenting a range of angular limb deformities (ALDs) and four nonaffected controls were used. The study comprised two trials at separate paddock locations. Trial A consisted of a 3-day baseline phase and 2 × 3-day treatment phases, during which two analgesics were administered to two ALD horses...
Assessing pain in horses.
The Veterinary record    January 27, 2019   Volume 184, Issue 4 124 doi: 10.1136/vr.l385
Gleerup KB.No abstract available
Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial.
Journal of sport rehabilitation    January 25, 2019   Volume 29, Issue 2 179-185 doi: 10.1123/jsr.2018-0252
Kim T, Lee J, Oh S, Kim S, Yoon B.A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Methods: A randomized controlled trial. Methods: Community and university campus. Methods: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Methods: The exercises were performed for 30 minutes, 2 days p...
Intravenous infusion of magnesium sulfate and its effect on horses with trigeminal-mediated headshaking.
Journal of veterinary internal medicine    January 22, 2019   Volume 33, Issue 2 923-932 doi: 10.1111/jvim.15410
Sheldon SA, Aleman M, Costa LRR, Santoyo AC, Howey Q, Madigan JE.Trigeminal-mediated headshaking results from low-threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal-mediated headshaking. Objective: To investigate head-shaking behavior in affected horses after IV magnesium sulfate infusion. Methods: Six geldings with trigeminal-mediated headshaking. Methods: Prospective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextros...
Comparison of three acute colic pain scales: Reliability, validity and usability.
Veterinary journal (London, England : 1997)    January 21, 2019   Volume 246 71-77 doi: 10.1016/j.tvjl.2019.01.004
Sutton GA, Atamna R, Steinman A, Mair TS.A valid, reliable and usable scale is needed for assessing severity of acute abdominal pain in horses. The study aim was to compare three different scales: (1) the equine acute abdominal pain scale (EAAPS); (2) a scale described by Mair and Smith (2005; M and S); and (3) a numerical rating scale (NRS). Forty brief films of horses (35 of colic cases and five of control horses) were randomly presented to 46 equine veterinarians from different countries. Participants, randomly divided into three groups, each used one scale. Five randomly selected films were shown twice for determining intra-obser...
Buffering mepivacaine with sodium bicarbonate speeds and potentiates analgesia of median and ulnar nerve blocks performed on horses.
The Veterinary record    January 19, 2019   Volume 184, Issue 5 155 doi: 10.1136/vr.104962
Boone L, Schumacher J, DeGraves F, Cole R.The objective of this study was to determine if buffering mepivacaine HCL (mepHCl) with sodium bicarbonate (NaHCO3) would significantly decrease the time to onset of analgesia when performing median and ulnar nerve blocks in naturally lame horses. Median and ulnar nerve blocks were performed on the naturally lame limb of nine horses during two separate study periods, with a minimum washout period of three days between study periods. Nerve blocks were performed by administering mepHCl alone or mepHCl mixed with NaHCO3 (nine parts 2 per cent mepHCl to one part 8.4 per cent NaHCO3). Lameness was ...
Trigeminal-mediated headshaking in horses: prevalence, impact, and management strategies.
Veterinary medicine (Auckland, N.Z.)    January 9, 2019   Volume 10 1-8 doi: 10.2147/VMRR.S163805
Roberts V.Trigeminal-mediated headshaking is a little-understood neuropathic facial pain condition of the horse. The condition may affect around 1% of the equine population to a degree of severity sufficient to require veterinary attention. As a pain condition, this represents a significant welfare issue. Horses are usually more severely affected at exercise which can leave them unable to perform, or even dangerous to ride and handle. With little known about the condition and variable response to treatments, severely affected horses are often euthanized. This review article considers the literature on t...
Correction: Effects of intrabursal administration of botulinum toxin type B on lameness in horses with degenerative injury to the podotrochlear apparatus.
American journal of veterinary research    January 4, 2019   Volume 80, Issue 1 78 doi: 10.2460/ajvr.80.1.78
No abstract available
Letter to the Editor: A response to ‘What is lameness and what (or who) is the gold standard to detect it?’.
Equine veterinary journal    December 20, 2018   Volume 51, Issue 2 270-272 doi: 10.1111/evj.13043
Adair S, Baus M, Bell R, Boero M, Bussy C, Cardenas F, Casey T, Castro J, Davis W, Erskine M, Farr R, Fischer A, Forbes B, Ford T, Genovese R....No abstract available
An Objective Assessment of the Effect of Anesthetizing the Median Nerve on Lameness Caused by Pain in the Cubital Joint.
Journal of equine veterinary science    December 19, 2018   Volume 75 9-13 doi: 10.1016/j.jevs.2018.12.008
McGlinchey L, Agne G, Passler T, Cole R, Schumacher J.The median nerve, along with the ulnar nerve, is often anesthetized when performing a lameness examination in horses. Because of the close proximity of the median nerve to the cubital joint, proximal migration of local anesthetic might ameliorate pain originating from the cubital joint. The objective of this study was to determine if a median nerve block will ameliorate lameness caused by pain in the cubital joint. A forelimb lameness was induced in six healthy horses by injecting 100 ng of recombinant equine interleukin 1 beta (IL-1β) into the cubital joint. The median nerve of the lame leg...
Intra-articular Corticosteroids for Knee Pain-What Have We Learned from the Equine Athlete and Current Best Practice.
The journal of knee surgery    December 18, 2018   Volume 32, Issue 1 9-25 doi: 10.1055/s-0038-1676449
McIlwraith CW, Lattermann C.The use of intra-articular corticosteroids for traumatic arthritis and osteoarthritis (OA) is common in the horse. The beneficial and deleterious effects of the principal corticosteroids used betamethasone esters (Celestone [Soluspan], methylprednisolone acetate [Depo Medrol], and triamcinolone acetonide [TA] [Vetalog or Kenalog]) have been defined for the horse. While TA has both disease-modifying as well as symptom-modifying effects, methyl prednisolone acetate has deleterious effects on the articular cartilage. Studies in traumatically injured joints show the same rationale (suppression of ...
Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses.
Equine veterinary journal    December 18, 2018   Volume 51, Issue 4 530-536 doi: 10.1111/evj.13054
Gozalo-Marcilla M, de Oliveira AR, Fonseca MW, Possebon FS, Pelligand L, Taylor PM, Luna SPL.Standing surgery avoids the risks of general anaesthesia in horses. Objective: To assess sedation, antinociception and gastrointestinal motility in standing horses after a detomidine loading dose and 2-h constant rate intravenous (i.v.) infusion, with or without methadone. Methods: Blinded, randomised, crossover with seven healthy adult cross-bred horses, three geldings and four females (404 ± 22 kg). Methods: Five i.v. treatments were administered to all horses with 1-week washout period: saline (SAL), detomidine low (2.5 μg/kg bwt + 6.25 μg/kg bwt/h) (DL) and high doses (5 μg/kg ...
Histological examination of the interspinous ligament in horses with overriding spinous processes.
Veterinary journal (London, England : 1997)    December 12, 2018   Volume 244 69-74 doi: 10.1016/j.tvjl.2018.12.012
Ehrle A, Ressel L, Ricci E, Merle R, Singer ER.The equine interspinous ligament (ISL) consists of an oblique crossing arrangement of collagenous bundles which are thought to counteract the tensile and rotational forces of distraction between the spinous processes (SPs) in the caudal thoracic and cranial lumbar spine. The aim of this controlled histological study was to assess the structural anatomy and innervation of the ISL in horses with clinically significant overriding (dorsal) SPs (ORSPs) and to compare the findings with the ISL of normal horses. Samples of the ISL were obtained from 10 horses that underwent subtotal ostectomy for tre...
The pharmacokinetics and pharmacodynamics of intravenous hydromorphone in horses.
Veterinary anaesthesia and analgesia    November 22, 2018   Volume 46, Issue 3 395-404 doi: 10.1016/j.vaa.2018.11.001
Reed R, Barletta M, Mitchell K, Hanafi A, Bullington A, Knych H, Quandt J, Ryan C, Giguère S.Describe the pharmacokinetics and pharmacodynamics of intravenous hydromorphone in healthy horses. Methods: Masked, randomized, cross-over, Latin square design. Methods: A group of eight healthy adult horses METHODS: Horses were administered each of four treatments with an 8 day washout. Treatments groups included intravenous hydromorphone 0.02 mg kg (LD), 0.04 mg kg (MD), 0.08 mg kg (HD) and saline (P). Blood samples for hydromorphone analysis were obtained for 24 hours after treatment. Plasma hydromorphone was quantified and pharmacokinetic parameters were determined using non-compartmental ...
Quantitative assessment of intravenous regional limb perfusion of tiludronate as an adjunctive treatment for lameness caused by navicular syndrome in horses.
American journal of veterinary research    November 21, 2018   Volume 79, Issue 12 1313-1320 doi: 10.2460/ajvr.79.12.1313
Schoonover MJ, Whitfield CT, Young JM, Sippel KM, Payton ME.OBJECTIVE To determine effects for 2 IV regional limb perfusion (IVRLP) protocols involving tiludronate on lameness of horses with navicular syndrome. ANIMALS 15 horses with bilateral forelimb navicular syndrome. PROCEDURES Shoeing and anti-inflammatory injection into the distal interphalangeal joint (DIPJ) of both forelimbs (day 0) were performed on all horses. On day 14, horses received 1 of 3 IVRLPs consisting of 0.1 mg of tiludronate/kg (low-dose tiludronate [LDT]; n = 5), 0.2 mg of tiludronate/kg (high-dose tiludronate [HDT]; 5), or saline (0.9% NaCl) solution (placebo; 5); treatments wer...
Equine Wounds over Synovial Structures.
The Veterinary clinics of North America. Equine practice    November 19, 2018   Volume 34, Issue 3 575-590 doi: 10.1016/j.cveq.2018.07.002
Ludwig EK, van Harreveld PD.Equine septic synovitis commonly occurs secondary to traumatic wounds. The distal limbs of horses have minimal soft tissue protection, thus wounds in these areas are more likely to involve adjacent synovial structures. Synovial sepsis can be debilitating due to difficulties clearing established infections and the degenerative changes that result from ongoing inflammation. Prompt diagnosis allows for immediate treatment, improving the prognosis. Goals for successful treatment of infected synovial structures due to wounds include early and accurate recognition of the condition, rapid resolution ...
Characterisation of the in vivo interactions between detomidine and methadone in horses: Pharmacokinetic and pharmacodynamic modelling.
Equine veterinary journal    November 17, 2018   Volume 51, Issue 4 517-529 doi: 10.1111/evj.13031
Gozalo-Marcilla M, Luna SPL, Moreira da Silva R, Crosignani N, Lopes NP, Taylor PM, Pelligand L.Pharmacokinetic (PK)/pharmacodynamic (PD) modelling offers new insights to design protocols for sedation and analgesia in standing horses. Objective: To evaluate the parameters and interactions between detomidine and methadone when given alone or combined in standing horses. Methods: Randomised, placebo-controlled, blinded, crossover. Methods: Eight adult healthy horses were given six treatments intravenously: saline (SAL); detomidine (5 μg/kg bwt; DET); methadone (0.2 mg/kg bwt; MET) alone or combined with detomidine (2.5 [MLD], 5 [MMD] or 10 [MHD] μg/kg bwt). Venous blood samples were ob...
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