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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.
Ocular Causes for Undesired Behaviors in the Horse.
The Veterinary clinics of North America. Equine practice    January 28, 2026   S0749-0739(25)00069-0 doi: 10.1016/j.cveq.2025.12.001
Knickelbein KE.Numerous ocular diseases cause visual impairment and induce ocular pain that may be associated with undesired behaviors in horses. Horses with ocular pain, indicated by the presence of blepharospasm, blepharoedema, ocular discharge or rubbing the eye, should be rested from work to avoid worsening the ocular disease and to avoid undesired behaviors associated with pain or vision impairment. Horses with ocular disease are frequently head shy. Some stoic horses may not have obvious outward clinical signs despite significant visual impairment, and as such, undesired behaviors such as spooking, bal...
Production and characterization of rNGFSP: a recombinant fusion immunogen eliciting dual anti-NGF and anti-Substance P therapeutic antibodies for Degenerative Joint Disease.
Biotechnology reports (Amsterdam, Netherlands)    January 12, 2026   Volume 49 e00946 doi: 10.1016/j.btre.2026.e00946
Varela V, Costa M, Maciel C, Barbeito J, Barrera EE, Gutierre E, Correa A, Elgue M, Carrasco S, Larrosa MD, Pereira M, Correa J, Crosignani N....Anti-NGF monoclonal antibodies have recently been approved for treating degenerative joint disease, including osteoarthritis pain, in dogs and cats. However, their widespread use is limited by high cost and the requirement for repeated injections. Nerve Growth Factor and Substance P play central roles in the initiation and maintenance of inflammation and chronic pain in OA. There is a pressing need for new, safe, cost-effective therapies that target the underlying mechanisms of OA chronic pain. Here, we designed and produced a novel recombinant fusion protein, termed rNGFSP, which functions as...
Parasympathetic tone, cardiovascular variables, and behavioral alterations in conscious horses before and after castration and during anesthesia: A pilot study.
Journal of equine veterinary science    January 9, 2026   Volume 158 105781 doi: 10.1016/j.jevs.2026.105781
Mendoza Flores JE, Terrazas A, Lara Sagahon AV, Aleman M.Parasympathetic tone activity (PTA) and its association with behavior in conscious versus anesthesia in horses are unknown. Objective: To study PTA, heart rate (HR), minimum alveolar concentration (MAC), and mean arterial pressure (MAP) during castration under anesthesia. To study PTA, HR, Horse Grimace Scale (HGS), locomotor activity (LA), and behavior in conscious horses before and after castration. Methods: Pilot study including seven healthy adult horses. After habituation (days 1, 2, and 3), PTAm, HR, HGS, LA, and behavior were investigated during pre-surgery (days 4-, 5-, and one-hour pr...
The Effect of Magnetotherapy on Back Pain Sensitivity and Muscle Tension in Recreational Horses-A Pilot Study.
Animals : an open access journal from MDPI    December 26, 2025   Volume 16, Issue 1 77 doi: 10.3390/ani16010077
Jastrzębska E, Dobbek D, Pawłowska A.Back pain in horses is a frequent musculoskeletal issue that affects performance and welfare. Magnetotherapy has been proposed as a complementary, non-invasive treatment to reduce pain and support soft tissue recovery, but studies in horses remain limited. This pilot study aimed to evaluate the effects of low-frequency pulsed magnetic field therapy on horses with hypersensitivity to palpation along the longissimus dorsi muscle. Four recreational horses participated in a 10-session magnetotherapy program, with changes assessed using palpation, neck flexibility tests, heart rate measurements and...
Calcitonin gene-related peptide concentration in cerebrospinal fluid and serum in horses affected by trigeminal-mediated headshaking.
Equine veterinary journal    December 19, 2025   doi: 10.1002/evj.70139
Weber LA, Oltmanns H, Chiavaccini L, Pickles KJ, Roberts V, Kloock T, Niebuhr T, Feige K.Trigeminal-mediated headshaking (TMHS) in horses shares clinical features with human trigeminal neuralgia (HTN). Increased levels of the neuropeptide calcitonin gene-related peptide (CGRP) have been found in the blood and cerebrospinal fluid (CSF) of HTN patients. Inhibition of CGRP in humans has shown promise for pain relief. Data on CGRP in horses affected by TMHS are currently lacking but if quantifiable and validated, could assist in developing new diagnostic and more rational therapeutic approaches. Objective: This study aimed to quantify and correlate CGRP concentrations in the serum and...
Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications.
Frontiers in veterinary science    December 19, 2025   Volume 12 1719123 doi: 10.3389/fvets.2025.1719123
Qiu Z, Wang J, Zhang Y, Liu X, Wei C, Ma T.Musculoskeletal injuries represent a primary cause of suboptimal performance and early retirement in equine athletes. To address this challenge, the veterinary community has long endeavored to develop safer and more effective therapeutic strategies. Extracorporeal shock wave therapy (ESWT), as a treatment for equine musculoskeletal injuries, has garnered substantial attention among equine veterinarians. Focused on the theme ESWT Therapy for Equine Musculoskeletal Disorders: From biological mechanisms to clinical applications, this article systematically reviews existing literature on the biolo...
I feel your pain: Individual differences in welfare indicators after castration in horses.
Veterinary journal (London, England : 1997)    December 16, 2025   Volume 315 106538 doi: 10.1016/j.tvjl.2025.106538
Briefer-Freymond S, Dalla Costa E, Jolivald A, Bruckmaier RM, Atallah E, Giorgia Riva M, Ijichi C.Personality affects both experience and expression of pain and the welfare impact of castration on horses is poorly understood. Therefore, the current study observed 19 horses to determine: the welfare impact of standard castration on horses; whether individuals consistently vary in their behavioural and emotional responses to pain; the influence of personality on behavioural and physiological responses to pain; whether Horse Grimace Scale (HGS) indicates how individuals feel about painful experiences. Eye temperature (IRT), salivary cortisol, HGS and a pain ethogram were measured at intervals...
Pilot study: Effects of whole-body vibrational therapy on equine thoracolumbar epaxial muscle response to pressure algometry.
Research in veterinary science    December 15, 2025   Volume 199 106027 doi: 10.1016/j.rvsc.2025.106027
Leibeck R, Lehman J, Birmingham S.Whole-body vibrational therapy (WBV) is well-studied in people, but there is a paucity of research regarding its effect on horses. It is suggested that the use of WBV in horses increases performance, aids in recovery, and stimulates nerves, bones, and muscles in ways that normal exercise does not. Objective: The purpose of this pilot study was to determine if frequent WBV therapy sessions affect mechanical nociceptive thresholds based on pressure algometry in horses without clinical signs of lameness or back pain. Methods: The mechanical nociceptive thresholds (MNTs) were measured for 5 horses...
Correction: An anatomical study of the subarachnoid space surrounding the trigeminal ganglion in horses-in preparation for a controlled glycerol rhizotomy in equids.
Frontiers in veterinary science    December 15, 2025   Volume 12 1749889 doi: 10.3389/fvets.2025.1749889
Becker R, Haenssgen K, Precht C, Khoma OZ, Hlushchuk R, Koch C, Kaessmeyer S, de Preux M.[This corrects the article DOI: 10.3389/fvets.2024.1424890.].
High-metacarpal deep digital flexor tenotomy and Steward clog shoeing for managing chronic refractory laminitis: A retrospective clinical study.
Veterinary surgery : VS    December 14, 2025   Volume 55, Issue 1 236-247 doi: 10.1111/vsu.70068
Hargitaiova K, Maleas G.To describe outcomes following high-metacarpal deep digital flexor tenotomy (DDFT) combined with Steward clog application in horses and ponies with refractory chronic laminitis. Methods: Retrospective observational study. Methods: Client-owned horses and ponies (7 horses, 8 ponies) with severe refractory laminitis. Methods: Medical records (2018-2019) were reviewed. All underwent standing high-metacarpal DDFT tenotomy proximal to the accessory ligament (AL-DDFT) junction, followed by customized Steward clogs application. Preoperative assessment included radiography and venography. Postoperativ...
Preliminary assessment of the leukocyte coping capacity as a point of care marker in horses with stress associated diseases.
BMC veterinary research    December 7, 2025   doi: 10.1186/s12917-025-05179-9
Jandová V, Huber N, AlMheiri FG, Bábor K, Trachsel DS.Stress represents a serious health and welfare concern; however, its objective assessment remains difficult. The equine gastric ulcer syndrome (EGUS) and orthopedic diseases that cause pain are among stress associated diseases in equine medicine. The leukocyte coping capacity (LCC) quantifies oxygen radical generation of neutrophil granulocytes which is altered under stress. Therefore, LCC could be a novel biomarker for stress in horses and we hypothesized that horses with stress associated diseases would have lower LCC values in comparison to horses without these diseases. Methods: In this ob...
Preliminary investigation of equine veterinary hospital staff attitudes towards pain assessment in a single centre.
The Veterinary record    December 4, 2025   doi: 10.1002/vetr.6122
Curry O, Everett A, Pearson G, Dwyer C, Duncan J.Despite the availability of several equine pain assessment tools, their use in equine veterinary practice appears limited compared to small animal practice. This study explores potential barriers to equine pain assessment, as reported by staff at a single UK equine teaching hospital. Methods: Nine hospital staff members were interviewed using semi-structured interviews. Key themes were identified through reflexive thematic analysis. Results: Participants acknowledged the importance of pain assessment, yet highlighted limitations in current methods and their inconsistent use. Key challenges inc...
Introducing an Innovative Pain Scale for Assessing Postpartum Pain in Mares: Preliminary Clinical Evaluation.
Animals : an open access journal from MDPI    November 30, 2025   Volume 15, Issue 23 3454 doi: 10.3390/ani15233454
Bolesławska-Szubartowska J, Kucharczuk M, Skrabska A, Zbysław A, Adamowicz J, Alszko A, Domagalska-Stomska K, Durska M, Dziekcierów A....Pain after giving birth is commonly observed in horses, yet there has not been a specific tool developed for assessing this pain in postpartum mares. The goal was to adapt existing equine pain scales and to preliminarily validate a practical pain scale for use by veterinarians and caregivers after foaling. Methods: The pain scale was developed by adapting items from other pain scales, including established orthopedic and colic equine pain scales, and incorporating caregiver feedback. The final scale includes eight areas for assessing pain: behavior, facial expressions, vital signs, udder exami...
Physiological and behavioural effects of continuous remifentanil-xylazine administration in donkeys.
Equine veterinary journal    November 27, 2025   doi: 10.1111/evj.70131
Damasceno KFA, Mouta AN, Alves LSA, Arcoverde KN, Aragão HR, Cavalcante JM, Veras de Paula V.Remifentanil and xylazine are used as continuous infusions to facilitate standing surgery in horses. Their use for this purpose has not been reported in donkeys. Objective: To evaluate the behavioural, sedative, and cardiorespiratory effects of continuous intravenous infusion of remifentanil and xylazine in donkeys. Methods: Non-blinded in vivo experiments. Methods: Ten donkeys were sedated with an intravenous bolus of xylazine (0.8 mg/kg). After 3 min, continuous infusions of xylazine (0.65 mg/kg/h) and remifentanil (6 μg/kg/h) were administered for 60 min. Cardiorespiratory physio...
Intraligamentary anaesthesia: a local anaesthesia technique in equine dentistry.
Acta veterinaria Scandinavica    November 26, 2025   Volume 67, Issue 1 49 doi: 10.1186/s13028-025-00836-3
Teysen S, Demey W, Menzies R, Staszyk C, Birkhed D, Lundström T.The injection of a local anaesthetic into the periodontal ligament (PDL) to achieve desensitisation of the pulp, periodontium, and adjacent tissues is a well-established technique in human dentistry, particularly in paediatric patients. This approach, commonly referred to as intraligamental or intraligamentary anaesthesia (ILA), has been widely adopted due to its effectiveness and relative simplicity. The aims of the present publication were: (1) to provide a review of the literature, (2) to describe an ILA technique adapted by the authors for use in equine dentistry, and (3) to evaluate this ...
Liposomal bupivacaine caudal epidural in horses results in adverse effects without analgesia.
Veterinary surgery : VS    November 20, 2025   Volume 55, Issue 1 218-224 doi: 10.1111/vsu.70055
Stokes C, Natalini CC, Wills R, Eddy A, Mochal-King C, O'Shea C, Fontenot RL.To evaluate the analgesic properties and adverse effects of liposomal bupivacaine administered via caudal epidural in horses. Methods: Pharmacodynamic study. Methods: A total of 10 healthy adult horses. Methods: Liposomal bupivacaine (10 mL; 1.3%) was administered into the caudal epidural space via an indwelling epidural catheter inserted to a length of 15 cm. Mechanical nociceptive threshold (MNT) testing with pressure algometry was used to measure analgesia at four anatomic locations for 72 h following injection. Physical examinations (including rectal temperature, heart rate, respirat...
Correction: Maldonado Moreno et al. Analgesic and Gastrointestinal Effects of Methadone in Horses Undergoing Orchiectomy. Animals 2025, 15, 2358.
Animals : an open access journal from MDPI    November 10, 2025   Volume 15, Issue 22 3252 doi: 10.3390/ani15223252
Maldonado Moreno N, Alves Moreira J, Araujo De Oliveira L, Sanches Gontijo A, Castilho Baldi ML, Rocha Wenceslau R, Batista da Silveira Xavier A.... [...].
Efficacy of acupuncture in racehorses: A review.
Open veterinary journal    October 31, 2025   Volume 15, Issue 10 4789-4796 doi: 10.5455/OVJ.2025.v15.i10.1
Purnama MTE, Fikri F, Çalışkan H, Wicaksono AP.Racehorses endure high physical demands, which often result in musculoskeletal pain, fatigue, and reduced performance. Although conventional therapies are effective, competition-related drug regulations restrict their use. Acupuncture, rooted in Traditional Chinese Veterinary Medicine, has gained interest as a non-pharmacological alternative for managing pain, enhancing recovery, and promoting overall welfare in equine athletes. This review aims to critically evaluate the current evidence on the efficacy of acupuncture in racehorses, focusing on musculoskeletal pain management, post-exercise r...
A Meta-Analysis of International Flunixin Pharmacokinetics in Horses: Toward Regulatory Harmonization and Individualized Detection Times Using Bayesian Paradigm.
Drug testing and analysis    October 25, 2025   Volume 18, Issue 1 32-50 doi: 10.1002/dta.3961
Kuroda T, Knych HK, Noble GK, Minamijima Y, Leung GN, Nomura M, Mizobe F, Ishikawa Y, Kusano K, Toutain PL.Flunixin meglumine is widely used to manage pain and inflammation in horses, and its regulation requires robust pharmacokinetic analysis for harmonization. In this study, we conducted a meta-analysis of flunixin disposition using plasma and urine concentration data from 65 horses across four countries to robustly estimate pharmacokinetic parameters in setting screening limits (SLs) for controlling medications in horses. A population (POP) model was developed using nonlinear mixed-effects model analysis. The irrelevant plasma concentration (IPC) and irrelevant urine concentration (IUC) were det...
Surgical stabilization of flail sternum and bilateral chest wall injury in an octogenarian after horse trampling injury.
Trauma surgery & acute care open    October 23, 2025   Volume 10, Issue 4 e001999 doi: 10.1136/tsaco-2025-001999
Tai JW, Ko B, Adams ME, Nobuhara CK, Knight AW, Forrester JD.No abstract available
Incorporating a Behavioral Medicine Approach in the Multi-Modal Management of Chronic Equine Gastric Ulcer Syndrome (EGUS): A Clinical Commentary.
Animals : an open access journal from MDPI    October 17, 2025   Volume 15, Issue 20 3019 doi: 10.3390/ani15203019
Klinck M, Lovett A, Sykes B.Equine gastric ulcer syndrome (EGUS) refers to mucosal gastric disease in horses, including equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD), which present as two distinct disease entities differing in pathophysiology and approach to disease management. Both diseases are a source of pain in affected horses, partly explaining why EGUS continues to receive substantial attention in the equine medical, welfare and equitation research sectors. There is a complex interplay between EGUS and a variety of physical and psychological stressors. Horses with EGUS are often...
What if Horses Were Humans? Comparing Rein Tension and Bit Pressures to Human Pressure Pain Thresholds.
Animals : an open access journal from MDPI    October 15, 2025   Volume 15, Issue 20 2989 doi: 10.3390/ani15202989
Musial F, Weiss T.Bit pressure and rein tension-induced mouth pain in horses have recently become a significant welfare concern, fueling debates within the equestrian community and beyond. Evidence indicates that bits can cause pain-related behaviors and even oral lesions. Although studying pressure-induced pain in animals is challenging, the similarities in the physiology of pain processing (nociception) across mammals suggest that it is reasonable to assume that pain perception in humans and horses is principally comparable. Therefore, we compared human pressure pain detection thresholds (PPDTs) to reported r...
Cervical epidural catheter for administration of detomidine and morphine in a model of carpal synovitis in the horse.
Veterinary surgery : VS    September 29, 2025   doi: 10.1111/vsu.70031
Edwards VL, Reed R, Perlini M, Moorman VJ.To determine the analgesic effects of detomidine and morphine administered by cervical epidural catheter (CEC) on a model of thoracic limb pain. Methods: Prospective, randomized, blinded crossover study. Methods: Five adult horses. Methods: Cervical epidural catheters were placed under ultrasound guidance, followed by induction of lipopolysaccharide (LPS)-mediated carpal synovitis. Horses received either saline or detomidine/morphine (DM; 10 μg/kg, 0.1 mg/kg, respectively) via CEC 4 h after synovitis. After a 7 day washout, synovitis was induced in the contralateral carpus, and the alternate ...
Prevalence of Low Back Pain in Competitive Dressage Riders: A Cross-Sectional Study.
Journal of chiropractic medicine    September 27, 2025   Volume 24, Issue 1-4 84-91 doi: 10.1016/j.jcm.2025.08.012
Landman DM, Handley A, Peterson C.The purpose of this study was to identify the point and lifetime prevalence of low back pain (LBP) among dressage riders and identify riding-related variables that may precipitate LBP. Unassigned: A cross-sectional, exploratory, quantitative study was conducted using an online questionnaire. One hundred dressage riders competing at preliminary and higher levels were recruited at the South African Equestrian Federation's registered shows. Frequencies and descriptive statistics were performed on each question in addition to cross-tabulations for associations between variables or differences betw...
Equine Abdominal Surgery: Predicting and Preventing Postoperative Complications.
The Veterinary clinics of North America. Equine practice    September 24, 2025   Volume 41, Issue 3 495-507 doi: 10.1016/j.cveq.2025.08.003
Mudge M.Morbidity after equine abdominal surgery is common and post-operative complications can be costly to owners. The focus of this article is on intraoperative decision-making and current evidence, including surgical techniques and prognostic information that can prevent and predict complications. Emerging techniques for intra-operative monitoring and intestinal viability assessment, anastomotic techniques, body wall suturing, peritonitis treatment, and pain management are discussed.
Behavioral and orthopedic issues in geldings with Postcastration adhesions: A retrospective study of 35 cases.
Research in veterinary science    September 23, 2025   Volume 196 105910 doi: 10.1016/j.rvsc.2025.105910
Domańska-Kruppa N, Benoit P, Żukiewicz-Benoit K, Domino M, Kliczkowska K, Szubart M, Stefanik E.Limited data is available on the diagnostic and therapeutic methods for pathologies caused by scarring after castration. It is well recognized that specific behaviors or untypical hindlimb lameness may be observed in geldings with gelding scars and adhesions caused by spermatic cord remnants after castration OBJECTIVES: To describe how to diagnose movement disorders associated with excessive adhesions caused by spermatic cord remnant after castration and to present a successful surgical treatment method. Methods: To assess the impact of gelding scars on horses' movement and behavior, medical r...
Owners’ everyday interactions with their horse: Pain-related issues and those of veterinary concern.
Animal welfare (South Mimms, England)    September 17, 2025   Volume 34 e62 doi: 10.1017/awf.2025.10036
Smith R, Perkins L, Pinchbeck G, Ireland J.The decisions made by horse owners on behalf of their animal, including decisions to involve a veterinarian, play an important role in the management of pain. This study explored horse owners' experiences to understand how they conceptualised chronic pain within the context of their horse-human relationship, what led them to seek veterinary involvement, and how veterinary interactions shaped their perceptions of pain and its management. An ethnographic approach using constructivist grounded theory methods was adopted. This paper draws upon field notes generated through 200 h of observation und...
Impinging and Overriding Spinous Processes in Horses: A Narrative Review.
Animals : an open access journal from MDPI    September 13, 2025   Volume 15, Issue 18 2679 doi: 10.3390/ani15182679
Pilati N, Pressanto MC, Palumbo Piccionello A, De Angelis Corvi F, Beccati F.The term overriding spinous processes (ORSPs), commonly known as "kissing spine syndrome," refers to a skeletal abnormality in horses that is characterized by the narrowing (<4 mm) of the interspinous space and touching or overlapping of the spinous processes (SPs). This condition primarily affects the mid- and caudal thoracic vertebrae; however, ORSP can also affect the lumbar SPs. In the veterinary community, kissing spine is widely recognized as a common condition in sport horses, as it is often associated with chronic back pain and contributes to poor performance. Despite its significant c...
Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse.
Veterinary surgery : VS    September 11, 2025   Volume 55, Issue 2 491-497 doi: 10.1111/vsu.70017
Marques GF, Moorman VJ, Ellis KL, Perlini M, Edwards VL.To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
Intrinsic characteristics of donkeys that affect drug treatment.
Journal of equine veterinary science    September 10, 2025   Volume 154 105700 doi: 10.1016/j.jevs.2025.105700
Lizarraga I, Castillo-Alcala F.Donkeys have contributed to the development and livelihoods of humans for almost 7,000 years. They have been used for traction and transportation, kept as pets, utilized in animal-assisted therapies, or farmed as food-producing animals. Over the past two decades, significant progress has been made in bridging the knowledge gap in veterinary medicine between donkeys and horses. Veterinary practitioners are now more aware that donkeys have important behavioral, anatomical, and physiological characteristics that distinguish them from horses. These peculiarities should be considered when treating ...