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.
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...
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 ...
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.
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...
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...
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...
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...
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 ...
Ajeebsanu MM, Koshy SA, Karakka Kal AK, Subhahar MB, Karatt TK, Philip M.Suzetrigine, a recently approved Na1.8 sodium channel blocker, shows strong potential in the treatment of neurological, psychiatric, and pain-related conditions. Its peripheral selectivity enables effective pain management while avoiding central nervous system complications and addiction risks linked to opioid use. Following FDA approval in January 2025, concerns have emerged regarding its possible misuse for performance enhancement in sports, highlighting the need for reliable detection tools in doping control. Methods: An analytical procedure was designed and validated to detect suzetrigine ...
Carroll AT, Reed RA, Berghaus LJ, McNabney D, Knych HK.To investigate the effect of cannabidiol (CBD) on thermal and mechanical thresholds and physiologic variables in horses. Unassigned: 6 horses (3 geldings and 3 mares) were enrolled in a prospective, randomized, masked crossover design from March 18 through May 3, 2025. Horses received 3.48 mg/kg CBD oil or placebo (sesame oil) orally every 24 hours for 3 days. Thermal and mechanical thresholds were determined at baseline and 4 and 12 hours after treatment administration on each day. Physiologic variables, including heart rate, respiratory rate, and rectal temperature, were recorded at the same...
Lieberth S, Thieme K, Dancker C, Merle R, Eule JC.Retrobulbar anaesthesia (RBA) is relevant for ocular surgery in standing sedated horses. Objective: Gathering insights on experiences with RBA techniques. Methods: Cross-sectional survey. Methods: An online survey collected information on the respondents' professional background, indications, injection methods, use of ultrasound assistance, medication, and complications associated with RBA in horses. Results: Two-hundred and thirty-eight veterinarians from 25 countries contributed. 86.1% were members of veterinary specialty colleges. RBA indications were enucleation (97.8%), corneal surgery (2...
Duggan MJS, Kearney C, Baltrimaite M, Labberté MC, Gibney R, Brama PAJ.The aim of this study was to refine the lipopolysaccharide (LPS)-induced synovitis model in normal carpal joints of Thoroughbred horses by comparing two low LPS doses. A further aim was to investigate the relationship between the induced synovitis and lameness. The study design consisted of two phases using nine horses with a unilateral crossover design and a within-animal saline control. Synoviocentesis was performed at post-injection hour (PIH) 0, 8, 24, 72 and 168, allowing for synovial fluid cytology and biomarker analysis. Objective gait and thermographic analysis were used to objectively...
Arantes JA, Rabelo IP, Bermudes L, Lacerenza MD, Mendes RP, Corrêa RR, Yamada DI, Valadão CAA, Dória RGS.This study aimed to compare the sedation quality and cardiorespiratory and behavioral effects of detomidine administered intravenously, either in intermittent boluses or as a continuous rate infusion, with butorphanol in horses pre-medicated with acepromazine for odontoplasty procedures. Unassigned: A prospective clinical study was conducted with fifteen adult horses randomly assigned to two groups: Bolus group (BG, = 7) and Infusion group (IG, = 8). Both groups received acepromazine premedication, followed by detomidine administration (bolus or infusion). Butorphanol was administered either...
Willette J, Guinn A, Munsterman A.Impactions of the jejunum are rarely described in the literature. The current case series describes six cases of adult horses with jejunal impactions with feed material diagnosed by exploratory celiotomy. Horses underwent exploratory celiotomy based off of their degree of pain despite medical management and concerns for a primary strangulating small intestinal lesion. All jejunal impactions were relieved via manual decompression of the impaction into the cecum. None of the cases underwent a resection or anastomosis at the site of impaction. All horses were treated with gastroprotectants (omepr...
Maldonado Moreno N, Alves Moreira J, Araujo De Oliveira L, Sanches Gontijo A, Castilho Baldi ML, Rocha Wenceslau R, Beier SL.A multimodal approach is recommended to optimize perioperative pain control in animals, although opioid use in horses remains limited due to the risks of central nervous system (CNS) stimulation and reduced intestinal motility. A group of 19 healthy, male, mixed-breed horses were divided into two groups and medicated with acepromazine (0.05 mg kg) and detomidine (10 µg kg), with methadone (0.05 mg kg) (ADM) or saline (ADS) administered intravenously (IV). Physiological variables, intestinal motility, gastric distention, and facial pain (EQUUS-FAP) were evaluated one day before (DB), before th...
Amari M, Brioschi FA, Auletta L, Ravasio G.Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups receive...
Bombardi C, Salamanca G, Tagliavia C, Grandis A, Zamith Cunha R, Gramenzi A, De Silva M, Zannoni A, Chiocchetti R.The amygdala is composed of several nuclei, including the lateral nucleus which is the main receiving area for the input from cortical and subcortical brain regions. It mediates fear, anxiety, stress, and pain across species. Evidence suggests that the endocannabinoid system may be a promising target for modulating these processes. Cannabinoid and cannabinoid-related receptors have been identified in the amygdala of rodents, carnivores, and humans, but not in horses. This study aimed to investigate the gene expression of cannabinoid receptors 1 (CB1R) and 2 (CB2R), transient receptor potential...
Geiger T, Lindenhahn L, Delarocque J, Geburek F.Data about efficacy of different training modalities during rehabilitation of horses with back pain is scarce. The aim of this study was to analyze the effect of water treadmill training, lunging and dry treadmill training in horses with back pain. Methods: Eighteen warmblood riding horses referred with confirmed clinical signs of back pain including abnormal responses to passive mobilisation were randomized into three groups to participate in a 6-week water treadmill training, lunging or dry treadmill program under otherwise identical conditions. Two clinicians, one blinded to the program, pe...
Smith R, Perkins E, Pinchbeck G, Ireland J.Poor pain management in horses is a welfare concern. The 'diagnosis' of pain cannot be separated from the broader set of interactions through which it emerges. The interactions that take place during veterinary consultations shape the ways in which, or whether, pain management is discussed. Objective: To understand owners' and veterinarians' decision making in relation to chronic pain and its management. Methods: Qualitative ethnographic study. Methods: Data were collected from four veterinary practices in Great Britain between May 2023 and April 2024. Around 200 h of ethnographic observatio...
Calatayud-Bonilla M, Carmona JU, Prades M.Myofascial pain syndrome (MPS) is caused by trigger points (TrPs): hypersensitive spots in taut muscle bands that impair function and cause pain. Dry needling (DN) is a common treatment in humans, but evidence in horses is limited. This prospective, controlled study evaluated the effectiveness of DN in reducing TrP-related pain in the brachiocephalic muscle of horses. Of the 98 horses enrolled, 66 were allocated to a treatment group receiving weekly DN sessions for three weeks, while 32 were assigned to a control group with no intervention. Pain and function were assessed using pressure algome...
Uldahl M, Mellor DJ.This commentary evaluates contemporary equestrian sport governance through the lens of equine welfare science. Drawing on evidence from the FEI Sport Forum 2025 debates, the IFHA Racing Integrity Handbook, media coverage of horse sport, recent scientific presentations, regulatory texts, and published research, we identify systemic shortcomings in how horse welfare is assessed, prioritised, and protected. Key issues include reliance on performance as a proxy for welfare, inadequate "fit-to-compete" protocols, neglect of horses' mental states, coercive tack and equipment practices (e.g., double ...
Amiet B, Rainger J, Zedler S, Stewart A, Woldeyohannes S, Goodwin W.To compare horses' aversive behavioural responses to the application of 5% prilocaine/lidocaine eutectic mixture of local anaesthetics (EMLA) cream versus subcutaneous infiltration of 2% lidocaine, followed by jugular vein catheterization. Methods: Blinded, randomized study. Methods: A group of 26 university-owned research horses. Methods: Each horse received both treatments at opposite jugular sites with ≥ 12 hours between procedures. One randomly assigned jugular site received 1 g cm of 5% EMLA cream 60 minutes before catheterization, while the contralateral site received 1.5 mL of 2% lido...
Kelemen Z, Vogl C, Torres Borda L, Auer U, Jenner F.Clinical care for patients with limited life expectancy often requires adjustments, prioritizing immediate benefits over long-term outcomes, as the relevance of future complications diminishes. This study identifies indicators of mortality risk in horses with chronic orthopaedic conditions to enhance individualized care and welfare. Over 3 years, 123 chronically lame horses and 6 healthy control horses at an animal sanctuary underwent regular (every 3 months) comprehensive health assessments and activity monitoring using wearable sensors. Data collected included body condition scores, muscul...
Berni P, Del Bue M, Conti V, Andreoli V, Ramoni R, Angelone M, Squassino GP, Bari E, Torre ML, Rinaldi M, Dotti S, Rossi R, Yusuf I, Mauri P....Most in vivo studies on MSC-secretome for osteoarthritis (OA) have relied on animal models, using products lacking pharmaceutical quality, not formulated for clinical use, and insufficiently characterized, limiting knowledge of its effectiveness. This study reports veterinary clinical trials on dogs and horses with spontaneous OA: in dogs (26 subjects), the trial is randomized, double-blinded, and controlled; in horses, 5 clinical cases were treated for safety assessment. Treatment consisted of hyaluronic acid with either lyosecretome - a freeze-dried, injectable MSC-secretome obtained through...
Ellis KL, Giancola S.Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
Boado A, Pollard D, Dyson S.There is limited information about the orthopaedic health of dressage horses. This study aimed to document the orthopaedic status, lesion distribution, and evolution of injuries in 70 horses undergoing a minimum of five in-depth orthopaedic assessments at six-months' intervals. Warmblood (70.0%) and Iberian (24.3%) breeds predominated. The median lameness grade at initial examination was 2/5 (interquartile range 2,2; range 0,3). Hypermetria (42.9%) or hypermetria and weakness (12.9%) were observed at the initial examination and did not change over time. Metacarpophalangeal/metatarsophalangeal ...
Patricio CR, Winter GHZ, Garbade P.Spinal articular dysfunction disrupts normal neural function and may lead to stiffness, pain or poor performance. Back pain is common in equine athletes, and it is a common complaint by horse owners requesting chiropractic evaluations. Objective: To describe the prevalence of spinal articular dysfunction in showjumping horses. Methods: Retrospective analysis of clinical records. Methods: Records from 3 years of examinations in horses, from beginners to high-performance levels. Each horse had 30 spinal segments evaluated for the presence of dysfunctional articulations. Exams were performed by...
Portier K, Schiesari C, Gauthier L, Yeng LT, Tabacchi Fantoni D, Formenton MR.Myofascial trigger points (MTrPs) are localized, hypersensitive areas in muscles that can cause pain and reduced performance. This study aimed to compare the prevalence and location of MTrPs in show-jumping and dressage horses. A secondary objective was to evaluate the potential of thermography, pressure algometry, and facial expression scoring in characterizing MTrPs in horses. Fourteen horses (seven dressage, seven show-jumping) were examined. Muscle palpation was used to identify MTrPs. Thermography was used to compare the skin surface temperature of MTrPs with adjacent control areas. Addit...
Quam V.Inflammation plays a role in acute and chronic equine tendon/ligament injury; anti-inflammatories are often indicated. Local corticosteroids provide consistent and profound short-term effects on pain and inflammation across species. However, there is no demonstrated benefit in the long term, and complications can occur. Alternative biologic anti-inflammatory treatments are available and should be used in horses at risk of complications. Nonetheless, corticosteroids remain an affordable and effective anti-inflammatory that, with continued research, may be indicated on a case-by-case basis as pa...
Vandeweerd JM, Coisnon C, Clegg P, Cambier C, Pierson A, Hontoir F, Saegerman C, Gustin P, Buczinski S.Various treatments of osteoarthritis (OA) have been described, including use of nutraceuticals. Objective: To review systematically the literature about the effects of nutraceuticals on clinical signs of pain or abnormal locomotion in horses, dogs, and cats, and to discuss methodological aspects of trials and systematic reviews. Methods: A systematic search of controlled trials evaluating the impact of nutraceuticals on OA in horses, dogs, and cats was performed, using Medline, CAB Abstracts, and Google Scholar. Scientific evidence was evaluated by means of criteria proposed by the Food and Dr...
Dalla Costa E, Pascuzzo R, Leach MC, Dai F, Lebelt D, Vantini S, Minero M.Pain recognition is fundamental for safeguarding animal welfare. Facial expressions have been investigated in several species and grimace scales have been developed as pain assessment tool in many species including horses (HGS) and mice (MGS). This study is intended to progress the validation of grimace scales, by proposing a statistical approach to identify a classifier that can estimate the pain status of the animal based on Facial Action Units (FAUs) included in HGS and MGS. To achieve this aim, through a validity study, the relation between FAUs included in HGS and MGS and the real pain co...
Toutain PL, Cester CC.To determine pharmacokinetic-pharmacodynamic (PK-PD) relationships and dose effects for meloxicam in horses and to propose a suitable dosage for use in clinical studies. Methods: 6 adult horses. Methods: The study was conducted by use of a randomized, Latin-square design. Arthritis was induced in the right carpal joint of each horse by administration of Freund's complete adjuvant. Various dosages of meloxicam (0, 0.25, 0.5, 1.0, and 2.0 mg/kg, IV) were then administered. Validated endpoints including stride length and overall clinical lameness score (scale of 0 to 20) were used to assess the e...
Hernández-Avalos I, Mota-Rojas D, Mendoza-Flores JE, Casas-Alvarado A, Flores-Padilla K, Miranda-Cortes AE, Torres-Bernal F, Gómez-Prado J....Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxi...
Block JA, Oegema TR, Sandy JD, Plaas A.Oral glucosamine (GlcN) has been widely studied for its potential therapeutic benefits in alleviating the pain and disability of osteoarthritis (OA). Its popularity has grown despite ongoing controversy regarding its effectiveness vs placebo in clinical trials, and lack of information regarding possible mechanisms of action. Here, we review the state of knowledge concerning the biology of GlcN as it relates to OA, and discuss a framework for future research directions. Methods: An editorial "narrative" review of peer-reviewed publications is organized into four topics (1) Chemistry and pharmac...
Ishihara A, Bertone AL, Rajala-Schultz PJ.To evaluate the association between subjective lameness grades and kinetic gait parameters and assess the variability in kinetic parameters in horses with experimentally induced forelimb lameness. Methods: 32 horses. Methods: Forelimb lameness was induced in each horse via injection of lipopolysaccharide into 1 metacarpophalangeal joint (40 experimental trials). Subjective lameness grading and 13 kinetic gait parameters (force plate analysis) were assessed before (baseline) and at 12, 18, and 24 hours after lipopolysaccharide injection. While horses were trotting, kinetic gait analysis was per...
Taylor PM, Pascoe PJ, Mama KR.This chapter begins by providing an overview of current philosophies relevant to equine pain management. Objective and subjective techniques for assessing pain and the limitations of these are then described in depth. The conclusion emphasizes the need for an evidence based approach to managing pain in the horse and sets the stage for subsequent chapters in this edition.
Torcivia C, McDonnell S.Horses have evolved to show little indication of discomfort or disability when in the presence of potential predators, including humans. This natural characteristic complicates the recognition of pain in equine patients. It has been our clinical impression that, whenever a person is present, horses tend to "perk up" and ongoing discomfort behavior (DB) more or less ceases. The objective of this study was to quantitatively evaluate and describe this effect. For each of 20 orthopedic surgical patients, continuous 24-h video was reviewed to record all occurrences of DB during a caretaker visit (3...
Magri C, Schramme M, Febre M, Cauvin E, Labadie F, Saulnier N, François I, Lechartier A, Aebischer D, Moncelet AS, Maddens S.The purpose of this prospective study was to evaluate the effects of single and repeated intra-articular administration of allogeneic, umbilical cord-derived, neonatal mesenchymal stem cells (MSC) in horses with lameness due to osteoarthritis (OA) of a metacarpophalangeal joint (MPJ). Twenty-eight horses were included. Horses were divided into two groups. Horses in group MSC1 received an MSC injection at M0 and a placebo injection at M1 (1 month after M0). Horses in group MSC2 received MSC injections at M0 and at M1. Joint injections were performed with a blinded syringe. Clinical assessment w...
Lindegaard C, Thomsen MH, Larsen S, Andersen PH.To compare the analgesic effect of intra-articular (IA) and intravenous (IV) morphine in horses with experimentally induced synovitis. Methods: Eight adult horses. Methods: Randomized, observer blinded, double dummy trial with sequential crossover design. Methods: Radiocarpal synovitis was induced by IA injection of lipopolysaccharide on two occasions separated by a 3-week washout period. In one study period horses received treatment IA; morphine IA (0.05 mg kg(-1)) plus saline IV and in the other study period they received treatment IV; saline IA plus morphine IV (0.05 mg kg(-1)). Lameness an...
Reix CE, Burn CC, Pritchard JC, Barr AR, Whay HR.Lameness is prevalent in working donkeys and has major welfare implications; however, a detailed study of the associated clinical signs is lacking. Objective: To describe the range and prevalence of clinical signs and conformation associated with lameness in working draught donkeys. Methods: Prospective, cross-sectional, observational study. Methods: Data were collected from 102 working draught donkeys in Pakistan. A lameness assessment adapted for working donkeys was used to record clinical signs of lameness, gait, limb conformation and pain responses in the feet, limbs and spine using observ...
Laverty S, Sandy JD, Celeste C, Vachon P, Marier JF, Plaas AH.To examine the concentration of glucosamine in the synovial fluid and its pharmacokinetics in serum in a large animal model following dosing with glucosamine HCl at clinically relevant levels. Methods: Eight adult female horses were studied. After an overnight fast, glucosamine HCl (20 mg/kg of body weight) was administered by either nasogastric (NG) intubation or intravenous (IV) injection. Blood samples were collected before dosing and at 5, 15, 30, 60, 120, 180, 240, 360, 480, and 720 minutes after dosing. Synovial fluid samples were collected from the radiocarpal joints 48 hours before dos...
Broster CE, Burn CC, Barr AR, Whay HR.Lameness is highly prevalent in working horses, but published reports on the associated pathological abnormalities are lacking. With over 42 million horses in developing countries and the majority used for work, lameness has major welfare implications. Objective: To describe the range and prevalence of pathological abnormalities associated with lameness in working horses. Methods: A standard lameness assessment was adapted for field use in working equids. Data on pathological abnormalities and pain responses in the feet, limbs and spine were collected through observation, palpation, manipulati...
van Weeren PR, Back W.Musculoskeletal disorders are the most prevalent health problem in aging horses. They are not life threatening, but are painful and an important welfare issue. Chronic joint disease (osteoarthritis) and chronic laminitis are the most prevalent. Treating osteoarthritis in the elderly horse is similar to treating performance horses, but aims at providing a stable situation with optimal comfort. Immediate medical treatment of flare-ups, long-term pain management, and adaptation of exercise and living conditions are the mainstays of treatment. Laminitis in the geriatric horse is related often to p...
Evans CH, Chevalier X, Wehling P.Autologous conditioned serum was developed in the mid 1990s as an expeditious, practical, and relatively inexpensive means of generating the interleukin-1 receptor antagonist, a naturally occurring inhibitor of the cytokine interleukin-1. The latter is thought to be an important mediator of inflammation, pain, and tissue destruction in musculoskeletal conditions. ACS has been widely and successfully used in the local treatment of human and equine osteoarthritis and radicular compression; it has also shown promise in treating tendinopathies, muscle injuries, and tunnel widening after reconstruc...
van Loon JPAM, Van Dierendonck MC.In recent decades, much effort has been invested in scientific studies of objective and reliable assessment of pain in horses. Various types of pain assessment tools have been described and (partly) validated for different types of pain in horses. Currently, composite pain scales and facial expression-based pain scales seem to be the most promising tools for pain assessment in horses and numerous studies have recently been published on the use of these pain scales in horses. Therefore, this narrative review mainly focusses on these two types of pain scales and on the studies that have appeared...
Andersen PH, Broomé S, Rashid M, Lundblad J, Ask K, Li Z, Hernlund E, Rhodin M, Kjellström H.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...
Frisbie DD, McCarthy HE, Archer CW, Barrett MF, McIlwraith CW.We sought to determine the effectiveness of chondroprogenitor cells derived from autologous and allogenic articular cartilage for the repair of cartilage defects in an equine model. Methods: Cartilage defects (15 mm) were created on the medial trochlear ridge of the femur. The following experimental treatments were compared with empty-defect controls: fibrin only, autologous chondroprogenitor cells plus fibrin, and allogenic chondroprogenitor cells plus fibrin (n = 4 or 12 per treatment). Horses underwent strenuous exercise throughout the twelve-month study, and evaluations included lameness (...
Graubner C, Gerber V, Doherr M, Spadavecchia C.The aim of this study was to refine a multi-dimensional scale based on physiological and behavioural parameters, known as the post abdominal surgery pain assessment scale (PASPAS), to quantify pain after laparotomy in horses. After a short introduction, eight observers used the scale to assess eight horses at multiple time points after laparotomy. In addition, a single observer was used to test the correlation of each parameter with the total pain index in 34 patients, and the effect of general anaesthesia on PASPAS was investigated in a control group of eight horses. Inter-observer variabilit...
Lesimple C, Hausberger M.Healthcare practitioners such as physicians or nurses often underestimate patients' well-being impairment (e.g., pain, anxiety) which may lead to undesirable consequences on treatment decisions. Lack of recognition/identification of signals and over-exposure are two reasons invoked, but a combination of factors may be involved. Studying human decoding of animals' expressions of emotions showed that "identification" to the subject was necessary to decode the other's internal state. In the present study we wanted to compare caretakers' reports on the prevalence of stereotypic or abnormal repetit...
Mellor DJ.A proposition addressed here is that, although bitted horses are viewed by many equestrians as being largely free of bit-related mouth pain, it seems likely that most behavioural signs of such pain are simply not recognised. Background information is provided on the following: the major features of pain generation and experience; cerebrocortical involvement in the conscious experience of pain by mammals; the numerous other subjective experiences mammals can have; adjunct physiological responses to pain; some general feature of behavioural responses to pain; and the neural bases of sensations g...
Taffarel MO, Luna SP, de Oliveira FA, Cardoso GS, Alonso Jde M, Pantoja JC, Brondani JT, Love E, Taylor P, White K, Murrell JC.Quantification of pain plays a vital role in the diagnosis and management of pain in animals. In order to refine and validate an acute pain scale for horses a prospective, randomized, blinded study was conducted. Twenty-four client owned adult horses were recruited and allocated to one of four following groups: anaesthesia only (GA); pre-emptive analgesia and anaesthesia (GAA,); anaesthesia, castration and postoperative analgesia (GC); or pre-emptive analgesia, anaesthesia and castration (GCA). One investigator, unaware of the treatment group, assessed all horses at time-points before and afte...
Flecknell P.The last decade has seen continued progress in both the recognition and management of animal pain. This upsurge in the use of analgesics in animals is welcome, but the main areas of use continue to be the control of postoperative or post-trauma pain, and the management of musculoskeletal pain, in companion animals and horses. The management of pain associated with other conditions, such as soft-tissue inflammation or cancer, is still relatively neglected. Pain management in farm animals, and in animals used in biomedical research could also be improved further. Apart from providing some intere...
Lencioni GC, de Sousa RV, de Souza Sardinha EJ, Corrêa RR, Zanella AJ.The aim of this study was to develop and evaluate a machine vision algorithm to assess the pain level in horses, using an automatic computational classifier based on the Horse Grimace Scale (HGS) and trained by machine learning method. The use of the Horse Grimace Scale is dependent on a human observer, who most of the time does not have availability to evaluate the animal for long periods and must also be well trained in order to apply the evaluation system correctly. In addition, even with adequate training, the presence of an unknown person near an animal in pain can result in behavioral ch...
Suva LJ, Cooper A, Watts AE, Ebetino FH, Price J, Gaddy D.Bisphosphonates (BPs) are characterized by their ability to bind strongly to bone mineral and inhibit bone resorption. However, BPs exert a wide range of pharmacological activities beyond the inhibition of bone resorption, including the inhibition of cancer cell metastases and angiogenesis and the inhibition of proliferation and apoptosis in vitro. Additionally, the inhibition of matrix metalloproteinase activity, altered cytokine and growth factor expression, as well as reductions in parameters of pain have also been reported. In humans, clinical BP use has transformed the treatment of post-m...
Cokelaere SM, Plomp SGM, de Boef E, de Leeuw M, Bool S, van de Lest CHA, van Weeren PR, Korthagen NM.Synovial inflammation is an important characteristic of arthritic disorders like osteoarthritis and rheumatoid arthritis. Orally administered non-steroidal anti-inflammatory drugs (NSAIDs) such as celecoxib are among the most widely prescribed drugs to manage these debilitating diseases. Intra-articular delivery in biodegradable in situ forming hydrogels overcomes adverse systemic effects and prolongs drug retention in the joint. In this study two formulations of celecoxib (40 mg/g and 120 mg/g) in a propyl-capped PCLA-PEG-PCLA triblock copolymer were sequentially evaluated in a multiple L...
This study presents the validation of two recently described pain scales, the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP), in horses with acute colic. A follow-up cohort study of 46 adult horses (n = 23 with acute colic; n = 23 healthy control horses) was performed for validation and refinement of the constructed scales. Both pain scales showed statistically significant differences between horses with colic and healthy control horses, and between horses with colic that co...
Tyrnenopoulou P, Diakakis N, Karayannopoulou M, Savvas I, Koliakos G.Regenerative medicine has become one of the most promising therapies of equine osteoarthritis. Platelet lysate (PL) is rich in bioactive proteins and growth factors that play a crucial role in tissue healing. Objective: To evaluate the efficacy of intra-articularly injected autologous PL in equine athletes with naturally occurring osteoarthritis. Methods: Fifteen warmblood geldings aged 8-19 years with osteoarthritis of the distal interphalangeal joint were included in this study. They were randomly divided into two groups; 10 horses received intra-articular injections of PL and 5 of normal s...
Pigott JH, Ishihara A, Wellman ML, Russell DS, Bertone AL.To compare the clinical and inflammatory joint responses to intra-articular injection of bone marrow-derived mesenchymal stem cells (MSC) including autologous, genetically modified autologous, allogeneic, or xenogeneic cells in horses. Methods: Six five-year-old Thoroughbred mares had one fetlock joint injected with Gey's balanced salt solution as the vehicle control. Each fetlock joint of each horse was subsequently injected with 15 million MSC from the described MSC groups, and were assessed for 28 days for clinical and inflammatory parameters representing synovitis, joint swelling, and pain...
Murrell JC, Johnson CB, White KL, Taylor PM, Haberham ZL, Waterman-Pearson AE.To identify changes in the amplitude spectrum of the electroencephalogram (EEG) during a standardized surgical model of nociception in horses. Methods: Thirteen entire male horses and ponies referred to Division of Clinical Veterinary Science, Bristol (n = 9) and Department of Clinical Veterinary Medicine (n = 4) for castration. Methods: Following pre-anaesthetic medication with acepromazine, anaesthesia was induced with guaiphenesin and thiopental and maintained with halothane in oxygen. The EEG was recorded continuously using subcutaneous needle electrodes. Additional monitoring comprised EC...
