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.
Mair T, Sherlock C.Most recurrent episodes of non-specific colic are self-limiting, and the results of clinical examinations are unremarkable. Differentiating these cases from serious diseases can be difficult, but repeated evaluations are warranted. Horses presenting with very frequent bouts of colic are more likely to have serious diseases and a higher mortality rate compared to horses presenting with less frequent bouts of transient colic. Horses with recurrent bouts of prolonged colic are more likely to have motility issues or partial intestinal obstruction. Non-gastrointestinal diseases can also cause recur...
Yocom A, Contino E, Kawcak C.Bisphosphonates are a group of drugs that can reduce bone resorption by incorporating into the crystal structure of exposed hydroxyapatite where they are taken up by osteoclasts. Bisphosphonates have several other mechanisms of action including reducing pain and inflammation and altering macrophage function. There are two types of bisphosphonates-nitrogenous and non-nitrogenous, the latter of which is used in horses. This article provides a literature-based review of the proposed mechanisms of action and therapeutic uses of bisphosphonates including a brief review of bone response to disease. ...
Kendall A, Lützelschwab C, Lundblad J, Skiöldebrand E.Nerve growth factor (NGF) is a neurotrophin that is increased in osteoarthritic joints of horses. In humans, NGF has been associated with pain, and both synovial and serum NGF concentrations are increased in osteoarthritic patients. Studies in humans also have shown that serum NGF concentration can increase with stress. Serum NGF concentration should be evaluated in horses with osteoarthritis-associated lameness. Objective: Quantify and compare serum NGF concentration in horses with osteoarthritis-associated lameness and sound horses. Additionally, the impact of short-term stress on serum NGF ...
Kim SM, Cho GJ.This study aimed to prove that deep learning can be effectively used for identifying various equine facial expressions as welfare indicators. In this study, a total of 749 horses (healthy: 586 and experiencing pain: 163) were investigated. Moreover, a model for recognizing facial expressions based on images and their classification into four categories, i.e., resting horses (RH), horses with pain (HP), horses immediately after exercise (HE), and horseshoeing horses (HH), was developed. The normalization of equine facial posture revealed that the profile (99.45%) had higher accuracy than the fr...
Tueshaus T, McKemie DS, Kanarr K, Kass PH, Knych HK.Codeine and acetaminophen in combination have proven to be an effective analgesic treatment for moderate-to-severe and postoperative pain in humans. Studies have demonstrated that codeine and acetaminophen, when administered as sole agents, are well tolerated by horses. In the current study, we hypothesized that administration of the combination of codeine and acetaminophen would result in a significant thermal antinociceptive effect compared with administration of either alone. Six horses were administered oral doses of codeine (1.2 mg/kg), acetaminophen (20 mg/kg), and codeine plus aceta...
McAndrews A, Zarucco L, Hopster K, Stefanovski D, Foster D, Driessen B.Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were s...
Mattila-Rautiainen S, Venojärvi M, Rautiainen H, Keski-Valkama A.Equine - Facilitated Therapy (EFT), an equine environment, and horses themselves can meet many physical and mental health needs beyond diagnostic categories. The horse's ability to produce a walk-like movement and the participant's ability to connect to non-judgemental living creatures, both of which can benefit participation and construct a positive self-image for chronic pain patients. The objective of this study is to evaluate the impact of EFT on perceived physical performance, level of pain, pain acceptance, depression and anxiety, and quality of life within a 12-week intervention for chr...
Soiluva J, Häyrinen L, Gangini G, Öistämö R, Gracia-Calvo LA, Raekallio MR.Traditional visual lameness assessment is subjective. Ethograms have been developed for evaluating pain and objective sensors to detect lameness. Heart rate (HR) and heart rate variability (HRV) have been used to evaluate stress and pain. The aim of our study was to compare subjective and behavioral lameness scores, a sensor system measuring movement asymmetry, HR, and HRV. We hypothesized that these measures would show related trends. In 30 horses, an inertial sensor system was used to measure movement asymmetries during trot in-hand. A horse was categorized as sound if each asymmetry was les...
Zaha C, Schuszler L, Dascalu R, Nistor P, Florea T, Imre K, Rujescu C, Sicoe B, Igna C.Horses with palmar foot pain do not show a typical increase in temperature in the palmar aspect of the hoof and heel due to low blood flow. The objectives of the current study were to determine the changes and differences in the thermographic pattern of the sole surface in horses with unilateral palmar foot pain and non-lame horses before and after training. We hypothesized that the thermal pattern and the local temperature of the frog area and toe area would be similar, with an increased local temperature after training in both lame and non-lame horses. A pilot study was conducted to investig...
Poth MKM, McKemie DS, Traynham M, Kass PH, Knych HK.The metabolism and pharmacokinetics of intravenous (i.v.) morphine in the horse have been described; however, administration of therapeutic doses has also been associated with neuroexcitation and adverse gastrointestinal effects. In this study, we hypothesized that oral administration would lead to comparable concentrations of morphine and its presumed active metabolite, morphine 6-glucuronide (M6G) without the adverse effects associated with i.v. administration. Eight horses were administered a single i.v. dose of 0.2 mg/kg morphine and oral doses of 0.2, 0.6, and 0.8 mg/kg of morphine in a...
Ishikawa Y, Sakai DM, Im JS, Zhang S, Reed RA, Quandt JE, Baldo CF, Walters B, Barletta M.To evaluate a regional anesthetic technique for blocking the abdominal midline in horses. Methods: Anatomical description and prospective, crossover, placebo-controlled, blinded study. Methods: Adult horses; two cadavers, six healthy animals. Methods: In stage 1, 0.5% methylene blue with 0.25% bupivacaine (0.5 mL kg) was injected using ultrasonography into the internal rectus abdominis sheath (RAS) of two cadavers with a one-point or two-point technique. The dye spread was described after the dissection of the abdomens. In stage 2, each horse was injected with 1 mL kg of 0.9% NaCl (treatment P...
Castro-Cuellar G, Cremer J, Queiroz-Williams P, Knych HK, Leise BS.The objective of this study was to describe the pharmacokinetics of intra-articular (IA) administered buprenorphine in horses with lipopolysaccharide (LPS)-induced synovitis. Radiocarpal synovitis was induced in six healthy adult horses with the IA injection of LPS (0.5 ng/joint) on two occasions in a randomized cross-over design. Treatments (IA buprenorphine (IAB) at 5 μg/kg plus intravenous saline; and intravenous buprenorphine (IVB) at 5 μg/kg plus IA saline) were administered 4 h following LPS injection. Concentrations of buprenorphine were assessed in plasma and synovial fluid (SF) ...
Zielińska P, Soroko-Dubrovina M, Dudek K, Ruzhanova-Gospodinova IS.The reason for undertaking this study was to investigate soft tissue response to high-intensity laser therapy (HILT) by measuring changes in skin surface temperature and longissimus dorsi muscle tone in the thoracolumbar back area in Thoroughbreds with back pain and diagnosed with and without Kissing Spines Syndrome (KSS). Thoroughbreds aged 3-4 years with clinically presented back pain underwent a radiological examination (to assess a lack or presence of KSS) and longissimus dorsi muscle palpation (to assess muscle tone and pain degree). The subjects were divided into two groups, those with K...
Millis DL, Bergh A.Light therapy, or photobiomodulation, is a collective name for methods where tissue is irradiated with different types of light, with the aim of stimulating healing. Despite being frequently used, there is no consensus regarding the optimal treatment protocols for light therapy, nor its clinical efficacy. A systematic literature review was conducted, searching the relevant literature regarding light therapy in three databases, published between 1980-2020. The risk of bias in each article was evaluated. Forty-five articles met the inclusion criteria; 24 articles were regarding dogs, 1 was regar...
Kaneps AJ.Regenerative medicine therapies have become significant tools for treatment of joint, soft tissue, and a variety of other conditions in animals and humans. Regenerative medicine aims to restore form and function of injured tissues using the body's own resources such as cells, fluids (ie, plasma and serum), and their resulting anti-inflammatory and prohealing cytokines. Platelet-rich plasma and other hemoderivatives have application for joint disorders such as osteoarthritis, cartilage injury, synovitis, and soft tissue injuries. These therapies achieve anti-inflammatory and healing effects wit...
Murer S, Polidori G, Beaumont F, Bogard F, Hakim H, Legrand F.Pudendal Neuralgia (PN) is a rare, debilitating disease caused by damage to the pudendal nerve, which innervates the anus, rectum, perineum, lower urinary tract, and genitalia. Although its etiology remains scientifically unknown, a number of sports practices, including horse-riding, are reported as triggering and/or aggravating factors. The present work summarizes the experimental measurements of the contact pressure at the interface between the rider and saddle, for a population of 12 experienced female riders. These tests reveal that dynamic horseback-riding leads to high levels of peak pre...
Orr R, Canetti EFD, Pope R, Lockie RG, Dawes JJ, Schram B.Mounted police officers are subject to unique occupational tasks which may lead to unique injuries. This study's aim was to describe policing injuries suffered by mounted police officers contextualized through comparison to non-mounted officers. Injury data from 01 July 2014 to 30 June 2020 were provided from a state policing agency's incident reporting database. The data reported the numbers and rates of injuries and classified the injuries by gender, cause, mechanism, nature, and hours worked. Of the 35,406 reported injuries, 35,255 (99.6%) injuries were reported by non-mounted police office...
Pezzanite LM, Griffenhagen GM, Bass L, Okudaira M, Larson B, Hendrickson DA.Liposomal local anaesthetic solutions may provide extended-duration analgesia postoperatively but have not been assessed following intra-peritoneal local infiltration in any species. Objective: To evaluate two doses of 1.33% liposomal bupivacaine (LB) versus 0.75% bupivacaine HCL (BHCl) for analgesia following laparoscopic ovariectomy in mares. Methods: Prospective cohort study. Methods: Fifteen healthy Quarter Horse mares (age 2-20 years) with normal bilateral ovarian palpation and appearance were enrolled. Horses were restrained in standing stocks and administered an α-2 agonist, butorpha...
Medeiros do Nascimento RC, Graboschii ACG, da Fonseca LS, Silva AR, Souto PC, da Fonseca LA, Goulart MOF, Escodro PB.In most animals, pain can compromise physiological functions and delay healing so, rapid detection of pain through behavior and inflammatory reaction with biomarkers are necessary. This study aimed to evaluate pain, physiological variations and Acute Phase Proteins (APP) in donkeys undergoing orchiectomy technique by inguinal access. For this research, 15 male northeastern donkeys kept in extensive management were selected, with a mean age of 4.5±3.1 years. All animals had the same anesthetic protocol, using dissociative anesthesia and local block with lidocaine, followed by orchiectomy by in...
Golzari K, Kong Y, Reed SA, Posada-Quintero HF.The continuous monitoring of stress, pain, and discomfort is key to providing a good quality of life for horses. The available tools based on observation are subjective and do not allow continuous monitoring. Given the link between emotions and sympathetic autonomic arousal, heart rate and heart rate variability are widely used for the non-invasive assessment of stress and pain in humans and horses. However, recent advances in pain and stress monitoring are increasingly using electrodermal activity (EDA), as it is a more sensitive and specific measure of sympathetic arousal than heart rate var...
La Rosa L, Twele L, Duchateau L, Gasthuys F, Kästner SB, Schauvliege S.To study the antinociceptive properties of epidural magnesium sulphate (MgSO) in standing horses Experimental, placebo-controlled, masked, cross-over A group of six healthy horses Through an epidural catheter, 1 mg kg MgSO (treatment Mg) diluted to a volume of 15 mL or the same volume of saline (treatment S) was administered over 15 minutes. Electrical, thermal and mechanical nociceptive thresholds were determined on the pelvic limb before and 20, 40, 60, 80, 100, 120, 140, 160 and 180 minutes after the start of the injection. Heart rate (HR) and respiratory frequency (f) were recorded every ...
Urayama S, Tanaka A, Kusano K, Sato H, Muranaka M, Mita H, Nagashima T, Matsuda H.Flunixin meglumine (FM), a nonselective cyclooxygenase (COX) inhibitor, is most frequently selected for the treatment of equine systemic inflammatory response syndrome (SIRS)/endotoxemia. However, FM has considerable adverse effects on gastrointestinal function. The aims of this study were to compare the effect of meloxicam (MX), a COX-2 selective inhibitor commonly used in equine clinical practice, with FM, and to investigate the potential for clinical application in horses with SIRS/endotoxemia. Fifteen horses were divided into three groups of five and orally administered MX (0.6 mg/kg), FM ...
Gold JR, Grubb T, Court M, Villarino NF.Acetaminophen is a common analgesic and antipyretic drug used in human medicine and might be an alternative to nonsteroidal anti-inflammatory drugs for treating pain and pyrexia in foals. The pharmacokinetics and safety of differing doses of acetaminophen have not been investigated in foals. Objective: To determine the plasma pharmacokinetics and any changes in haematology and biochemistry profiles following oral administration of single doses of acetaminophen at 10, 20, and 40 mg/kg to foals. Methods: Randomised cross-over pharmacokinetic study. Methods: Six Quarter Horse (two colts and fou...
Laukkanen T, Karma L, Virtala AM, Mykkänen A, Pehkonen J, Rossi H, Tuomola K, Raekallio M.Equine dental diseases are often underdiagnosed and their signs inadequately reported. Many horse owners have difficulties in recognizing pain-related behavioral signs and in associating them with dental pain. Our objective was to determine what type and degree of dental findings may cause behavioral signs associated with dental pain. In this cross-sectional study, dental examination was performed on 183 adult horses and cheek tooth findings were scored. Owners filled in an internet-based questionnaire including 35 questions concerning eating behavior, bit behavior, and general behavior of the...
Marzok M, Almubarak AI, Kandeel M, El-Khodery S.Epidural analgesia using the alpha-2 agonist detomidine (DE), alone or in combination with lidocaine (LD), is frequently employed for standing surgical procedures in horses, but its use has not been evaluated in donkeys. Methods: In a randomised controlled prospective trial, 24 healthy adult donkeys were assigned to four groups (n = 6), each receiving 40 μg/kg of DE, 0.22 mg/kg of LD, combined DE and LD (DELD) or 0.9% sterile normal saline epidurally. After epidural injection of each treatment, the onset, degree and duration of sedation and anatomical extension of anti-nociception were obse...
Maney JK, Dzikiti BT, Escobar A, Knych HK, Bennett RC.Morphine is the prototypical μ-opioid receptor agonist used to provide analgesia in veterinary species. Its effects are well-described in horses but not donkeys. Objective: To determine the antinociceptive effects of two doses of morphine in donkeys. To describe preliminary pharmacokinetic parameters of morphine in donkeys. Methods: In vivo experiment. Methods: Eight adult castrated male donkeys were given intravenous (IV) 0.9% saline, morphine 0.1 mg/kg bwt (LDM), or morphine 0.5 mg/kg bwt (HDM) in a randomised order with a minimum 1-week washout period. Mechanical nociceptive thresholds (...
Anderson K, Morrice-West AV, Walmsley EA, Fisher AD, Whitton RC, Hitchens PL.Musculoskeletal injuries are observed in Thoroughbred racehorses and may become catastrophic. Currently, there are limited methods for early detection of such injuries. Most injuries develop gradually due to accumulated damage, providing the opportunity for early detection. Horses experiencing pain or lameness may exhibit changes in behaviour so the development of an objective, real-time system monitoring horse behaviour may enable detection of bone injuries before catastrophic failure. Objective: To determine whether intensive observational methods of assessing horse behaviour can be replaced...
Sanches GL, Ribeiro LMF, Motta AP, Petrucci LBDV, Gobbi FP, Quirino CR, Di Filippo PA.This study aimed to compare the antinociceptive effects of tramadol 5% and lidocaine 2% on mental nerve block in horses of the Brazilian Pony breed. Eight adult non-pregnant mares were used in this study. The ponies were tranquilized with acepromazine (5 µg kg, IV), and the infiltration of the mental foramen was performed in Treatment 1- tramadol 5% (T, 150 mg) or Treatment 2- lidocaine 2% (L, 60 mg), both at a total dose of 3 ml in each foramen. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), rectal te...
Peraza J, Hector RC, Lee S, Terhaar HM, Knych HK, Wotman KL.Acetaminophen (paracetamol) is increasingly used to treat painful conditions in horses but its ocular penetration has not been studied. Objective: To determine whether orally administered acetaminophen penetrates the aqueous humour of the normal equine eye and report an aqueous humour:serum acetaminophen concentration ratio in horses. Methods: In vivo experiment. Methods: Six privately owned horses with normal ophthalmic examinations weighing 568 ± 65 kg (mean ± standard deviation) and aged 11 ± 4 years were given 20 mg/kg acetaminophen orally every 12 h for a total of s...
Rosa MVD, Rosa M, Botteon PTL.This study aimed to evaluate the use of equine amniotic membrane (EAM), frozen indirectly using liquid nitrogen and stored between -10° and -24°C, in the treatment of equine skin lesions. Six healthy female horses, aged 3-10 years, were included in this study. EAM was collected from previously evaluated healthy parturient mares. Wounds were surgically created at the distal ends of the forelimbs. One limb was chosen for treatment, and the contralateral limb was chosen as the control. Pain sensitivity, presence of granulation tissue, secretions, and bleeding after debridement during cleaning w...
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...
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...
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...
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...
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...
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...
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 (...
van Loon JP, de Grauw JC, van Dierendonck M, L'ami JJ, Back W, van Weeren PR.Intra-articular administration of morphine as a local analgesic and anti-inflammatory drug is widely used in human medicine. In equids, little is known about its clinical analgesic and anti-inflammatory efficacy. Objective: To use an inflammatory orthopaedic pain model to investigate the analgesic and anti-inflammatory effects of intra-articularly administered morphine as a new treatment modality in horses with acute arthritis. Methods: In a crossover study design, synovitis was induced in the left or right talocrural joint by means of intra-articular injection of 0.5 ng lipopolyssacharide (LP...
Haussler KK, Erb HN.An objective measure of neck, back and croup pain is needed in horses with musculoskeletal injuries, vague upper limb lameness or poor performance. Objective: To establish mechanical nociceptive thresholds (MNTs) within the axial skeleton and evaluate the effects of subject status and ridden exercise. Methods: Thirty-six mature horses (10 nonridden; 26 actively ridden) were used to assess MNTs evoked by a pressure algometer (PA) with a 1 cm2 rubber plunger tip at 62 midline and bilaterally symmetrical anatomical landmarks along the axial skeleton. Pressure was applied at a uniform rate of appl...
Stubbs NC, Kaiser LJ, Hauptman J, Clayton HM.In human subjects with back pain, the deep spinal stabiliser m. multifidus is inhibited ipsilaterally leading to atrophy, asymmetry and intervertebral instability. Specific physiotherapeutic exercises are required to reactivate m. multifidus. This study assesses the effect of dynamic mobilisation exercises on size and symmetry of m. multifidus in the equine caudal thoracic and lumbar spine. Objective: Regular performance of dynamic mobilisation exercises over a period of 3 months increases cross sectional area (CSA) and left-right symmetry of m. multifidus muscles in the caudal thoracic and lu...
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...
Clutton RE.Opioid analgesics have been the foundation of human pain management for centuries, and their value in animals has increased since it was proposed that it is the veterinarian's duty to alleviate pain whenever it may occur. Compared with other domesticated species, the horse has benefitted less from the increased understanding of opioid pharmacology in animals, because early literature was overlooked and later work, which examined adverse side effects rather than analgesia, concluded that analgesic and excitatory doses were irreconcilably close. More recent studies have indicated a widening role...
Wagner AE.The stress response represents an animal's attempt to reestablish the body's homeostasis after injury, intense physical activity, or psychological strain. Two different neuroendocrine pathways may be activated in stressful situations: the hypothalamic-pituitary-adrenocortical axis, leading to increased cortisol levels, and the sympathoadrenomedullar system, leading to increased catecholamine levels. By applying some of the evaluation methods described in this article in the appropriate clinical situations, equine veterinarians can almost certainly improve their ability to recognize and manage ...
Dyson SJ, Murray R, Schramme MC.The diagnosis of foot-related lameness often remains elusive and it can be difficult to offer rational treatment, or to predict outcome. Objective: To describe the spectrum of injuries of the foot identified using magnetic resonance imaging (MRI), to determine their relative prevalence among MRI diagnoses and to establish the long-term results of treatment. Methods: The MR images of horses examined from January 2001--December 2003 were reviewed. Horses were selected for MRI if the pain causing lameness was localised to the foot using perineural analgesia but any clinical, radiological or ultra...
Martin BB, Klide AM.The diagnosis of back pain is often a diagnosis of exclusion of other problems in the face of poor performance. It requires careful observation, thought, an open mind, and experience. The signs of back pain can be extremely variable and range from subtle to obvious. Obvious forelimb or hind limb lameness is not usually a sign of back pain. The most common differential diagnosis may be back pain secondary to degenerative joint disease of the hocks, fetlocks, or stifle. These diseases can mimic signs of back pain including lack of impulsion, shortening of the stride length, and change in the str...
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.
Ruíz-López P, Domínguez JM, Granados MDM.To review monitors currently available for the assessment of nociception-antinociception in veterinary medicine. Methods: PubMed, Web of Science and Google Scholar. The results were initially filtered manually based on the title and the abstract. Conclusions: The provision of adequate antinociception is difficult to achieve in veterinary anaesthesia. Currently, heart rate and arterial blood pressure are used to monitor the response to a noxious stimulus during anaesthesia, with minimum alveolar concentration-sparing effect and stress-related hormones used for this purpose in research studies. ...
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...
Love EJ, Murrell J, Whay HR.This review evaluates the thermal and mechanical nociceptive threshold testing techniques that have been used in horses and discusses them with reference to their applications, limitations and the factors which can influence both the testing procedure itself and the animal's responses. Methods to optimise the reliability and repeatability of the testing procedures are suggested and the potential clinical applications discussed. Methods: Web of Science and Medline. Conclusions: Thermal and mechanical nociceptive threshold testing techniques have valuable roles in both the identification of alte...
Haussler KK.The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until...
Jones E, Viñuela-Fernandez I, Eager RA, Delaney A, Anderson H, Patel A, Robertson DC, Allchorne A, Sirinathsinghji EC, Milne EM, MacIntyre N....Laminitis is a common debilitating disease in horses that involves painful disruption of the lamellar dermo-epidermal junction within the hoof. This condition is often refractory to conventional anti-inflammatory analgesia and results in unremitting pain, which in severe cases requires euthanasia. The mechanisms underlying pain in laminitis were investigated using quantification of behavioural pain indicators in conjunction with histological studies of peripheral nerves innervating the hoof. Laminitic horses displayed consistently altered or abnormal behaviours such as increased forelimb lifti...
Zimmerman M, Dyson S, Murray R.There has been no objective study comparing radiological features of spinous processes (SPs) in the thoracolumbar region and/or scintigraphic findings with clinical signs. Objective: To investigate the relationship between the presence or absence of clinical signs of back pain and: 1) radiological findings of close, impinging or overriding SPs; 2) increased radiopharmaceutical uptake (IRU) in the SPs; and 3) the combination of radiological findings and IRU. Also to determine the prevalence of concurrent osseous pathology. Methods: Five-hundred and eighty-two horses, presented for perceived bac...
