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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.
Alterations in Metabolic Status and Headshaking Behavior Following Intravenous Administration of Hypertonic Solutions in Horses with Trigeminal-Mediated Headshaking. Trigeminal-nerve-mediated headshaking represents a major welfare challenge for owners and veterinarians and is caused by a low threshold firing of the trigeminal nerve resulting in pain manifested as violent head jerking that often terminates the horse’s career and life due to poor quality of life and suffering. As metabolic changes such as acid⁻base status and electrolytes play a role in nerve firing, this study sought to assess the effects following administration of hypertonic solutions on headshaking behavior in affected horses. This prospective randomized controlled crossover desi...
The detection of capsaicin and dihydrocapsaicin in horse serum following long-term local administration. Capsaicin and dihydrocapsaicin are alkaloids with analgesic effects in humans and animals. When used locally, both of them minimalise pain sensation by defunctionalising nerve endings. According to the Federation Equestrian International Prohibited Substances List, these are substance banned in horse competitions. The aim of the study was to determine the detection time of capsaicin in both plasma and serum after long-term use of a gel recommended for commercial use and applied as intended. The objective of the study was to select the best material for the detection of capsaicin as a doping su...
Evaluation of the equine mental foramen block: cadaveric and in vivo injectate diffusion. To describe injectate diffusion for two equine mental foramen block techniques. Methods: Descriptive anatomic study. Methods: A total of 12 equine heads and three live horses. Methods: Equine heads were longitudinally sectioned to create 24 hemi-heads for testing two mental foramen block techniques (T1 and T2) and two injectate volumes (3 and 5 mL) of mixed dye and contrast medium. T1 needles were directed rostrocaudally into the mental foramen for 3 cm, and T2 needles were directed dorsolaterally to ventromedially into the foramen for 1 cm. Hemi-heads were randomly assigned one injection tech...
Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus. subspecies () is mostly known as an opportunistic pathogen found in horses and as a rare human zoonosis. An 82-year-old male, who had daily contact with horses, was admitted in a septic condition. The patient presented with dyspnea, hemoptysis, impaired general condition, and severe pain in a swollen left shoulder. Synovial fluid from the affected joint and blood cultures showed growth of subsp. . Transesophageal echocardiography showed a vegetation on the aortic valve consistent with endocarditis. Arthroscopic revision revealed synovitis and erosion of the rotator cuff. Technetium-99m scin...
Evaluation of Systemic and Local Inflammatory Parameters and Manifestations of Pain in an Equine Experimental Wound Model. In the last decades, a well-established equine wound model has been used to study fibroproliferative wound healing disorders. The aim of this study was to characterize the degree of discomfort of wounding and sampling in an equine excisional wound model by evaluating systemic and local inflammatory responses and signs of pain. A total of 12 cutaneous wounds, three on each shoulder and each metatarsus, were created in a standing surgical procedure. Wounds were biopsied on days 2, 4, 7, 14, 21, and 28 after surgery. Clinical parameters (rectal temperature, heart rate, respiratory frequency) and ...
Neck, Back, and Pelvic Pain in Sport Horses. Pain localized to the neck, back, and or pelvis can result in a profound effect on the horse's performance. These conditions can present with a varied and nonspecific set of clinical signs. A careful and thorough examination of these areas by means of physical examination, lameness evaluation both in hand and under saddle, diagnostic anesthesia, and the use of multiple imaging modalities in combination is often necessary to have an accurate prognosis. Medical and surgical management where appropriate of the conditions highlighted in this article are discussed as well as their individual progno...
Management and Rehabilitation of Joint Disease in Sport Horses. Joint disease is one of the most common issues effecting sport horses. Because there is no cure for joint disease, treatment goals surround slowing progression of the disease, minimizing pain, increasing function, and optimizing performance. Accomplishing these goals often requires a multimodal approach that combines systemic medications or supplements; intra-articular therapies, such as corticosteroids or biologics; management considerations; and physical therapy exercises.
Influence of caudal epidural analgesia on cortisol concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. To determine the influence of epidural detomidine and morphine on serum corticosteroid concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. Methods: Blinded prospective study. Methods: Nine university-owned mares. Methods: Five of 9 horses received caudal epidural detomidine hydrochloride (0.01 mg/kg) and morphine sulfate (0.1 mg/kg) prior to surgery. All horses received local anesthetic around the ovarian pedicle, 0.02 mg/kg butorphanol IV at the start of the procedure and after first ovary removal, were sedated as required throughout the p...
Local mepivacaine before castration of horses under medetomidine isoflurane balanced anaesthesia is effective to reduce perioperative nociception and cytokine release. In horses castration with primary intention healing is usually performed under balanced inhalation anaesthesia. To optimise analgesia, the use of local anaesthesia was tested. Objective: To investigate the effect of local mepivacaine before castration with first intention healing under balanced medetomidine-isoflurane anaesthesia and flunixin meglumine, morphine analgesia on perioperative cytokine levels and pain in horses. Methods: Prospective blinded clinical study. Methods: Twenty stallions were randomly assigned to control or mepivacaine groups. Flunixin meglumine was administered before s...
Evaluation of the diagnostic accuracy of skeletal scintigraphy for the causes of front foot pain determined by magnetic resonance imaging. There is good correlation between increased radiopharmaceutical uptake anywhere in the feet of sports or leisure horses and the presence of foot pain. However, low sensitivity of scintigraphy for identifying lesions contributing to foot pain as determined by magnetic resonance imaging (MRI) has been reported. The aim of this retrospective, cross-sectional, analytical study was to assess the accuracy of scintigraphy for identifying the cause(s) of foot pain, using MRI as the reference standard. Sports and leisure horses that underwent both skeletal scintigraphy and MRI of the front feet between...
Sustained intra-articular release of celecoxib in an equine repeated LPS synovitis model. 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...
Specific bioactive collagen peptides (PETAGILE® ) as supplement for horses with osteoarthritis: A two-centred study. The aim of the study was to evaluate the clinical efficacy of specific bioactive collagen peptides (BCP), here administered orally as PETAGILE® , on horses with mild to moderate, naturally occurring osteoarthritis. Data from a two-centred pilot study were used for the meta-analysis. Thirty-eight privately owned horses of various breeds were available. In one centre, 18 of these patients (6 ± 3 years; 519 ± 100 kg BW) received either 25 g (n = 6) or 50 g (n = 12) BCP/day orally for 12 weeks. In the second centre, 20 horses (18 ± 4 years; 413 ± 94 kg BW) received either a...
Evaluation of post-operative pain after active desufflation at completion of laparoscopy in mares undergoing ovariectomy. The cause of transient post-operative pain in a subset of horses undergoing laparoscopy is unclear. The objective of this study was to evaluate if residual pneumoperitoneum is associated with transient post-operative pain in mares undergoing ovariectomy. Thirty-eight mares undergoing routine standing laparoscopic ovariectomy were randomly allocated into 2 groups. At the completion of laparoscopy, either the abdominal cavity was actively desufflated or the cannulas were opened to achieve ambient pressure before incisional closure. Assessments were performed for 18 hours after surgery using a va...
Greenshell™ Mussels: A Review of Veterinary Trials and Future Research Directions. The therapeutic benefits of Greenshell™ mussel (GSM; Perna canaliculus) preparations have been studied using in vitro test systems, animal models, and human clinical trials focusing mainly on anti-inflammatory and anti-arthritic effects. Activity is thought to be linked to key active ingredients that include omega-3 polyunsaturated fatty acids, a variety of carotenoids and other bioactive compounds. In this paper, we review the studies that have been undertaken in dogs, cats, and horses, and outline new research directions in shellfish breeding and high-value nutrition research programmes ta...
Practical Fluid Therapy and Treatment Modalities for Field Conditions for Horses and Foals with Gastrointestinal Problems. With advances in technology and owner education, field management in equine veterinary medicine continues to evolve. Equine gastrointestinal disease is one of the most common types of emergencies evaluated by equine practitioners, and many of these patients can be effectively managed in the field. Although the equine veterinarian must make numerous decisions, fluid therapy, pain management, and antimicrobial use are 3 of the major choices that must be addressed when initiating field treatment of equine gastrointestinal disease. This article addresses the practical use of these 3 treatment cate...
Use of Nasotracheal Intubation during General Anesthesia in Two Ponies with Tracheal Collapse. Ponies with tracheal collapse may have an increased anesthetic risk due to airway obstruction during induction and recovery. To our knowledge, there are no anesthetic descriptions of these patients, despite a reported 5.6% incidence and 77% mortality rate. Two Shetland ponies with tracheal collapse, a 12-year-old male (pony 1) and a 27-year-old female (pony 2), were referred for right eye enucleation due to a perforating corneal ulcer and severe recurrent uveitis, respectively. Pony 1 was stressed, had lung stridor and hyperthermia, and developed inspiratory dyspnea with handling. Radiography ...
B-mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses. Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and fi...
Immune Relevant Models for Ocular Inflammatory Diseases. Ocular inflammatory diseases, such as dry eye and uveitis, are common, painful, difficult to treat, and may result in vision loss or blindness. Ocular side effects from the use of antiinflammatory drugs (such as corticosteroids or nonsteroidal antiinflammatories) to treat ocular inflammation have prompted development of more specific and safer medications to treat inflammatory and immune-mediated diseases of the eye. To assess the efficacy and safety of these new therapeutics, appropriate immune-relevant animal models of ocular inflammation are needed. Both induced and naturally-occurring mode...
Comparison of Analgesic Effects of a Constant Rate Infusion of Both Tramadol and Acetaminophen Versus those of Infusions of Each Individual Drug in Horses. The choice of analgesic agents for the horse is limited, and many have side effects that can restrict their use for chronic and prolonged pain. Little information has been published on tramadol and acetaminophen use in the horse. The study evaluated the analgesic effects of coadministration of tramadol and acetaminophen compared to those of each drug individually in a crossover study. The study was performed on six healthy horses each infused with the following over 1 hour: control (normal saline), tramadol, acetaminophen, or both (acetaminophen and tramadol infused together). Nociception (usi...
Advances in Diagnostics and Treatments in Horses with Acute Colic and Postoperative Ileus. Differentiating between medical and surgical causes of colic is one of the primary goals of the colic workup, because early surgical intervention improves prognosis in horses requiring surgery. Despite the increasing availability of advanced diagnostics (hematologic analyses, abdominal ultrasound imaging, etc), the most accurate indicators of the need for surgery remain the presence of moderate to severe signs of abdominal pain, recurrence of pain after appropriate analgesic therapy, and the absence of intestinal borborygmi. Investigation of novel biomarkers, which may help to differentiate su...
Effects of stacked wedge pads and chains applied to the forefeet of Tennessee Walking Horses for a five-day period on behavioral and biochemical indicators of pain, stress, and inflammation. OBJECTIVE To determine the effects of stacked wedge pads and chains applied to the forefeet of Tennessee Walking Horses on behavioral and biochemical indicators of pain, stress, and inflamation. ANIMALS 20 Tennessee Walking Horses. PROCEDURES Horses were randomly assigned to 2 treatment groups: keg shoes (control; n = 10) or stacked wedge pads and exercise with chains (10). Ten days before treatment application, an accelerometer was attached at the left metatarsus of each horse to record daily activity. Horses were exercised for 20 minutes daily, beginning on day -7. On day 0, exercise ceased,...
Clinical usefulness of intravenous constant rate infusion of fentanyl and medetomidine under sevoflurane anesthesia in Thoroughbred racehorses undergoing internal fixation surgery. A total of 20 racehorses with longitudinal fractures underwent internal fixation surgery under sevoflurane anesthesia combined with infusion of medetomidine (3 µg/kg/hr) alone (10 horses, group M) or medetomidine and fentanyl (7 µg/kg/hr) (10 horses, group FM). In group FM, the end-tidal sevoflurane concentration during surgery was maintained significantly lower than in group M (2.8-2.9% for group M vs. 2.2-2.6% for group FM, P<0.01). The mean arterial blood pressure was maintained over 70 mmHg using dobutamine infusion (group M, 0.36-0.54 µg/kg/min; group FM, 0.27-0.65 µg/kg/min), and ...
The effects of subconjunctival bupivacaine, lidocaine, and mepivacaine on corneal sensitivity in healthy horses. To compare the efficacy and duration of effect of three local anesthetics on corneal sensitivity when administered subconjunctivally in horses. Methods: Eight healthy adult horses. Methods: A randomized, masked, crossover study design was used, with a two-week washout period between trials. The subconjunctival space of the randomly selected eye was injected with 0.2 mLs of bupivacaine (0.5%), lidocaine (2%), mepivacaine (2%), or saline. All horses received each medication once. The contralateral eye served as a control. The corneal touch threshold (CTT) was measured in both eyes with a Cochet-...
Is there a place for dexmedetomidine in equine anaesthesia and analgesia? A systematic review (2005-2017). The objective of this review was to perform a literature compilation of all the equine publications that used dexmedetomidine as the first article on this topic was published, in 2005. We also aimed to answer the question whether the use of dexmedetomidine can currently be justified. For that, we compiled information from databases, such as PubMed, Google Scholar and Web of Science and the proceedings of the last veterinary anaesthesiology meetings. Dexmedetomidine is an attractive drug to be used in horses, mainly due to its pharmacokinetic profile and pharmacodynamics that favour its use as ...
A scoping review of the evidence for efficacy of acupuncture in companion animals. Acupuncture has become increasingly popular in veterinary medicine. Within the scientific literature there is debate regarding its efficacy. Due to the complex nature of acupuncture, a scoping review was undertaken to identify and categorize the evidence related to acupuncture in companion animals (dogs, cats, and horses). Our search identified 843 relevant citations. Narrative reviews represented the largest proportion of studies (43%). We identified 179 experimental studies and 175 case reports/case series that examined the efficacy of acupuncture. Dogs were the most common subjects in the e...
Effect of butorphanol, midazolam or ketamine on romifidine based sedation in horses during standing cheek tooth removal. Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on romifidine based sedation in horses during cheek tooth removal. Methods: Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with romifidine (same dose) an...
Effects of transdermal lidocaine or lidocaine with prilocaine or tetracaine on mechanical superficial sensation and nociceptive thermal thresholds in horses. To evaluate the transdermal local anaesthetic effect of lidocaine or lidocaine combined with prilocaine or tetracaine in horses. Methods: Experimental, randomized study. Methods: A total of five healthy adult warmblood horses. Methods: Horses were clipped bilaterally at the withers, cranial saddle area and caudal saddle area. Baseline measurements for mechanical superficial sensation via von Frey filaments and nociceptive thermal thresholds were performed. A 5% lidocaine patch (12 hour exposure, treatment L), a lidocaine/prilocaine cream (each 2.5%, treatment LP) and a lidocaine/tetracaine cre...
Neosaxitoxin, a Paralytic Shellfish Poison toxin, effectively manages bucked shins pain, as a local long-acting pain blocker in an equine model. Local anesthesia is an effective method to control pain. Neosaxitoxin is a phycotoxin whose molecular mechanism includes a reversible inhibition of voltage-gated sodium channels at the axonal level, impeding nerve impulse propagation. The present study was designed to evaluate the clinical efficacy of Neosaxitoxin as a local long-acting pain blocker in horse bucked shins, and it was found to effectively control pain. While Neosaxitoxin and Gonyautoxin, another Paralytic Shellfish Poison (PSP) toxin, have been successfully used in humans as long-lasting pain blockers, this finding marks the fir...
Microglia and astrocyte activation in the spinal cord of lame horses. To determine the microglial and astrocyte response to painful lameness in horses. Methods: Ionized calcium binding adaptor molecule 1 (Iba-1) and glial fibrillary acidic protein (GFAP) expression, cell density and morphology were determined through immunofluorescence within the dorsal horn of equine spinal cord. Methods: A total of five adult horses with acute or chronic unilateral lameness, previously scheduled for euthanasia. Methods: Musculoskeletal lameness was evaluated in five horses through visual evaluation according to clinical guidelines. Spinal cord samples were obtained immediately...
Unusual presentation of cyathostomiasis in an adult Thoroughbred mare. A recently purchased 16-year-old Thoroughbred mare with a history of recurrent colic and low body weight, also had lameness in 3 limbs, pain at the sacro-iliac joint, and increased corneal opacity of the right eye. Response to supportive therapy was poor and euthanasia was elected. A postmortem examination and histopathology confirmed cyathostomiasis within the large colon and cecum and chronic anterior uveitis of the right eye. Une jument Thoroughbred, âgée de 16 ans et récemment achetée, avec une anamnèse de coliques récurrentes et de faible poids corporel souffrait aussi de boiterie ...
