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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.
Assessment of a novel equine tarsocrural experimental joint disease model using recombinant interleukin-1β and arthroscopic articular sampling of the medial malleolus of the tibia on the standing sedated horse. Joint disease and osteoarthritis are common problems in the horse and numerous experimental studies have been developed to determine the safety and efficacy of new therapies. Synovitis, a critical component of joint disease, has been experimentally induced using recombinant interleukin-1 beta (reIL-1β) to investigate new joint therapies in a controlled environment, although the use of reIL-1β has not been reported in the equine tarsocrural joint. A common consequence of performing controlled experiments is that articular tissue collection typically requires general anesthesia or euthanasia. ...
Osteochondritis dissecans-like lesions of the occipital condyle and cervical articular process joints in a Saddlebred colt horse. Osteochondritis dissecans (OCD) is a sequela to osteochondrosis, whereby the cartilage superficial to the site of osteochondrosis fractures and gives rise to osteochondral fragments in the affected joint. In this case, both the radiological and computed tomography findings were supportive of classical severe OCD but the histologic findings were not supportive of the diagnosis of OCD. Methods: A 1 year and 6 months old, Saddlebred, colt was presented for evaluation of chronic cervical pain. Standing laterolateral radiographs revealed an osteochondral fragment with corresponding irregular subc...
Pharmacokinetics and antinociceptive effects of the soluble epoxide hydrolase inhibitor t-TUCB in horses with experimentally induced radiocarpal synovitis. This study determined the pharmacokinetics, antinociceptive, and anti-inflammatory effects of the soluble epoxide hydrolase (sEH) inhibitor t-TUCB (trans-4-{4-[3-(4-Trifluoromethoxy-phenyl)-ureido]-cyclohexyloxy}-benzoic acid) in horses with lipopolysaccharide (LPS)-induced radiocarpal synovitis. A total of seven adult healthy mares (n = 4-6/treatment) were administered 3 μg LPS into one radiocarpal joint and t-TUCB intravenously (i.v.) at 0 (control), 0.03, 0.1, 0.3, and 1 mg/kg in a blinded, randomized, crossover design with at least 3 weeks washout between. Two investigators independe...
Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya. The aim of this study was to determine the treatments and their outcomes in horses with colic in Nairobi County, Kenya. Methods: This is a retrospective study to determine the occurrence, treatments, pain management, and outcomes of colic in horses in Nairobi County. Association between pain management protocols and the outcomes of colic with regard to recovery or death was also determined. Data collected from four equine practitioners were organized manually and given numerical codes as appropriate to facilitate entry into the computer. The coded data were entered into Microsoft Excel 2010 an...
Postoperative pharmacokinetics of meloxicam in horses after surgery for colic syndrome. NSAIDs are often used in horses with colic syndrome during the postoperative period, due to their ability to contrast endotoxemia and to promote an analgesic and anti-inflammatory effect. As the pharmacokinetics of a drug are often modified in unhealthy animals compared to healthy subjects, the aim of this study was to evaluate the pharmacokinetic profile of meloxicam after i.v. administration in horses undergoing laparotomy for colic syndrome. Eight horses received 0.6 mg/kg of meloxicam i.v. towards the end of surgery. Blood samples were taken at scheduled time points during the following 2...
Comparison of the Effects of Interleukin-1 on Equine Articular Cartilage Explants and Cocultures of Osteochondral and Synovial Explants. Osteoarthritis (OA) is a ubiquitous disease affecting many horses. The disease causes chronic pain and decreased performance for patients and great cost to owners for diagnosis and treatment. The most common treatments include systemic non-steroidal anti-inflammatory drugs and intra-articular injection of corticosteroids. There is excellent support for the palliative pain relief these treatments provide; however, they do not arrest progression and may in some instances hasten advancement of disease. Orthobiologic treatments have been investigated as potential OA treatments that may not only am...
Effect of topical application of 2% lidocaine gel on corneal sensitivity of clinically normal equine eyes. To assess the degree and duration of corneal anaesthesia provided by topical application of a non-ophthalmic 2% lidocaine gel in horses. Methods: Experimental, 'blinded', randomized prospective study. Methods: Twelve adult horses without relevant ocular abnormalities. Methods: Baseline corneal touch threshold (CTT) measurements were obtained bilaterally by use of a Cochet-Bonnet aesthesiometer just prior to topical treatment. A volume of 0.2mL of 2% lidocaine gel was administered in one randomly selected eye and the same volume of a viscous lubricant in the other eye to serve as control. The C...
Low plasma cortisol and fecal cortisol metabolite measures as indicators of compromised welfare in domestic horses (Equus caballus). The hypothalamic-pituitary-adrenal (HPA) axis response to chronic stress is far from straight forward, particularly with regards to animal welfare. There are reports of no effect as well as both decreases and increases in cortisol after chronic stressors. Therefore, the first aim of the present study was to determine how measures of compromised welfare, such as chronic pain and haematological anomalies, related to cortisol levels in domestic horses (Equus caballus). Domestic horses are an informative model to investigate the impact of chronic stress (due to environment, pain, work, housing con...
Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO). Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Covariance analysis of the primary endpoint resulted in a mean difference ...
Response to acupuncture treatment in horses with chronic laminitis. There is a need for evidence-based scientific research to address the question of the effectiveness of acupuncture in improving clinical signs of laminitis in horses. The objective of this study was to compare lameness levels before and after 2 acupuncture treatments in horses with chronic laminitis. Twelve adult horses with chronic laminitis received 2 acupuncture treatments 1 week apart. The points were treated using dry needling, hemo-acupuncture, and aqua-acupuncture. Lameness level was objectively evaluated using an inertial sensor-based lameness evaluation system (Lameness Locator), as w...
Esthesiometric evaluation of corneal analgesia after topical application of 1% morphine sulfate in normal horses. To evaluate whether topical ocular application of 1% morphine sulfate would change corneal sensitivity and to identify the duration of action. Methods: Eight healthy adult horses. Methods: Corneal touch threshold (CTT) was measured in the center of one randomly selected eye of each horse by Cochet-Bonnet esthesiometer (Luneau Cochet-Bonnet Esthesiometer; Western Ophthalmics, Lynnwood, WA, USA). Immediately following baseline CTT measurement, 0.3 ml of 1.0% preservative-free morphine sulfate (Morphine Sulfate 25 mg/ml Preservative-free; Hospira, Lake Forest, IL, USA) (3 mg) was applied to th...
Duration of action of mepivacaine and lidocaine in equine palmar digital perineural blocks in an experimental lameness model. To establish and compare the onset and duration of action of 2 local anesthetics based on objective lameness and skin sensitivity assessment. Methods: Interventional crossover experimental trial with balanced randomization. Methods: Eight horses. Methods: Reversible forelimb lameness was induced in 8 horses. A palmar digital nerve block (PDNB) was applied with mepivacaine or lidocaine (both 2%). Quantitative lameness and skin sensitivity data were collected with an inertial sensor system and a force gauge, respectively. The times to lameness resolution/skin desensitization (T1), consistent lam...
Circulating miR-23b-3p, miR-145-5p and miR-200b-3p are potential biomarkers to monitor acute pain associated with laminitis in horses. Circulating microRNAs (miRNAs) are emerging as promising biomarkers for several disorders and related pain. In equine practice, acute laminitis is a common disease characterised by intense pain that severely compromises horse welfare. Recently, the Horse Grimace Scale (HGS), a facial expression-based pain coding system, was shown to be a valid welfare indicator to identify pain linked to acute laminitis. The present study aimed to: determine whether miRNAs can be used as biomarkers for acute pain in horses (Equus caballus) affected by laminitis; integrate miRNAs to their target genes and to ca...
Regional Nerve Blocks for Equine Dentistry. Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse. The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures. When the infraorb...
Update on the use of cyclooxygenase-2-selective nonsteroidal anti-inflammatory drugs in horses. Nonsteroidal anti-inflammatory drugs work through inhibition of cyclooxygenase (COX) and are highly effective for the treatment of pain and inflammation in horses. There are 2 clinically relevant isoforms of COX. Cyclooxygenase-1 is constitutively expressed and is considered important for a variety of physiologic functions, including gastrointestinal homeostasis. Thus, NSAIDs that selectively inhibit COX-2 while sparing COX-1 may be associated with a lower incidence of adverse gastrointestinal effects. Various formulations of firocoxib, a COX-2-selective NSAID, labeled for use in horses are av...
The effect of postsurgical pain on attentional processing in horses. To investigate the effect of postsurgical pain on the performance of horses in a novel object and auditory startle task. Methods: Prospective clinical study. Methods: Twenty horses undergoing different types of surgery and 16 control horses that did not undergo surgery. Methods: The interaction of 36 horses with novel objects and a response to an auditory stimulus were measured at two time points; the day before surgery (T1) and the day after surgery (T2) for surgical horses (G1), and at a similar time interval for control horses (G2). Pain and sedation were measured using simple descriptive s...
Alterations in thoracolumbosacral movement when pain causing lameness has been improved by diagnostic analgesia. Lameness, thoracolumbosacral pain and reduced range of motion (ROM) often coexist; better understanding of their relationship is needed. The objectives were to determine if thoracolumbosacral movement of horses changes when pain causing lameness is improved by diagnostic analgesia. We hypothesised that reduction of lameness will increase ROM of the thoracolumbosacral region. Thirteen horses with different types of hind limb lameness were trotted in straight lines and lunged on a 10m diameter circle on left and right reins before and after lameness was subjectively substantially improved by dia...
Laparoscopic evaluation of the small intestine in the standing horse: Technique and effects. To evaluate the feasibility and clinical outcomes after laparoscopic evaluation of the small intestines via laparoscopy. Methods: Prospective pilot study. Methods: Healthy adult horses (n = 5). Methods: Horses were restrained in standing stocks and received an infusion of detomidine. One port was placed in the left last intercostal space and 3 ports were placed in the right paralumbar fossa. The small intestine was run with atraumatic laparoscopic grasping forceps, from the duodenocolic plica to the ileocecal plica. Postoperative pain was scored every 4 hours for the first 48 hours. Horses...
Sedative and antinociceptive effects of different combinations of detomidine and methadone in standing horses. To evaluate intravenous (IV) detomidine with methadone in horses to identify a combination which provides sedation and antinociception without adverse effects. Methods: Randomized, placebo-controlled, blinded, crossover. Methods: A group of eight adult healthy horses aged (mean ± standard deviation) 7 ± 2 years and 372 ± 27 kg. Methods: A total of six treatments were administered IV: saline (SAL); detomidine (5 μg kg; DET); methadone (0.2 mg kg; MET) alone or combined with detomidine [2.5 (MLD), 5 (MMD) or 10 (MHD) μg kg]. Thermal, mechanical and electrical nociceptive thresholds were mea...
Algometry to measure pain threshold in the horse’s back – An in vivo and in vitro study. The aim of this study was to provide information on algometric transmission of pressure through the dorsal thoracolumbar tissues of the equine back. Using a commercially available algometer, measurements were carried out with six different tips (hemispheric and cylindrical surfaces, contact areas 0.5 cm2, 1 cm2, and 2 cm2). In nine live horses the threshold of pressure that lead to any reaction was documented. In postmortem specimens of five euthanized horses the transmission of algometer pressure onto a pressure sensor placed underneath the dorsal thoracolumbar tissues at the level of the ...
Randomized, controlled clinical trial of safety and plasma concentrations of diclofenac in healthy neonatal foals after repeated topical application of 1% diclofenac sodium cream. OBJECTIVE To determine the plasma pharmacokinetics and safety of 1% diclofenac sodium cream applied topically to neonatal foals every 12 hours for 7 days. ANIMALS Twelve 2- to 14-day old healthy Arabian and Arabian-pony cross neonatal foals. PROCEDURES A 1.27-cm strip of cream containing 7.3 mg of diclofenac sodium (n = 6 foals) or an equivalent amount of placebo cream (6 foals) was applied topically to a 5-cm square of shaved skin over the anterolateral aspect of the left tarsometatarsal region every 12 hours for 7 days. Physical examination, CBC, serum biochemistry, urinalysis, gastric endos...
Pain Management in Horses. There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach...
Equine Dental Pulp Connective Tissue Particles Reduced Lameness in Horses in a Controlled Clinical Trial. To assess if injection of allogeneic dental pulp tissue particles would improve lameness in horses with naturally occurring osteoarthritis (OA) or soft tissue (ST) injury. Methods: Prospective, randomized, blinded, and controlled clinical trial and client survey assessment. Methods: Forty lame client-owned horses. Methods: Sterile dental pulp, recovered from otherwise healthy foals that perish during dystocia, was processed under good manufacturing processing to produce mechanically manipulated, unexpanded pulp tissue particles containing viable cells surrounded in extracellular matrix. Forty ...
Veterinary problems of endurance horses in England and Wales. Several studies have shown that a considerable proportion of horses are eliminated from endurance rides due to lameness and metabolic problems. Limited information is available on specific veterinary issues in endurance horses and there are no descriptive data on veterinary problems in a large population of endurance horses. The aim of this study was to describe veterinary problems occurring in endurance horses in England and Wales, the regions of the United Kingdom where endurance rides are organised and regulated by Endurance Great Britain (Endurance GB). A comprehensive online self-complete...
Repeated intra-articular injection of allogeneic mesenchymal stem cells causes an adverse response compared to autologous cells in the equine model. Intra-articular injection of mesenchymal stem cells (MSCs) is efficacious in osteoarthritis therapy. A direct comparison of the response of the synovial joint to intra-articular injection of autologous versus allogeneic MSCs has not been performed. The objective of this study was to assess the clinical response to repeated intra-articular injection of allogeneic versus autologous MSCs prepared in a way to minimize xeno-contaminants in a large animal model. Intra-articular injections of bone marrow-derived, culture-expanded MSCs to a forelimb metacarpophalangeal joint were performed at week 0 ...
Comparison of the effects of an intravenous lidocaine infusion combined with 1% isoflurane versus 2% isoflurane alone on selected cardiovascular variables and recovery characteristics during equine general anaesthesia. To compare the effects of a lidocaine constant rate infusion (CRI) combined with 1% isoflurane versus those of 2% isoflurane alone on cardiovascular variables in anaesthetized horses, and to estimate the sample size required to detect a difference in recovery quality. Methods: Prospective, randomized, blinded, crossover study. Methods: Twelve healthy experimental horses. Methods: Horses were anaesthetized twice using an intravenous (IV) administration of acepromazine, romifidine, diazepam and ketamine. Horses were placed in dorsal recumbency and ventilated mechanically. During the first 10 min...
