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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.
Perineural Injection of the Ethmoidal Nerve of Horses. To describe the anatomical location of the ethmoidal nerve in the equine periorbital region and to determine the accuracy of a technique used to deposit local anesthetic solution adjacent to the nerve. Methods: Prospective experimental study. Methods: Adult equine cadaver heads (n=6 for preliminary dissection; n=15 [30 nerve sites] for evaluation of injection technique). Methods: Preliminary dissections were performed to identify landmarks for injection of local anesthetic adjacent to the ethmoidal nerve. For evaluation of the injection technique a 20 gauge 6 cm spinal needle was inserted into...
Quantitative assessment of two methods of tiludronate administration for the treatment of lameness caused by navicular syndrome in horses. To determine effects of 2 tiludronate administration protocols on measures of lameness in horses with navicular syndrome (NS). Methods: 12 horses with bilateral forelimb NS. Methods: Horses were randomly assigned to receive tiludronate (1 mg/kg), diluted in 5 L of isotonic electrolyte solution and delivered through a jugular vein catheter (systemic treatment group; n = 6), or tiludronate (0.1 mg/kg), diluted with saline (0.9% NaCl) solution to a total volume of 35 mL and delivered into the lateral digital vein of each forelimb with an IV regional limb perfusion (IVRLP) technique (IVRLP group; ...
Duration of in vivo endotoxin tolerance in horses. Endotoxemia models are used to study mechanisms and treatments of early sepsis. Repeated endotoxin exposures induce periods of endotoxin tolerance, characterized by diminished proinflammatory responses to lipopolysaccharide (LPS) and modulated production of proinflammatory cytokines. Repeated measure designs using equine endotoxemia models are rarely performed, despite the advantages associated with reduced variability, because the altered responsiveness would confound study results and because the duration of equine endotoxin tolerance is unknown. We determined the interval of endotoxin toler...
Joint Mobilization and Manipulation for the Equine Athlete. Joint mobilization and manipulation provide important diagnostic and therapeutic approaches for addressing musculoskeletal issues in veterinary medicine. Soft tissue and joint mobilization are used to assess the quality and quantity of joint range of motion and as a primary means of treating musculoskeletal disorders. Spinal manipulation was shown to be effective for reducing pain, improving flexibility, reducing muscle tone, and improving symmetry of spinal kinematics in horses. Because of potential misuse and safety issues, joint mobilization and manipulative therapies should be provided onl...
Pain: Its Diagnosis and Management in the Rehabilitation of Horses. This article provides a brief overview of pain physiology and its relevance to equine patients. Objective and subjective techniques for assessing pain in the horse are described in depth. Pharmacologic and interventional pain modulation treatments are discussed with a focus on the rehabilitating horse.
A randomised, double-blinded, placebo-controlled clinical study on intra-articular hyaluronan treatment in equine lameness originating from the metacarpophalangeal joint. Intra-articular inflammation resulting in lameness is a common health problem in horses. Exogenous intra-articular hyaluronic acid has been shown to provide an analgesic effect and reduce pain in equine and human osteoarthritis. High molecular weight non-animal stabilized hyaluronic acid (NASHA) has gained popularity in the treatment of human arthritic conditions due to its long-acting pain-relieving effects. The aim of this study was to compare the response to treatment of lameness localized in the equine metacarpophalangeal joint injected with non-animal stabilized hyaluronic acid (NASHA) an...
Prevalence of Anatomical Variation of the Sixth Cervical Vertebra and Association with Vertebral Canal Stenosis and Articular Process Osteoarthritis in the Horse. The sixth cervical vertebra (C6) has unique morphology due to a ventral extension from the transverse process known as the ventral lamina. Little information was found regarding the prevalence and clinical relevance of morphologic variations. Aims of this observational, retrospective study were to characterize C6 morphologic variations in a large sample of horses. Cervical radiographic studies of 100 horses were retrieved. Data recorded were signalment, clinical history, morphology of the C6 ventral lamina, presence of articular process osteoarthritis, and presence of static vertebral canal st...
Acupuncture and Equine Rehabilitation. Acupuncture is one of the most common veterinary integrative medicine modalities. Acupuncture can greatly contribute to a rehabilitation protocol by promoting analgesia, tissue healing, and muscle strength. Acupuncture is safe, has minimal detrimental side effects, and is well tolerated by most horses.
Principles and Application of Hydrotherapy for Equine Athletes. Hydrotherapy has become a key element within equine rehabilitation protocols and is used to address range of motion, proprioception, strength, neuromotor control, pain, and inflammation. Various forms of hydrotherapy can be tailored to the individual's injury and the expected return to athletic performance. This article describes the mechanisms of action of hydrotherapies and potential use in the clinical management of equine musculoskeletal injuries.
Evaluation of intra-articular injection of autologous platelet lysate (PL) in horses with osteoarthritis of the distal interphalangeal joint. 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 8-19Â 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...
Lower attention to daily environment: a novel cue for detecting chronic horses’ back pain? Chronic pain is thought to affect patients' cognitive functioning, including attention. Loss of attention is likely to have an impact on the execution of daily tasks, and, therefore, to have negative effects. However, relationships between chronic pain and cognitive deficits are still debated. Pre-clinical studies using laboratory animals prove useful to model pain-related cognitive impairment, but animal models had to predict effects in the real world. This study investigates attentional engagement of domestic horses by comparing observations in a home setting and evaluations of vertebral dis...
Corneal edema in four horses treated with a superficial keratectomy and Gundersen inlay flap. To describe the clinical presentation, treatment, and outcome of four horses with severe corneal edema caused by suspected endothelial disease treated with a superficial keratectomy and Gundersen inlay flap and to determine whether this procedure (i) reduces corneal edema, (ii) reduces ocular pain, (iii) eliminates recurrent corneal ulceration, and (iv) improves vision in these horses. Methods: Four horses met inclusion criterion of (i) diagnosis with endothelial disease by a board-certified veterinary ophthalmologist and (ii) surgical treatment with a superficial keratectomy and Gundersen inl...
Efficacy of a single-formula acupuncture treatment for horses with palmar heel pain. Acupuncture is used without strong scientific evidence to treat many diseases of the horse, including palmar heel pain. Research is needed to provide evidence for the application of these treatments. Within the confines of our study, acupuncture did not reliably modulate palmar heel pain in horses. Efficacité d’un traitement d’acupuncture à formule simple pour les chevaux souffrant de douleur du talon palmaire. L’acupuncture est utilisée, en l’absence de solides preuves scientifiques, pour traiter plusieurs affections des chevaux, y compris la douleur du talon palmaire. De la recher...
Internal Fixation of Cervical Fractures in Three Horses. To describe the surgical treatment outcome of cervical fractures in 3 horses. Methods: Case report. Methods: Three client-owned horses with cervical vertebral fractures. Methods: Three horses were refered for neck stiffness, pain, and ataxia after a cervical trauma because of a fall. Radiographic examination showed an oblique displaced fracture of the caudal aspect of the body of the second cervical vertebra (C2) in horse 1, an oblique displaced fracture of the caudal aspect of C4 involving the disc between C4 and C5 in horse 2, and a displaced transverse fracture of the body of the axis (C2) ...
[Horse riding as a form of recreation and professional sport taking into account the spine mobility of riders – a preliminary results]. Horse riding becoming increasingly common and popular form of recreation and leisure activities. However, enforced, proper posture while riding a horse, may contribute to decrease mobility of spine and lead to occurrence back pain. Objective: The aim of this study was to assess the impact of the systematic training of horse riding on the global mobility of the spine and back pain prevalence in-training horse riders professionally and recreational. Methods: The study included 70 horse riders. The subjects were divided into two groups: 1) professional horse riders (n=50; 71.43%) or 2) a group of...
Effect of Pre- and Postoperative Phenylbutazone and Morphine Administration on the Breathing Response to Skin Incision, Recovery Quality, Behavior, and Cardiorespiratory Variables in Horses Undergoing Fetlock Arthroscopy: A Pilot Study. This prospective blinded randomized study aimed to determine whether the timing of morphine and phenylbutazone administration affects the breathing response to skin incision, recovery quality, behavior, and cardiorespiratory variables in horses undergoing fetlock arthroscopy. Ten Standardbred horses were premedicated with acepromazine (0.04 mg kg(-1) IM) and romifidine (0.04 mg kg(-1) IV). Anesthesia was induced with diazepam (0.05 mg kg(-1)) and ketamine (2.2 mg kg(-1)) IV at T0. Horses in group PRE (n = 5) received morphine (0.1 mg kg(-1)) and phenylbutazone (2.2 mg kg(-1)) I...
Preliminary investigation comparing a detomidine continuous rate infusion combined with either morphine or buprenorphine for standing sedation in horses. To compare sedative and analgesic properties of buprenorphine or morphine for standing procedures combined with a detomidine continuous rate infusion (CRI). Methods: Blinded, prospective, randomized clinical pilot study. Methods: Ten horses presented for dental or sinus procedures. Methods: Horses received 0.02 mg kg(-1) acepromazine intravenously (IV), followed 30 minutes later by detomidine 10 μg kg(-1) IV. Five minutes later, buprenorphine 0.01 mg kg(-1) (n = 6) or morphine 0.1 mg kg(-1) (n = 4) was administered IV. Detomidine was administered by CRI (0.2 μg kg(-1) minute(-1)) and adjuste...
Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases. The majority of research on the evaluation of horses with colic is focused on referral hospital populations. Early identification of critical cases is important to optimise outcome and welfare. The aim of this prospective study was to survey the primary evaluation of horses with clinical signs of abdominal pain by veterinary practitioners, and compare the initial presentation of critical and non-critical cases. Results: Data from 1016 primary evaluations of horses presenting with clinical signs of colic were submitted by 167 veterinary practitioners across the United Kingdom over a 13Â month p...
Veterinary practitioners’ selection of diagnostic tests for the primary evaluation of colic in the horse. The aim of this study was to survey veterinary practitioners' selection of diagnostic tests for horses with clinical signs of abdominal pain. A questionnaire was distributed to veterinary surgeons involved in the primary evaluation of horses with abdominal pain, including the respondent's demographics, selection of diagnostic tests and factors affecting decision-making. Data analysis included descriptive analysis, categorisation of free text and simple univariable correlations to explore the relationships between independent variables and the relative self-estimated frequency that diagnostic t...
Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015. Atrial fibrillation is a common equine arrhythmia. Quinidine alone, or with digoxin are common treatments. Studies on outcome in Warmblood populations in which duration of the AF is often unknown are limited. Objective: To identify the factors that are associated with the success of full treatment cardioversion with oral medication, and establish whether there are differences in these factors between institutions. Methods: Retrospective case series using patient records of Equine University Clinic of Utrecht University and Rossdales Equine Hospital, Newmarket. Methods: Forty-nine horses treate...
Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015. Diffusion of local anaesthetic solution after a mid-pastern ring block has not been investigated. Objective: To demonstrate potential distribution of local anaesthetic solution following injection of radiodense contrast medium as performed for a mid-pastern ring block. Methods: Experimental. Methods: Twelve mature horses were used. One and a half ml radiodense contrast medium was injected over the medial or lateral palmar digital nerve at the level of the proximal aspect of the ungular cartilages. A dorsal ring block was performed on the ipsilateral side, 1.5 cm proximal to the palpable palm...
Antinociceptive effects of methadone combined with detomidine or acepromazine in horses. To investigate two protocols to provide antinociception in horses. Objective: To evaluate the antinociceptive effects of intravenous methadone combined with detomidine or acepromazine in adult horses. Methods: Randomised, blinded, crossover study. Methods: Mechanical, thermal and electrical stimuli were applied to the dorsal left and right metacarpus and coronary band of the left thoracic limb, respectively. A thermal stimulus was applied caudal to the withers. The horses were treated with saline (C), a combination of methadone (0.2 mg/kg bwt) and detomidine (10 μg/kg bwt) (MD) or methadone...
Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A scale-construction study. Although recognition of equine pain has been studied extensively over the past decades there is still need for improvement in objective identification of pain in horses with acute colic. This study describes scale construction and clinical applicability of 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 cohort follow-up study was performed using 50 adult horses (n = 25 with acute colic, n = 25 controls). Composite pain scores were assessed by direct ...
Pharmacokinetics and disposition of flupirtine in the horse. Flupirtine (FLU) is a non-opioid analgesic drug, with no antipyretic or anti-inflammatory effects, used in the treatment of a wide range of pain states in human beings. It does not induce the side effects associated with the classical drugs used as pain relievers. The aim of this study was to evaluate the pharmacokinetic profiles of FLU after IV and PO administration in healthy horses. Six mixed breed adult mares were randomly assigned to two treatment groups using an open, single-dose, two-treatment, two-phase, paired, cross-over design (2 × 2 Latin-square). Group 1 (n = 3) received ...
Novel treatment of equine odontoclastic tooth resorption and hypercementosis of incisor teeth in a 22-year-old Arabian mare. Equine odontoclastic tooth resorption and hypercementosis is a rarely reported condition in the incisor and canine teeth of older horses. Histologically, there is internal and external resorption of the tooth with formation of excessive cementum. Once lesions become infected or supragingival this condition is very painful. The clinical manifestation, diagnosis and treatment of hypercementosis in an Arabian mare are described. La résorption dentaire odontoclasique et l’hypercémentose représentent une affection rarement signalée des dents incisives et canines chez les chevaux âgés. Sur ...
Systematic pain assessment in horses. Accurate recognition and quantification of pain in horses is imperative for adequate pain management. The past decade has seen a much needed surge in formal development of systematic pain assessment tools for the objective monitoring of pain in equine patients. This narrative review describes parameters that can be used to detect pain in horses, provides an overview of the various pain scales developed (visual analogue scales, simple descriptive scales, numerical rating scales, time budget analysis, composite pain scales and grimace scales), and highlights their strengths and weaknesses for po...
Morphine Synovial Fluid Concentrations After Intravenous Regional Limb Perfusion in Standing Horses. To determine synovial concentrations of morphine after intravenous regional limb perfusion (IVRLP) with morphine or morphine in combination with gentamicin in clinically healthy, standing sedated horses. Methods: Experimental. Methods: Adult horses (n = 6). Methods: IVRLP was performed using 0.1 mg/kg morphine (M) in standing sedated horses. After a 3-week washout period, IVRLP was performed on the same forelimb with a combination of 0.1 mg/kg morphine and 1 g gentamicin (M/G). Synovial fluid from the middle carpal joint of the perfused limb and jugular blood samples were collected i...
Use of a minimally invasive fasciotomy technique for treatment of antebrachial compartment syndrome in two horses. An 18-year-old Paint stallion (horse 1) and a 17-year-old Morgan gelding (horse 2) were evaluated because of an acute onset of severe unilateral forelimb lameness. Results: Both horses were unable to bear weight on the affected forelimb and had a dropped elbow appearance. Radial nerve paralysis, triceps myopathy, and fractures of the humerus and ulna were ruled out. The caudal aspect of the affected antebrachium of each horse was very firm to palpation and became firmer when weight was shifted onto the limb. Ultrasonographic examination revealed swelling and suspected intramuscular hemorrhage ...
Acupuncture Treatment of Pain along the Gall Bladder Meridian in 15 Horses. This study reports on clinically significant relief of pain along the gall bladder meridian in 15 sport horses. Both local and distant points were needled in this study. Pain relief was marked not only locally but also in remote areas along the gall bladder meridian. Clinical improvement was observed in all 15 horses within 30Â seconds to 2Â minutes after the treatment had started. Twelve horses and three horses were rated as "cured" and "improved", respectively, when they were re-examined 1-8 days after the treatment. The relief of somatic pain was often associated with improved riding perfor...
