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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.
Sedative and mechanical hypoalgesic effects of butorphanol in xylazine-premedicated donkeys.
Equine veterinary journal    May 28, 2014   Volume 47, Issue 3 308-312 doi: 10.1111/evj.12274
Lizarraga I, Castillo-Alcala F.Combinations of α2 -adrenoceptor and opioid agonists are commonly used in equids, but little scientific information is available on donkeys. Objective: To compare the sedative and hypoalgesic effects of xylazine alone or in combination with different dosages of butorphanol in donkeys. Methods: Placebo-controlled, operator-blinded, randomised, crossover, Latin square study. Methods: Six donkeys received intravenous normal saline and normal saline (NS-NS); xylazine (0.5 mg/kg bwt) and normal saline (X-NS); xylazine and 10 μg/kg bwt butorphanol (X-B10); xylazine and 20 μg/kg bwt butorpha...
Pain control in horses: what do we really know?
Equine veterinary journal    May 15, 2014   Volume 46, Issue 4 517-523 doi: 10.1111/evj.12265
Sanchez LC, Robertson SA.Currently, approaches to pain control in horses are a mixture of art and science. Recognition of overt pain behaviours, such as rolling, kicking at the abdomen, flank watching, lameness or blepharospasm, may be obvious; subtle signs of pain can include changes in facial expression or head position, location in the stall and response to palpation or human interaction. Nonsteroidal anti-inflammatory drugs (i.e. phenylbutazone, flunixin meglumine and firocoxib), opioids (i.e. butorphanol, morphine and buprenorphine) and α2 -adrenergic agonists (i.e. xylazine, detomidine, romifidine and medetomid...
Outcome of palmar/plantar digital neurectomy in horses with foot pain evaluated with magnetic resonance imaging: 50 cases (2005-2011).
Equine veterinary journal    May 14, 2014   Volume 47, Issue 2 160-164 doi: 10.1111/evj.12262
Gutierrez-Nibeyro SD, Werpy NM, White NA, Mitchell MA, Edwards RB, Mitchell RD, Gold SJ, Allen AK.There is limited knowledge of the foot lesions that influence the outcome of palmar/plantar digital neurectomy (PDN). Objective: 1) To report the short- and long-term outcomes of horses that underwent PDN to alleviate chronic foot pain due to lesions diagnosed by magnetic resonance imaging (MRI) and 2) factors that may influence the outcome of PDN. Methods: Multicentre retrospective study. Methods: Medical records of 50 horses subjected to PDN due to chronic foot pain were reviewed. Age, breed, sex, athletic activity, duration of lameness, affected limb(s), response to anaesthesia of the palma...
Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 1: lidocaine and ketamine.
Veterinary anaesthesia and analgesia    May 10, 2014   Volume 41, Issue 4 335-345 doi: 10.1111/vaa.12179
Gozalo-Marcilla M, Gasthuys F, Schauvliege S.To review the literature with regard to the use of different intravenous agents as supplements to inhalational anaesthesia in horses. These drugs include lidocaine, ketamine, opioids and α2 -agonists. The Part 1 of this review will focus in the use of lidocaine and ketamine. Methods: Pubmed & Web of Science. Search terms: horse, inhalant anaesthesia, balanced anaesthesia, partial intravenous anaesthesia, lidocaine, ketamine. Conclusions: Different drugs and their combinations can be administered systemically in anaesthetized horses, with the aim of reducing the amount of the volatile agen...
A description of the severity of equestrian-related injuries (ERIs) using clinical parameters and patient-reported outcomes.
Injury    May 2, 2014   Volume 45, Issue 9 1484-1487 doi: 10.1016/j.injury.2014.04.017
Papachristos A, Edwards E, Dowrick A, Gosling C.Despite a number of injury prevention campaigns and interventions, horse riding continues to be a dangerous activity, resulting in more accidents per hour than motorcycling, skiing and football. Injuries are often serious, with one in four patients requiring admission to hospital. This study aims to describe the severity of equestrian-related injuries (ERIs) using both clinical parameters and patient-reported outcomes. Methods: A retrospective study of all patients aged ≥18 years admitted to The Alfred Hospital between January 2003 and January 2008 with an ERI was performed. Specific clinica...
Mass envenomation of a mare and foal by bees.
Australian veterinary journal    April 29, 2014   Volume 92, Issue 5 141-148 doi: 10.1111/avj.12177
Lewis N, Racklyeft DJ.The clinical course of toxic envenomation of a mare and her foal after an attack by a swarm of bees in the Upper Hunter Valley of New South Wales is described. Early agitation and urticaria were followed by more severe systemic clinical signs within 18 h. There was severe, generalised angioedema, rhabdomyolysis, hypovolaemia, gastrointestinal stasis and renal injury. A particular feature in the mare was almost maniacal behaviour during the first 48 h. Clinical pathological examination showed evidence of haemoconcentration, intravascular haemolysis, thrombocytopenia, azotaemia, rhabdomyolysis a...
In vivo diffusion characteristics following perineural injection of the deep branch of the lateral plantar nerve with mepivacaine or iohexol in horses.
Equine veterinary journal    April 20, 2014   Volume 47, Issue 2 230-234 doi: 10.1111/evj.12261
Contino EK, King MR, Valdés-Martínez A, McIlwraith CW.Hindlimb proximal suspensory desmopathy is a common injury of sport horses but diagnosis can be difficult because diagnostic analgesia of the region lacks specificity. Perineural analgesia of the deep branch of the lateral plantar nerve (DBLPN) has been proposed as a more specific method of isolating pain of the proximal aspect of the suspensory ligament but the technique has not been evaluated in vivo. Objective: To determine the extent of diffusion of contrast medium and mepivacaine following DBLPN analgesia using a single-needle injection technique and to determine if there is inadvertent i...
Pharmacokinetic-pharmacodynamic modelling of intravenous buprenorphine in conscious horses.
Veterinary anaesthesia and analgesia    April 16, 2014   Volume 42, Issue 1 17-29 doi: 10.1111/vaa.12165
Love EJ, Pelligand L, Taylor PM, Murrell JC, Sear JW.Describe the pharmacokinetics of buprenorphine and norbuprenorphine in horses and to relate the plasma buprenorphine concentration to the pharmacodynamic effects. Methods: Single phase non-blinded study. Methods: Six dedicated research horses, aged 3-10 years and weighing 480-515 kg. Methods: Thermal and mechanical nociceptive thresholds, heart and respiratory rates and locomotor activity were measured before and 15, 30, 45 & 60 minutes and 2, 4, 6, 8, 12 & 24 hours post-administration of 10 μg kg(-1) buprenorphine IV. Intestinal motility was measured 1, 6, 12 & 24 hours af...
Headshaking in 5 horses after paranasal sinus surgery.
Veterinary surgery : VS    April 5, 2014   Volume 43, Issue 6 678-684 doi: 10.1111/j.1532-950X.2014.12147.x
Gilsenan WF, Getman LM, Parente EJ, Johnson AL.To report headshaking and presumptive trigeminal neuritis as a potential complication after paranasal sinus surgery in horses. Methods: Retrospective case series. Methods: Horses (n = 5) that developed headshaking within 45 days of paranasal sinus surgery. Methods: Medical records (2007-2010) of horses that had been evaluated for headshaking after paranasal sinus surgery were reviewed. Results: Of 5 horses that developed headshaking within 45 days of paranasal sinus surgery, resolution occurred after treatment in 2 horses. One horse was euthanatized because clinical signs associated with h...
Spontaneous electroencephalographic changes in a castration model as an indicator of nociception: a comparison between donkeys and ponies.
Equine veterinary journal    April 1, 2014   Volume 47, Issue 1 36-42 doi: 10.1111/evj.12250
Grint NJ, Johnson CB, Clutton RE, Whay HR, Murrell JC.Donkeys are believed to be less demonstrative of pain than ponies. Research into comparative sensory processing between these species is required to elucidate these behavioural differences. Objective: To compare changes in the electroencephalogram (EEG) recorded during castration between donkeys and ponies. Methods: Prospective clinical study. Methods: Six ponies and 6 donkeys were castrated under halothane anaesthesia after acepromazine premedication and thiopental anaesthetic induction. Markers were inserted into the EEG recording at the time of skin incision (skin) and emasculation (emasc) ...
Progress in equine pain assessment?
Veterinary journal (London, England : 1997)    March 31, 2014   Volume 200, Issue 2 210-211 doi: 10.1016/j.tvjl.2014.03.012
Dugdale AH.No abstract available
Veterinary anaesthesia and analgesia: from chloroform to designer drugs.
The Veterinary record    March 29, 2014   Volume 174, Issue 13 318-321 doi: 10.1136/vr.g2249
Taylor P.No abstract available
Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration.
PloS one    March 19, 2014   Volume 9, Issue 3 e92281 doi: 10.1371/journal.pone.0092281
Dalla Costa E, Minero M, Lebelt D, Stucke D, Canali E, Leach MC.The assessment of pain is critical for the welfare of horses, in particular when pain is induced by common management procedures such as castration. Existing pain assessment methods have several limitations, which reduce the applicability in everyday life. Assessment of facial expression changes, as a novel means of pain scoring, may offer numerous advantages and overcome some of these limitations. The objective of this study was to develop and validate a standardised pain scale based on facial expressions in horses (Horse Grimace Scale [HGS]). Results: Forty stallions were assigned to one of ...
A pharmacokinetic/clinical approach to postulate a local action of intra-articular xylazine administration in the horse: a preliminary study.
Journal of veterinary pharmacology and therapeutics    March 8, 2014   Volume 37, Issue 5 464-471 doi: 10.1111/jvp.12110
Di Salvo A, Della Rocca G, Bazzica C, Giontella A, Cagnardi P, Nannarone S.The study aims to evaluate whether the analgesic effect of intra-articular (IA) route of xylazine administered to horses following arthroscopic surgery is due to a local or a systemic action. Two connected studies were performed. In the first, 1 mg/kg b.w. of xylazine was injected IA, and blood samples were taken to assess drug systemic absorption. In addition, systemic effects of the drug (sedation, ataxia or reduction of respiratory and cardiac rate) were registered. Control horses injected with saline IA were included in the study to exclude the influence of anaesthesia in the occurrence o...
Analgesic and gastrointestinal effects of epidural morphine in horses after laparoscopic cryptorchidectomy under general anesthesia.
Veterinary anaesthesia and analgesia    February 27, 2014   Volume 41, Issue 4 430-437 doi: 10.1111/vaa.12133
Martin-Flores M, Campoy L, Kinsley MA, Mohammed HO, Gleed RD, Cheetham J.To evaluate the hypothesis that epidural morphine (0.1 mg kg(-1) ) decreases pain in horses after laparoscopic surgery without adversely affecting gastrointestinal (GI) motility. Methods: Randomized clinical trial. Methods: Eighteen horses undergoing laparoscopic cryptorchidectomy under general anesthesia. Methods: Horses were randomly assigned to receive either epidural morphine (0.1 mg kg(-1) ) or no epidural before the start of surgery. Pain behaviors were assessed during the first two post-operative days using a numerical rating scale. Barium-filled spheres were administered through a naso...
The influence of various confounding factors on mechanical nociceptive thresholds in the donkey.
Veterinary anaesthesia and analgesia    February 27, 2014   Volume 41, Issue 4 421-429 doi: 10.1111/vaa.12132
Grint NJ, Beths T, Yvorchuk K, Taylor PM, Dixon M, Whay HR, Murrell JC.To evaluate a mechanical nociceptive threshold (MNT) testing device in the donkey, and to investigate the influence of potential confounders on MNTs generated. Methods: Prospective, randomised. Methods: Sixteen castrated male donkeys aged 4-9 years, weighing 105-170 kg. Methods: Mechanical nociceptive thresholds were measured using an actuator with three pins placed on the dorsal aspect of the distal limb, connected to a force meter. The pins (surface area 15 mm(2) ) were extruded onto the limb by pressurising an air-filled syringe, until the MNT force (when foot-lift was observed) or 25 N (cu...
Effects of intrabursal administration of botulinum toxin type B on lameness in horses with degenerative injury to the podotrochlear apparatus.
American journal of veterinary research    February 26, 2014   Volume 75, Issue 3 282-289 doi: 10.2460/ajvr.75.3.282
Gutierrez-Nibeyro SD, Santos MP, White NA, Brown JA, Adams MN, McKnight AL, Schaeffer DJ.To determine the safety and short-term efficacy of intrabursal administration of botulinum toxin type B (BTXB) to alleviate lameness in horses with degenerative injury to the podotrochlear apparatus (PA). Methods: 10 Quarter Horses with degenerative injury to the PA. Methods: Degenerative injury to the PA was confirmed with diagnostic analgesia and imaging. Then, BTXB (3.8 to 4.5 U/kg) was injected into the podotrochlear (navicular) bursa of each horse. Three horses were used in a safety evaluation. Subsequently, video recordings of lameness evaluations were obtained for 7 client-owned horses ...
The range and prevalence of clinical signs and conformation associated with lameness in working draught donkeys in Pakistan.
Equine veterinary journal    February 21, 2014   Volume 46, Issue 6 771-777 doi: 10.1111/evj.12231
Reix CE, Burn CC, Pritchard JC, Barr AR, Whay HR.Lameness is prevalent in working donkeys and has major welfare implications; however, a detailed study of the associated clinical signs is lacking. Objective: To describe the range and prevalence of clinical signs and conformation associated with lameness in working draught donkeys. Methods: Prospective, cross-sectional, observational study. Methods: Data were collected from 102 working draught donkeys in Pakistan. A lameness assessment adapted for working donkeys was used to record clinical signs of lameness, gait, limb conformation and pain responses in the feet, limbs and spine using observ...
Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions.
Equine veterinary journal    February 18, 2014   Volume 46, Issue 4 427-434 doi: 10.1111/evj.12224
Naylor RJ, Taylor AH, Knowles EJ, Wilford S, Linnenkohl W, Mair TS, Johns IC.Ex vivo evidence suggests that cyclo-oxygenase (COX) 2-preferential inhibitor nonsteroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, have a less detrimental effect on intestinal healing than flunixin meglumine (FM). Whether this translates to a beneficial effect in horses with naturally occurring strangulating small intestinal (SSI) lesions is unknown. Objective: To compare the clinical outcome of horses with naturally occurring SSI lesions treated with meloxicam or FM. Methods: Randomised prospective study. Methods: Cases presenting to the Royal Veterinary College Equine Referral H...
Subtotal ostectomy of impinging dorsal spinous processes in 23 standing horses.
Veterinary surgery : VS    February 15, 2014   Volume 43, Issue 1 95-98 doi: 10.1111/j.1532-950x.2013.12078.x
Brink P.To (1) describe a safe, efficient surgical technique for subtotal ostectomy (SO) of diseased dorsal spinal processes (DSP) of the caudal thoracic vertebrae with the horse standing and (2) report outcome. Methods: Case series. Methods: Horses (n = 23) with reduced performance caused by impingement of the DSP of the caudal thoracic vertebrae. Methods: Affected DSP were resected through a dorsal median incision with the horse standing, sedated, and the surgical site desensitized with local anesthetic. Radiography was used to confirm removal of impinging bone before wound closure. Results: No seri...
Characterization of a reversible lameness model in the horse.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    February 4, 2014   Volume 27, Issue 2 113-119 doi: 10.3415/VCOT-13-08-0101
Wilgenbusch C, McClure SR, Thomsen D, Schleining J, Riedesel D, Wang C.Characterization of a model of reversible foot lameness in the horse. Methods: Both forelimb hooves were fitted with a circumferential clamp. After three baseline measurements utilizing a force platform, one clamp was tightened to induce a grade 2.5/5 lameness and left in place for 120 hours. Serial heart rate and force platform measurements were obtained and the asymmetry index was calculated. After 120 hours, the clamp was released and force platform data recorded until the horse returned to soundness. The procedure was repeated for the opposite forelimb. The responses of treatment compared ...
Evaluation of a single intra-articular injection of autologous protein solution for treatment of osteoarthritis in horses.
American journal of veterinary research    January 30, 2014   Volume 75, Issue 2 141-151 doi: 10.2460/ajvr.75.2.141
Bertone AL, Ishihara A, Zekas LJ, Wellman ML, Lewis KB, Schwarze RA, Barnaba AR, Schmall ML, Kanter PM, Genovese RL.To evaluate intra-articular autologous protein solution (APS) for the treatment of osteoarthritis in horses. Animals-40 client-owned horses with naturally occuring osteoarthritis. Methods: APS was generated from a dual-device system that concentrated plasma and WBC proteins and enriched platelet growth factors. Horses were randomly assigned to receive an intra-articular injection of 5 mL of saline (0.9% NaCl) solution (n = 20) or APS (20), exercised on a treadmill, and evaluated on the basis of lameness grades, kinetic gait analysis, joint circumference, and range of motion for 14 days. Horses...
Standing equine dental surgery.
The Veterinary clinics of North America. Equine practice    January 24, 2014   Volume 30, Issue 1 63-90 doi: 10.1016/j.cveq.2013.11.002
Menzies RA, Easley J.Dental surgeries refer to procedures that affect the dental tissues or their supporting structures. With the development of specific, efficacious, and conservative treatments, morbidity risks have been lowered and chances of benefiting the health of equids improved. Advances in quality of sedation, analgesia, and locoregional anesthesia allow a majority of dental surgeries to be performed in the standing patient. This update focuses on an orthograde endodontic technique, a minimally invasive buccotomy technique, with the potential to combine it with a transbuccal screw extraction technique, an...
How accurate are we at assessing others’ well-being? The example of welfare assessment in horses.
Frontiers in psychology    January 24, 2014   Volume 5 21 doi: 10.3389/fpsyg.2014.00021
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...
Identifying optimal parameters for quantification of changes in pelvic movement symmetry as a response to diagnostic analgesia in the hindlimbs of horses.
Equine veterinary journal    January 23, 2014   Volume 46, Issue 6 759-763 doi: 10.1111/evj.12220
Pfau T, Spicer-Jenkins C, Smith RK, Bolt DM, Fiske-Jackson A, Witte TH.Subjective evaluation of the response to diagnostic analgesia of hindlimb lameness is influenced by expectation bias. Quantification of pelvic movement with inertial measurement units is possible, but it is unclear which measure of movement symmetry best reflects the changes seen after diagnostic analgesia. Objective: To test our hypothesis that objective measures closely relating to those used for subjective visual lameness scoring (quantifying the difference between sacral upward or downward movement or between movement amplitudes of the left and right tubera coxae) would show the largest an...
Peritoneal response to abdominal surgery: the role of equine abdominal adhesions and current prophylactic strategies.
Veterinary medicine international    January 20, 2014   Volume 2014 279730 doi: 10.1155/2014/279730
Alonso Jde M, Alves AL, Watanabe MJ, Rodrigues CA, Hussni CA.Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular...
Monitoring equine visceral pain with a composite pain scale score and correlation with survival after emergency gastrointestinal surgery.
Veterinary journal (London, England : 1997)    January 11, 2014   Volume 200, Issue 1 109-115 doi: 10.1016/j.tvjl.2014.01.003
van Loon JP, Jonckheer-Sheehy VS, Back W, van Weeren PR, Hellebrekers LJ.Recognition and management of equine pain have been studied extensively in recent decades and this has led to significant advances. However, there is still room for improvement in the ability to identify and treat pain in horses that have undergone emergency gastrointestinal surgery. This study assessed the validity and clinical application of the composite pain scale (CPS) in horses after emergency gastrointestinal surgery. Composite pain scores were determined every 4h over 3 days following emergency gastrointestinal surgery in 48 horses. Inter-observer reliability was determined and another...
Anesthesia and analgesia for standing equine surgery.
The Veterinary clinics of North America. Equine practice    December 31, 2013   Volume 30, Issue 1 1-17 doi: 10.1016/j.cveq.2013.11.008
Vigani A, Garcia-Pereira FL.Morbidity and mortality rate in equine anesthesia is still unacceptably high. Thus it is critical contemplating whether the benefit of general anesthesia for a specific patient and procedure outweighs the risks. Sedative protocols that would allow performing diagnostic and surgical procedures with the patient remaining standing would therefore be ideal. Infusion of short-acting agents allows to rapidly achieve a titratable steady state of sedation. Supplementing sedatives and tranquilizers with systemic analgesic or regional anesthetic techniques (i.e. epidurals) facilitates standing surgical ...
Effect of anesthetizing individual compartments of the stifle joint in horses with experimentally induced stifle joint lameness.
American journal of veterinary research    December 29, 2013   Volume 75, Issue 1 19-25 doi: 10.2460/ajvr.75.1.19
Tóth F, Schumacher J, Schramme MC, Hecht S.To evaluate the effects of sequential anesthesia of the individual compartments of the equine stifle joint on lameness induced by intra-articular deposition of interleukin (IL)-1β. Methods: 6 horses. Methods: For each horse, baseline hind limb lameness was first evaluated. A randomly selected compartment of 1 stifle joint was then injected with IL-1β to induce synovitis and lameness; subsequently, the same compartment was anesthetized with 2% mepivacaine hydrochloride, and lameness was reevaluated. Two weeks later, baseline lameness was evaluated, and lameness was similarly induced; thereaft...
Musculoskeletal scintigraphy of the equine athlete.
Seminars in nuclear medicine    December 10, 2013   Volume 44, Issue 1 4-14 doi: 10.1053/j.semnuclmed.2013.08.003
Dyson S.Nuclear scintigraphic examination of equine athletes has a potentially important role in the diagnosis of lameness or poor performance, but increased radiopharmaceutical uptake (IRU) is not necessarily synonymous with pain causing lameness. Nuclear scintigraphy is highly sensitive to changes in bone turnover that may be induced by loading and knowledge of normal patterns of RU is crucial for accurate diagnosis. Blood pool images can be useful for identification of some soft tissue injuries, although acute bone injuries may also have intense IRU in blood pool images. Some muscle injuries may be...
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