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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.
Efficacy of ketamine hydrochloride administered as a basilar sesamoid nerve block in alleviating foot pain in horses caused by natural disease.
Equine veterinary journal    December 5, 2013   Volume 46, Issue 5 639-641 doi: 10.1111/evj.12188
Schumacher J, DeGraves F, Cesar F, Duran S.A local anaesthetic agent capable of temporarily resolving lameness after being administered perineurally would be helpful because rapid return of lameness would allow for other analgesic techniques to be performed within a short period of time. Objective: To determine if a 3% solution of ketamine hydrochloride (HCl), administered around the palmar nerves at the level of the base of the proximal sesamoid bones, can improve naturally occurring lameness that can be improved or abolished with a basilar sesamoid nerve block performed using lidocaine HCl and to compare the change in gait produced u...
Efficacy of intramuscular meperidine hydrochloride versus placebo in experimental foot lameness in horses.
Equine veterinary journal. Supplement    December 1, 2013   Issue 45 48-53 doi: 10.1111/evj.12168
Foreman JH, Ruemmler R.There are no peer reviewed, blinded controlled studies regarding the skeletal analgesic efficacy of intramuscularly administered meperidine in horses. Objective: Using an adjustable heart bar shoe model of equine foot pain, the objective of this study was to test the hypothesis that meperidine (pethidine) administered intramuscularly would prove more efficacious in alleviating lameness than a saline placebo. Methods: Crossover pharmacodynamic experiment. Methods: Eight healthy adult Thoroughbred horses randomly underwent weekly i.m. treatments 1 h after lameness induction: saline placebo (1â...
An inertial sensor-based system can objectively assess diagnostic anaesthesia of the equine foot.
Equine veterinary journal. Supplement    December 1, 2013   Issue 45 26-30 doi: 10.1111/evj.12158
Maliye S, Voute L, Lund D, Marshall JF.In order for changes in lameness to be accurately and repeatably detected and recorded during diagnostic investigations, an objective measure of lameness is required. Objective: To ascertain whether an inertial sensor-based system can distinguish between a positive and negative response to diagnostic anaesthesia of the foot and objectively assess the effect of a positive response on the trot. Methods: Restrospective clinical study. Methods: Data obtained during lameness investigations undertaken between August 2011 and December 2012 in which either a palmar digital or abaxial sesamoid nerve bl...
Colic in equine neonates: 137 cases (2000-2010).
Journal of the American Veterinary Medical Association    November 23, 2013   Volume 243, Issue 11 1586-1595 doi: 10.2460/javma.243.11.1586
Mackinnon MC, Southwood LL, Burke MJ, Palmer JE.To document causes of colic in equine neonates, evaluate clinical features of neonates managed medically versus surgically, determine short- and long-term survival rates for neonates with specific medical and surgical lesions, and assess ability of patients to achieve intended use. Methods: Retrospective case series. Methods: 137 client-owned equine neonates (< 30 days old) with a history of colic or signs of colic within 1 hour after hospital admission examined between 2000 and 2010. Methods: Signalment, history, results of physical examination, laboratory data, ancillary diagnostic tests, de...
Distal limb desensitisation following analgesia of the digital flexor tendon sheath in horses using four different techniques.
Equine veterinary journal    November 21, 2013   Volume 46, Issue 4 488-493 doi: 10.1111/evj.12186
Jordana M, Martens A, Duchateau L, Vanderperren K, Saunders J, Oosterlinck M, Pille F.Controversy exists about the desensitisation obtained after diagnostic analgesia of the digital flexor tendon sheath (DFTS) during lameness examinations. Objective: To determine whether DFTS analgesia results in inadvertent desensitisation of the palmar/plantar digital nerves and whether this depends on the injection technique used. Methods: Crossover experimental study. Methods: The DFTS of 9 horses were injected with local anaesthetic solution and radiodense contrast medium using one of the following techniques: Proximal (at lateral proximal recess of the DFTS), Axial (axial to the lateral p...
Stress and pain: their relationship to health related quality of life (HRQL) for horses.
Equine veterinary journal    October 15, 2013   Volume 45, Issue 6 653-655 doi: 10.1111/evj.12152
Muir WW.No abstract available
Comparison of clinical examinations of back disorders and humans’ evaluation of back pain in riding school horses.
BMC veterinary research    October 15, 2013   Volume 9 209 doi: 10.1186/1746-6148-9-209
Lesimple C, Fureix C, Biquand V, Hausberger M.Questionnaires are a common tool to assess people's opinion on a large scale or to sound them out about their subjective views. The caretakers' opinion about animals' "personality" has been used in many studies. The aim of the present study was to assess whether the owners' subjective evaluation was effective to detect back disorders. Back disorders have been shown to have a high prevalence in working horses. Caretakers from 17 riding schools (1 caretaker/school, 161 horses) were given a questionnaire about their horses' health status, including back disorders. Out of these 161 horses, 59 were...
Cardiorespiratory and antinociceptive effects of two different doses of lidocaine administered to horses during a constant intravenous infusion of xylazine and ketamine.
BMC veterinary research    October 9, 2013   Volume 9 199 doi: 10.1186/1746-6148-9-199
Nóbrega Neto PI, Luna SP, Queiroz-Williams P, Mama KR, Steffey EP, Carregaro AB.This study investigated the antinociceptive effects of a constant rate infusion (CRI) of lidocaine during xylazine and ketamine anesthesia in horses and aimed to correlate these effects with cardiorespiratory variables, bispectral index (BIS) and plasma lidocaine concentrations. Six adult crossbred mares weighing 320-400 kg were anesthetized on three different occasions. Sedation was performed with xylazine (0.75 mg/kg IV) and anesthetic induction with guaifenesin (75 mg/kg IV) and ketamine (2 mg/kg IV). Anesthesia was maintained with 37.5 μg/kg/min of xylazine and 87.5 μg/kg/min of ketamine...
Use of a hand-assisted laparoscopic surgical technique for closure of an extensive mesojejunal rent in a horse.
Journal of the American Veterinary Medical Association    October 8, 2013   Volume 243, Issue 8 1166-1169 doi: 10.2460/javma.243.8.1166
Witte TH, Wilke M, Stahl C, Jandová V, Haralambus R, Straub R.A 7-year-old 573-kg (1,261 -lb) Swiss Warmblood gelding was evaluated because of signs of acute abdominal pain. Results: Physical examination revealed a markedly distended abdomen with subjectively reduced borborygmi in all abdominal quadrants. A large, gas-distended viscus was present at the pelvic brim preventing complete palpation of the abdomen per rectum. Ultrasonographic evaluation could not be safely performed in the initial evaluation because of severe signs of abdominal pain. Results: Ventral midline celiotomy was performed, and right dorsal displacement of the ascending colon was cor...
Inflammatory effects of autologous, genetically modified autologous, allogeneic, and xenogeneic mesenchymal stem cells after intra-articular injection in horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    October 1, 2013   Volume 26, Issue 6 453-460 doi: 10.3415/VCOT-13-01-0008
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...
Minimum end-tidal sevoflurane concentration necessary to prevent movement during a constant rate infusion of morphine, or morphine plus dexmedetomidine in ponies.
Veterinary anaesthesia and analgesia    September 30, 2013   Volume 41, Issue 2 212-219 doi: 10.1111/vaa.12090
Gozalo-Marcilla M, Hopster K, Gasthuys F, Krajewski AE, Schwarz A, Schauvliege S.To compare the effects of a constant rate infusion (CRI) of dexmedetomidine and morphine to those of morphine alone on the minimum end-tidal sevoflurane concentration necessary to prevent movement (MACNM ) in ponies. Methods: Prospective, randomized, crossover, 'blinded', experimental study. Methods: Five healthy adult gelding ponies were anaesthetized twice with a 3-week washout period. Methods: After induction of anaesthesia with sevoflurane in oxygen (via nasotracheal tube), the ponies were positioned on a surgical table (T0), and anaesthesia was maintained with sevoflurane (Fe'SEVO 2.5%) i...
Effect of Clostridium botulinum toxin type A injections into the deep digital flexor muscle on the range of motion of the metacarpus and carpus, and the force distribution underneath the hooves, of sound horses at the walk.
Veterinary journal (London, England : 1997)    September 26, 2013   Volume 198 Suppl 1 e152-e156 doi: 10.1016/j.tvjl.2013.09.051
Hardeman LC, van der Meij BR, Oosterlinck M, Veraa S, van der Kolk JH, Wijnberg ID, Back W.In the treatment of laminitis, reducing deep digital flexor muscle (DDFM) activity might diminish its pull on the distal phalanx, thereby preventing displacement and providing pain relief. Injection of Clostridium botulinum toxin type A into the DDFM of horses is potentially therapeutic. However, the effects of C. botulinum toxin type A on the gait characteristics of sound horses at the walk are not known. The aim of this study was to test if a reduced DDFM activity would lead to (1) alterations of the sagittal range of motion of the metacarpus (SROM) and range of motion of the carpal joint (C...
Effect of postoperative xylazine administration on cardiopulmonary function and recovery quality after isoflurane anesthesia in horses.
Veterinary surgery : VS    September 3, 2013   Volume 42, Issue 7 877-884 doi: 10.1111/j.1532-950X.2013.12050.x
Ida KK, Fantoni DT, Ibiapina BT, Souto MT, Zoppa AL, Silva LC, Ambrósio AM.To evaluate equine cardiopulmonary function and recovery quality after administration of 0.25 or 0.50 mg/kg xylazine intravenously (IV) during recovery. Methods: Randomized, blinded, prospective, clinical study. Methods: Horses (n = 20). Methods: During recovery after 3 hours of isoflurane anesthesia for arthroscopic surgery, horses were administered either 0.25 mg/kg (G25, n = 10) or 0.50 mg/kg (G50, n = 10) xylazine intravenously. Vital signs and arterial blood samples were obtained during recovery before sedation (baseline), 5, 10, 20, 30, and 45 minutes after xylazine and 30 minutes after ...
Ultrasound-guided injection of the maxillary nerve in the horse.
Equine veterinary journal    August 30, 2013   Volume 46, Issue 2 180-184 doi: 10.1111/evj.12106
O'Neill HD, Garcia-Pereira FL, Mohankumar PS.Infiltration of the equine maxillary nerve with local anaesthetic can be useful for both diagnostic and surgical procedures. The deep location and proximity of the nerve to surrounding vascular and orbital structures make an accurate, complication-free injection a challenge using traditional techniques reliant upon surface anatomical landmarks. Objective: To develop an ultrasound-guided injection technique of the maxillary nerve in equine cadavers and to evaluate its efficacy and potential for complications in vivo. Methods: Descriptive cadaver anatomical and clinical study. Methods: The relev...
Clinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horses.
Equine veterinary journal    August 30, 2013   Volume 46, Issue 3 375-379 doi: 10.1111/evj.12125
Mahne AT, Rioja E, Marais HJ, Villarino NF, Rubio-Martinez LM.Antimicrobial i.v. regional limb perfusion (IV-RLP) is clinically performed on anaesthetised or sedated horses with or without regional anaesthesia. To date, no scientific data are available on the clinical and pharmacokinetic effects of these anaesthetic protocols on antimicrobial IV-RLP, which is believed to result in better tourniquet efficiency due to decreased movement. Objective: To determine the effects of regional or general anaesthesia on the clinical and synovial pharmacokinetic parameters of amikacin administered by IV-RLP to horses. Methods: Experimental crossover study. Methods: E...
Effect of forelimb lameness on hoof kinematics of horses at a walk.
American journal of veterinary research    August 28, 2013   Volume 74, Issue 9 1192-1197 doi: 10.2460/ajvr.74.9.1192
Moorman VJ, Reiser RF, Peterson ML, McIlwraith CW, Kawcak CE.To determine kinematic changes to the hoof of horses at a walk after induction of unilateral, weight-bearing forelimb lameness and to determine whether hoof kinematics return to prelameness (baseline) values after perineural anesthesia. Methods: 6 clinically normal Quarter Horses. Methods: For each horse, a sole-pressure model was used to induce 3 grades of lameness in the right forelimb, after which perineural anesthesia was administered to eliminate lameness. Optical kinematics were obtained for both forelimbs with the horse walking before (baseline) and after induction of each grade of lame...
Effect of forelimb lameness on hoof kinematics of horses at a trot.
American journal of veterinary research    August 28, 2013   Volume 74, Issue 9 1183-1191 doi: 10.2460/ajvr.74.9.1183
Moorman VJ, Reiser RF, Peterson ML, McIlwraith CW, Kawcak CE.To determine kinematic changes to the hoof of horses at a trot after induction of unilateral, weight-bearing forelimb lameness and to determine whether hoof kinematics return to prelameness values after perineural anesthesia. Methods: 6 clinically normal Quarter Horses. Methods: For each horse, a sole-pressure model was used to induce 3 grades (grades 1, 2, and 3) of lameness in the right forelimb, after which perineural anesthesia was administered to alleviate lameness. Optical kinematics were obtained for both forelimbs with the horse trotting before (baseline) and after induction of each gr...
Validation of two behaviour-based pain scales for horses with acute colic.
Veterinary journal (London, England : 1997)    August 28, 2013   Volume 197, Issue 3 646-650 doi: 10.1016/j.tvjl.2013.04.007
Sutton GA, Paltiel O, Soffer M, Turner D.Two behaviour-based scales for evaluating abdominal pain in horses (Equine Acute Abdominal Pain Scales, EAAPS-1 and -2) and a numerical rating scale (NRS) were compared for reliability and validity. Forty-one equine veterinarians randomly assigned into three groups were each presented a different set of 28 moving picture films randomly chosen among 36 films of horses with colic and four controls. One randomly chosen film was embedded twice within each set. The first (n=15) and the second (n=16) groups scored pain with the EAAPS-1 and EAPPS-2, respectively, while the third (n=10) used the NRS. ...
Expression of purinergic P2X receptor subtypes 1, 2, 3 and 7 in equine laminitis.
Veterinary journal (London, England : 1997)    August 20, 2013   Volume 198, Issue 2 472-478 doi: 10.1016/j.tvjl.2013.08.017
Zamboulis DE, Senior M, Clegg PD, Milner PI.Tissue sensitisation and chronic pain have been described in chronic-active laminitis in the horse, making treatment of such cases difficult. Purinergic P2X receptors are linked to chronic pain and inflammation. The aim of this study was to examine the expression of purinergic P2X receptor subtypes 1, 2, 3 and 7 in the hoof, palmar digital vessels and nerve, dorsal root ganglia and spinal cord in horses with chronic-active laminitis (n=5) compared to non-laminitic horses (n=5). Immunohistochemical analysis was performed on tissue sections using antibodies against P2X receptor subtypes 1-3 and ...
A comparison of two morphine doses on the quality of recovery from general anaesthesia in horses.
Research in veterinary science    August 9, 2013   Volume 95, Issue 3 1195-1200 doi: 10.1016/j.rvsc.2013.07.001
Chesnel MA, Clutton RE.Previous studies indicated that perioperative morphine improves recovery quality after general anaesthesia in horses. This clinical trial investigated whether this effect was dose-dependant. Twenty-six horses anaesthetised for surgery were block-randomised to receive one of two intraoperative morphine treatments: Treatment M1 consisted of a constant rate infusion (CRI) of morphine at 0.1mg/kg/h, begun after a loading dose (LD) of 0.15 mg/kg. Treatment M2 was a CRI of 0.2mg/kg/h preceded by an LD of 0.3mg/kg. During recovery, times at the first attempt and at achieving sternal recumbency and st...
Do horses get headaches? The need for better neurophysiological techniques to elucidate equine central nociceptive pain syndromes.
Veterinary journal (London, England : 1997)    August 6, 2013   Volume 198, Issue 1 13-14 doi: 10.1016/j.tvjl.2013.07.031
van Loon JP.No abstract available
Nociceptive thermal threshold testing in horses – effect of neuroleptic sedation and neuroleptanalgesia at different stimulation sites.
BMC veterinary research    July 9, 2013   Volume 9 135 doi: 10.1186/1746-6148-9-135
Poller C, Hopster K, Rohn K, Kästner SB.Aim of the study was to compare the effect of neuroleptic sedation with acepromazine and neuroleptanalgesia with acepromazine and buprenorphine on thermal thresholds (TT) obtained at the nostrils and at the withers. The study was carried out as a randomized, blinded, controlled trial with cross-over design. Thermal thresholds were determined by incremental contact heat applied to the skin above the nostril (N) or the withers (W). Eleven horses were treated with saline (S), acepromazine (0.05 mg/kg) (ACE) or acepromazine and buprenorphine (0.0075 mg/kg) (AB) intravenously (IV). Single stimula...
Occurence of cauda equina neuritis symptoms after epidural catheter placement and drug delivery in a horse.
Veterinary anaesthesia and analgesia    July 6, 2013   Volume 40, Issue 6 653-655 doi: 10.1111/vaa.12067
Steblaj B, Bosseler L, Schauvliege S.No abstract available
Evaluation of intra-articular hyaluronan, sodium chondroitin sulfate and N-acetyl-D-glucosamine combination versus saline (0.9% NaCl) for osteoarthritis using an equine model.
Veterinary journal (London, England : 1997)    July 6, 2013   Volume 197, Issue 3 824-829 doi: 10.1016/j.tvjl.2013.05.033
Frisbie DD, McIlwraith CW, Kawcak CE, Werpy NM.A randomized blinded placebo controlled trial was conducted to assess the clinical, biochemical and histological effects of a hyaluronan, sodium chondroitin sulfate and N-acetyl-D-glucosamine combination (PG) administered through an intra-articular (IA) route for the treatment of osteoarthritis (OA) at the time of injury. OA was induced in one carpal joint of each of 16 horses. Horses were designated placebo or IA PG treated. All horses were treated with 125 mg amikacin sulfate IA and 5 mL physiological saline in the middle carpal joint bilaterally on study Days 0 (after induction of OA), 7, 1...
Postsurgical segmental mesenteric ischemic thrombosis in a horse.
The Canadian veterinary journal = La revue veterinaire canadienne    July 3, 2013   Volume 54, Issue 1 83-85 
Martín-Cuervo M, Gracia LA, Vieitez V, Jiménez J, Durán E, Ezquerra LJ.A 16-year-old, Lusitanian stallion was admitted to the Veterinary Teaching Hospital with a 12-hour history of signs of abdominal pain. Exploratory celiotomy was performed due to an inguinal hernia, and a second celiotomy was performed in response to the abdominal pain. The horse was euthanized and mesenteric venous thrombosis was diagnosed and considered likely due to peritonitis and systemic inflammatory response syndrome (SIRS). Un étalon Lusitanien âgé de 16 ans a été admis à l’hôpital d’enseignement vétérinaire avec une anamnèse de 12 heures de douleurs abdominales. Une coel...
A long-term study on the clinical effects of mechanical widening of cheek teeth diastemata for treatment of periodontitis in 202 horses (2008-2011).
Equine veterinary journal    June 28, 2013   Volume 46, Issue 1 76-80 doi: 10.1111/evj.12085
Dixon PM, Ceen S, Barnett T, O'Leary JM, Parkin TD, Barakzai S.Cheek teeth diastemata are a common cause of painful periodontal disease in horses, but there is limited objective information on their treatment. Objective: To assess the long-term response to diastema widening in clinically affected horses. Methods: Retrospective study. Methods: Medical records from cases of cheek teeth diastemata treated by diastema widening referred to the University of Edinburgh Equine Hospital from 2008 to 2011 were analysed. Results: During this period, 302 horses were diagnosed with clinically significant cheek teeth diastemata, of which 202, median age 11 years, with ...
Postcastration analgesia in ponies using buprenorphine hydrochloride.
The Veterinary record    June 4, 2013   Volume 172, Issue 24 635 doi: 10.1136/vr.101440
Love EJ, Taylor PM, Whay HR, Murrell J.Buprenorphine has recently obtained UK Marketing Authorisation for horses. The analgesic effects are long lasting, and have considerable potential for postoperative pain relief. This observer blinded, randomised study aimed to evaluate postsurgical analgesia in ponies premedicated with buprenorphine prior to castration under intravenous anaesthesia. Ponies received either 0.01 mg/kg bodyweight (BW) buprenorphine (group B) or an equivalent volume of 5 per cent glucose (group C) given intravenously before induction of anaesthesia. Pain was assessed and recorded using dynamic interactive visual a...
Assessment of the wind-up phenomenon in the equine nociceptive trigeminal system.
Veterinary journal (London, England : 1997)    May 30, 2013   Volume 198, Issue 1 81-87 doi: 10.1016/j.tvjl.2013.04.012
Veres-Nyéki KO, Leandri M, Spadavecchia C.Repeated sub-threshold nociceptive electrical stimulation resulting in temporal summation of the limb nociceptive withdrawal reflex is a well-established non-invasive model to investigate the wind-up phenomenon in horses. Due to structural similarities of the trigeminal sensory nucleus to the dorsal horn of the spinal cord, temporal summation should be evoked by repeated transcutaneous electrical stimulation of trigeminal afferents. To evaluate this hypothesis repeated transcutaneous electrical stimulation was applied to the supraorbital and infraorbital nerves of 10 horses. Stimulation intens...
Medullary decompression of the radius as treatment for lameness in a horse.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    April 24, 2013   Volume 26, Issue 4 311-317 doi: 10.3415/VCOT-12-09-0123
Rubio-Martínez LM, Carstens A.Increased intraosseous pressure (IOP) is a well-characterized source of pain in humans that can be successfully treated by medullary decompression. This report describes the clinical and diagnostic findings, treatment and successful outcome of a horse with a four week long, non-weight bearing lameness secondary to suspected traumatically-induced increased IOP in the left radius. Scintigraphic examination characterized by severe increase in radiopharmaceutical uptake within the affected radius aided in the initial localization of the source of lameness. Decompression of the affected radius was ...
Pain along the gall bladder meridian in 100 horses.
Journal of acupuncture and meridian studies    March 22, 2013   Volume 6, Issue 3 169-172 doi: 10.1016/j.jams.2013.03.001
Still J.This case series describes clinical findings in 100 horses displaying pain patterns resembling the anatomical course of the gall bladder meridian. The palpatory pain (tenderness) was detected in individual points, as well as along entire sections of the meridian. A few tender points and areas were also diagnosed outside of the meridian. These data are clinically relevant in terms of the diagnosis and classification of musculoskeletal pain in horses. Therapeutic trials will be reported in a subsequent study.
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