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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.
Temporohyoid osteoarthropathy in two young horses.
Australian veterinary journal    March 11, 2013   Volume 91, Issue 5 209-212 doi: 10.1111/avj.12039
Readford PK, Lester GD, Secombe CJ.Two cases of temporohyoid osteoarthropathy (THO) in young Australian horses are described. The pathogenesis of THO is yet to be fully elucidated, but current theories include extension of infection from otitis media or interna to the temporohyoid joint or a primary but non-infectious degenerative condition within the temporohyoid joint. The young age of the horses and the unilateral distribution suggested an infectious aetiology. Both horses partially responded to treatment with broad-spectrum antimicrobial and anti-inflammatory drugs with concurrent management of ulcerative keratitis. The man...
Use of a soluble epoxide hydrolase inhibitor as an adjunctive analgesic in a horse with laminitis.
Veterinary anaesthesia and analgesia    March 7, 2013   Volume 40, Issue 4 440-448 doi: 10.1111/vaa.12030
Guedes AG, Morisseau C, Sole A, Soares JH, Ulu A, Dong H, Hammock BD.A 4-year old, 500 kg Thoroughbred female horse diagnosed with bilateral forelimb laminitis and cellulitis on the left forelimb became severely painful and refractory to non-steroidal anti-inflammatory therapy (flunixin meglumine on days 1, 2, 3 and 4; and phenylbutazone on days 5, 6 and 7) alone or in combination with gabapentin (days 6 and 7). Methods: Pain scores assessed independently by three individuals with a visual analog scale (VAS; 0 = no pain and 10 = worst possible pain) were 8.5 on day 6, and it increased to 9.5 on day 7. Non-invasive blood pressure monitoring revealed severe hyper...
Attitude of Brazilian veterinarians in the recognition and treatment of pain in horses and cattle.
Veterinary anaesthesia and analgesia    March 6, 2013   Volume 40, Issue 4 410-418 doi: 10.1111/vaa.12025
Lorena SE, Luna SP, Lascelles BD, Corrente JE.The objective of this study was to assess the use of analgesics, describe the attitudes of Brazilian veterinarians towards pain relief in horses and cattle and evaluate the differences due to gender, year of graduation and type of practice. Methods: Prospective survey. Methods: Questionnaires were sent to 1000 large animal veterinarians by mail, internet and delivered in person during national meetings. The survey investigated the attitudes of Brazilian veterinarians to the recognition and treatment of pain in large animals and consisted of sections asking about demographic data, use of analge...
The use of maggot debridement therapy in 41 equids.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 120-125 doi: 10.1111/j.2042-3306.2012.00609.x
Lepage OM, Doumbia A, Perron-Lepage MF, Gangl M.Maggot debridement therapy is a long-established tool to promote wound healing. Objective: To describe and assess the results of this technique in equids with various lesions. Methods: Retrospective analysis performed on cases in which, depending on clinical case, type, size and location of the wound, maggots were applied either in direct or indirect contact with the wound. Results: Treated cases (n = 41) included horses with foot pathology (n = 9), laceration of the limbs (n = 15), other soft tissue abscesses or wounds (n = 6), fistulous withers (n = 5), other musculoskeletal infection (n = 2...
Dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness.
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 17-20 doi: 10.1111/j.2042-3306.2012.00655.x
Foreman JH, Bergstrom BE, Golden KS, Roark JJ, Coren DS, Foreman CR, Schumacher SA.There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM). Objective: The objective of this experiment was to compare the efficacy of various dosages of FM with a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose-dependent manner when tested in a reversible model of foot lameness. Methods: Ten horses shod with adjustable heart bar shoes had weekly modified AAEP grade 4.0/5.0 lameness induced by tightening a set screw against the heart bar. Heart rate (HR) and lameness score...
Comparison of efficacy and duration of effect on corneal sensitivity among anesthetic agents following ocular administration in clinically normal horses.
American journal of veterinary research    February 27, 2013   Volume 74, Issue 3 459-464 doi: 10.2460/ajvr.74.3.459
Pucket JD, Allbaugh RA, Rankin AJ, Ou Z, Bello NM.To compare efficacy and duration of effect on corneal sensitivity of 0.5% proparacaine hydrochloride, 0.5% bupivacaine hydrochloride, 2% lidocaine hydrochloride, and 2% mepivacaine hydrochloride solutions following ocular administration in clinically normal horses. Methods: 68 clinically normal horses. Methods: 60 horses were assigned to receive 1 anesthetic agent in 1 eye. For each of another 8 horses, 1 eye was treated with each of the anesthetic agents in random order with a 1-week washout period between treatments. Corneal sensitivity was assessed via corneal touch threshold (CTT) measurem...
Intramuscular administration of sodium benzylpenicillin in horses as an alternative to procaine benzylpenicillin.
Research in veterinary science    February 15, 2013   Volume 95, Issue 1 212-218 doi: 10.1016/j.rvsc.2013.01.019
Olsén L, Bremer H, Olofsson K, Bröjer J, Bondesson U, Bergh A, Nostell K, Broström H, Bengtsson B, Ingvast-Larsson C.The aim was to supply information about the possibility of replacing the procaine salt with the sodium salt for benzylpenicillin IM treatment in horse in order to diminish the risk for procaine adverse effects. In a crossover study eight horses were given 15 mg/kg sodium benzylpenicillin (Na-pc) twice daily or procaine benzylpenicillin (control) once daily IM for four days. The half-life of Na-pc was 1.9h, peak concentration was 14,600 ng/mL reached after about 23 min. Trough plasma concentration was 281 ng/mL and protein binding 62.8%. The fT>MIC for Staphylococcus aureus was 63% and 100% for...
To limp, or not to limp, is that the question?
Veterinary journal (London, England : 1997)    February 13, 2013   Volume 195, Issue 3 269-270 doi: 10.1016/j.tvjl.2013.01.001
Pfau T, Roepstorff L.No abstract available
Topics in equine anesthesia.
The Veterinary clinics of North America. Equine practice    February 9, 2013   Volume 29, Issue 1 ix-x doi: 10.1016/j.cveq.2013.01.001
Clark-Price SC.No abstract available
Distribution of purinergic P2X receptors in the equine digit, cervical spinal cord and dorsal root ganglia.
Purinergic signalling    February 6, 2013   Volume 9, Issue 3 383-393 doi: 10.1007/s11302-013-9356-5
Zamboulis DE, Senior JM, Clegg PD, Gallagher JA, Carter SD, Milner PI.Purinergic pathways are considered important in pain transmission, and P2X receptors are a key part of this system which has received little attention in the horse. The aim of this study was to identify and characterise the distribution of P2X receptor subtypes in the equine digit and associated vasculature and nervous tissue, including peripheral nerves, dorsal root ganglia and cervical spinal cord, using PCR, Western blot analysis and immunohistochemistry. mRNA signal for most of the tested P2X receptor subunits (P2X1-5, 7) was detected in all sampled equine tissues, whereas P2X6 receptor su...
Effects of postanesthetic sedation with romifidine or xylazine on quality of recovery from isoflurane anesthesia in horses.
Journal of the American Veterinary Medical Association    February 1, 2013   Volume 242, Issue 4 533-539 doi: 10.2460/javma.242.4.533
Woodhouse KJ, Brosnan RJ, Nguyen KQ, Moniz GW, Galuppo LD.To test the hypothesis that postanesthetic sedation with romifidine would dose-dependently improve recovery quality of recovery from isoflurane anesthesia in horses more than postanesthetic sedation with xylazine. Methods: Prospective, randomized, blinded clinical trial. Methods: 101 healthy adult horses examined at the University of California-Davis Veterinary Medical Teaching Hospital from 2007 to 2009. Methods: Horses were sedated with xylazine, and anesthesia was induced with guaifenesin, diazepam, and ketamine via a standardized drug protocol. Anesthesia for surgical or diagnostic procedu...
An investigation of the relationship between hindlimb lameness and saddle slip.
Equine veterinary journal    January 29, 2013   Volume 45, Issue 5 570-577 doi: 10.1111/evj.12029
Greve L, Dyson SJ.We have observed saddle slip consistently to one side because of a crooked rider, an ill-fitting saddle, asymmetry in a horse's thoracolumbar shape and lameness. Currently, there are no objective data to permit assessment of the relative importance of each factor. Objective: To document the frequency of occurrence of saddle slip in horses with hindlimb lameness compared with other horses. To describe the effect of lameness characteristics and grade, the abolition of lameness by diagnostic analgesia, breed, size, thoracolumbar shape and symmetry and the rider's weight. Methods: One hundred and ...
Anesthesia for the horse with colic.
The Veterinary clinics of North America. Equine practice    January 18, 2013   Volume 29, Issue 1 193-214 doi: 10.1016/j.cveq.2012.11.005
Boesch JM.This article discusses anesthesia for horses with colic from acute gastrointestinal disease. Emphasis is placed on new developments in pre-, intra-, and immediate postoperative management over the last decade, including early goal-directed therapy (EGDT) in the resuscitation of septic patients, the controversy over the optimal fluid type to administer, and the management of complications, such as cardiovascular depression, hypoventilation and hypoxemia, and decreased colloid oncotic pressure (COP). An update on analgesia is also provided; older drugs such as ketamine and lidocaine are increasi...
Excision of the deep branch of the lateral palmar nerve of horses to resolve lameness caused by proximal suspensory desmitis.
Veterinary surgery : VS    December 12, 2012   Volume 42, Issue 3 296-301 doi: 10.1111/j.1532-950X.2012.01073.x
Guasco PG, Kelly G, Schumacher J, Henry RW.To assess outcome after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN) as a treatment for horses with persistent lameness associated with chronic proximal suspensory desmitis (PSD) of the thoracic limb. Methods: Case series. Methods: Adult, mixed-breed horses (n = 4), weighing 510-585 kg, used for amateur show-jumping. Methods: Records of 4 horses chronically lame because of PSD of one or both thoracic limbs that were treated by neurectomy of the DBLPaN were reviewed. The site of pain causing lameness was localized using regional anesthesia. The proximal aspect of the suspe...
Treatment of equine synovial pain: developing an evidence base.
The Veterinary record    November 28, 2012   Volume 171, Issue 21 525-526 doi: 10.1136/vr.e7924
Barr A.No abstract available
Evaluation of squeeze-induced somnolence in neonatal foals.
American journal of veterinary research    November 28, 2012   Volume 73, Issue 12 1881-1889 doi: 10.2460/ajvr.73.12.1881
Toth B, Aleman M, Brosnan RJ, Dickinson PJ, Conley AJ, Stanley SD, Nogradi N, Williams CD, Madigan JE.To test the hypothesis that application of a rope restraint device would result in behavioral, electroencephalographic, and humoral changes consistent with sleep and analgesia in neonatal foals. Methods: 8 healthy neonatal foals. Methods: Following acclimatization to experimental conditions, each foal underwent a series of assessments before and during or at the end of a period of restraint via application of a restraint device (soft linen rope). Assessments included measurements of heart and respiratory rates, rectal temperature, and circulating β-endorphin and steroid hormone concentrations...
Synovial folds in equine articular process joints.
Equine veterinary journal    November 12, 2012   Volume 45, Issue 4 448-453 doi: 10.1111/j.2042-3306.2012.00687.x
Thomsen LN, Berg LC, Markussen B, Thomsen PD.Cervical synovial folds have been suggested as a potential cause of neck pain in humans. Little is known about the extent and characteristics of cervical synovial folds in horses. Objective: The objective of this explorative study was to determine the frequency of synovial folds in equine cervical articular process joints and to provide a characterisation of the size and morphology of the synovial folds. Methods: Equine cervical articular process joints from 6 horses were included in the study, ranging from cervical vertebra 2 (C2) to cervical vertebra 7 (C7) bilaterally. The articular process...
A behaviour-based pain scale for horses with acute colic: scale construction.
Veterinary journal (London, England : 1997)    November 8, 2012   Volume 196, Issue 3 394-401 doi: 10.1016/j.tvjl.2012.10.008
Sutton GA, Dahan R, Turner D, Paltiel O.A validated tool for assessing the severity of acute abdominal pain is needed for the effective management of colic in horses. Two behaviour-based colic pain scales were constructed by combining together mathematical and judgemental approaches. The mathematical approach identified easily-recognised pain behaviours to select as items. The judgemental approach further modified the items and weighted them based on expert-opinion. Thirty equine practitioners assessed the level of pain demonstrated in 23 film clips of clinical cases exhibiting signs of acute abdominal pain prospectively using a 10c...
Steroid diffusion into the navicular bursa occurs in horses affected by palmar foot pain.
The Veterinary record    November 7, 2012   Volume 171, Issue 25 642 doi: 10.1136/vr.101075
Manfredi JM, Boyce M, Malone ED, Anderson C, Anderson LB, Trumble TN.Palmar foot pain is frequently treated by steroid injections into the distal interphalangeal joint (DIPJ) in the anticipation that the steroid will diffuse to the navicular bursa and palmar foot structures. The object of this study was to determine if triamcinolone acetonide (TA) would in fact be able to locally diffuse from the DIPJ into the navicular bursa in horses affected by palmar foot pain. Both forelimb DIPJs (nine horses) were injected with 10 mg of TA. Navicular bursa fluid samples, both forelimb and one hind limb (systemic control), were analysed for TA with high-performance liquid ...
Effect of butorphanol on thermal nociceptive threshold in healthy pony foals.
Equine veterinary journal    November 5, 2012   Volume 45, Issue 4 503-506 doi: 10.1111/j.2042-3306.2012.00673.x
McGowan KT, Elfenbein JR, Robertson SA, Sanchez LC.Pain management is an important component of foal nursing care, and no objective data currently exist regarding the analgesic efficacy of opioids in foals. Objective: To evaluate the somatic antinociceptive effects of 2 commonly used doses of intravenous (i.v.) butorphanol in healthy foals. Our hypothesis was that thermal nociceptive threshold would increase following i.v. butorphanol in a dose-dependent manner in both neonatal and older pony foals. Methods: Seven healthy neonatal pony foals (age 1-2 weeks), and 11 healthy older pony foals (age 4-8 weeks). Five foals were used during both age ...
Clinical outcome of collateral ligament injuries of the tarsus.
The Canadian veterinary journal = La revue veterinaire canadienne    November 2, 2012   Volume 53, Issue 5 518-524 
Lamb L, Zubrod C, Hague B, Brakenhoff J, Major M.The significance of collateral ligament desmitis of the tarsocrural joint is often clinically underestimated, because it is an uncommon injury with a guarded prognosis for athletic soundness. The objective of this study was to describe the clinical presentation, treatment, and outcome of 12 horses with collateral ligament desmitis, along with tarsocrural joint synovitis secondary to hemarthrosis. Criteria for inclusion in this study included clinical signs of tarsocrural joint synovitis and sonographic evidence of collateral ligament desmitis. This retrospective study evaluated horses over an ...
The horse as a model of naturally occurring osteoarthritis.
Bone & joint research    November 1, 2012   Volume 1, Issue 11 297-309 doi: 10.1302/2046-3758.111.2000132
McIlwraith CW, Frisbie DD, Kawcak CE.Osteoarthritis (OA) is an important cause of pain, disability and economic loss in humans, and is similarly important in the horse. Recent knowledge on post-traumatic OA has suggested opportunities for early intervention, but it is difficult to identify the appropriate time of these interventions. The horse provides two useful mechanisms to answer these questions: 1) extensive experience with clinical OA in horses; and 2) use of a consistently predictable model of OA that can help study early pathobiological events, define targets for therapeutic intervention and then test these putative thera...
Where does it hurt?
Equine veterinary journal    October 31, 2012   Volume 44, Issue 6 627-628 doi: 10.1111/j.2042-3306.2012.00661.x
Barr AR.No abstract available
Systemic or intrasynovial medication as singular or as combination treatment in horses with (peri-)synovial pain.
The Veterinary record    October 23, 2012   Volume 171, Issue 21 527 doi: 10.1136/vr.100811
Brommer H, Schipper P, Barneveld A, van Weeren PR.Records of lame horses (2004-2007) with (peri-)synovial pain of the metacarpophalangeal joint (MCPJ, n = 53), digital flexor tendon sheath (DFTS, n = 20), and distal interphalangeal joint (DIPJ, n = 31) were evaluated (n = 104). Cases were grouped according to the following treatments: (1) systemic administration of NSAIDs (n = 40); (2) intrasynovial administration of glucocorticosteroids (n = 30); (3) combination treatment (n = 34). Outcome was defined as successful when the owner reported that the horse had returned to its previous level of performance within a period of up to six months aft...
Efficacy of epidural lidocaine combined with tramadol or neostigmine on perineal analgesia in the horse.
Equine veterinary journal    October 23, 2012   Volume 45, Issue 4 497-502 doi: 10.1111/j.2042-3306.2012.00654.x
DeRossi R, Módolo TJ, Maciel FB, Pagliosa RC.Short duration of analgesia is among the limitations of a single epidural injection with lidocaine in horses. Objective: To evaluate the effectiveness and safety of epidural lidocaine in combination with either tramadol or neostigmine for perineal analgesia in horses. Methods: Epidural catheters were placed in 6 saddle horses that then were given 3 treatments: 2% lidocaine (0.2 mg/kg bwt) alone, 2% lidocaine (0.2 mg/kg bwt) plus tramadol (0.5 mg/kg bwt), and 2% lidocaine (0.2 mg/kg bwt) plus neostigmine (1.0 μg/kg bwt). The order of treatments was randomised. Haemodynamic variables, respirato...
Minimally invasive repair of a calcaneus fracture in a Standardbred foal.
Journal of the American Veterinary Medical Association    October 20, 2012   Volume 241, Issue 9 1209-1213 doi: 10.2460/javma.241.9.1209
Bonilla AG, Smith KJ.A 4-month-old Standardbred colt was examined because of a fractured right calcaneus of 8 days' duration with increased distraction of the fracture fragment evident on sequential radiographs. Results: The foal was severely lame with diffuse periarticular tarsal swelling. Radiographically, a complete, displaced long oblique fracture of the right calcaneal body was evident. Because the fracture gap was increasing with time and lameness remained severe, despite medical management, surgical repair was recommended. Results: The foal was anesthetized, and minimally invasive fracture reduction and int...
Pharmacokinetics and pharmacodynamics of tramadol in horses following oral administration.
Journal of veterinary pharmacology and therapeutics    October 13, 2012   Volume 36, Issue 4 389-398 doi: 10.1111/jvp.12009
Knych HK, Corado CR, McKemie DS, Scholtz E, Sams R.Tramadol is a synthetic opioid used in human medicine, and to a lesser extent in veterinary medicine, for the treatment of both acute and chronic pain. In humans, the analgesic effects are owing to the actions of both the parent compound and an active metabolite (M1). The goal of the current study was to extend current knowledge of the pharmacokinetics of tramadol and M1 following oral administration of three doses of tramadol to horses. A total of nine healthy adult horses received a single oral administration of 3, 6, and 9 mg/kg of tramadol via nasogastric tube. Blood samples were collected...
Assessment of unassisted recovery from repeated general isoflurane anesthesia in horses following post-anesthetic administration of xylazine or acepromazine or a combination of xylazine and ketamine.
Veterinary anaesthesia and analgesia    September 27, 2012   Volume 40, Issue 1 3-12 doi: 10.1111/j.1467-2995.2012.00782.x
Valverde A, Black B, Cribb NC, Hathway A, Daw A.To compare the effects of sedative doses of acepromazine, xylazine or xylazine/ketamine administered to horses after isoflurane anesthesia on the quality of recovery and anesthesia recovery times. To determine if recovery scores improve after repeated consecutive anesthetic episodes. Methods: Prospective, randomized, crossover study. Methods: Fifteen adult research horses, 6.5±3.4 years old and weighing 499±40 kg. Methods: Horses undergoing three anesthetic episodes with isoflurane for magnetic resonance of the forelimbs were administered acepromazine (0.02 mg kg(-1) i.v.) or xylazine (0.3 m...
The effects of perineural and intrasynovial anaesthesia of the equine foot on subsequent magnetic resonance images.
Equine veterinary journal    September 26, 2012   Volume 45, Issue 3 320-325 doi: 10.1111/j.2042-3306.2012.00649.x
Black B, Cribb NC, Nykamp SG, Thomason JJ, Trout DR.Artefacts caused by regional anaesthesia can influence image interpretation of ultrasonography and nuclear scintigraphy. Perineural and intrasynovial anaesthesia are commonly performed prior to magnetic resonance imaging (MRI); and the effects on MR images, if any, are unknown. Objective: To determine if perineural and intrasynovial anaesthesia of structures in the equine foot cause iatrogenic changes detectable with MRI. Methods: A baseline MRI examination of both front feet was performed on 15 horses, 2-6 days prior to mepivacaine injection adjacent to the lateral and medial palmar digital n...
Acupuncture Points of the Horse’s Distal Thoracic Limb: A Neuroanatomic Approach to the Transposition of Traditional Points.
Animals : an open access journal from MDPI    September 17, 2012   Volume 2, Issue 3 455-471 doi: 10.3390/ani2030455
Lancaster LS, Bowker RM.Veterinary acupuncture charts were developed based on the concept of transpositional points whereby human acupuncture maps were adapted to animal anatomy. Transpositional acupuncture points have traditionally been placed in specific locations around the horse's coronet and distal limb believed to be the closest approximation to the human distal limb points. Because the horse has a single digit and lacks several structures analogous to the human hand and foot, precisely transposing all of the human digital points is not anatomically possible. To date there is no published research on the effect...
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