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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.
Minimum end-tidal sevoflurane concentration necessary to prevent movement during a constant rate infusion of morphine, or morphine plus dexmedetomidine in ponies. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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...
Nociceptive thermal threshold testing in horses – effect of neuroleptic sedation and neuroleptanalgesia at different stimulation sites. 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...
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. 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. 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). 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. 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. 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. 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. 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.
Temporohyoid osteoarthropathy in two young horses. 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. 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. 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. 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. 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. 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. 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% ...
Distribution of purinergic P2X receptors in the equine digit, cervical spinal cord and dorsal root ganglia. 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...
