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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.
Ethyl pyruvate diminishes the inflammatory response to lipopolysaccharide infusion in horses. Endotoxaemia contributes to morbidity and mortality in horses with colic due to inflammatory cascade activation. Effective therapeutic interventions are limited for these horses. Ethyl pyruvate (EP), an anti-inflammatory agent that alters the expression of proinflammatory cytokines, improved survival and organ function in sepsis and gastrointestinal injury in rodents and swine. Therapeutic efficacy of EP is unknown in endotoxaemic horses. Objective: Determine the effects of EP on signs of endotoxaemia and expression of proinflammatory cytokines following administration of lipopolysaccharide (L...
Upregulation of articular synovial membrane μ-opioid-like receptors in an acute equine synovitis model. Intra-articular injection of opioids provides analgesia in painful equine joints and μ-opioid receptors (MORs) have been demonstrated in equine synovial membranes. The aim of this study was to determine whether acute inflammatory conditions will lead to up-regulation of MOR in equine synovial membranes and whether anti-inflammatory treatment can prevent any such upregulation. In a two-period, blinded, placebo-controlled randomised cross-over design, lipopolysaccharide (LPS, 1.0 ng) was injected into the left or right middle carpal joint of seven healthy ponies. Arthroscopy and synovial membra...
Murray Valley encephalomyelitis in a horse. A 5-year-old Thoroughbred mare presented with signs of severe pain and was taken to exploratory laparotomy based on suspicion of an acute abdominal lesion. A mild gastrointestinal lesion was discovered, but was considered disproportional to the severity of signs displayed. The mare was later euthanased because of intractable pain. Comprehensive postmortem examination, including polymerase chain reaction testing of central nervous system tissue samples, allowed a definitive diagnosis of Murray Valley encephalomyelitis to be made. This case demonstrates the variability of clinical presentations ...
A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses. To compare the results of a novel minimally invasive surgical technique with intralesional corticosteroid medication, as treatment for overriding dorsal spinous processes (ORDSP) in horses. Methods: Retrospective controlled clinical case series. Methods: Horses (n = 68) with ORDSP. Methods: ORDSP was diagnosed based on history, clinical, and radiographic examination. All narrowed spaces were treated. Horses undergoing medical treatment had methylprednisolone acetate injected directly in the affected space under radiographic control. Surgical cases had interspinous ligament desmotomy (ISLD) usi...
Analgesia in foals. The alleviation of pain in foals is an important welfare issue, increases patient and personnel safety, results in less disruption of homeostasis, and enhances return to normal function. It is important to anticipate and prevent noxious stimuli because pain in the neonatal period can alter pain processing, leading to altered pain thresholds and responses later in life as well as aversive behaviors. The key to assessing pain in foals is observation of behavior. Despite limited pharmacokinetic and efficacy information, understanding the unique physiology of foals and the mode of action of availa...
Expression of pleiotrophin, an important regulator of cell migration, is inhibited in intestinal epithelial cells by treatment with non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs for the suppression of inflammation and pain. However, the analgesic properties of NSAIDs are also associated with significant negative side effects, most notably in the gastrointestinal (GI) tract. Increasingly, evidence indicates that the ulcerogenic properties of some NSAIDs are not exclusively the result of inhibition of cyclooxygenase isoforms in the GI tract, and other mechanisms, including inhibition of cell migration and epithelial restitution, are being explored. Recently, microarray analysis was used ...
Cardiorespiratory, gastrointestinal, and analgesic effects of morphine sulfate in conscious healthy horses. To compare the cardiorespiratory, gastrointestinal, analgesic, and behavioral effects between IV and IM administration of morphine in conscious horses with no signs of pain. Methods: 6 healthy adult horses. Methods: Horses received saline (0.9% NaCl) solution (IM or IV) or morphine sulfate (0.05 and 0.1 mg/kg, IM or IV) in a randomized, masked crossover study design. The following variables were measured before and for 360 minutes after drug administration: heart and respiratory rates; systolic, diastolic, and mean arterial blood pressures; rectal temperature; arterial pH and blood gas variabl...
A comparative study of xylazine-induced mechanical hypoalgesia in donkeys and horses. To compare the effects of xylazine on mechanical nociceptive thresholds in donkeys and horses. Methods: Randomized, controlled, crossover, Latin-square, operator-blinded design. Methods: Six 3.1 ± 0.89 year old standard donkeys weighing 145.0 ± 30.5 kg and six 9.6 ± 4.4 year old Thoroughbred horses weighing 456.0 ± 69.0 kg. Methods: Each animal received one of four doses of xylazine (0.5, 0.7, 0.9, and 1.1 mg kg(-1) ), or acepromazine (0.05 mg kg(-1) ) or saline solution (0.9%) intravenously and mechanical nociceptive thresholds were assessed over 90 minutes. The areas under the threshold ...
Comparison of an inertial sensor system of lameness quantification with subjective lameness evaluation. Subjective evaluation of mild lameness has been shown to have poor interobserver reliability. Traditional methods of objective lameness evaluation require specialised conditions and equipment. Wireless inertial sensor systems have been developed to allow for simple, rapid, objective lameness detection in horses trotted over ground. Objective: The purpose of this study was to compare the sensitivities of an inertial sensor system and subjective evaluation performed by experienced equine practitioners at detecting lameness in horses. We hypothesised that the inertial sensor system would identify...
The use of intrathecal analgesia and contrast radiography as preoperative diagnostic methods for digital flexor tendon sheath pathology. The sensitivity of ultrasonography for the diagnosis of manica flexoria (MF) tears within the digital flexor tendon sheath (DFTS) is lower than for diagnosis of marginal tears of the deep digital flexor tendon (DDFT). Additional diagnostic tools would assist in appropriate decision making for either conservative or surgical management. Objective: To evaluate the improvement in lameness of horses with MF or DDFT tears following intrathecal analgesia and to assess the sensitivity and specificity of contrast radiography for the diagnosis of these tears. Methods: The case records of horses present...
Function of the ramus communicans of the medial and lateral palmar nerves of the horse. The role of the communicating branch between the medial and lateral palmar nerves of horses (i.e. the ramus communicans) in conveying sensory impulses proximally should be determined to avoid errors in interpreting diagnostic anaesthesia of the palmar nerves. Objective: Sensory nerve fibres in the ramus communicans of horses pass proximally from the lateral palmar nerve to merge with the medial palmar nerve, but not vice versa. Objective: To determine the direction of sensory impulses through the ramus communicans between lateral and medial palmar nerves. Methods: Pain in a thoracic foot was c...
Effect of ketamine hydrochloride on the analgesic effects of tramadol hydrochloride in horses with signs of chronic laminitis-associated pain. To investigate the effects of ketamine hydrochloride on the analgesic effects of tramadol hydrochloride in horses with signs of pain associated with naturally occurring chronic laminitis. Methods: 15 client-owned adult horses with chronic laminitis. Methods: Each horse received tramadol alone or tramadol and ketamine in a randomized, crossover study (≥ 2 months between treatments). Tramadol (5 mg/kg) was administered orally every 12 hours for 1 week. When appropriate, ketamine (0.6 mg/kg/h) was administered IV for 6 hours on each of the first 3 days of tramadol administration. Noninvasive sy...
Evaluation of oral administration of firocoxib for the management of musculoskeletal pain and lameness associated with osteoarthritis in horses. To generate data on the effects of firocoxib administration to horses with osteoarthritis. Methods: Client-owned horses with signs of lameness and joint pain associated with osteoarthritis. Methods: Firocoxib was administered as an oral paste (0.1 mg/kg, q 24 h) for 14 days. Assessments were performed on day 0 (baseline) and days 7 and 14. Results: 390 of 429 horses from 80 sites in 25 states met the criteria for analysis. Quarter Horse and Thoroughbred were the 2 most commonly represented breeds, comprising half of the study population. Signs of musculoskeletal pain or lameness attributed to ...
Short- and long-term results following standing fracture repair in 34 horses. Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow-up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. Objective: To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. Methods: Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedatio...
Comparison between magnetic resonance imaging and histological findings in the navicular bone of horses with foot pain. There is limited knowledge about both histological features in early navicular disease and what histological features are represented by increased signal intensity in fat-suppressed magnetic resonance (MR) images of the navicular bone. Objective: To characterise increased signal intensity in the spongiosa of the navicular bone in fat-suppressed MR images and to compare this with histopathology; and to compare objective grading of all aspects of the navicular bone on MR images with histological findings. Methods: One or both front feet of 22 horses with foot pain and a median lameness duration ...
Equine laparoscopy: equipment and basic principles. Laparoscopic techniques for veterinary surgery are growing in popularity for the same reason the use of minimally invasive procedures has increased tremendously in human surgery. Compared with open surgery, the benefits of laparoscopic surgery include smaller incisions, reduced postoperative morbidity and pain, shorter hospitalization, a more rapid return to normal activities, and, in some instances, superior access. Laparoscopic surgery is different from open surgery in equipment/instrumentation and psychomotor skills. This first article in a series on equine laparoscopic surgery introduces t...
Diffusion of contrast medium after four different techniques for analgesia of the proximal metacarpal region: an in vivo and in vitro study. There is limited information on potential diffusion of local anaesthetic solution after various diagnostic analgesic techniques of the proximal metacarpal region. Objective: To document potential distribution of local anaesthetic solution following 4 techniques used for diagnostic analgesia of the proximal metacarpal region. Methods: Radiodense contrast medium was injected around the lateral palmar or medial and lateral palmar metacarpal nerves in 8 mature horses, using 4 different techniques. Radiographs were obtained 0, 10 and 20 min after injection and were analysed subjectively. A mixture ...
Caudal anaesthesia of the infraorbital nerve for diagnosis of idiopathic headshaking and caudal compression of the infraorbital nerve for its treatment, in 58 horses. Idiopathic headshaking is often a facial pain syndrome, but a diagnostic protocol has not been described. In a previous study, caudal compression of the infraorbital nerve for treatment offered a fair success rate, but low case numbers and short follow-up time were limitations. Objective: To describe a diagnostic protocol for headshaking, examining the role of bilateral local analgesia of the posterior ethmoidal nerve (PET block). To report longer-term follow-up after surgery of the original cases and further cases and to determine whether changes to the technique influence success rates and c...
Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis. Various treatments of osteoarthritis (OA) have been described, including use of nutraceuticals. Objective: To review systematically the literature about the effects of nutraceuticals on clinical signs of pain or abnormal locomotion in horses, dogs, and cats, and to discuss methodological aspects of trials and systematic reviews. Methods: A systematic search of controlled trials evaluating the impact of nutraceuticals on OA in horses, dogs, and cats was performed, using Medline, CAB Abstracts, and Google Scholar. Scientific evidence was evaluated by means of criteria proposed by the Food and Dr...
Medetomidine continuous rate intravenous infusion in horses in which surgical anaesthesia is maintained with isoflurane and intravenous infusions of lidocaine and ketamine. To evaluate medetomidine as a continuous rate infusion (CRI) in horses in which anaesthesia is maintained with isoflurane and CRIs of ketamine and lidocaine. Methods: Prospective, randomized, blinded clinical trial. Methods: Forty horses undergoing elective surgery. Methods: After sedation and induction, anaesthesia was maintained with isoflurane. Mechanical ventilation was employed. All horses received lidocaine (1.5 mg kg(-1) initially, then 2 mg kg(-1) hour(-1)) and ketamine (2 mg kg(-1) hour(-1)), both CRIs reducing to 1.5 mg kg(-1) hour(-1) after 50 minutes. Horses in group MILK received ...
Antinociceptive effects of low dose lumbosacral epidural ropivacaine in healthy ponies. The objective of this study was to evaluate the safety and efficacy of low dose lumbosacral epidural ropivacaine in ponies. Antinociceptive effects of epidural ropivacaine were evaluated by means of mechanical nociceptive thresholds (MNTs) at several spinal levels in conscious ponies. The effects of ropivacaine on nociceptive afferent transmission to the spinal cord were also assessed by measuring spinal cord somatosensory evoked potentials (SSEPs) in anaesthetised ponies. Ataxia scores were determined in conscious ponies to assess the effects on motor function. A randomised, placebo controlle...
Standing low-field magnetic resonance imaging in horses with chronic foot pain. Conventional imaging modalities can diagnose the source of foot pain in most cases, but have limitations in some horses, which can be overcome by using magnetic resonance imaging (MRI). However, there are no reports of the MRI appearance and prevalence of foot lesions of a large series of horses with chronic foot lameness. Methods: In the present study, 79 horses with unilateral or bilateral forelimb lameness because of chronic foot pain underwent standing low-field MRI to make a definitive diagnosis. Results: Of the 79 horses, 74 (94%) had alterations in >1 structure in the lame or lamest foo...
Analgesic and anti-hyperalgesic effects of epidural morphine in an equine LPS-induced acute synovitis model. Epidural morphine is widely used in veterinary medicine, but there is no information about the anti-hyperalgesic and anti-inflammatory effects in acute inflammatory joint disease in horses. The analgesic, anti-hyperalgesic and anti-inflammatory effects of epidural morphine (100mg/animal or 0.17 ± 0.02 mg/kg) were therefore investigated in horses with acute synovitis. In a cross-over study, synovitis was induced in the talocrural joint by intra-articular lipopolysaccharide (LPS). The effect of epidural morphine was evaluated using physiological, kinematic and behavioural variables. Ranges of m...
Clinical evaluation of detomidine-butorphanol-guaifenesin-ketamine as short term TIVA in Spiti ponies. Veterinarians working under remote field conditions are routinely presented with variety of surgical interventions in equines like castrations, management of wound, traumatic and congenital hernias and musculoskeletal disorders thus necessitating the use of general anaesthesia for management of these conditions. The present study was carried out to evaluate and recommend the suitable short term anaesthetic technique for Spiti ponies under field conditions. Seven clinically healthy male Spiti ponies presented for castration were evaluated for short term Total Intravenous Anaesthesia (TIVA) usin...
Ileal impaction in 245 horses: 1995-2007. The objective of this study was to identify parameters that would assist in determining the probability of a successful outcome with medical management versus surgical intervention in horses with ileal impaction. Medical records of 245 horses admitted for ileal impaction were reviewed and placed into 2 groups: medical (med) and surgical (sx) treatment. Persistence of abdominal pain, gastric reflux, frequency of analgesic administration, and 1-year survival were evaluated. There were no differences in signalment, abdominal pain, or heart rate among groups; however, significantly more sx horses ...
Sacroiliac injuries in horses. This article reviews the pathology, diagnosis, and treatment of sacroiliac joint injuries. These injuries can be acute or chronic and can involve soft tissue structures surrounding the joint or the bony structures of the joint. The several diagnostic modalities for sacroiliac injuries vary in usefulness and accessibility. Treatment of sacroiliac problems is usually supportive and nonspecific and includes the use of antiinflammatory medications and an appropriate exercise regimen. The prognosis depends on the cause, but severe injuries can limit a horse's future athletic activity.
[Traumatology and sport injuries in professional and amateur show-jumping competitors].
Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin
The objective of this study was to investigate the frequency, extent, and effective preventive measures of sport injuries in professional and amateur-show jumping competitors. In a retrospective study design, 264 show-jumping riders (105 professionals, 159 amateurs) were interviewed by means of a standardised questionnaire. In total, 636 injuries were reported in detail. Injuries were categorised into severity grade I (36.0 %) (not requiring medical attention), grade II (34.6 %) (single medical treatment), grade III (20.9 %) (several outpatient medical treatments) and grade IV (8.5 %) (req... Phenylbutazone and flunixin meglumine used singly or in combination in experimental lameness in horses. Using an adjustable heart bar shoe model of foot pain, the objective of this study was to test the hypothesis that the combined use of phenylbutazone (PBZ) and flunixin meglumine (FM) would prove more efficacious in alleviating lameness than either drug alone. Methods: One hour after induction of lameness at weekly intervals, 8 healthy adult Thoroughbred horses randomly underwent one of 4 i.v. treatments: saline (SAL) placebo (1 ml/45 kg bwt), PBZ (4.4 mg/kg bwt), FM (1.1 mg/kg bwt) or PBZ+FM (at the same dosages as given individually). Heart rate (HR) and lameness score (LS) responses were as...
