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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.
Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications. Musculoskeletal injuries represent a primary cause of suboptimal performance and early retirement in equine athletes. To address this challenge, the veterinary community has long endeavored to develop safer and more effective therapeutic strategies. Extracorporeal shock wave therapy (ESWT), as a treatment for equine musculoskeletal injuries, has garnered substantial attention among equine veterinarians. Focused on the theme ESWT Therapy for Equine Musculoskeletal Disorders: From biological mechanisms to clinical applications, this article systematically reviews existing literature on the biolo...
I feel your pain: Individual differences in welfare indicators after castration in horses. Personality affects both experience and expression of pain and the welfare impact of castration on horses is poorly understood. Therefore, the current study observed 19 horses to determine: the welfare impact of standard castration on horses; whether individuals consistently vary in their behavioural and emotional responses to pain; the influence of personality on behavioural and physiological responses to pain; whether Horse Grimace Scale (HGS) indicates how individuals feel about painful experiences. Eye temperature (IRT), salivary cortisol, HGS and a pain ethogram were measured at intervals...
Pilot study: Effects of whole-body vibrational therapy on equine thoracolumbar epaxial muscle response to pressure algometry. Whole-body vibrational therapy (WBV) is well-studied in people, but there is a paucity of research regarding its effect on horses. It is suggested that the use of WBV in horses increases performance, aids in recovery, and stimulates nerves, bones, and muscles in ways that normal exercise does not. Objective: The purpose of this pilot study was to determine if frequent WBV therapy sessions affect mechanical nociceptive thresholds based on pressure algometry in horses without clinical signs of lameness or back pain. Methods: The mechanical nociceptive thresholds (MNTs) were measured for 5 horses...
Correction: An anatomical study of the subarachnoid space surrounding the trigeminal ganglion in horses-in preparation for a controlled glycerol rhizotomy in equids. [This corrects the article DOI: 10.3389/fvets.2024.1424890.].
High-metacarpal deep digital flexor tenotomy and Steward clog shoeing for managing chronic refractory laminitis: A retrospective clinical study. To describe outcomes following high-metacarpal deep digital flexor tenotomy (DDFT) combined with Steward clog application in horses and ponies with refractory chronic laminitis. Methods: Retrospective observational study. Methods: Client-owned horses and ponies (7 horses, 8 ponies) with severe refractory laminitis. Methods: Medical records (2018-2019) were reviewed. All underwent standing high-metacarpal DDFT tenotomy proximal to the accessory ligament (AL-DDFT) junction, followed by customized Steward clogs application. Preoperative assessment included radiography and venography. Postoperativ...
Preliminary assessment of the leukocyte coping capacity as a point of care marker in horses with stress associated diseases. Stress represents a serious health and welfare concern; however, its objective assessment remains difficult. The equine gastric ulcer syndrome (EGUS) and orthopedic diseases that cause pain are among stress associated diseases in equine medicine. The leukocyte coping capacity (LCC) quantifies oxygen radical generation of neutrophil granulocytes which is altered under stress. Therefore, LCC could be a novel biomarker for stress in horses and we hypothesized that horses with stress associated diseases would have lower LCC values in comparison to horses without these diseases. Methods: In this ob...
Preliminary investigation of equine veterinary hospital staff attitudes towards pain assessment in a single centre. Despite the availability of several equine pain assessment tools, their use in equine veterinary practice appears limited compared to small animal practice. This study explores potential barriers to equine pain assessment, as reported by staff at a single UK equine teaching hospital. Methods: Nine hospital staff members were interviewed using semi-structured interviews. Key themes were identified through reflexive thematic analysis. Results: Participants acknowledged the importance of pain assessment, yet highlighted limitations in current methods and their inconsistent use. Key challenges inc...
Introducing an Innovative Pain Scale for Assessing Postpartum Pain in Mares: Preliminary Clinical Evaluation. Pain after giving birth is commonly observed in horses, yet there has not been a specific tool developed for assessing this pain in postpartum mares. The goal was to adapt existing equine pain scales and to preliminarily validate a practical pain scale for use by veterinarians and caregivers after foaling. Methods: The pain scale was developed by adapting items from other pain scales, including established orthopedic and colic equine pain scales, and incorporating caregiver feedback. The final scale includes eight areas for assessing pain: behavior, facial expressions, vital signs, udder exami...
Physiological and behavioural effects of continuous remifentanil-xylazine administration in donkeys. Remifentanil and xylazine are used as continuous infusions to facilitate standing surgery in horses. Their use for this purpose has not been reported in donkeys. Objective: To evaluate the behavioural, sedative, and cardiorespiratory effects of continuous intravenous infusion of remifentanil and xylazine in donkeys. Methods: Non-blinded in vivo experiments. Methods: Ten donkeys were sedated with an intravenous bolus of xylazine (0.8 mg/kg). After 3 min, continuous infusions of xylazine (0.65 mg/kg/h) and remifentanil (6 μg/kg/h) were administered for 60 min. Cardiorespiratory physio...
Intraligamentary anaesthesia: a local anaesthesia technique in equine dentistry. The injection of a local anaesthetic into the periodontal ligament (PDL) to achieve desensitisation of the pulp, periodontium, and adjacent tissues is a well-established technique in human dentistry, particularly in paediatric patients. This approach, commonly referred to as intraligamental or intraligamentary anaesthesia (ILA), has been widely adopted due to its effectiveness and relative simplicity. The aims of the present publication were: (1) to provide a review of the literature, (2) to describe an ILA technique adapted by the authors for use in equine dentistry, and (3) to evaluate this ...
Liposomal bupivacaine caudal epidural in horses results in adverse effects without analgesia. To evaluate the analgesic properties and adverse effects of liposomal bupivacaine administered via caudal epidural in horses. Methods: Pharmacodynamic study. Methods: A total of 10 healthy adult horses. Methods: Liposomal bupivacaine (10 mL; 1.3%) was administered into the caudal epidural space via an indwelling epidural catheter inserted to a length of 15 cm. Mechanical nociceptive threshold (MNT) testing with pressure algometry was used to measure analgesia at four anatomic locations for 72 h following injection. Physical examinations (including rectal temperature, heart rate, respirat...
Efficacy of acupuncture in racehorses: A review. Racehorses endure high physical demands, which often result in musculoskeletal pain, fatigue, and reduced performance. Although conventional therapies are effective, competition-related drug regulations restrict their use. Acupuncture, rooted in Traditional Chinese Veterinary Medicine, has gained interest as a non-pharmacological alternative for managing pain, enhancing recovery, and promoting overall welfare in equine athletes. This review aims to critically evaluate the current evidence on the efficacy of acupuncture in racehorses, focusing on musculoskeletal pain management, post-exercise r...
A Meta-Analysis of International Flunixin Pharmacokinetics in Horses: Toward Regulatory Harmonization and Individualized Detection Times Using Bayesian Paradigm. Flunixin meglumine is widely used to manage pain and inflammation in horses, and its regulation requires robust pharmacokinetic analysis for harmonization. In this study, we conducted a meta-analysis of flunixin disposition using plasma and urine concentration data from 65 horses across four countries to robustly estimate pharmacokinetic parameters in setting screening limits (SLs) for controlling medications in horses. A population (POP) model was developed using nonlinear mixed-effects model analysis. The irrelevant plasma concentration (IPC) and irrelevant urine concentration (IUC) were det...
Incorporating a Behavioral Medicine Approach in the Multi-Modal Management of Chronic Equine Gastric Ulcer Syndrome (EGUS): A Clinical Commentary. Equine gastric ulcer syndrome (EGUS) refers to mucosal gastric disease in horses, including equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD), which present as two distinct disease entities differing in pathophysiology and approach to disease management. Both diseases are a source of pain in affected horses, partly explaining why EGUS continues to receive substantial attention in the equine medical, welfare and equitation research sectors. There is a complex interplay between EGUS and a variety of physical and psychological stressors. Horses with EGUS are often...
What if Horses Were Humans? Comparing Rein Tension and Bit Pressures to Human Pressure Pain Thresholds. Bit pressure and rein tension-induced mouth pain in horses have recently become a significant welfare concern, fueling debates within the equestrian community and beyond. Evidence indicates that bits can cause pain-related behaviors and even oral lesions. Although studying pressure-induced pain in animals is challenging, the similarities in the physiology of pain processing (nociception) across mammals suggest that it is reasonable to assume that pain perception in humans and horses is principally comparable. Therefore, we compared human pressure pain detection thresholds (PPDTs) to reported r...
Cervical epidural catheter for administration of detomidine and morphine in a model of carpal synovitis in the horse. To determine the analgesic effects of detomidine and morphine administered by cervical epidural catheter (CEC) on a model of thoracic limb pain. Methods: Prospective, randomized, blinded crossover study. Methods: Five adult horses. Methods: Cervical epidural catheters were placed under ultrasound guidance, followed by induction of lipopolysaccharide (LPS)-mediated carpal synovitis. Horses received either saline or detomidine/morphine (DM; 10 μg/kg, 0.1 mg/kg, respectively) via CEC 4 h after synovitis. After a 7 day washout, synovitis was induced in the contralateral carpus, and the alternate ...
Prevalence of Low Back Pain in Competitive Dressage Riders: A Cross-Sectional Study. Objective: The purpose of this study was to identify the point and lifetime prevalence of low back pain (LBP) among dressage riders and identify riding-related variables that may precipitate LBP.Methods: A cross-sectional, exploratory, quantitative study was conducted using an online questionnaire. One hundred dressage riders competing at preliminary and higher levels were recruited at the South African Equestrian Federation's registered shows. Frequencies and descriptive statistics were performed on each question in addition to cross-tabulations for associations between variables or differenc...
Equine Abdominal Surgery: Predicting and Preventing Postoperative Complications. Morbidity after equine abdominal surgery is common and post-operative complications can be costly to owners. The focus of this article is on intraoperative decision-making and current evidence, including surgical techniques and prognostic information that can prevent and predict complications. Emerging techniques for intra-operative monitoring and intestinal viability assessment, anastomotic techniques, body wall suturing, peritonitis treatment, and pain management are discussed.
Behavioral and orthopedic issues in geldings with Postcastration adhesions: A retrospective study of 35 cases. Limited data is available on the diagnostic and therapeutic methods for pathologies caused by scarring after castration. It is well recognized that specific behaviors or untypical hindlimb lameness may be observed in geldings with gelding scars and adhesions caused by spermatic cord remnants after castration OBJECTIVES: To describe how to diagnose movement disorders associated with excessive adhesions caused by spermatic cord remnant after castration and to present a successful surgical treatment method. Methods: To assess the impact of gelding scars on horses' movement and behavior, medical r...
Owners’ everyday interactions with their horse: Pain-related issues and those of veterinary concern. The decisions made by horse owners on behalf of their animal, including decisions to involve a veterinarian, play an important role in the management of pain. This study explored horse owners' experiences to understand how they conceptualised chronic pain within the context of their horse-human relationship, what led them to seek veterinary involvement, and how veterinary interactions shaped their perceptions of pain and its management. An ethnographic approach using constructivist grounded theory methods was adopted. This paper draws upon field notes generated through 200 h of observation und...
Impinging and Overriding Spinous Processes in Horses: A Narrative Review. The term overriding spinous processes (ORSPs), commonly known as "kissing spine syndrome," refers to a skeletal abnormality in horses that is characterized by the narrowing (<4 mm) of the interspinous space and touching or overlapping of the spinous processes (SPs). This condition primarily affects the mid- and caudal thoracic vertebrae; however, ORSP can also affect the lumbar SPs. In the veterinary community, kissing spine is widely recognized as a common condition in sport horses, as it is often associated with chronic back pain and contributes to poor performance. Despite its significan...
Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse. To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
Intrinsic characteristics of donkeys that affect drug treatment. Donkeys have contributed to the development and livelihoods of humans for almost 7,000 years. They have been used for traction and transportation, kept as pets, utilized in animal-assisted therapies, or farmed as food-producing animals. Over the past two decades, significant progress has been made in bridging the knowledge gap in veterinary medicine between donkeys and horses. Veterinary practitioners are now more aware that donkeys have important behavioral, anatomical, and physiological characteristics that distinguish them from horses. These peculiarities should be considered when treating ...
Suzetrigine in Equestrian Sports: Optimized Extraction and LC-HRMS Detection Strategies. Suzetrigine, a recently approved Na1.8 sodium channel blocker, shows strong potential in the treatment of neurological, psychiatric, and pain-related conditions. Its peripheral selectivity enables effective pain management while avoiding central nervous system complications and addiction risks linked to opioid use. Following FDA approval in January 2025, concerns have emerged regarding its possible misuse for performance enhancement in sports, highlighting the need for reliable detection tools in doping control. Methods: An analytical procedure was designed and validated to detect suzetrigine ...
Hippotherapy in the Treatment of CMD and Bruxism in Dentistry. Dysfunctions and disorders of the craniomandibular system are accompanied by pathophysiological changes of muscle groups in the throat/neck and facial area, e.g., pain in the jaw and muscles of mastication and disturbance of occlusion, leading to teeth injury (loss of dental hard tissue, fractures/sensibility disorders, etc.). For muscular dysfunctions, even in the context of psychosomatic disorders and chronic stress, hippotherapy is particularly suitable, since it helps actively to relieve muscle tensions. In the current project we combined hippotherapy with progressive muscle relaxation (PM...
Oral cannabidiol increases thermal threshold in horses without physiologic adverse effects. To investigate the effect of cannabidiol (CBD) on thermal and mechanical thresholds and physiologic variables in horses. Unassigned: 6 horses (3 geldings and 3 mares) were enrolled in a prospective, randomized, masked crossover design from March 18 through May 3, 2025. Horses received 3.48 mg/kg CBD oil or placebo (sesame oil) orally every 24 hours for 3 days. Thermal and mechanical thresholds were determined at baseline and 4 and 12 hours after treatment administration on each day. Physiologic variables, including heart rate, respiratory rate, and rectal temperature, were recorded at the same...
Global survey on the utilisation and experiences with different retrobulbar anaesthesia techniques in horses. Retrobulbar anaesthesia (RBA) is relevant for ocular surgery in standing sedated horses. Objective: Gathering insights on experiences with RBA techniques. Methods: Cross-sectional survey. Methods: An online survey collected information on the respondents' professional background, indications, injection methods, use of ultrasound assistance, medication, and complications associated with RBA in horses. Results: Two-hundred and thirty-eight veterinarians from 25 countries contributed. 86.1% were members of veterinary specialty colleges. RBA indications were enucleation (97.8%), corneal surgery (2...
Refinement of the Lipopolysaccharide-Induced Synovitis Model in Equine Middle Carpal Joints. The aim of this study was to refine the lipopolysaccharide (LPS)-induced synovitis model in normal carpal joints of Thoroughbred horses by comparing two low LPS doses. A further aim was to investigate the relationship between the induced synovitis and lameness. The study design consisted of two phases using nine horses with a unilateral crossover design and a within-animal saline control. Synoviocentesis was performed at post-injection hour (PIH) 0, 8, 24, 72 and 168, allowing for synovial fluid cytology and biomarker analysis. Objective gait and thermographic analysis were used to objectively...
