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.
Ajeebsanu MM, Koshy SA, Karakka Kal AK, Subhahar MB, Karatt TK, Philip M.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 ...
Geibel MA, Kildal D, Geibel AM, Ott S.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...
Carroll AT, Reed RA, Berghaus LJ, McNabney D, Knych HK.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...
Lieberth S, Thieme K, Dancker C, Merle R, Eule JC.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...
Duggan MJS, Kearney C, Baltrimaite M, Labberté MC, Gibney R, Brama PAJ.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...
Arantes JA, Rabelo IP, Bermudes L, Lacerenza MD, Mendes RP, Corrêa RR, Yamada DI, Valadão CAA, Dória RGS.This study aimed to compare the sedation quality and cardiorespiratory and behavioral effects of detomidine administered intravenously, either in intermittent boluses or as a continuous rate infusion, with butorphanol in horses pre-medicated with acepromazine for odontoplasty procedures. Unassigned: A prospective clinical study was conducted with fifteen adult horses randomly assigned to two groups: Bolus group (BG, = 7) and Infusion group (IG, = 8). Both groups received acepromazine premedication, followed by detomidine administration (bolus or infusion). Butorphanol was administered either...
Willette J, Guinn A, Munsterman A.Impactions of the jejunum are rarely described in the literature. The current case series describes six cases of adult horses with jejunal impactions with feed material diagnosed by exploratory celiotomy. Horses underwent exploratory celiotomy based off of their degree of pain despite medical management and concerns for a primary strangulating small intestinal lesion. All jejunal impactions were relieved via manual decompression of the impaction into the cecum. None of the cases underwent a resection or anastomosis at the site of impaction. All horses were treated with gastroprotectants (omepr...
Maldonado Moreno N, Alves Moreira J, Araujo De Oliveira L, Sanches Gontijo A, Castilho Baldi ML, Rocha Wenceslau R, Beier SL.A multimodal approach is recommended to optimize perioperative pain control in animals, although opioid use in horses remains limited due to the risks of central nervous system (CNS) stimulation and reduced intestinal motility. A group of 19 healthy, male, mixed-breed horses were divided into two groups and medicated with acepromazine (0.05 mg kg) and detomidine (10 µg kg), with methadone (0.05 mg kg) (ADM) or saline (ADS) administered intravenously (IV). Physiological variables, intestinal motility, gastric distention, and facial pain (EQUUS-FAP) were evaluated one day before (DB), before th...
Amari M, Brioschi FA, Auletta L, Ravasio G.Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups receive...
Bombardi C, Salamanca G, Tagliavia C, Grandis A, Zamith Cunha R, Gramenzi A, De Silva M, Zannoni A, Chiocchetti R.The amygdala is composed of several nuclei, including the lateral nucleus which is the main receiving area for the input from cortical and subcortical brain regions. It mediates fear, anxiety, stress, and pain across species. Evidence suggests that the endocannabinoid system may be a promising target for modulating these processes. Cannabinoid and cannabinoid-related receptors have been identified in the amygdala of rodents, carnivores, and humans, but not in horses. This study aimed to investigate the gene expression of cannabinoid receptors 1 (CB1R) and 2 (CB2R), transient receptor potential...
Geiger T, Lindenhahn L, Delarocque J, Geburek F.Data about efficacy of different training modalities during rehabilitation of horses with back pain is scarce. The aim of this study was to analyze the effect of water treadmill training, lunging and dry treadmill training in horses with back pain. Methods: Eighteen warmblood riding horses referred with confirmed clinical signs of back pain including abnormal responses to passive mobilisation were randomized into three groups to participate in a 6-week water treadmill training, lunging or dry treadmill program under otherwise identical conditions. Two clinicians, one blinded to the program, pe...
Smith R, Perkins E, Pinchbeck G, Ireland J.Poor pain management in horses is a welfare concern. The 'diagnosis' of pain cannot be separated from the broader set of interactions through which it emerges. The interactions that take place during veterinary consultations shape the ways in which, or whether, pain management is discussed. Objective: To understand owners' and veterinarians' decision making in relation to chronic pain and its management. Methods: Qualitative ethnographic study. Methods: Data were collected from four veterinary practices in Great Britain between May 2023 and April 2024. Around 200 h of ethnographic observatio...
Calatayud-Bonilla M, Carmona JU, Prades M.Myofascial pain syndrome (MPS) is caused by trigger points (TrPs): hypersensitive spots in taut muscle bands that impair function and cause pain. Dry needling (DN) is a common treatment in humans, but evidence in horses is limited. This prospective, controlled study evaluated the effectiveness of DN in reducing TrP-related pain in the brachiocephalic muscle of horses. Of the 98 horses enrolled, 66 were allocated to a treatment group receiving weekly DN sessions for three weeks, while 32 were assigned to a control group with no intervention. Pain and function were assessed using pressure algome...
Uldahl M, Mellor DJ.This commentary evaluates contemporary equestrian sport governance through the lens of equine welfare science. Drawing on evidence from the FEI Sport Forum 2025 debates, the IFHA Racing Integrity Handbook, media coverage of horse sport, recent scientific presentations, regulatory texts, and published research, we identify systemic shortcomings in how horse welfare is assessed, prioritised, and protected. Key issues include reliance on performance as a proxy for welfare, inadequate "fit-to-compete" protocols, neglect of horses' mental states, coercive tack and equipment practices (e.g., double ...
Amiet B, Rainger J, Zedler S, Stewart A, Woldeyohannes S, Goodwin W.To compare horses' aversive behavioural responses to the application of 5% prilocaine/lidocaine eutectic mixture of local anaesthetics (EMLA) cream versus subcutaneous infiltration of 2% lidocaine, followed by jugular vein catheterization. Methods: Blinded, randomized study. Methods: A group of 26 university-owned research horses. Methods: Each horse received both treatments at opposite jugular sites with ≥ 12 hours between procedures. One randomly assigned jugular site received 1 g cm of 5% EMLA cream 60 minutes before catheterization, while the contralateral site received 1.5 mL of 2% lido...
Kelemen Z, Vogl C, Torres Borda L, Auer U, Jenner F.Clinical care for patients with limited life expectancy often requires adjustments, prioritizing immediate benefits over long-term outcomes, as the relevance of future complications diminishes. This study identifies indicators of mortality risk in horses with chronic orthopaedic conditions to enhance individualized care and welfare. Over 3 years, 123 chronically lame horses and 6 healthy control horses at an animal sanctuary underwent regular (every 3 months) comprehensive health assessments and activity monitoring using wearable sensors. Data collected included body condition scores, muscul...
Berni P, Del Bue M, Conti V, Andreoli V, Ramoni R, Angelone M, Squassino GP, Bari E, Torre ML, Rinaldi M, Dotti S, Rossi R, Yusuf I, Mauri P....Most in vivo studies on MSC-secretome for osteoarthritis (OA) have relied on animal models, using products lacking pharmaceutical quality, not formulated for clinical use, and insufficiently characterized, limiting knowledge of its effectiveness. This study reports veterinary clinical trials on dogs and horses with spontaneous OA: in dogs (26 subjects), the trial is randomized, double-blinded, and controlled; in horses, 5 clinical cases were treated for safety assessment. Treatment consisted of hyaluronic acid with either lyosecretome - a freeze-dried, injectable MSC-secretome obtained through...
Ellis KL, Giancola S.Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
Boado A, Pollard D, Dyson S.There is limited information about the orthopaedic health of dressage horses. This study aimed to document the orthopaedic status, lesion distribution, and evolution of injuries in 70 horses undergoing a minimum of five in-depth orthopaedic assessments at six-months' intervals. Warmblood (70.0%) and Iberian (24.3%) breeds predominated. The median lameness grade at initial examination was 2/5 (interquartile range 2,2; range 0,3). Hypermetria (42.9%) or hypermetria and weakness (12.9%) were observed at the initial examination and did not change over time. Metacarpophalangeal/metatarsophalangeal ...
Curti F, Marsocci A, Massarelli D, Magnifica F.Several studies have highlighted the association between low back pain (LBP) and horse riding, but none have specifically analyzed the underlying causes. Furthermore, there is a lack of literature addressing LBP in equestrian athletes, as the focus is often placed on the health of the horse rather than that of the rider. This study aims to determine if surface electromyography can identify changes in spinal erector activation pre- and post-training in an equestrian athlete with recurring nonspecific LBP by measuring the flexion relaxation phenomenon (FRP). The patient, an equestrian athlete, e...
Patricio CR, Winter GHZ, Garbade P.Spinal articular dysfunction disrupts normal neural function and may lead to stiffness, pain or poor performance. Back pain is common in equine athletes, and it is a common complaint by horse owners requesting chiropractic evaluations. Objective: To describe the prevalence of spinal articular dysfunction in showjumping horses. Methods: Retrospective analysis of clinical records. Methods: Records from 3 years of examinations in horses, from beginners to high-performance levels. Each horse had 30 spinal segments evaluated for the presence of dysfunctional articulations. Exams were performed by...
Portier K, Schiesari C, Gauthier L, Yeng LT, Tabacchi Fantoni D, Formenton MR.Myofascial trigger points (MTrPs) are localized, hypersensitive areas in muscles that can cause pain and reduced performance. This study aimed to compare the prevalence and location of MTrPs in show-jumping and dressage horses. A secondary objective was to evaluate the potential of thermography, pressure algometry, and facial expression scoring in characterizing MTrPs in horses. Fourteen horses (seven dressage, seven show-jumping) were examined. Muscle palpation was used to identify MTrPs. Thermography was used to compare the skin surface temperature of MTrPs with adjacent control areas. Addit...
Quam V.Inflammation plays a role in acute and chronic equine tendon/ligament injury; anti-inflammatories are often indicated. Local corticosteroids provide consistent and profound short-term effects on pain and inflammation across species. However, there is no demonstrated benefit in the long term, and complications can occur. Alternative biologic anti-inflammatory treatments are available and should be used in horses at risk of complications. Nonetheless, corticosteroids remain an affordable and effective anti-inflammatory that, with continued research, may be indicated on a case-by-case basis as pa...
Rodrigues APDC, Pozzobon R, De Bastiani G, De La Côrte FD, Azevedo MDS.Lameness, which arises from functional or structural changes in the limbs or axial skeleton, causes asymmetry in the movement of the equine head and/or pelvis. This study aimed to investigate the lameness patterns of horses that underwent lameness examination or monitoring during the years 2016 to 2020. This retrospective study used data from the lameness examination, evaluated using an objective assessment with body-mounted wireless inertial sensors. The lameness examination comprised clinical history, static inspection, palpation, gait evaluation (for which the animals were equipped with a w...
Resano-Zuazu M, Carmona JU, Argüelles D.Myofascial pain syndrome (MPS) is a common source of musculoskeletal pain, characterized by trigger points (TrPs). In horses, MPS is frequently underdiagnosed, and evidence on DN effectiveness is limited. This study investigated whether DN can improve the biomechanics in horses using an artificial intelligence (AI)-based markerless smartphone application (app). Fourteen horses participated, including nine used in assisted therapy, four leisure horses, and one with mixed use. The presence of TrPs was evaluated in six muscles through manual palpation: brachiocephalicus, trapezius, gluteus medius...
Calle-González N, Rivero JL, Olivares J, Miró F, Argüelles D, Requena F, Munoz A.Capacitive-resistive electrical transfer (CRET) is an endogenous non-invasive technique, used as deep diathermy. We pursue to analyze the temperature changes by applying different CRET protocols in the thoracolumbar spine of horses, between thoracic vertebrae 15 and lumbar 2. Unassigned: Ten clinically sound horses without thoracolumbar pain underwent various CRET protocols applied to a standardized thoracolumbar region (T15-L2). The protocols included sham (device off), low intensity (LIP, 5%), medium intensity (MIP, 30%), and high intensity (HIP, 40%). The HIP protocol was further divided in...
Soroko-Dubrovina M, Zielińska P, Dudek KD, Śniegucka K, Nawrot K.The aim of the present study was to assess the thermal effects of high-intensity laser therapy (HILT) on the temporomandibular joint (TMJ) area of clinically healthy Thoroughbred racehorses. The study was conducted on 21 clinically healthy Thoroughbreds in regular training. The horses were subjected to thermographic examinations before and immediately after a HILT session to measure changes in the body surface temperature in the TMJ area. The left TMJ was subjected to therapy, while the contralateral joint served as a control. Statistically significant differences in the body surface temperatu...
Beck AA, Paz LB, Frank MI, Pereira RCF, De La Côrte FD.To evaluate the effect of IA injections of botulinum toxin type A (BoNT-A) in horses with chronic, naturally occurring distal tarsal osteoarthritis. Unassigned: 9 horses were selected after physical and radiographic assessments. Horses also underwent an objective lameness examination and were included if they had a hindlimb impact lameness (Pmin ≥ 3 mm), which positively responded (≥ 50%) to the tarsometatarsal and centrodistal joints' anesthetic block. Horses randomly received an intra-articular injection of BoNT-A or an equivalent volume of saline solution. Horses were reevaluated at pos...
van Loon JP, de Grauw JC, van Dierendonck M, L'ami JJ, Back W, van Weeren PR.Intra-articular administration of morphine as a local analgesic and anti-inflammatory drug is widely used in human medicine. In equids, little is known about its clinical analgesic and anti-inflammatory efficacy. Objective: To use an inflammatory orthopaedic pain model to investigate the analgesic and anti-inflammatory effects of intra-articularly administered morphine as a new treatment modality in horses with acute arthritis. Methods: In a crossover study design, synovitis was induced in the left or right talocrural joint by means of intra-articular injection of 0.5 ng lipopolyssacharide (LP...
Haussler KK, Erb HN.An objective measure of neck, back and croup pain is needed in horses with musculoskeletal injuries, vague upper limb lameness or poor performance. Objective: To establish mechanical nociceptive thresholds (MNTs) within the axial skeleton and evaluate the effects of subject status and ridden exercise. Methods: Thirty-six mature horses (10 nonridden; 26 actively ridden) were used to assess MNTs evoked by a pressure algometer (PA) with a 1 cm2 rubber plunger tip at 62 midline and bilaterally symmetrical anatomical landmarks along the axial skeleton. Pressure was applied at a uniform rate of appl...
Stubbs NC, Kaiser LJ, Hauptman J, Clayton HM.In human subjects with back pain, the deep spinal stabiliser m. multifidus is inhibited ipsilaterally leading to atrophy, asymmetry and intervertebral instability. Specific physiotherapeutic exercises are required to reactivate m. multifidus. This study assesses the effect of dynamic mobilisation exercises on size and symmetry of m. multifidus in the equine caudal thoracic and lumbar spine. Objective: Regular performance of dynamic mobilisation exercises over a period of 3 months increases cross sectional area (CSA) and left-right symmetry of m. multifidus muscles in the caudal thoracic and lu...
Anderson JR, Phelan MM, Clegg PD, Peffers MJ, Rubio-Martinez LM.Osteoarthritis (OA), osteochondrosis (OC), and synovial sepsis in horses cause loss of function and pain. Reliable biomarkers are required to achieve accurate and rapid diagnosis, with synovial fluid (SF) holding a unique source of biochemical information. Nuclear magnetic resonance (NMR) spectroscopy allows global metabolite analysis of a small volume of SF, with minimal sample preprocessing using a noninvasive and nondestructive method. Equine SF metabolic profiles from both nonseptic joints (OA and OC) and septic joints were analyzed using 1D H NMR spectroscopy. Univariate and multivariate ...
Haussler KK, Erb HN.Pressure algometry (PA) is a potential modality for objectively measuring mechanical nociceptive thresholds (MNTs) in horses. Its ability to differentiate musculoskeletal pain sites from nonpain sites is unknown and must be assessed prior to its clinical application. Objective: To assess the ability of PA to detect induced musculoskeletal pain. Methods: Twenty clinically normal mature horses (2 groups of 10 horses, over 2 years) were used to measure MNTs before and after implantation and removal of 2 fixation half-pins in the dorsal spinous processes of 2 adjacent vertebrae. To assess hyperalg...
Toutain PL, Autefage A, Legrand C, Alvinerie M.The purpose of the present study was to establish in the horse the relationship between plasma concentration profiles of phenylbutazone (PBZ) and flunixin meglumine (FM) and their pharmacological effects in order to build a predictive pharmacokinetic/pharmacodynamic (PK/PD) model. In five horses, an experimental arthritis was induced by injecting Freund's adjuvant into a carpal joint. PBZ (4 mg/kg) and FM (1 mg/kg) were injected by the intravenous route as a single intravenous dose in two different trials. Five pharmacodynamic end-points were regularly measured after test article injection usi...
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. ...
Hammer A, Nilsagård Y, Forsberg A, Pepa H, Skargren E, Oberg B.The aim of this study was to investigate whether therapeutic riding (TR, Sweden) hippotherapy (HT, United States) may affect balance, gait, spasticity, functional strength, coordination, pain, self-rated level of muscle tension (SRLMT), activities of daily living (ADL), and health-related quality of life. Eleven patients with multiple sclerosis (MS) were studied in a single-subject experimental design iSSED) study, type A-B-A. The intervention comprised ten weekly TR/HT sessions of 30 minutes each. The subjects were measured a maximum of 13 times. Physical tests were: the Berg balance scale, t...
Clutton RE.Opioid analgesics have been the foundation of human pain management for centuries, and their value in animals has increased since it was proposed that it is the veterinarian's duty to alleviate pain whenever it may occur. Compared with other domesticated species, the horse has benefitted less from the increased understanding of opioid pharmacology in animals, because early literature was overlooked and later work, which examined adverse side effects rather than analgesia, concluded that analgesic and excitatory doses were irreconcilably close. More recent studies have indicated a widening role...
Wagner AE.The stress response represents an animal's attempt to reestablish the body's homeostasis after injury, intense physical activity, or psychological strain. Two different neuroendocrine pathways may be activated in stressful situations: the hypothalamic-pituitary-adrenocortical axis, leading to increased cortisol levels, and the sympathoadrenomedullar system, leading to increased catecholamine levels. By applying some of the evaluation methods described in this article in the appropriate clinical situations, equine veterinarians can almost certainly improve their ability to recognize and manage ...
Dyson SJ, Murray R, Schramme MC.The diagnosis of foot-related lameness often remains elusive and it can be difficult to offer rational treatment, or to predict outcome. Objective: To describe the spectrum of injuries of the foot identified using magnetic resonance imaging (MRI), to determine their relative prevalence among MRI diagnoses and to establish the long-term results of treatment. Methods: The MR images of horses examined from January 2001--December 2003 were reviewed. Horses were selected for MRI if the pain causing lameness was localised to the foot using perineural analgesia but any clinical, radiological or ultra...
Martin BB, Klide AM.The diagnosis of back pain is often a diagnosis of exclusion of other problems in the face of poor performance. It requires careful observation, thought, an open mind, and experience. The signs of back pain can be extremely variable and range from subtle to obvious. Obvious forelimb or hind limb lameness is not usually a sign of back pain. The most common differential diagnosis may be back pain secondary to degenerative joint disease of the hocks, fetlocks, or stifle. These diseases can mimic signs of back pain including lack of impulsion, shortening of the stride length, and change in the str...
Ruíz-López P, Domínguez JM, Granados MDM.To review monitors currently available for the assessment of nociception-antinociception in veterinary medicine. Methods: PubMed, Web of Science and Google Scholar. The results were initially filtered manually based on the title and the abstract. Conclusions: The provision of adequate antinociception is difficult to achieve in veterinary anaesthesia. Currently, heart rate and arterial blood pressure are used to monitor the response to a noxious stimulus during anaesthesia, with minimum alveolar concentration-sparing effect and stress-related hormones used for this purpose in research studies. ...
Love EJ, Murrell J, Whay HR.This review evaluates the thermal and mechanical nociceptive threshold testing techniques that have been used in horses and discusses them with reference to their applications, limitations and the factors which can influence both the testing procedure itself and the animal's responses. Methods to optimise the reliability and repeatability of the testing procedures are suggested and the potential clinical applications discussed. Methods: Web of Science and Medline. Conclusions: Thermal and mechanical nociceptive threshold testing techniques have valuable roles in both the identification of alte...
Haussler KK.The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until...
Jones E, Viñuela-Fernandez I, Eager RA, Delaney A, Anderson H, Patel A, Robertson DC, Allchorne A, Sirinathsinghji EC, Milne EM, MacIntyre N....Laminitis is a common debilitating disease in horses that involves painful disruption of the lamellar dermo-epidermal junction within the hoof. This condition is often refractory to conventional anti-inflammatory analgesia and results in unremitting pain, which in severe cases requires euthanasia. The mechanisms underlying pain in laminitis were investigated using quantification of behavioural pain indicators in conjunction with histological studies of peripheral nerves innervating the hoof. Laminitic horses displayed consistently altered or abnormal behaviours such as increased forelimb lifti...
Zimmerman M, Dyson S, Murray R.There has been no objective study comparing radiological features of spinous processes (SPs) in the thoracolumbar region and/or scintigraphic findings with clinical signs. Objective: To investigate the relationship between the presence or absence of clinical signs of back pain and: 1) radiological findings of close, impinging or overriding SPs; 2) increased radiopharmaceutical uptake (IRU) in the SPs; and 3) the combination of radiological findings and IRU. Also to determine the prevalence of concurrent osseous pathology. Methods: Five-hundred and eighty-two horses, presented for perceived bac...
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...
Cook VL, Meyer CT, Campbell NB, Blikslager AT.To determine whether treatment of horses with firocoxib affects recovery of ischemic-injured jejunum, while providing effective analgesia. Methods: 18 horses. Methods: Horses (n = 6 horses/group) received saline (0.9% NaCl) solution (1 mL/50 kg, IV), flunixin meglumine (1.1 mg/kg, IV, q 12 h), or firocoxib (0.09 mg/kg, IV, q 24 h) before 2 hours of jejunal ischemia. Horses were monitored via pain scores and received butorphanol for analgesia. After 18 hours, ischemic-injured and control mucosa were placed in Ussing chambers for measurement of transepithelial resistance and permeability to lipo...
van Loon JPAM, Macri L.The objective assessment of chronic pain is of utmost importance for improving welfare and quality of life in horses. Freedom from disease and pain is one of the 'five freedoms' that are necessary for animal welfare. The aim of this study was to develop a pain scale for the assessment of chronic pain in horses (Horse Chronic Pain Scale; HCPS), which is based on behavioural and facial expressions. The scale was used to assess 53 horses (26 horses diagnosed with chronic painful conditions by means of clinical examination and additional diagnostic procedures (consisting of osteoarthritis, chronic...
Habacher G, Pittler MH, Ernst E.Acupuncture is a popular complementary treatment option in human medicine. Increasingly, owners also seek acupuncture for their animals. The aim of the systematic review reported here was to summarize and assess the clinical evidence for or against the effectiveness of acupuncture in veterinary medicine. Systematic searches were conducted on Medline, Embase, Amed, Cinahl, Japana Centra Revuo Medicina and Chikusan Bunken Kensaku. Hand-searches included conference proceedings, bibliographies, and contact with experts and veterinary acupuncture associations. There were no restrictions regarding t...
Wennerstrand J, Johnston C, Roethlisberger-Holm K, Erichsen C, Eksell P, Drevemo S.Earlier studies have developed a clinical tool to evaluate objectively the function of the equine back. The ability to differentiate horses with back pain from asymptomatic, fully functioning horses using kinematic measures from this tool has not been evaluated. Objective: To compare the kinematics of the back at walk and trot in riding horses with back dysfunction to the same parameters in asymptomatic sport horses. Methods: The kinematics of the back in 12 horses with impaired performance and back pain were studied at walk and trot on a treadmill. Data were captured for 10 sees at 240 Hz. Ra...
Rochais C, Fureix C, Lesimple C, Hausberger M.Chronic pain is thought to affect patients' cognitive functioning, including attention. Loss of attention is likely to have an impact on the execution of daily tasks, and, therefore, to have negative effects. However, relationships between chronic pain and cognitive deficits are still debated. Pre-clinical studies using laboratory animals prove useful to model pain-related cognitive impairment, but animal models had to predict effects in the real world. This study investigates attentional engagement of domestic horses by comparing observations in a home setting and evaluations of vertebral dis...
Sullivan KA, Hill AE, Haussler KK.Common methods used to treat back problems in horses need to be assessed objectively. Objective: To measure spinal mechanical nociceptive thresholds (MNTs) and evaluate the effects of chiropractic, massage and phenylbutazone, compared with active and inactive control groups. Methods: Baseline MNTs at 7 sites within the thoracolumbar and sacral regions were measured in 38 healthy mature horses exhibiting no clinical signs of lumbar pain. Horses were assigned to one of 3 treatment groups: instrument-assisted chiropractic treatment, therapeutic massage and phenylbutazone; or 2 control groups: rid...
Petit A, Redout EM, van de Lest CH, de Grauw JC, Müller B, Meyboom R, van Midwoud P, Vermonden T, Hennink WE, René van Weeren P.In this study, the intra-articular tolerability and suitability for local and sustained release of an in situ forming gel composed of an acetyl-capped poly(ε-caprolactone-co-lactide)-b-poly(ethylene glycol)-b-poly(ε-caprolactone-co-lactide) (PCLA-PEG-PCLA) copolymer loaded with celecoxib was investigated in horse joints. The systems were loaded with two dosages of celecoxib, 50 mg/g ('low CLB gel') and 260 mg/g ('high CLB gel'). Subsequently, they were injected into the joints of five healthy horses. For 72 h after intra-articular injection, they induced a transient inflammatory response,...
van Loon JPAM, Van Dierendonck MC.Objective pain assessment is important to guide and tailor therapy in clinical practice. This study describes the clinical applicability and validity of two pain scales, the Composite Pain Scale (CPS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) in horses with orthopaedic trauma or after orthopaedic surgery. A cohort follow-up study was performed using 77 adult horses (n=43 with orthopaedic trauma or injury; n=34 controls). Composite and facial expression-based pain scores were assessed by direct observations of pairs of two independent observers. All horse...
Davidson EJ.Lameness examination is commonly performed in the athletic horse. A skilled lameness diagnostician must have keen clinical and observational skills. Evaluation starts with a detailed history and thorough physical examination. Next, gait evaluation in the moving horse is performed. Lame horses have asymmetrical body movement due to unconscious shift of body weight. Recognition of the resultant head nod and pelvic hike is the basis for lameness diagnosis. Lameness identification is enhanced by circling, limb flexions, and riding. Most lame horses do not exhibit pathognomonic gait characteristics...
Sanchez LC, Robertson SA.Currently, approaches to pain control in horses are a mixture of art and science. Recognition of overt pain behaviours, such as rolling, kicking at the abdomen, flank watching, lameness or blepharospasm, may be obvious; subtle signs of pain can include changes in facial expression or head position, location in the stall and response to palpation or human interaction. Nonsteroidal anti-inflammatory drugs (i.e. phenylbutazone, flunixin meglumine and firocoxib), opioids (i.e. butorphanol, morphine and buprenorphine) and α2 -adrenergic agonists (i.e. xylazine, detomidine, romifidine and medetomid...
Kraft CN, Pennekamp PH, Becker U, Young M, Diedrich O, Lüring C, von Falkenhausen M.Most orthopaedic problems experienced by competitive horseback riders are related to pain in the lower back, hip joint, and hamstring muscles. Riders-especially, show jumpers-are frequently hampered in their performance because of lumbar pain. To date, there has been no research into lumbar disk degeneration in elite competitive riders. Objective: Competitive horseback riding accelerates lumbar disk degeneration. Methods: Cross-sectional study; Level of evidence, 3. Methods: Fifty-eight elite riders (18 men, 40 women; mean age, 32.4 years) and a control group of 30 nonriding volunteers (17 men...
Schauvliege S, Cuypers C, Michielsen A, Gasthuys F, Gozalo-Marcilla M.To summarize the different methods used to assess sedation and/or adjust the dose or administration rate of alpha-2 agonists in horses and to propose an algorithm to adjust the administration rate of a constant rate infusion of an alpha-2 agonist in horses. Methods: PubMed and Web of Science; search terms: horse, sedation and score. Conclusions: Most authors distinguish between sedation depth, sedation quality and degree of ataxia. These three features are evaluated using scoring systems similar to those classically used to assess pain, i.e. simple descriptive scales, numerical rating scales (...
