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.
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...
Cole RC, DeGraves FJ, Brown J, Schumacher J.To compare the effect of 2.5 mL 2% mepivacaine to the effect of 0.5 mL 2% mepivacaine administered over each palmar digital nerve, as an abaxial sesamoid nerve block (ASNB), to 6 horses lame because of naturally occurring digital pain. Unassigned: In a crossover study design with 3 horses in each group, the trotting gait of the horses was analyzed with an inertial sensor-based, motion-analysis system (Q with Lameness Locator; Equinosis LLC) immediately before and after treatment with either 0.5 or 2.5 mL mepivacaine administered over each nerve near the base of the proximal sesamoid bone of th...
Hellige M, Geburek F.A number of indications exist that necessitate radiologic examination of the equine cervical spine. Different neurologic and pain-associated clinical signs within the scope of lameness or poor performance may be associated to pathologies of the cervical spine. Moreover, the number of requests for radiographic examinations of the cervical spine, for example as part of the pre-purchase examination, has increased significantly in recent years. However, the interpretation of radiographs represents a challenge, particularly in the case of clinically sound horses, as it often necessitates the resolu...
Bacon EK, Donnelly CG, Finno CJ, Haase B, Velie BD.Multimodal analgesic administration is a promising strategy for mitigating side effects typically associated with analgesia; nevertheless, variation in analgesic effectiveness still poses a considerable safety concern for both horses and veterinarians. Pharmacogenomic studies have started delving into genetic influences on varying drug effectiveness and related side effects. However, current findings have narrow implications and are limited in their ability to individualize analgesic dosages in horses. Hydromorphone and detomidine were administered to a cohort of 48 horses at standardized time...
Bustamante R, Segura IÁ, Santiago I.Locoregional techniques promote multimodal analgesia and may reduce general anaesthetic requirements. However, there is limited evidence in foals. The rectus sheath block (RSB) is an interfascial plane block previously described in other species such as dogs, cats, pigs, and calves, and recently in foals, which targets desensitization of ventral abdominal midline. This block may provide an efficacious analgesic alternative for ventral celiotomies and umbilical surgeries. This case series reports the use of a bilateral RSB with 0.25-0.3 mL kg-1 bupivacaine (maximum dose of 2 mg kg-1) per hemiab...
Van den Branden E, Salamone M, Broothaers K, Peere S, Polfliet E, Dewulf M, Van Steenkiste G, van Loon G, Smits K, Govaere J.The use of transvaginal ultrasound-guided follicle aspiration (TVA) for oocyte collection has become a widely used procedure in horses for embryo production (IVEP). The TVA procedure is characterized by various manipulations, which are physical restraint, perineal preparation, transrectal palpation, insertion of an intravaginal device, and needle punctures. These repeated transvaginal and transovarian punctures have raised concerns about their potential effects on mare welfare. Our study aimed to investigate the effects of TVA manipulations, and especially puncturing, on pain and stress in ma...
Franzen V, Reisbeck D, Leibl Y, Schoster A, May A.While there is agreement that horses experience pain during the actual headshaking attacks, there is still a lack of research about the time between the individual episodes in this species. Objective: To evaluate the signs of pain in horses with TMHS at rest in the absence of common triggering factors. Methods: Twenty TMHS horses (not head shaking at the time of pain assessment), 20 horses with colic, and 20 clinically healthy horses. Methods: Descriptive study assessing pain in TMHS horses during the absence of clinical signs using the Horse Grimace scale (HGS). To grade the pain shown with T...
Tharwat M, Al-Sobayil F.Colic or acute abdominal pain is the most prevalent cause of emergency intervention in veterinary medicine, and it has been considered the principal reason for collapse and/or euthanasia in a wide range of studies. The condition may be initiated by a number of different disorders affecting the abdominal viscera, but acute gut disease is the most common etiology in equines showing colic symptoms. of the main goals of colic management is to distinguish between surgical and medical causes, as prompt surgical intervention can significantly improve outcomes for those requiring surgery. Despite the ...
Strugava L, Gomes ARC, Lorga AD, Bosak VL, Rossa AP, Janiszewski JDR, Machado M, Dornbusch PT, Moreno JCD.To describe anatomical references and sonoanatomy of an echo-guided injection for blocking the tibial and common fibular nerves with the use of a caudocranial midfemoral approach and to evaluate dye spreading in horse cadavers. Unassigned: 1 horse cadaver preserved in glycerin was used for the anatomical study, and 14 fresh horse cadavers were used for the dye spreading study. The experimental procedures were conducted on the first cadaver on March 25, 2021, and on the last cadaver on October 5, 2022. A glycerin-preserved horse cadaver's pelvic limb was dissected to identify anatomical landmar...
Nagy A, Dyson SJ.There is no description of comparative magnetic resonance imaging (MRI) and fan-beam computed tomography (CT) findings in the fetlock of lame sports horses. Objective: To document low-field MRI and fan-beam CT diagnoses in the lame and nonlame limbs of sports horses with fetlock region pain, and to evaluate whether combined imaging provides superior information to either technique alone. Methods: Retrospective descriptive study. Methods: Clinical records of sports horses with pain causing lameness localised to the metacarpo/metatarsophalangeal joint region that had undergone fan-beam CT and lo...
de Secondi C, Cantatore F, Marcatili M, Biggi M, Withers J, de Zani D, Zani D.Back pain is a debilitating condition hampering horses' athletic careers. Thoracic spondylosis (TS), a known cause of back pain, leads to osteophytes formation across intervertebral joints. In horses, TS is poorly reported, with anecdotal signs and response to treatment. To report clinical presentation, diagnostic imaging findings, treatment and outcome in horses with TS. The clinical records of horses diagnosed with TS between 2010 and 2023 were reviewed. Signalment, clinical and imaging findings, treatment, and outcome were analysed. Thoracic spondylosis was graded from 1 to 5. Grades, concu...
Oyaneder L, Lagos N, Dörner C.The present study was conducted to evaluate the safety and the long-lasting anesthetic properties of Neosaxitoxin (NeoSTX) when injected into the intercoccygeal space in standing horses. A group of eighteen (n = 18) healthy client-owned mature crossbreed horses were enrolled in this study. Caudal epidural injection was ascertained by two methods, the "hanging drop" technique and radiographs. Horses were allocated into three groups (n = 6) each group receiving different dosages of NeoSTX. To assess the onset of action and duration of anesthesia, six horses received 20 μg in 2 mL, six 20...
Mota-Rojas D, Whittaker AL, Coria-Avila GA, Martínez-Burnes J, Mora-Medina P, Domínguez-Oliva A, Hernández-Avalos I, Olmos-Hernández A....The growing interest in managing and recognizing pain in animals has led to the search for more sensitive methods to evaluate it, especially because some species conceal any visible changes associated with pain or are not easily assessed. Research has shown that an animal's facial expression changes when exposed to painful stimuli. Thus, developing several pain scales (grimace scales) in species such as horses, cattle, pigs, sheep, donkeys, rabbits, rats, mice, and cats has helped to improve the study of pain in veterinary medicine. The possibility of using facial expression as an indicator of...
Kemp KL, Yuen NKY, Skinner JE, Bertin FR.Phenylbutazone is prescribed to manage pain caused by hyperinsulinemia-associated laminitis. Phenylbutazone reduces glucose and insulin concentrations in horses with insulin dysregulation (ID) but the underlying mechanism of action is unknown. Objective: Investigate the effect of phenylbutazone on tissue insulin sensitivity in horses. It is hypothesized that the reduced glucose and insulin concentrations in horses with ID receiving phenylbutazone are mediated by a higher tissue insulin sensitivity. Methods: Fifteen light breed horses, including seven with ID. Methods: Randomized cross-over stu...
McCarthy RD, Ordóñez HJ, Semevolos SA.To compare core temperatures of superficial and deep digital flexor tendons (SDFT, DDFT) during application of a compression cooling system versus ice boots and during subsequent lower limb bandaging. Methods: Experimental study. Methods: Paired forelimbs of six sedated horses. Methods: Thermocouples were placed in the core of SDFT and DDFT of both front limbs of each horse. A compression cooling system was applied to one front limb and an ice boot was applied to the other front limb for 60 min and then removed for 60 min. Standing bandages were then applied to both front limbs for 60 mi...
Navarrete-Calvo R, Morgaz J, Ruíz-López P, Gómez-Villamandos RJ, Domínguez JM, Quirós-Carmona S, Granados MM.Spectral entropy and bispectral index (BIS) can differentiate between conscious and unconscious levels in horses. This study aimed to determine whether spectral entropy and BIS parameters can distinguish between different end-tidal isoflurane concentrations (EtIso, %), and whether these parameters change when a nociceptive stimulus is applied. Ten clinically healthy horses were anaesthetized using xylazine, diazepam, ketamine, and isoflurane. The following parameters were monitored: EtIso, response entropy (RE), state entropy (SE), RE-SE difference, BIS, and electromyography (EMG). Three EtIso...
Pain management in horses plays a pivotal role in the therapeutic approach to several diseases. Horses have cannabinoid receptors at the level of dorsal root ganglia, blood vessels, and synoviocytes that can be up or down- regulated by inflammatory conditions, justifying the possible efficacy of exogenous cannabinoids (i.e., phytocannabinoids) in managing several painful pathologies in this animal species. However, the current use of supplements containing cannabidiol (CBD) in equines is based on anecdotal evidence, without the support of sufficient pharmacokinetic studies. In humans, the conc...
Guo W, Li Z, Mao W, Liu X, Yang Y, Yu J, Yang H, Gao R.Flunixin meglumine (FM) is commonly used in painful conditions in horses; however, it may contribute to equine gastric ulcer syndrome (EGUS). Some veterinarians combine omeprazole (OME) and FM to reduce EGUS risk. However, the efficacy and safety of this combination in Mongolian horses with chronic lameness remain unknown. Objective: To investigate the changes in lameness and EGUS scores in Mongolian horses through the comparison of three treatment strategies: FM, FM + OME and placebo treated control (CON) and to assess the effects of these treatments on gastric fluid pH, serum total prote...
Guzmán JFC, Gontijo AS, Melgaço ES, Faria SA, Baldi MLC, Sousa LN, Wenceslau RR, Fantini P, Xavier ABDS, Beier SL.Morphine has significant clinical and analgesic effects in horses, but its impact on the gastrointestinal tract requires further understanding. This study assessed the analgesic and gastrointestinal effects of morphine in horses undergoing elective orchiectomy in the quadrupedal position. Thirty uncastrated male horses were randomly assigned to three groups: orchiectomy without morphine and sedation protocol (OSM), orchiectomy with morphine and sedation protocol (OM), and administration of morphine alone in the absence of orchiectomy (M). The anesthetic protocol involved acepromazine (0.05 mg/...
Perrone G, Giampaoli C, Smirnoff AL, Ochoa A, Pareja R, De Simone E.Osteoarthritis (OA) is the most common pathology in sport horses, presenting a chronic and recurrent course. Traditional anti-inflammatory treatments provide only temporary clinical improvement and pain relief; however, they have been associated with metabolic disorders in articular cartilage in the medium term. In this study, we generated a llama polyclonal antibody against equine TNF-α, which was used for intra-articular treatment in horses with OA. Treatment effects were assessed through clinical examination and the determination of inflammatory parameters (MMP-2, MMP-9, LDH, and GAGs) in ...
Lundblad J, Rhodin M, Hernlund E, Bjarnestig H, Hidén Rudander S, Haubro Andersen P.Facial expressions in prey animals such as equines can convey information regarding their internal state and are therefore often used as cues for welfare and pain evaluation. The state of pain is commonly compared to a neutral state with little consideration given to other experiences that could affect the animal, although this situation is rare outside of experimental contexts. To evaluate the effect of managerial contexts on facial expressions from a nociceptive input, conspecific isolation and sedation with known physiological effects were compared to compound states of nociception. Using a...
King MR, Colla S.Successful rehabilitation of muscle injury requires a comprehensive understanding of the injury process, healing phases, and resources to be employed. The initial phase is characterized by acute inflammatory signs, followed by the regenerative and remodeling phases. Therapeutic exercises can be utilized in all 3 phases, progressing from isometric exercises to aquatic therapies. The classification and phase of injury and the individual response to the applied therapies will guide the progression of the therapeutic exercises through the rehabilitation program.
van Loon JPAM, Trindade PHE, da Silva GV, Keus J, Huberts C, de Grauw JC, Lanci A.Pain assessment based on facial expressions has been described in foals. Objective: To extend previous pilot findings of the Equine Utrecht University Scale for Facial Assessment of Pain in Foals (EQUUS-FAP FOAL). Methods: Prospective blinded case-control study (known groups analysis). Methods: Video recordings (30-60 s) of n = 100 foals (38 patients and 62 controls) were collected. Videos were randomised and scored by two observers, blinded for the condition of the animals. Inter- and intra-observer agreement was tested by Intra Class Correlation (ICC) analysis. Differences between pati...
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 (...
