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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.
Pharmacokinetics and pharmacodynamics of intra-articular isoflupredone following administration to horses with lipopolysaccharide-induced synovitis.
BMC veterinary research    December 13, 2022   Volume 18, Issue 1 436 doi: 10.1186/s12917-022-03537-5
Knych HK, Weiner D, Harrison L, McKemie DS.Intra-articular corticosteroids, such as isoflupredone acetate, are commonly used in the treatment of joint inflammation, especially in performance horses. Following administration in a non-inflamed joints blood concentrations of isoflupredone were low and detectable for only a short period of time post-administration compared to synovial fluid concentrations. For some drugs, inflammation can affect pharmacokinetics, therefore, the goal of the current study was to describe the pharmacokinetics of isoflupredone acetate following intra-articular administration using a model of acute synovitis. S...
Lymphomatosis as a Cause of Abdominal Pain and Distension in Two Adult Horses.
Journal of equine veterinary science    December 9, 2022   Volume 120 104193 doi: 10.1016/j.jevs.2022.104193
Perry LR, Butler AJ, John E, Martinson S, Buote M, Foote K, Burton S, Stoughton WB.Two equine patients presented separately with severe abdominal distention, colic, lethargy, and decreased appetite. An ante-mortem diagnosis of lymphoma was reached in each case based on peritoneal fluid cytology. Due to a poor prognosis, the horses were humanely euthanized. Post-mortem examination with histology and immunohistochemistry confirmed both cases as lymphoma: alimentary B-cell lymphoma of the distal jejunum and cecum in one case, and T-cell lymphoma of the cecum in the second case. Both cases exhibited extensive metastasis with peritoneal and pleural serosae covered in small nodule...
Agmatine Administration Effects on Equine Gastric Ulceration and Lameness.
Journal of clinical medicine    December 8, 2022   Volume 11, Issue 24 doi: 10.3390/jcm11247283
Taguchi T, Morales Yniguez FJ, Takawira C, Andrews FM, Lopez MJ.Osteoarthritis (OA) accounts for up to 60% of equine lameness. Agmatine, a decarboxylated arginine, may be a viable option for OA management, based on reports of its analgesic properties. Six adult thoroughbred horses, with lameness attributable to thoracic limb OA, received either daily oral phenylbutazone (6.6 mg/kg), agmatine sulfate (25 mg/kg) or a control for 30 days, with 21-day washout periods between treatments. Subjective lameness, thoracic limb ground reaction forces (GRF), plasma agmatine and agmatine metabolite levels were evaluated using an established rubric, a force platform, an...
TLR-activated mesenchymal stromal cell therapy and antibiotics to treat multi-drug resistant Staphylococcal septic arthritis in an equine model.
Annals of translational medicine    December 6, 2022   Volume 10, Issue 21 1157 doi: 10.21037/atm-22-1746
Pezzanite LM, Chow L, Phillips J, Griffenhagen GM, Moore AR, Schaer TP, Engiles JB, Werpy N, Gilbertie J, Schnabel LV, Antczak D, Miller D, Dow S....Rapid development of antibiotic resistance necessitates advancement of novel therapeutic strategies to treat infection. Mesenchymal stromal cells (MSC) possess antimicrobial and immunomodulatory properties, mediated through antimicrobial peptide secretion and recruitment of innate immune cells including neutrophils and monocytes. TLR-3 activation of human, canine and equine MSC has been shown to enhance bacterial killing and clearance in vitro, in rodent Staphylococcal biofilm infection models and dogs with spontaneous multi-drug-resistant infections. The objective of this study was to determi...
A Case Series of 11 Horses Diagnosed with Bone Spavin Treated with High Intensity Laser Therapy (HILT).
Journal of equine veterinary science    December 2, 2022   Volume 120 104188 doi: 10.1016/j.jevs.2022.104188
Zielińska P, Śniegucka K, Kiełbowicz Z.The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 month...
Intratesticular Versus Intrafunicular Lidocaine to Reduce Perioperative Nociception and Immunological Response in Ponies Undergoing Field Castration.
Veterinary sciences    November 28, 2022   Volume 9, Issue 12 664 doi: 10.3390/vetsci9120664
Vullo C, Crupi R, Di Paola R, Cuzzocrea S, Gugliandolo E, Biondi V, Catone G.The aim of this study was to evaluate the impact of intratesticular or intrafunicular lidocaine to reduce perioperative nociception and cytokine release in ponies undergoing field castration under total intravenous anaesthesia. Before castration, one group was injected with intrafunicular (FL) lidocaine and the other received intratesticular (TL) lidocaine. All ponies were premedicated with acepromazine (0.05 mg/kg) intramuscularly. Twenty minutes after the administration of acepromazine, xylazine (1 mg/kg) and butorphanol (0.02 mg/kg) were administered intravenously. Lidocaine 2% was given 1 ...
Acupuncture in Zoological Companion Animals.
The veterinary clinics of North America. Exotic animal practice    November 20, 2022   Volume 26, Issue 1 257-280 doi: 10.1016/j.cvex.2022.07.008
Koh RB, Harrison TM.Over the past years, the concept of pain management in veterinary medicine has evolved and led to the establishment of a new concept of multimodal approach to pain management, as the current standard of care. The use of multimodal analgesia combining pharmacologic and nonpharmacologic techniques not only helps optimize the quality and efficacy of analgesia but also may prevent the development of chronic or persistent pain. During the past decade, acupuncture has become more popular and evolved into one of the most used forms of integrative medicine interventions and nonpharmacologic therapeuti...
Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Extracorporeal Shockwave Therapy.
Animals : an open access journal from MDPI    November 12, 2022   Volume 12, Issue 22 doi: 10.3390/ani12223124
Boström A, Bergh A, Hyytiäinen H, Asplund K.Extracorporeal shockwave therapy (ECSWT) is increasingly used to treat different types of musculoskeletal conditions in sport and companion animals. To explore the scientific basis for the treatment, we conducted a systematic review of the literature on ECSWT used in horses, dogs, and cats. Methods: Relevant articles published in 1980-2020 were identified from three major databases. Each article was assessed for risk of bias. Results: The review identified 27 relevant articles on the effects of ECSWT in horses, nine in dogs, but none in cats. Typically, ECSWT involved one to three treatment se...
Equine shock wave therapy – where are we now?
Equine veterinary journal    October 28, 2022   Volume 55, Issue 4 593-606 doi: 10.1111/evj.13890
Johnson SA, Richards RB, Frisbie DD, Esselman AM, McClure SR.Over the past three decades, electrohydraulic extracorporeal shock wave therapy (ESWT) as a treatment modality for equine orthopaedic disorders has sparked exponential interest among practitioners, but its clinical applications are quickly evolving and a current review highlighting modernised equine clinical use is lacking. The objective of this review is to summarise the most current ESWT technology, evidence for its use, proposed mechanisms of action and clinical applications in horses while also highlighting the areas requiring further investigation. The three ways to generate a shock wave ...
Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes.
Frontiers in veterinary science    October 28, 2022   Volume 9 995299 doi: 10.3389/fvets.2022.995299
Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K.The placement of caudal epidural catheters in horses has become more frequent as a multi-modal analgesic strategy. Despite its integration into clinical practice, there are limited reports describing the use of caudal epidural catheterization for prolonged use in horses. The purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes. Medical records of hospitalized equine patients that underwent pla...
Non-Steroidal Anti-Inflammatory Drugs and Associated Toxicities in Horses.
Animals : an open access journal from MDPI    October 26, 2022   Volume 12, Issue 21 doi: 10.3390/ani12212939
Flood J, Stewart AJ.Effective pain management in horses can be a challenge despite the understanding that appropriate analgesia improves animal welfare and increases treatment success. The administration of NSAID drugs, particularly phenylbutazone and flunixin, are common practice in equine veterinary patients. Known for their analgesic and anti-inflammatory properties, NSAIDs are used for the treatment of a variety of conditions in horses, from gastrointestinal to orthopedic pain. Despite extensive usage, NSAIDs have a narrow margin of safety and the body of literature documenting the efficacy and side effects o...
Intra-articular 2.5% polyacrylamide hydrogel, a new concept in the medication of equine osteoarthritis: A review.
Journal of equine veterinary science    October 20, 2022   Volume 119 104143 doi: 10.1016/j.jevs.2022.104143
Tnibar A.Recent clinical and experimental trials have demonstrated that intra-articular 2.5% Polyacrylamide hydrogel (PAAG) is highly effective (82.5% free of lameness horses at 2 year follow-up), lasting and safe for the treatment of equine osteoarthritis (OA). Over the last decade, intra-articular 2.5% PAAG has shown to be a potent and promising drug in the medication of OA in horses, as no other single medical treatment for OA has such prolonged efficacy. Most of these studies were presenting some limitations. Preliminary observations on the mechanisms of action of intra-articular 2.5% PAAG support ...
The Effect of Chiropractic Treatment on Limb Lameness and Concurrent Axial Skeleton Pain and Dysfunction in Horses.
Animals : an open access journal from MDPI    October 19, 2022   Volume 12, Issue 20 doi: 10.3390/ani12202845
Maldonado MD, Parkinson SD, Story MR, Haussler KK.Chiropractic care is a common treatment modality used in equine practice to manage back pain and stiffness but has limited evidence for treating lameness. The objective of this blinded, controlled clinical trial was to evaluate the effect of chiropractic treatment on chronic lameness and concurrent axial skeleton pain and dysfunction. Two groups of horses with multiple limb lameness (polo) or isolated hind limb lameness (Quarter Horses) were enrolled. Outcome measures included subjective and objective measures of lameness, spinal pain and stiffness, epaxial muscle hypertonicity, and mechanical...
Occurrence and Definitions of Intra and Postoperative Complications Related to Laparoscopy in Equids: A Scoping Review.
Veterinary sciences    October 17, 2022   Volume 9, Issue 10 577 doi: 10.3390/vetsci9100577
Cerullo A, Gandini M, Giusto G.Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scien...
Rehabilitation: Proprioception, Incoordination, and Paresis.
The Veterinary clinics of North America. Equine practice    October 14, 2022   Volume 38, Issue 3 557-568 doi: 10.1016/j.cveq.2022.06.010
King MR.Physiotherapeutic exercises aimed at stimulating motor control, flexibility, and stability are regularly employed in human physical therapy programs. Specifically, the use of such exercises has been shown to reduce both pain and reinjury. Pursuant to the equine patient, several core strengthening exercises and their role in activating deep epaxial musculature to subsequently improve postural motor control and alter thoracolumbar kinematics have been investigated. Both baited and passive exercises offer opportunities to facilitate stretching during dynamic phases and strengthening during static...
Clinical Application of Acupuncture in Equine Practice.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 525-539 doi: 10.1016/j.cveq.2022.07.001
Repac J, Mangan E, Xie H.Acupuncture is an inexpensive nonpharmacological modality that has a variety of musculoskeletal, neurologic, and internal medicine applications for the equine practitioner. Common uses include back pain colic, laminitis, laryngeal hemiplegia, and suprascapular neuropathy. Although there is a growing body of literature supporting the use of acupuncture in equids, there remains a need for further robust, double-blinded, placebo-controlled clinical efficacy trials.
Integrative Approach to Neck Pain and Dysfunction.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 485-492 doi: 10.1016/j.cveq.2022.06.006
Story MR.Equine cervical pain and dysfunction may be difficult to diagnose and effectively manage. Understanding techniques in integrative medicine often allows the practitioner to observe and palpate areas of pain and dysfunction in the horse being evaluated in ways often not taught or used in conventional medicine. There are many integrative therapies that also may be utilized to more effectively manage these horses, resulting in a more comfortable and functional horse.
Spinal Mobilization and Manipulation in Horses.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 509-523 doi: 10.1016/j.cveq.2022.06.008
Haussler KK, Holt TN.There is a growing body of evidence to support the use of spinal mobilization and manipulation techniques in equine practice. Outcome parameters reported across studies include measures of joint motion, nociception, muscle tone, and performance. Spinal examination procedures include static and dynamic assessments of the quantity and the quality of both active and passive movements. Tiered treatment approaches are recommended to stage the application of various therapies based on ease, cost, and efficacy.
Clinical Application of Myofascial Therapy in Horses.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 493-507 doi: 10.1016/j.cveq.2022.06.007
Luomala T.Fascia is a complex and intriguing tissue, which can take on structural properties of being loose or dense, irregular or regular. Fascia functions by connecting, separating, and uniting different structures of the body. Myofascial dysfunction can be a significant source of pain and can be categorized as densification, adhesion, and fibrosis. Digital palpation and treatment of myofascial disorders can be provided via superficial or deep techniques. Different myofascial treatment techniques include slow and fast techniques, which can be applied at different depths, angles, and rhythms.
Integrative Philosophy: Case Management.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 455-461 doi: 10.1016/j.cveq.2022.06.004
Adair S.This article serves as an introduction into integrative case management as it applies to the horse's mental health, pain management, and tissue healing. The integrative philosophy pertains to the combination of conventional Western medicine and complementary and alternative therapies to provide the best patient care possible using currently available evidence. The goal is to improve the health of the patient in a more holistic manner.
Preventative Care: Managing the Geriatric Horse with Integrative Therapies.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 475-483 doi: 10.1016/j.cveq.2022.06.005
Boldt E.Horses 15 years of age and older now account for a significant portion of the equine population. Integrative therapies can provide important diagnostic and treatment tools for managing and maintaining the health of geriatric horses. Aged horses are often afflicted with chronic disease processes that are difficult to effectively manage with conventional medicinal approaches, such as laminitis and osteoarthritis. Diagnostic and therapeutic approaches using integrative therapies, such as acupuncture and spinal manipulation, are presented in this article for managing aged horses with metabolic dis...
Therapeutic Exercises for Equine Sacroiliac Joint Pain and Dysfunction.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 569-584 doi: 10.1016/j.cveq.2022.07.002
Goff L.This article provides the equine practitioner with a review of sacroiliac joint pain and dysfunction and outlines the importance of providing a specific prescription for a safe and effective therapeutic exercise program. The continuum of clinical dysfunction associated with the sacroiliac region is presented with prescribed interventions. The intent is to encourage the practitioner to perform a thorough assessment of the sacroiliac joint and the adjacent soft tissues and to use sound clinical reasoning to formulate a therapeutic exercise plan.
Changes in Head, Withers, and Pelvis Movement Asymmetry in Lame Horses as a Function of Diagnostic Anesthesia Outcome, Surface and Direction.
Journal of equine veterinary science    October 6, 2022   Volume 118 104136 doi: 10.1016/j.jevs.2022.104136
Marunova E, Hoenecke K, Fiske-Jackson A, Smith RKW, Bolt DM, Perrier M, Gerdes C, Hernlund E, Rhodin M, Pfau T.Evaluation of diagnostic anesthesia during equine lameness examination requires comparison of complex movement patterns and can be influenced by expectation bias. There is limited research about how changes in movement asymmetries after successful analgesia are affected by different exercise conditions. Movement asymmetry of head, withers and pelvis was quantified in N = 31 horses undergoing forelimb or hindlimb diagnostic anesthesia. Evaluation on a straight line and a circle was performed with subjective diagnostic anesthesia outcome and quantitative changes recorded. Mixed linear mode...
Changes in Perioperative Antimicrobial and Anti-Inflammatory Drugs Regimens for Colic Surgery in Horses: A Single Center Report.
Veterinary sciences    October 4, 2022   Volume 9, Issue 10 546 doi: 10.3390/vetsci9100546
Gandini M, Cerullo A, Franci P, Giusto G.Reducing postoperative incisional infection is the main reason to administer postoperative antimicrobials (AMD) after emergency laparotomy in horses, while reducing inflammation and providing analgesia are the reasons to administer anti-inflammatory drugs (AID). The basis for postoperative AMD and AID administration is empirical and only recently has been questioned. Empirical approaches can be changed, and these changes, along with the description of their outcomes, can help produce appropriate stewardship. The aim of this study is to report the changes in AMD and AID regimens in horses under...
Optical photothermal infrared spectroscopy can differentiate equine osteoarthritic plasma extracellular vesicles from healthy controls.
Analytical methods : advancing methods and applications    September 29, 2022   Volume 14, Issue 37 3661-3670 doi: 10.1039/d2ay00779g
Clarke EJ, Lima C, Anderson JR, Castanheira C, Beckett A, James V, Hyett J, Goodacre R, Peffers MJ.Equine osteoarthritis is a chronic degenerative disease of the articular joint, characterised by cartilage degradation resulting in pain and reduced mobility and thus is a prominent equine welfare concern. Diagnosis is usually at a late stage through clinical examination and radiographic imaging, whilst treatment is symptomatic not curative. Extracellular vesicles are nanoparticles that are involved in intercellular communication. The objective of this study was to investigate the feasibility of Raman and Optical Photothermal Infrared Spectroscopies to detect osteoarthritis using plasma-derive...
Anti-nociceptive efficacy of the soluble epoxide hydrolase inhibitor t-TUCB in horses with mechanically induced lameness.
Research in veterinary science    September 22, 2022   Volume 152 504-509 doi: 10.1016/j.rvsc.2022.09.017
Carlson A, Johnson PJ, Lei Z, Keegan KG.Soluble epoxide hydrolase (sEH) inhibitors are novel anti-inflammatory and analgesic agents that could improve pain management in horses. The objective of the present study was to evaluate the anti-nociceptive effect of a single-dose intravenous administration of the sEH inhibitor trans-4-{4-[3-(4-trifluro-methoxy-phenyl)-ureido]-cyclohexyloxy}-benzoic acid (t-TUCB) using an adjustable heart bar shoe (a-HBS) model of lameness. We hypothesized that t-TUCB would improve objective and subjective lameness measures compared to the control. Methods: Reversible lameness was induced in 8 horses for 24...
Bilateral Change in Vertical Hoof Force Distribution in Horses with Unilateral Forelimb Lameness before and after Successful Diagnostic Anaesthesia.
Animals : an open access journal from MDPI    September 19, 2022   Volume 12, Issue 18 2485 doi: 10.3390/ani12182485
Hoffmann JR, Geburek F, Hagen J, Büttner K, Cruz AM, Röcken M.Kinetic examinations of horses with induced lameness as well as the effect of perineural anaesthesia in sound horses have shown promise, but clinical studies regarding the effect of diagnostic anaesthesia during the different stance phases are rare. Fourteen horses with unilateral forelimb lameness were examined with the Hoof™ System during trot to assess vertical force distribution (in kg) affecting both front hooves before and after diagnostic anaesthesia during landing, midstance, and breakover. For statistical analysis, a covariance analysis with repeated measurements regarding the limb ...
Facial Expressions of Horses Using Weighted Multivariate Statistics for Assessment of Subtle Local Pain Induced by Polylactide-Based Polymers Implanted Subcutaneously.
Animals : an open access journal from MDPI    September 13, 2022   Volume 12, Issue 18 2400 doi: 10.3390/ani12182400
Carvalho JRG, Trindade PHE, Conde G, Antonioli ML, Funnicelli MIG, Dias PP, Canola PA, Chinelatto MA, Ferraz GC.Facial-expression-based analysis has been widely applied as a pain coding system in horses. Herein, we aimed to identify pain in horses undergoing subcutaneously polylactide-based polymer implantation. The sham group was submitted only to surgical incision. The horses were filmed before and 24 and 48 h after implantation. Five statistical methods for evaluating their facial expressions (FEs) were tested. Primarily, three levels of scores (0, 1, and 2) were applied to the seven FEs (ear movements, eyebrow tension, orbicularis tension, dilated nostrils, eye opening, muzzle tension, and masticato...
CT measures of osseous cervicothoracic intervertebral foramina are repeatable and associated with CT measures of adjacent articular processes in horses. Rovel T, Duchateau L, Saunders J, Vandenberghe F, Vanderperren K.Narrowing of the equine cervicothoracic intervertebral foramina (IF) has the potential to cause forelimb lameness and/or neck pain although limited information is available on CT of the IF. The aims of this retrospective, analytical study were to describe a protocol for quantifying CT cervicothoracic IF size; evaluate the repeatability of IF size measures; test associations between IF size and adjacent articular process (AP) size, ventral extent, and anatomic location; and determine the proportion of IF with narrowing. Computed tomographic images were acquired in 20 Warmblood horses that prese...
Plasma atropine concentrations associated with decreased intestinal motility in horses.
Frontiers in veterinary science    September 2, 2022   Volume 9 951300 doi: 10.3389/fvets.2022.951300
Ekstrand C, Michanek P, Gehring R, Sundell A, Källse A, Hedeland M, Ström L.Atropine is an essential part of the treatment protocol for equine uveitis. Topical atropine administration has been associated with decreased intestinal motility and abdominal pain in horses. Experimental studies have indicated that frequent dosing is associated with a higher risk than dosing every 6 h. Unfortunately, no quantitative pharmacodynamic data for inhibition of the equine gut are published. Unassigned: Eight standardbred horses were assigned to receive either atropine or saline (control) to be infused over 30 min in a two-treatment cross-over design. Atropine concentrations in plas...