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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.
Gas-Filled Intradural Cyst within the Cauda Equine.
Journal of Korean Neurosurgical Society    March 31, 2011   Volume 49, Issue 3 182-185 doi: 10.3340/jkns.2011.49.3.182
Cho HL, Lee SH, Kim JS.A case of radicular pain that resulted from a gas-filled intradural cyst in an 80-year-old male is described. Temporary improvement of radicular pain was observed after CT-guided aspiration. However, recurrent radicular pain led to surgical treatment. In this report, the authors document the radiologic and intraoperative features of a gas-filled intradural cyst that migrated into the nerve root, and propose an optimal treatment plan based on a review of the literature.
Assessment of the sedative effects of buprenorphine administered with 10 μg/kg detomidine in horses.
The Veterinary record    March 31, 2011   Volume 168, Issue 14 379 doi: 10.1136/vr.c7288
Love EJ, Taylor PM, Murrell J, Whay HR, Waterman-Pearson AE.The aim of this randomised, observer-blinded, crossover study was to compare the effects of six treatments, administered intravenously to six horses: saline and saline (S/S); detomidine and saline (D/S); detomidine and 5 µg/kg buprenorphine (D/B5); detomidine and 7.5 µg/kg buprenorphine (D/B7.5); detomidine and 10 µg/kg buprenorphine (D/B10); and detomidine and 25 µg/kg butorphanol (D/BUT). The detomidine dose was 10 µg/kg for all treatments in which it was included. Sedation was subjectively assessed and recorded on a visual analogue scale. Peak sedation, duration of sedation and the are...
Intra-articular injection of morphine to the horse: establishment of an in vitro-in vivo relationship.
Drug development and industrial pharmacy    March 21, 2011   Volume 37, Issue 9 1043-1048 doi: 10.3109/03639045.2011.559245
Frost AB, Lindegaard C, Larsen F, Østergaard J, Larsen SW, Larsen C.In the area of parenteral depots, a strong need exists for the development of suitable in vitro drug release models that might enable establishment of in vitro-in vivo relations (IVIVRs). Objective: The objective of this study was to investigate the possibility of establishing an IVIVR between morphine disappearance from the joint cavity and in vitro release data obtained employing the rotating dialysis cell model. Methods: In vitro release experiments were conducted using the rotating dialysis cell model. For establishment of an IVIVR, data from a previous study on pharmacokinetics of intra-a...
Technical note: a 2-stage cecal cannulation technique in standing horses.
Journal of animal science    March 18, 2011   Volume 89, Issue 8 2425-2429 doi: 10.2527/jas.2010-3718
Beard WL, Slough TL, Gunkel CD.Cecal cannulation is necessary for sampling of intestinal contents for a variety of nutritional or digestive physiology studies. This report describes a 2-stage technique for permanent cecal cannulation in standing horses. For the first procedure, a right flank laparotomy is performed and a small pouch of the cecal base exteriorized and sutured to the body wall. The second procedure is performed approximately 1 wk later. During the second procedure, the exposed cecal pouch is removed and the cannula inserted. Ten horses were cannulated using this technique. After the first procedure, 1 horse d...
Dynamic mobilisation exercises increase cross sectional area of musculus multifidus.
Equine veterinary journal    March 15, 2011   Volume 43, Issue 5 522-529 doi: 10.1111/j.2042-3306.2010.00322.x
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...
Analysis of gabapentin in equine plasma with measurement uncertainty estimation by liquid chromatography-tandem mass spectrometry.
Journal of analytical toxicology    March 15, 2011   Volume 35, Issue 2 75-84 doi: 10.1093/anatox/35.2.75
Liu Y, Uboh CE, Soma LR, Li X, Guan F, You Y, Rudy JA, Chen JW.Gabapentin (GPT) is an antiepileptic drug that was approved in 1993 for use in the management of neurotrophic pain and as an adjunctive therapy for refractory partial seizure in humans. It is also being tested in veterinary medicine as an adjunctive medication in the treatment of pain due to laminitis, neuropathic, or chronic pain. Gabapentin is readily available by prescription and even on the internet; therefore, it has the potential of being used in racehorses to mask pain. It is for this reason that a sensitive liquid chromatography-tandem mass spectrometry method has now been developed fo...
Hypothalamic-pituitary gland axis function and dysfunction in horses.
The Veterinary clinics of North America. Equine practice    March 12, 2011   Volume 27, Issue 1 1-17 doi: 10.1016/j.cveq.2010.12.006
Hurcombe SD.Hypothalamic-pituitary (HP) dysfunction has been documented in a limited capacity in horses and foals associated with critical illness, stress, and pain. This article reviews species-specific details of anatomy, function, hormones, receptors, and testing of the HP axis in the horse. A discussion of critical care medicine relevant to HP dysfunction in the horse with some reference to current understanding in human medicine is made, focusing primarily on current and relevant literature. A brief mention of other conditions described in human and veterinary medicine is also provided for reference ...
Ultrasonographic findings in horses with foot pain but without radiographically detectable osseous abnormalities. Rabba S, Bolen G, Verwilghen D, Salciccia A, Busoni V.Foot pain is an important cause of lameness in horses. When horses with foot pain have no detectable radiographic abnormalities, soft-tissue assessment remains a diagnostic challenge without magnetic resonance (MR) imaging. Ultrasonography can provide an alternative to MR imaging when that modality is not available but the extent of changes that might be seen has not been characterized. We reviewed the ultrasonographic findings in 39 horses with lameness responding positively to anesthesia of the palmar digital nerves and without radiographically detectable osseous abnormalities. Thirty of the...
Comparison of ketamine and alfaxalone for induction and maintenance of anaesthesia in ponies undergoing castration.
Veterinary anaesthesia and analgesia    January 11, 2011   Volume 38, Issue 1 37-43 doi: 10.1111/j.1467-2995.2010.00584.x
Klöppel H, Leece EA.To compare alfaxalone with ketamine for total intravenous anaesthesia in ponies undergoing castration. Methods: Prospective, randomised, blinded clinical study. Methods: Forty-two, 12-month-old Welsh Mountain ponies. Methods: Ponies were assigned randomly to receive ketamine or alfaxalone. After administration of romifidine 100 μg kg(-1) and butorphanol 50 μg kg(-1) intravenously (IV), sedation and response to tactile stimulation were scored. If sedation was insufficient, romifidine 30 μg kg(-1) was administered IV. Anaesthesia was induced with ketamine 2.2 mg kg(-1) or alfaxalone 1 mg kg(-...
Thermal and mechanical nociceptive threshold testing in horses: a review.
Veterinary anaesthesia and analgesia    January 11, 2011   Volume 38, Issue 1 3-14 doi: 10.1111/j.1467-2995.2010.00580.x
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...
Core decompression of the equine navicular bone: an in vivo study in healthy horses.
Veterinary surgery : VS    January 11, 2011   Volume 40, Issue 2 151-162 doi: 10.1111/j.1532-950X.2010.00765.x
Jenner F, Kirker-Head C.To determine the physiologic response of the equine navicular bone to core decompression surgery in healthy horses. Methods: Experimental in vivo study. Methods: Healthy adult horses (n=6). Methods: Core decompression was completed by creating three 2.5-mm-diameter drill channels into the navicular bone under arthroscopic control. The venous (P(V)), arterial (P(A)), articular (P(DIPJ)), and intraosseous pressures (IOP) were recorded before and after decompression drilling. Each IOP measurement consisted of a baseline (IOP(B)) and a stress test (intramedullary injection of saline solution, IOP(...
Sensory nerve conduction and nociception in the equine lower forelimb during perineural bupivacaine infusion along the palmar nerves.
Canadian journal of veterinary research = Revue canadienne de recherche veterinaire    January 5, 2011   Volume 74, Issue 4 305-313 
Zarucco L, Driessen B, Scandella M, Cozzi F, Cantile C.The purpose of this investigation was to study lateral palmar nerve (LPN) and medial palmar nerve (MPN) morphology and determine nociception and sensory nerve conduction velocity (SNCV) following placement of continuous peripheral nerve block (CPNB) catheters along LPN and MPN with subsequent bupivacaine (BUP) infusion. Myelinated nerve fiber distribution in LPN and MPN was examined after harvesting nerve specimens in 3 anesthetized horses and processing them for morphometric analysis. In 5 sedated horses, CPNB catheters were placed along each PN in both forelimbs. Horses then received in one ...
Transient cauda equina syndrome related to a sacral schwannoma with cauda equine compression after a lumbar epidural block -A case report-.
Korean journal of anesthesiology    December 31, 2010   Volume 59 Suppl, Issue Suppl S222-S225 doi: 10.4097/kjae.2010.59.S.S222
Kim HT, Gim TJ, Lee JH.A 53-year-old man had chronic low back and leg pain for four years without any history of trauma or neurological manifestations. There was a reduction in symptoms after a lumbar epidural block. Two hours later after the procedure, the patient complained of perineal numbness and lower extremity weakness. The neurological evaluation revealed loss of sensation in the saddle area and the posterior aspect of the leg. The deep-tendon reflexes were decreased in the leg. The patient was unable to urinate. The MRI revealed a schwannoma at the S3 level of the sacral spine with cauda equina compression. ...
Quantitative assessment of increased sensitivity of chronic laminitic horses to hoof tester evoked pain.
Equine veterinary journal    December 15, 2010   Volume 43, Issue 1 62-68 doi: 10.1111/j.2042-3306.2010.00137.x
Viñuela-Fernandez I, Jones E, McKendrick IJ, Molony V.To evaluate quantitative sensory testing (QST) of the feet of laminitic horses using a power-assisted hoof tester. Objective: Hoof Compression Thresholds (HCTs) can be measured reliably and are consistently lower in horses with chronic laminitis than in normal horses. Methods: HCTs of chronic laminitic (n=7) and normal horses (n=7) were repeatedly measured using a hydraulically powered and feedback controlled hoof tester. Data from 2 tests, at 3 sites in both forefeet, during 3 sessions were collected and statistically analysed using linear mixed models. Results: The mean±s.e. HCT for the lam...
Recognition of pain and use of analgesia in horses by veterinarians in New Zealand.
New Zealand veterinary journal    December 15, 2010   Volume 58, Issue 6 274-280 doi: 10.1080/00480169.2010.69402
Waran N, Williams VM, Clarke N, Bridge IS.To explore attitudes towards and use of analgesia in horses by veterinarians in New Zealand. Methods: A postal questionnaire was sent out to 457 veterinarians identified as working with horses in New Zealand. Questions covered demographics and practice data; analgesic drugs available for use and used in practice; analgesic management of specific conditions including assessment of pain, drugs used, and frequency of cases; factors influencing the choice and use of analgesic agents; and attitudes and personal experience. Results: Ninety-seven questionnaires containing useable data were received, ...
Determination of firocoxib in equine plasma using high performance liquid chromatography.
Journal of chromatography. B, Analytical technologies in the biomedical and life sciences    December 3, 2010   Volume 879, Issue 2 205-208 doi: 10.1016/j.jchromb.2010.11.026
Cox S, Yarbrough J.A new method of analysis has been developed and validated for the determination of firocoxib, a new nonsteroidal anti-inflammatory drug (NSAID) approved for use in horses and dogs to control pain and inflammation associated with osteoarthritis. Following a liquid extraction using ethyl acetate:hexane (40:60), samples were separated by isocratic reversed-phase HPLC on a Sunfire C(18) column and quantified using UV detection at 290 nm. The mobile phase was a mixture of water with 0.025% trifluoroacetic acid and acetonitrile, with a flow-rate of 1.1 ml/min. The procedure produced a linear curve o...
Genomic structure, polymorphism and expression of ACCN1 and ACCN3 genes in the horse.
Animal genetics    November 26, 2010   Volume 41 Suppl 2 138-144 doi: 10.1111/j.1365-2052.2010.02123.x
Mata X, Ducasse A, Vaiman A, Diribarne M, Fraud AS, Guérin G.A category of cation gate proteins was shown to be present in sensory neurons and act as receptors of protons present in tissues such as muscles. The Amiloride-sensitive Cation Channel, Neuronal (ACCN) gene family is known to play a role in the transmission of pain through specialized pH sensitive neurons. Muscles from horses submitted to strenuous exercises produce lactic acid, which may induce variable pain through ACCN differential properties. The sequences of the equine cDNAs were determined to be 2.6 kb in length with an open reading frame of 1539 bp for ACCN1 and 2.1 kb in length with an...
The fine line between pressure and pain: ask the horse.
Veterinary journal (London, England : 1997)    November 19, 2010   Volume 188, Issue 3 250-251 doi: 10.1016/j.tvjl.2010.10.011
McGreevy PD.No abstract available
Preface: Pain in horses: physiology, pathophysiology, and therapeutic implications.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 xi-xii doi: 10.1016/j.cveq.2010.08.003
Muir WW.No abstract available
Treatment of visceral pain in horses.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 603-617 doi: 10.1016/j.cveq.2010.08.002
Robertson SA, Sanchez LC.Identification and alleviation of visceral pain is a frequent concern for the equine owner and veterinarian. This article discusses sources, methods for identification and quantitation, and options for treatment of visceral pain in horses.
Opioid analgesia in horses.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 493-514 doi: 10.1016/j.cveq.2010.07.002
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...
NMDA receptor antagonists and pain: ketamine.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 565-578 doi: 10.1016/j.cveq.2010.07.009
Muir WW.N-Methyl-D-aspartate (NMDA) is a synthetic chemical binding molecule (ligand) that selectively binds to the "slow response" glutamate NMDA receptor (NMDAR). NMDARs are important for normal brain function and play a central role in learning, memory, and the development of central nervous system hyperactive states. Diverse chemicals belonging to various drug families have demonstrated NMDAR antagonistic effects. Ketamine has been shown to produce antihyperalgesic effects produced by incision and tissue or nerve damage, and has become popular in equine practice as an anesthetic and more recently ...
Effects of stress on pain in horses and incorporating pain scales for equine practice.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 481-492 doi: 10.1016/j.cveq.2010.07.001
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 ...
Local anesthetics as pain therapy in horses.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 533-549 doi: 10.1016/j.cveq.2010.07.004
Doherty TJ, Seddighi MR.This article describes the rationale behind the use of systemically administered lidocaine as an analgesic. The analgesic efficacy of intravenously administered lidocaine is well documented by studies in human patients and laboratory animals. The mechanism by which systemically administered lidocaine produces analgesia is uncertain but is thought to include action at sodium, calcium, and potassium channels and the N-methyl-D-aspartate acid receptor. In addition, the anti-inflammatory actions of lidocaine are important in producing analgesia because inflammatory mediators augment neuronal excit...
Laminitic pain: parallels with pain states in humans and other species.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 643-671 doi: 10.1016/j.cveq.2010.08.001
Collins SN, Pollitt C, Wylie CE, Matiasek K.Laminitis poses a threat to all horses, and is widely considered as being one of the most important diseases of horses and a global equine welfare problem. The effects of laminitis lead to debilitation, development of pronounced digital pain, and great suffering in the afflicted animal. The precise pathophysiological processes that result in laminitic pain are poorly defined, and hence the delivery of effective palliative care is clinically challenging. Knowledge and understanding of pain states in other animal species may further aid the elucidation of equine laminitic pain mechanisms, guide ...
Pain: mechanisms and management in horses.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 467-480 doi: 10.1016/j.cveq.2010.07.008
Muir WW.Pain is a multidimensional sensory phenomenon that has evolved as a protective method for maintaining homeostasis and facilitating tissue repair. Both excitatory and inhibitory physiologic and pathologic mechanisms are involved in its generation and maintenance. Untreated pain and nervous system changes (plasticity) that occur during chronic pain make pain much more difficult or impossible to effectively treat. Therapies directed toward the treatment of pain should be mechanism based and preventative whenever possible. Prospective, randomized clinical trials conducted in horses that suffer fro...
Spinal anesthetics and analgesics in the horse.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 551-564 doi: 10.1016/j.cveq.2010.07.005
Natalini CC.In the past 10 years, there have been many recent advances in spinal techniques in horses, both epidural and subarachnoid, to identify drugs or drug combinations that have sensory effects without motor nerve paralysis, thus providing pain control without these horses becoming recumbent. Opioids, alpha-2 agonists, dissociative drugs, and others have been investigated. Many of these drugs, which have serious side effects when injected systemically in horses, have been shown to have useful analgesic effects when injected spinally. Morphine-like opioids have the greatest potential for spinal use a...
Pain in osteoarthritis.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 619-642 doi: 10.1016/j.cveq.2010.07.007
van Weeren PR, de Grauw JC.This article focuses on pain associated with osteoarthritis (OA). It first describes the basic biology of articular cartilage and other joint structures and the defining features of the osteoarthritic disease process. Subsequently, the possible origins of pain in OA are discussed before embarking on how to manage this clinical entity. The emphasis is on the pharmacologic management of joint pain, and attention is paid to systemic therapeutic strategies as well as to local (intra-articular) treatment modalities. Nonmedical ways of modulating joint pain are briefly mentioned, but not extensively...
Alpha-2 agonists as pain therapy in horses.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 515-532 doi: 10.1016/j.cveq.2010.07.003
Valverde A.Alpha-2 agonists, such as xylazine, clonidine, romifidine, detomidine, medetomidine, and dexmedetomidine, are potent analgesic drugs that also induce physiologic and behavioral changes, such as hypertension, bradycardia, atrioventricular block, excessive sedation and ataxia, all of which can potentially limit their systemic use as analgesics in some clinical cases. The use of medetomidine and dexmetomidine has been introduced for equine anesthesia/analgesia, and although not approved in this species, their increased specificity for alpha-2 receptors may offer some potential advantages over the...
The role of manual therapies in equine pain management.
The Veterinary clinics of North America. Equine practice    November 9, 2010   Volume 26, Issue 3 579-601 doi: 10.1016/j.cveq.2010.07.006
Haussler KK.Manual therapy includes a diverse array of techniques, such as touch therapies, massage, physical therapy, osteopathy, and chiropractic, that were originally developed for use in humans and have been gradually applied to horses. All forms of manual therapy have variable reported levels of effectiveness for treating musculoskeletal issues in humans, but mostly only anecdotal evidence exists in horses. This article explores the scientific literature for evidence of efficacy, safety, and common mechanisms of action of the different forms of manual therapies for potential use in managing acute or ...
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