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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.
Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses. Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or withou...
Outcome of medical and surgical treatment of cecal impaction in horses: 114 cases (1994-2004). To determine short- and long-term outcomes, including recurrence rates, for horses with cecal impaction treated medically or surgically. Methods: Retrospective case series. Methods: 114 horses. Methods: Medical records were reviewed for information on signalment, history, clinical findings, treatment (medical vs surgical), and short-term outcome. Information on longterm outcome was obtained through a mail survey and telephone interview with owners. Results: 54 horses were treated medically, 49 horses were treated surgically, and 11 horses were euthanized after initial examination without furth...
Determination and use of mechanical nociceptive thresholds of the thoracic limb to assess pain associated with induced osteoarthritis of the middle carpal joint in horses. To establish reference mechanical nociceptive threshold (MNT) values of the equine thoracic limb and to assess the use of MNT values to detect pain associated with induced osteoarthritis in the middle carpal joint. Methods: 24 adult horses. Methods: MNT values were evoked by a pressure algometer at 17 sites within each thoracic limb during 2 baseline sessions conducted an average of 5 days apart. Effects of age, sex, weight, and wither height on MNT values were assessed separately for each site. Tolerance of horses to the procedure was graded subjectively and correlated with MNT values. Synovi...
Neuropathic changes in equine laminitis pain. 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...
Effect of fentanyl on visceral and somatic nociception in conscious horses. Transdermal fentanyl is used clinically in horses based on pharmacokinetic data and antinociceptive effects documented in other species. Objective: Fentanyl IV administration increases both visceral and somatic nociceptive threshold in conscious horses. Methods: Six clinically normal horses, each fitted with a permanent gastric cannula. Methods: Visceral nociception was evaluated with 2 methods of threshold detection--olorectal distention and duodenal distention. Somatic nociception was assessed by measurement of thermal threshold. Fentanyl was administered as an increasing stepwise infusion f...
The use of alpha-2 agonists in the equine practice: comparison between three molecules. Alpha-2 agonists are synthetic drugs which cause sedation, analgesia and myorelaxation due to their interaction with alpha-2 adrenoreceptors, widely distributed throughout bodily systems. Because of these actions such drugs are generally used in veterinary practice: to tranquilize animals (pharmacologic restraint) for the safety of both veterinar-ians and cooperators. Such properties facilitate diagnostic examinations or minimally in-vasive and poorly painful surgical procedures, as well as limiting stress factors to the patients. The aim of this study is to find out the minor dosage able to m...
Gabapentin for the treatment of neuropathic pain in a pregnant horse. A 24-year-old 732-kg (1,610-lb) pregnant Belgian draft horse mare developed neuropathy and signs of intractable pain following colic surgery. Results: Following recovery from colic surgery to treat compression of the small and large intestines because of a large fetus, the mare was noticed to have signs of femoral neuropathy involving the left hind limb. Within 36 hours after recovery, the mare developed signs of severe pain that were unresponsive to conventional treatment. No gastrointestinal tract or muscular abnormalities were found, and the discomfort was attributed to neuropathic pain. Re...
Tail docking in horses: a review of the issues. Routinely performed painful procedures are of increasing interest and, in 2001 (Royal Order, May 17), Belgium prohibited docking in several vertebrates including horses. In 2004, opponents to this decision submitted a Bill (Doc51 0969/001) to Parliament, intending to obtain derogation for Belgian draught horses, which were traditionally docked. The Animal Welfare Council of Belgium, an official body advising the Minister of Public Health, was asked to evaluate this complex question, including biological, ethical and socio-economic aspects, on the basis of the available peer-reviewed studies. I...
Verification of scintigraphic imaging for injury diagnosis in 264 horses with foot pain. Nuclear scintigraphy is commonly used as a diagnostic aid for foot pain, but there is limited information about different patterns of radiopharmaceutical uptake (RU) and their correlation with the results of other imaging modalities. Objective: To describe patterns of RU in horses with foot pain. Methods: Scintigraphic images of the feet of 264 horses with front foot pain were analysed subjectively and using region of interest analysis. Magnetic resonance images of all feet were analysed prospectively; the navicular bones were reassessed retrospectively and assigned a grade. A Spearman rank co...
Magnetic resonance imaging evaluation of 264 horses with foot pain: the podotrochlear apparatus, deep digital flexor tendon and collateral ligaments of the distal interphalangeal joint. To improve understanding of the interrelationships between injuries of the podotrochlear apparatus and deep digital flexor tendon (DDFT). Objective: There is a difference in frequency of different types of lesions at different anatomical sites of the DDFT. Lesions of the collateral sesamoidean ligament (CSL), distal sesamoidean impar ligament (DSIL), distal interphalangeal (DIP) joint and navicular bursa are seen in association with lesions of the navicular bone. Methods: The magnetic resonance (MR) images of 264 horses with unilateral or bilateral foot pain were analysed and graded. Descripti...
Use of concurrent scintigraphic and magnetic resonance imaging evaluation to improve understanding of the pathogenesis of injury of the podotrochlear apparatus. Use of physiological methods of diagnostic imaging could provide insight into the pathogenesis of foot pain in live horses. Objective: To describe patterns and intensity of increased radiopharmaceutical uptake (IRU) in the navicular bone, and relate this to distribution and types of signal intensity change in the navicular bone and to the presence or absence of lesions of the related soft tissue structures detected using MRI. Methods: Scintigraphic and MR images of 264 horses with unilateral or bilateral foot pain were analysed and graded. A Spearman rank correlation was used to test for relat...
The horse as the healer-a study of riding in patients with back pain. A total of 24 patients, considerably disabled in daily activities by back pain, participated in an Equine Assisted Therapy (EAT) programme. The patients also had several health problems in addition to their current pain. The programme emphasised the principles of body awareness. The study is aimed at investigating not only whether symptom reduction would be achieved, but also at identifying qualities of EAT that were particularly beneficial for the patients' well being. The study was performed according to action research principles. The treatment reduced the pain and lessened other symptoms. ...
Left- and right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. To describe a technique for, and outcome after, left- or right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. Methods: Clinical report. Methods: Horses (n=3) with unilateral renal disease. Methods: Horses were sedated with detomidine (0.01 mg/kg intravenously [IV]) and levomethadone (0.05 mg/kg IV). Paravertebral anesthesia and infiltration-anesthesia with 2% lidocaine were used to create a surgical field incorporating the 17th intercostal space and paralumbar fossa. Two separate, ipsilateral portals and a mini-laparotomy were used. The perirenal peri...
Congenital retrosternal (Morgagni) diaphragmatic hernias in three horses. 3 Horses were examined and treated because of sudden onset of signs of abdominal pain. Results: All horses had a retrosternal (Morgagni) hernia involving the right side of the diaphragm. In each horse, the large colon was incarcerated in a right muscular defect in the diaphragm with a large hernial sac. Results: Definitive surgical repair of the hernia was not performed during the initial celiotomy. The hernia was repaired with mesh herniorrhaphy, but without resection of the hernia sac in 2 horses. For 1 horse, conservative management was applied. In the 2 horses treated with surgical correct...
Effects of intra-articular botulinum toxin type A in an equine model of acute synovitis: a pilot study. To test the hypothesis that botulinum toxin type A (BoNT-A) can attenuate lameness associated with acute synovitis in an equine model. Methods: Four horses 2-6 yrs of age with clinically normal carpi were studied for 15 days. Kinematic gait analysis and clinical measures of lameness were conducted before and after experimental interventions. Horses were randomly assigned to either placebo (saline) or treatment (BoNT-A) groups. On day 0 of the intervention, 50 units of BoNT-A or an equivalent volume of saline (0.09%) was given into the middle carpal joints. On day 14, acute synovitis was induce...
Cuboid nutcracker fracture due to horseback riding in children: case series and review of the literature. We report 4 cases of nutcracker fractures of the cuboid resulting from equestrian sport in pediatric population. These lesions are often consistent with a trauma in forced abduction of the forefoot. The particular mechanism of the cuboid fracture due to horseback riding in children is discussed. The methods used to radiographically evaluate the compression fracture of the cuboid and its associated injuries are presented. Left untreated, these fractures can lead to severe alterations in foot mechanics and function, such as to severe pain. In addition, the surgical treatment to correct the nutcr...
The effects of morphine on the recovery of horses from halothane anaesthesia. To investigate the effects of peri-operative morphine on the quality and duration of recovery from halothane anaesthesia in horses. Methods: Prospective randomized study. Methods: Twenty-two client owned horses, ASA category I or II. Methods: Horses undergoing elective surgical procedures were divided into two groups and paired according to procedure, body position during surgery, body mass and breed. Group M+ received morphine by intravenous injection (0.15 mg kg(-1)) before induction of anaesthesia and then by infusion (0.1 mg kg(-1) hour(-1)) during anaesthesia. Group M- received the same a...
Effects of the cyclooxygenase inhibitor meloxicam on recovery of ischemia-injured equine jejunum. To determine the effect of meloxicam and flunixin meglumine on recovery of ischemia-injured equine jejunum. Methods: 18 horses. Methods: Horses received butorphanol tartrate; were treated IV with saline (0.9% NaCl) solution (SS; 12 mL; n = 6), flunixin meglumine (1.1 mg/kg; 6), or meloxicam (0.6 mg/kg; 6) 1 hour before ischemia was induced for 2 hours in a portion of jejunum; and were allowed to recover for 18 hours. Flunixin and SS treatments were repeated after 12 hours; all 3 treatments were administered immediately prior to euthanasia. Selected clinical variables, postoperative pain scores...
Evaluation of avocado and soybean unsaponifiable extracts for treatment of horses with experimentally induced osteoarthritis. To evaluate the use of a combination of avocado and soybean unsaponifiable (ASU) extracts for the treatment of experimentally induced osteoarthritis in horses. Methods: 16 horses. Methods: Osteoarthritis was induced via osteochondral fragmentation in 1 middle carpal joint of each horse; the other joint underwent a sham operation. Horses were randomly allocated to receive oral treatment with ASU extracts (1:2 [avocado-to-soybean] ratio mixed in 6 mL of molasses; n = 8) or molasses (6 mL) alone (placebo treatment; 8) once daily from days 0 to 70. Lameness, response to joint flexion, synovial eff...
The effect of plain, eggbar and 6 degrees-wedge shoes on the distribution of pressure under the hoof of horses at the walk. To quantify the effect of plain, wedged and eggbar shoes on the distribution of pressure under the hoof of horses at the walk, at selected areas of interest (AOI), to find scientific evidence for the perceived efficacy of these shoes in the treatment of palmar heel pain. Methods: Six clinically sound adult Warmblood mares weighing 551 (SD 25) kg were shod (forelegs) with either plain, eggbar or 6 degrees-wedge shoes using a latin-square experimental design. All horses were shod by the same farrier, and each balanced and aligned for its individual conformation. Data were collected on three walk...
The effect of induced forelimb lameness on thoracolumbar kinematics during treadmill locomotion. Lameness has often been suggested to result in altered movement of the back, but there are no detailed studies describing such a relationship in quantitative terms. Objective: To quantify the effect of induced subtle forelimb lameness on thoracolumbar kinematics in the horse. Methods: Kinematics of 6 riding horses was measured at walk and at trot on a treadmill before and after the induction of reversible forelimb lameness grade 2 (AAEP scale 1-5). Ground reaction forces (GRF) for individual limbs were calculated from kinematics. Results: The horses significantly unloaded the painful limb by 1...
Structural and biomechanical aspects of equine sacroiliac joint function and their relationship to clinical disease. Pain originating from the sacroiliac joint (SIJ) in horses has long been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction (SID) has been difficult to achieve. Clinical presentation of SID appears to fall into two categories. The first, presenting as pain and poor performance, is responsive to local analgesia of periarticular structures with poorly defined pathology. The second presents primarily as poor performance with bony pathological changes as a result of chronic instability. Diagnostic tests based on biomechanics as well as manual provocation for SIJ pai...
Effects of vertebral mobilization and manipulation on kinematics of the thoracolumbar region. To measure passive spinal movements induced during dorsoventral mobilization and evaluate effects of induced pain and spinal manipulative therapy (SMT) on passive vertebral mobility in standing horses. Methods: 10 healthy adult horses. Methods: Baseline vertical displacements, applied force, stiffness, and frequency of the oscillations were measured during dorsoventral spinal mobilization at 5 thoracolumbar intervertebral sites. As a model for back pain, fixation pins were temporarily implanted into the dorsal spinous processes of adjacent vertebrae at 2 of the intervertebral sites. Vertebral ...
An investigation into the depth of penetration of low level laser therapy through the equine tendon in vivo. Low level laser therapy (LLLT) is frequently used in the treatment of wounds, soft tissue injury and in pain management. The exact penetration depth of LLLT in human tissue remains unspecified. Similar uncertainty regarding penetration depth arises in treating animals. This study was designed to test the hypothesis that transmission of LLLT in horses is increased by clipping the hair and/or by cleaning the area to be treated with alcohol, but is unaffected by coat colour. A LLLT probe (810 nm, 500 mW) was applied to the medial aspect of the superficial flexor tendon of seventeen equine forelim...
Raising heels of hind hooves changes the equine coffin, fetlock and hock joint angle: a kinematic evaluation on the treadmill at walk and trot. Raised heels are commonly recommended for various equine orthopaedic conditions. However, the simultaneous effect of raised heels on the different joint angles of the equine hindlimb throughout the motion cycle has not been previously evaluated. Objective: To document the simultaneous effect of raised heels on the joint angles of the equine hindlimb coffin, fetlock and hock joints. Methods: Eight sound, adult, Warmblood horses were evaluated barefoot and with a heel wedge of 8 or 16 degrees, walking and trotting on a horizontal treadmill. Markers placed on the dorsal and cranial aspect of the ...
[Influence of the riding discipline and riding intensity on the incidence of back pain in competitive horseback riders].
Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin
The connection between morphologic changes of the spine and the intensity of training has been assessed for a number of sport activities. The influence of horseback riding on the spine has only rarely been evaluated. The aim of our study was to evaluate to what degree horseback riders suffer from back pain and whether there is an association between this parameter and the category i. e. the intensity of horseback riding. Furthermore we wanted to judge whether riding may have a positive effect on pre-existent back pain. Methods: 508 horseback riders (63.2 % females; 36.8 % males) competing in e... Alteration of distal tarsal subchondral bone thickness pattern in horses with tarsal pain. Understanding of the development of pathology and source of pain in distal tarsal osteoarthritis is poorly understood. Magnetic resonance imaging is often used in the analysis of human osteoarthritis (OA) because it is sensitive to early changes. Objective: In association with distal tarsal joint (DTJ) pain, there will be an alteration in the characteristic subchondral bone (SCB) thickness pattern of horses with no history of pain when subjected to low-level exercise. Methods: Sixteen cadaver tarsal joints were collected from 9 mature horses with a history of tarsal pain and radiographic evide...
Field fracture management. Emergency management of distal limb and skull fractures in horses is vital to the successful outcome of these cases. Distal limb fractures, in particular, require careful assessment and counseling of the owner as well as adequate stabilization or coaptation of the fracture. Horses with limb or skull fractures may also have concurrent pain, blood loss, and other fluid losses that can result in shock requiring fluid therapy before definitive treatment of the fracture. Proper emergency fracture stabilization, initial treatment in the field, and patient transport are discussed.
Endoscopic resection of dorsal spinous processes and interspinous ligament in ten horses. To describe endoscopic surgical subtotal resection of the dorsal spinous processes (DSP) and interspinous ligament in horses. Methods: Descriptive clinical study. Methods: Adult horses (n=10) with back pain and impinging dorsal spinous processes Methods: Diseased portions of DSP and interspinous ligament were resected by endoscopic surgery, using Destandau Endospine to create a surgical space and provide triangulation for the endoscope, suction cannula, and surgical instruments. Medical records of 10 horses with pain attributable to DSP pathology treated by endoscopic resection of DSP were rev...
