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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.
MRI and CT diagnosis of acute desmopathy of the lateral collateral sesmoidean (navicular) ligament and long-term outcome in a horse.
Veterinary journal (London, England : 1997)    October 17, 2006   Volume 174, Issue 2 410-413 doi: 10.1016/j.tvjl.2006.08.003
Kofler J, Kneissl S, Malleczek D.Clinical, magnetic resonance imaging (MRI) and computed tomography (CT) findings of acute desmopathy of the lateral collateral sesmoidean (navicular) ligament (CSL) in a 13-year-old Hanoverian mare are presented. On admission to the clinic the horse showed a grade 5/6 left front-limb lameness at the walk, pain on coffin joint manipulation, and coffin joint effusion. Despite a positive palmar digital nerve block, radiographs and ultrasonography did not indicate reasons for the severe clinical signs. However, MRI revealed damage to the CSL and bone marrow oedema of the navicular bone (NB), where...
Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse.
Veterinary surgery : VS    October 10, 2006   Volume 35, Issue 7 663-668 doi: 10.1111/j.1532-950X.2006.00205.x
Nagy AD, Simhofer H.To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. Methods: Clinical case report. Methods: Two-year-old Noriker filly. Methods: Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus. Results: Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems...
Regional differences in transdermal penetration of fentanyl through equine skin.
Research in veterinary science    October 2, 2006   Volume 82, Issue 2 252-256 doi: 10.1016/j.rvsc.2006.07.015
Mills PC, Cross SE.The rate and regional differences for the penetration of fentanyl through equine skin was investigated in vitro using a commercial transdermal therapeutic system (TTS) or 'patch'. Skin collected from the thorax, groin and leg (dorsal metacarpal) regions of five horses was placed in diffusion cells and a fentanyl TTS applied to each skin sample. Drug penetration through each skin sample over 48 h measured using high performance liquid chromatography (HPLC). Cumulative penetration (microg/cm2) was plotted against time (h) and used to regress the steady state flux (microg/cm2/h) of fentanyl throu...
Evidence of bias affecting the interpretation of the results of local anaesthetic nerve blocks when assessing lameness in horses.
The Veterinary record    September 12, 2006   Volume 159, Issue 11 346-349 doi: 10.1136/vr.159.11.346
Arkell M, Archer RM, Guitian FJ, May SA.Eighteen observers were influenced to different extents in the grades of lameness they allocated to eight horses by whether they knew that a nerve block had been administered; on a scale from 0 to 10 the mean difference in grade allocated once the observer knew a horse had been nerve-blocked was increased by 0.4. The consistency of the assessments made by the individual observers was good, with a an average of 0.6 of a grade difference when grading the same horse on two occasions. The agreement between the assessments of four orthopaedic experts was reasonable (+/-1 grade), but significantly p...
Suspected complex regional pain syndrome in 2 horses.
Journal of veterinary internal medicine    September 8, 2006   Volume 20, Issue 4 1014-1017 doi: 10.1892/0891-6640(2006)20[1014:scrpsi]2.0.co;2
Collins NM, Keen JA, Barakzai SZ, Mayhew IG, McGorum BC.No abstract available
Use of magnetic resonance imaging to diagnose distal sesamoid bone injury in a horse.
Journal of the American Veterinary Medical Association    September 5, 2006   Volume 229, Issue 5 717-720 doi: 10.2460/javma.229.5.717
Barber MJ, Sampson SN, Schneider RK, Baszler T, Tucker RL.A 5-year-old Appaloosa mare was examined for severe left forelimb lameness of 4 months' duration. Results: Lameness was evident at the walk and trot and was exacerbated when the horse circled to the left. Signs of pain were elicited in response to hoof testers placed over the frog of the left front hoof, and a palmar digital nerve block eliminated the lameness. Radiographs revealed no abnormalities, but magnetic resonance imaging (MRI) revealed increased bone density in the medullary cavity of the distal sesamoid (navicular) bone in the proton density and T2-weighted images and a defect in the...
Prevalence of gastric squamous ulceration in horses with abdominal pain.
Equine veterinary journal    July 27, 2006   Volume 38, Issue 4 347-349 doi: 10.2746/042516406777749164
Dukti SA, Perkins S, Murphy J, Barr B, Boston R, Southwood LL, Bernard W.Prevalence of gastric ulcerations differs widely according to breed and circumstances of management. Further study of the biological variables involved is required in order to identify more exactly the reasons for the reported range. Objective: The objectives of this present study, which do not appear to have been addressed previously in the literature, were 1) the prevalence of gastric ulceration in horses with abdominal pain. 2) difference in prevalence in horses responding to medical therapy and those requiring surgical intervention. 3) whether gastric ulceration is associated with any part...
Arthrogenic lameness of the fetlock: synovial fluid markers of inflammation and cartilage turnover in relation to clinical joint pain.
Equine veterinary journal    July 27, 2006   Volume 38, Issue 4 305-311 doi: 10.2746/042516406777749236
de Grauw JC, van de Lest CH, van Weeren R, Brommer H, Brama PA.Joint pain is one of the most common causes of lameness in the horse but its pathogenesis is poorly understood. Objective: To investigate which synovial fluid markers may be related to the presence of clinically detectable joint pain in the horse. Methods: Concentrations of structural (CPII, C2C, GAG) and inflammatory markers (PGE2, LTB4, CysLTs, bradykinin and substance P) were measured in fetlock joint fluid from 22 horses in which lameness was localised to the fetlock region by perineural anaesthesia. Levels of these markers were then compared in horses that responded (n = 15) to those that...
Risk factors for colic in horses after general anaesthesia for MRI or nonabdominal surgery: absence of evidence of effect from perianaesthetic morphine.
Equine veterinary journal    July 27, 2006   Volume 38, Issue 4 368-374 doi: 10.2746/042516406777749263
Andersen MS, Clark L, Dyson SJ, Newton JR.Post anaesthetic colic is a recognised risk of general anaesthesia (GA), but causes are poorly understood. Objective: To identify risk factors for development of colic following GA for magnetic resonance imaging (MRI) or nonabdominal surgery and to test whether the use of perianaesthetic morphine was associated with an increased risk of post anaesthetic colic. Methods: A total of 553 anaesthetic and clinical records of 500 horses anaesthetised at the Animal Health Trust were analysed, 342 (62%) involved MRI and 211 (38%) nonabdominal, predominantly orthopaedic surgery. Multivariable logistic r...
Maggot debridement therapy for serious horse wounds – a survey of practitioners.
Veterinary journal (London, England : 1997)    July 10, 2006   Volume 174, Issue 1 86-91 doi: 10.1016/j.tvjl.2006.05.012
Sherman RA, Morrison S, Ng D.Hoof disease and injuries are common and serious problems for equines. Maggot debridement therapy (MDT) has been used to treat problematic wounds in humans, but has been used only rarely in other animals. US veterinarians who had employed MDT were surveyed to investigate their reasons for the choice of this treatment and their clinical experiences with it. Between 1997 and 2003, 13 horses were treated by eight veterinarians who used MDT to control infection or debride wounds, which could not easily be reached surgically or were not responding to conventional therapy. Seven animals were lame, a...
Force platform evaluation of lameness severity following extracorporeal shock wave therapy in horses with unilateral forelimb lameness.
Journal of the American Veterinary Medical Association    July 5, 2006   Volume 229, Issue 1 100-103 doi: 10.2460/javma.229.1.100
Dahlberg JA, McClure SR, Evans RB, Reinertson EL.To measure alterations in lameness severity that occur following use of extracorporeal shock wave therapy (ESWT) in horses with naturally occurring unilateral forelimb lameness. Methods: Nonrandomized clinical trial. Methods: 9 horses with unilateral forelimb lameness. Methods: Force platform gait analysis was performed prior to administration of any treatments (baseline) and after use of local anesthesia to eliminate the lameness. Extracorporeal shock wave therapy was then administered, and gait analysis was repeated 8 hours later and then daily for 7 days. Results: Compared with the baseline...
Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion.
Toxicology and applied pharmacology    July 3, 2006   Volume 216, Issue 3 373-386 doi: 10.1016/j.taap.2006.06.011
Knobloch M, Portier CJ, Levionnois OL, Theurillat R, Thormann W, Spadavecchia C, Mevissen M.Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 microg/ml S-ketamine over 120 ...
Equine laminitis: bites by Bothrops spp cause hoof lamellar pathology in the contralateral as well as in the bitten limb.
Toxicon : official journal of the International Society on Toxinology    June 29, 2006   Volume 48, Issue 3 307-312 doi: 10.1016/j.toxicon.2006.06.010
Acosta de Pérez O, Teibler P, Leiva L, Ríos E, Sanchez Negrette M, Pollitt C.The envenoming caused by Bothrops snakebite includes local symptoms, such as pronounced edema, hemorrhage, intense pain, vesicles, blisters and myonecrosis. The principal systemic symptom consists in the alteration of blood clotting, due to fibrinogen consumption and platelet abnormalities. The horses involved in this study had this symptomatology and one of them exhibited symptoms consistent with laminitis in the bitten and in the contralateral limbs. Laminitis lesions were characterized by separation of the hoof lamellar basement membrane (BM) from basal cells of the epidermis. These results...
Needle electromyographic activity of myofascial trigger points and control sites in equine cleidobrachialis muscle–an observational study.
Acupuncture in medicine : journal of the British Medical Acupuncture Society    June 20, 2006   Volume 24, Issue 2 61-70 doi: 10.1136/aim.24.2.61
Macgregor J, Graf von Schweinitz D.Myofascial trigger points are commonly described in humans, and many studies have shown abnormal spontaneous electrical activity, spike activity and local twitch responses at these sites. Myofascial trigger points have only rarely been described in horses, and studies of their electrophysiological characteristics have not previously been published. The objective of this study was to explore the electromyographic (EMG) and other characteristics of myofascial trigger points in equine muscle, and to compare them with normal muscle tissue. Methods: Four horses with chronic pain signs and impaired ...
Analgesic effects of subarachnoidally administered hyperbaric opioids in horses.
American journal of veterinary research    June 3, 2006   Volume 67, Issue 6 941-946 doi: 10.2460/ajvr.67.6.941
Natalini CC, Polydoro Ada S, Linardi RL.To evaluate the effects of subarachnoidally administered hyperbaric morphine, buprenorphine, and methadone on avoidance threshold to noxious electrical stimulation of the perineal, sacral, lumbar, and thoracic regions in horses. Methods: 6 healthy adult horses. Methods: Horses were assigned to receive subarachnoid administration of hyperbaric morphine (0.01 mg/kg), buprenorphine (0.001 mg/kg), methadone (0.01 mg/kg), or 10% dextrose solution in equal volumes (5 mL). Electrical stimulation was applied every 10 minutes for 60 minutes and every 30 minutes for 120 minutes after subarachnoid inject...
Pharmacokinetics of the opioid antagonist N-methylnaltrexone and evaluation of its effects on gastrointestinal tract function in horses treated or not treated with morphine.
American journal of veterinary research    June 3, 2006   Volume 67, Issue 6 998-1004 doi: 10.2460/ajvr.67.6.998
Boscan P, Van Hoogmoed LM, Pypendop BH, Farver TB, Snyder JR.To determine the pharmacokinetics and effects of the morphine antagonist N-methylnaltrexone (MNTX) on gastrointestinal tract function in horses when administered alone and in combination with morphine. Methods: 5 healthy adult horses. Methods: Horses were treated with MNTX (1 mg/kg, IV), and serial blood samples were collected for determination of drug pharmacokinetics. For evaluation of effects on the gastrointestinal tract when administered alone, MNTX was administered at a dosage of 0.75 mg/kg, IV, twice daily for 4 days. For evaluation of effects when administered concurrently with morphin...
Effectiveness of acupuncture in veterinary medicine: systematic review.
Journal of veterinary internal medicine    June 1, 2006   Volume 20, Issue 3 480-488 doi: 10.1892/0891-6640(2006)20[480:eoaivm]2.0.co;2
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...
The effects of i.v. fentanyl administration on the minimum alveolar concentration of isoflurane in horses.
British journal of anaesthesia    May 23, 2006   Volume 97, Issue 2 232-237 doi: 10.1093/bja/ael116
Thomasy SM, Steffey EP, Mama KR, Solano A, Stanley SD.Fentanyl decreases the minimum alveolar concentration (MAC) of inhaled anaesthetics and has been used clinically to reduce the requirements of other anaesthetic drugs in humans and small animals. We hypothesized that i.v. fentanyl would decrease the MAC of isoflurane in horses in a dose-dependent manner. Methods: Following determination of baseline MAC of isoflurane, fentanyl was administered i.v. to target plasma concentrations of 1, 8 and 16 ng ml(-1). Each horse was randomly assigned two of three target concentrations administered in ascending order. Loading and infusion doses for each hors...
Evaluation of administration of isoflurane at approximately the minimum alveolar concentration on depression of a nociceptive withdrawal reflex evoked by transcutaneous electrical stimulation in ponies.
American journal of veterinary research    May 3, 2006   Volume 67, Issue 5 762-769 doi: 10.2460/ajvr.67.5.762
Spadavecchia C, Levionnois O, Kronen PW, Leandri M, Spadavecchia L, Schatzmann U.To investigate effects of isoflurane at approximately the minimum alveolar concentration (MAC) on the nociceptive withdrawal reflex (NWR) of the forelimb of ponies as a method for quantifying anesthetic potency. Methods: 7 healthy adult Shetland ponies. Methods: Individual MAC (iMAC) for isoflurane was determined for each pony. Then, effects of isoflurane administered at 0.85, 0.95, and 1.05 iMAC on the NWR were assessed. At each concentration, the NWR threshold was defined electromyographically for the common digital extensor and deltoid muscles by stimulating the digital nerve; additional el...
Use of intra-articular administration of ethyl alcohol for arthrodesis of the tarsometatarsal joint in healthy horses.
American journal of veterinary research    May 3, 2006   Volume 67, Issue 5 850-857 doi: 10.2460/ajvr.67.5.850
Shoemaker RW, Allen AL, Richardson CE, Wilson DG.To evaluate the efficacy and safety of intra-articular administration of ethyl alcohol for arthrodesis of tarsometatarsal joints in horses. Methods: 8 healthy female horses without lameness or radiographic evidence of tarsal joint osteoarthritis. Methods: In each horse, 1 tarsometatarsal joint was treated with 4 mL of 70% ethyl alcohol and the opposite joint was treated with 4 mL of 95% ethyl alcohol. Lameness examinations were performed daily for 2 weeks, followed by monthly evaluations for the duration of the 12-month study. Radiographic evaluations of both tarsi were performed 1 month after...
Morphine-associated pruritus after single extradural administration in a horse.
Veterinary anaesthesia and analgesia    April 26, 2006   Volume 33, Issue 3 193-198 doi: 10.1111/j.1467-2995.2005.00246.x
Burford JH, Corley KT.Pruritus following a single administration of 100 microg kg(-1) of preservative-free morphine sulphate given via an extradural catheter was seen in a 580 kg horse. The catheter was placed in the first intercoccygeal space. Focal irritation, represented by both local alopecia over the left gluteal muscles and serum exudation, occurred 4-8 hours after injection. This was attributed to the extradural morphine administration.
Morphine administration in horses anaesthetized for upper respiratory tract surgery.
Veterinary anaesthesia and analgesia    April 26, 2006   Volume 33, Issue 3 179-188 doi: 10.1111/j.1467-2995.2005.00247.x
Love EJ, Lane JG, Murison PJ.To determine the effect of morphine administration on commonly monitored cardio-respiratory variables and recovery quality in horses undergoing anaesthesia and surgery. Methods: Prospective, randomized clinical study. Methods: Thirty-eight thoroughbred horses, 32 geldings and six mares, 3-13 years old, weighing 411-600 kg. Methods: A standard anaesthetic technique was used. Twenty minutes after induction of anaesthesia horses received 0.1 mg kg(-1) (0.1 m) or 0.2 mg kg(-1) (0.2 m) morphine by intravenous injection. A control group did not receive morphine. Heart rate, respiratory rate (fr), me...
Electroencephalographic and electromyographic changes during the use of detomidine and detomidine-butorphanol combination in standing horses.
Acta veterinaria Hungarica    April 15, 2006   Volume 54, Issue 1 35-42 doi: 10.1556/AVet.54.2006.1.4
Kruluc P, Nemec A.Clinically, the use of detomidine and butorphanol is suitable for sedation and deepening of analgosedation. The aim of our study was to establish the influence of detomidine used alone and a butorphanol-detomidine combination on brain activity and to evaluate and compare brain responses (using electroencephalography, EEG) by recording SEF90 (spectral edge frequency 90%), individual brain wave fractions (beta, alpha, theta and delta) and electromyographic (EMG) changes in the left temporal muscle in standing horses. Ten clinically healthy cold-blooded horses were divided into two groups of five...
Use of force plate analysis to assess the analgesic effects of etodolac in horses with navicular syndrome.
American journal of veterinary research    April 4, 2006   Volume 67, Issue 4 557-561 doi: 10.2460/ajvr.67.4.557
Symonds KD, MacAllister CG, Erkert RS, Payton ME.To evaluate the musculoskeletal analgesic effect of etodolac administered PO every 12 or 24 hours in chronically lame horses by use of force plate analysis. Methods: 22 horses with navicular syndrome. Methods: Horses received etodolac (23 mg/kg, PO, q 12 h; n = 7), etodolac (23 mg/kg, PO, q 24 h; 8), or corn syrup (20 mL, PO, q 24 h; control treatment; 7) for 3 days. Combined forelimb peak vertical ground reaction force (PVF) was measured via force plate analysis before the first treatment (baseline) and at 6, 12, 24, and 36 hours after the last treatment. Differences in mean PVF (mPVF) betwee...
Arthroscopically assisted arthrodesis of the distal interphalangeal joint with transarticular screws inserted through a dorsal hoof wall approach in a horse.
Journal of the American Veterinary Medical Association    March 16, 2006   Volume 228, Issue 6 909-913 doi: 10.2460/javma.228.6.909
Busschers E, Richardson DW.A 16-year-old Thoroughbred gelding was examined because of chronic right forelimb lameness. Results: On radiographs of the right front foot, the distal interphalangeal (DIP) joint space was narrow, and osteophytes and periarticular bony proliferation indicative of severe osteoarthritis were seen. Arthrodesis of the right DIP joint was recommended to improve the horse's comfort on the limb. Results: The horse was anesthetized, and palmar and dorsal arthroscopic approaches were used to remove as much of the articular cartilage as was accessible. Holes were then drilled through the dorsal aspect ...
[Disorders of the origin of the suspensory ligament in the horse: a diagnostic challenge].
Schweizer Archiv fur Tierheilkunde    March 3, 2006   Volume 148, Issue 2 86-97 doi: 10.1024/0036-7281.148.2.86
Lischer ChJ, Bischofberger AS, Fürst A, Lang J, Ueltschi G.Lameness in horses due to pain originating from the proximal metacarpal/metatarsal region remains a diagnostic challenge. In cases of obvious lameness the pain can be localised to this region by diagnostic anaesthesia. Because a variety of disorders can cause lameness in this region different imaging modalities including radiography, ultrasonography and scintigraphy should be used to arrive at an accurate diagnosis. Even though a precise anatomic-pathologic diagnosis can still be an enigma, because not only bone and joints, but also soft tissue structures including the proximal suspensory liga...
Use of ultrasonography to diagnose large colon volvulus in horses.
Journal of the American Veterinary Medical Association    February 2, 2006   Volume 228, Issue 3 409-413 doi: 10.2460/javma.228.3.409
Abutarbush SM.To describe the use of ultrasonography to diagnose large colon volvulus (LCV) in horses. Methods: Descriptive report. Methods: 4 horses with clinical signs of abdominal pain. Methods: Each horse was administered analgesic agents for pain control and placed in stocks. Ultrasonographic evaluations were performed with a 3.5-MHz sector scanning transducer that was placed parallel to the long axis of the horse (longitudinal imaging) over an area of the left ventral aspect of the abdomen. The boundaries of the evaluated region included the ventral midline, 2 vertical lines at the level of the left 1...
Magnetic resonance imaging characteristics of the foot in horses with palmar foot pain and control horses. Murray RC, Schramme MC, Dyson SJ, Branch MV, Blunden TS.Palmar foot pain is a common cause of lameness. Magnetic resonance imaging (MRI) has the potential to detect damage in all tissues of the equine foot, but an understanding of the differences in magnetic resonance (MR) images between feet from horses with and without palmar foot pain is required. This study aimed to describe MR findings in feet from horses with no history of foot-related lameness, and to compare these with MR findings in horses with lameness improved by palmar digital local analgesia. Thirty-four limbs from horses euthanized with a clinical diagnosis of navicular syndrome (amen...
Therapy for osteoarthritis in the horse – how do we know that it works?
Veterinary journal (London, England : 1997)    January 24, 2006   Volume 171, Issue 1 9-10 doi: 10.1016/j.tvjl.2005.02.003
Clegg PD.No abstract available
Analgesic effects of epidural administration of hydromorphone in horses.
American journal of veterinary research    January 24, 2006   Volume 67, Issue 1 11-15 doi: 10.2460/ajvr.67.1.11
Natalini CC, Linardi RL.To evaluate the effects of epidural administration of hydromorphone on avoidance threshold to noxious electrical stimulation of the perineal, sacral, lumbar, and thoracic regions in horses. Methods: 6 healthy adult horses. Methods: Horses were assigned to receive hydromorphone (0.04 mg/kg) or a control solution (20 mL of sterile water) administered epidurally into in the first intercoccygeal space. Treatments were administered at time intervals of > or = 7 days. Electrical stimulation was applied for 6 hours after epidural injection over the dermatomes of the perineal, sacral, lumbar, and t...
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