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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.
Histopathology in horses with chronic palmar foot pain and age-matched controls. Part 1: Navicular bone and related structures. Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Objective: Abnormalities of the collateral sesamoidean ligaments (CSLs), distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), navicular bone, navicular bursa, distal interphalangeal (DIP) joint or collateral ligaments (CLs) of the DIP joint may contribute to palmar foot pain. Methods: Feet were selected from horses with a history of unilateral or bilateral forelimb lameness of at least 2 months' duration that was improv...
Effect of local analgesia on movement of the equine back. Diagnostic infiltration of local anaesthetic solution is commonly used in cases of equine back pain. Evaluation is subjective and it is not known how local analgesia of the back affects horses without clinical signs of back pain. Objective: To evaluate the effect of infiltration of local anaesthetics on the movement of the back in horses without clinical signs of back pain, and to evaluate the usefulness of kinematic studies as an objective and quantitative tool in evaluating local analgesia in clinical practice. Methods: The kinematics of the back in 10 clinically sound horses were measured o...
Histopathology in horses with chronic palmar foot pain and age-matched controls. Part 2: The deep digital flexor tendon. Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Objective: Abnormalities of the deep digital flexor tendon (DDFT) may contribute to palmar foot pain; ageing degenerative changes may be seen in horses free from lameness; and horses with lameness are likely to have a greater severity of abnormalities than age-matched horses with no history of foot pain. Methods: Feet were selected from horses with a history of uni- or bilateral forelimb lameness of at least 2 months' duration. Histology of th...
Mechanical nociceptive thresholds in the axial skeleton of horses. An objective measure of neck, back and croup pain is needed in horses with musculoskeletal injuries, vague upper limb lameness or poor performance. Objective: To establish mechanical nociceptive thresholds (MNTs) within the axial skeleton and evaluate the effects of subject status and ridden exercise. Methods: Thirty-six mature horses (10 nonridden; 26 actively ridden) were used to assess MNTs evoked by a pressure algometer (PA) with a 1 cm2 rubber plunger tip at 62 midline and bilaterally symmetrical anatomical landmarks along the axial skeleton. Pressure was applied at a uniform rate of appl...
Intravenous continuous infusion of lidocaine for treatment of equine ileus. To determine if intravenous lidocaine is useful and safe as a treatment for equine ileus. Methods: Prospective double-blinded placebo-controlled trial. Methods: Horses (n = 32) with a diagnosis of postoperative ileus (POI) or enteritis and that had refluxed >20 L or had been refluxing for >24 hours. Methods: Refluxing horses were administered lidocaine (1.3 mg/kg intravenously [IV] as a bolus followed by a 0.05 mg/kg/min infusion) or saline (0.9% NaCl) solution placebo for 24 hours. Variables evaluated included volume and duration of reflux, time to 1st fecal passage, signs of pain, anal...
Pressure algometry for the detection of induced back pain in horses: a preliminary study. Pressure algometry (PA) is a potential modality for objectively measuring mechanical nociceptive thresholds (MNTs) in horses. Its ability to differentiate musculoskeletal pain sites from nonpain sites is unknown and must be assessed prior to its clinical application. Objective: To assess the ability of PA to detect induced musculoskeletal pain. Methods: Twenty clinically normal mature horses (2 groups of 10 horses, over 2 years) were used to measure MNTs before and after implantation and removal of 2 fixation half-pins in the dorsal spinous processes of 2 adjacent vertebrae. To assess hyperalg...
Spine fractures caused by horse riding. Retrospective study and review of literature. Objective: Study of demographic data concerning spinal fractures caused by horse riding, classification of fractures according to the AO and Load Sharing classifications, evaluation of mid-term radiological results and long-term functional results. Methods: A review of medical reports and radiological examinations of patients presented to our hospital with horse riding-related spine fractures over a 13-year period; long-term functional follow-up is performed using the Roland Morris Disability Questionnaire (RMDQ-24). Results: Thirty-six spine fract...
Deep digital flexor tendonitis in the equine foot diagnosed by low-field magnetic resonance imaging in the standing patient: 18 cases. Injury to the distal aspects of the deep digital flexor tendon (DDFT) is an important cause of lameness in horses. The purpose of this study was to review the magnetic resonance imaging (MRI) findings of 18 horses affected by DDFT injuries in the foot. The MRI was performed with the horses standing using an open low-field (0.21 T) MRI scanner. The results were compared with those previously reported for horses using high-field MRI. Eighteen of 84 horses (21%) with undiagnosed forefoot pain were found to have lesions affecting the DDFT. The history, clinical findings and results of radiography,...
Evaluation of therapeutic riding (Sweden)/hippotherapy (United States). A single-subject experimental design study replicated in eleven patients with multiple sclerosis. The aim of this study was to investigate whether therapeutic riding (TR, Sweden) hippotherapy (HT, United States) may affect balance, gait, spasticity, functional strength, coordination, pain, self-rated level of muscle tension (SRLMT), activities of daily living (ADL), and health-related quality of life. Eleven patients with multiple sclerosis (MS) were studied in a single-subject experimental design iSSED) study, type A-B-A. The intervention comprised ten weekly TR/HT sessions of 30 minutes each. The subjects were measured a maximum of 13 times. Physical tests were: the Berg balance scale, t...
Evaluation of skin sensitivity after shock wave treatment in horses. To evaluate the effects of shock wave treatment on cutaneous nerve function, compared with the effects of local nerve block and sedation. Methods: 18 clinically sound Swiss Warmbloods. Methods: Horses were randomly allocated to 3 groups and received different amounts and types of shock waves (extracorporeal shock wave treatment [ESWT] or radial pressure wave treatment [RPWT]). Horses were sedated with xylazine and levomethadone. Shock waves were applied to the lateral palmar digital nerve at the level of the proximal sesamoid bones on 1 forelimb. Skin sensitivity was evaluated by means of an e...
Subtotal ostectomy of dorsal spinous processes performed in nine standing horses. To describe and evaluate subtotal ostectomy of dorsal spinous processes (DSP) performed in standing horses. Methods: Retrospective study. Methods: Nine adult horses. Methods: The diseased portions of the DSP were removed with the horses standing and sedated after infiltrating a local anesthetic agent around the affected DSP. Medical records of affected horses were reviewed to determine history, findings of physical and radiographic examination, surgical technique, postoperative complications, and outcome. Results: Five horses had subtotal ostectomy of DSP because of osteomyelitis, and 4 becaus...
Investigation of the immediate analgesic effects of extracorporeal shock wave therapy for treatment of navicular disease in horses. To measure the acute analgesic properties of extracorporeal shock wave therapy (ESWT) in horses with navicular disease using objective ground reaction forces (GRF). Methods: Prospective study. Methods: Nine client-owned horses with unilateral forelimb lameness caused by navicular disease. Methods: Horses were trotted at 3 m/s over a force plate to record pre-treatment GRF of the lame and contra-lateral forelimbs. After ESWT of the lame limb, applied with a radial unit to each of the frog and heel bulb areas with 1500 pulses at 4 bar and 10 Hz, GRF measurements were repeated at 15 minutes and 2...
Treatment of a second carpal bone fracture by removal under ultrasonographic guidance in a horse. To report an unusual 2nd carpal bone (C2) slab fracture and its treatment, using an ultrasonographically assisted, minimally invasive arthrotomy technique, for fragment removal. Methods: Case report. Methods: An 11-year-old crossbred Warmblood gelding. Methods: A bone fragment, spanning the height of C2, identified on the palmaromedial aspect of C2 was demarcated intraoperatively using ultrasonographically guided needles and removed by arthrotomy. Results: Fracture fragment removal was achieved using a small, ultrasonographically guided arthrotomy. The horse has become sound after treatment an...
Severe acute rhabdomyolysis associated with Streptococcus equi infection in four horses. Four Quarter Horses (9 months to 7 years of age) with submandibular lymphadenopathy and firm muscles (palpation of which elicited signs of pain) were evaluated; in general, the horses had a stiff gait, and 3 horses became recumbent. Streptococcus equi was cultured from aspirates of lymph nodes or samples of purulent material collected from the auditory tube diverticula. Once the horses were recumbent, their condition deteriorated rapidly despite aggressive antimicrobial and antiinflammatory treatment, necessitating euthanasia within 24 to 48 hours. One horse did not become recumbent and recove...
Laparoscopic ovariectomy using the endo-GIA stapling device and endo-catch pouches and evaluation of analgesic efficacy of epidural morphine sulfate in 10 mares. To evaluate use of ENDO-GIA staples and ENDO-Catch pouches for ovariectomy in mares and to evaluate the efficacy of epidural morphine analgesia. Methods: Randomized clinical trial. Methods: Mares (n = 10) with normal ovaries. Methods: An Endo-GIA II stapler (United States Surgical Corp., Norwalk, CT) was used to amputate the ovaries bilaterally, in standing mares, and Endo-Catch II pouches (United States Surgical Corp.) were used for retrieval. Epidural morphine was used in 5 mares, and procedure duration, volume of lidocaine required to desensitize the ovarian pedicle, and sedation were compa...
Effect of romifidine on the nociceptive withdrawal reflex and temporal summation in conscious horses. To investigate the action of a single IV administration of romifidine on the thresholds of the nociceptive withdrawal reflex (NWR) and temporal summation in conscious horses. Methods: 10 adult horses. Methods: Single electrical stimulations were applied on the digital nerves to evoke NWR from the left forelimb and hind limb. Repeated electrical stimulations (10 stimuli, 5 Hz) were given to obtain temporal summation. Surface electromyographic reflex activity was recorded from the common digital extensor and cranial tibial muscles. After baseline assessment of NWR and temporal summation threshol...
Enlargements of the distal third metacarpus and metatarsus in Thoroughbred foals at pasture from birth to 160 days of age. To assess the relationship between the radiographic and microscopic appearance of the physeal regions of the distal third metacarpal (Mc3) and metatarsal (Mt3) bones of Thoroughbred foals at 160 days of age, and to clinically assess changes in contour of the distal Mc3 and Mt3 physeal regions from birth to 160 days of age. To assess relationships between maximum clinical physis scores and age, time of year, foal's sex, condition score, growth rate, copper (Cu) concentration in the liver of the foal, and supplementation of the dam with Cu in late gestation. Methods: Dams were given Cu (n=5 and ...
Musculoskeletal problems associated with lameness and poor performance among horses used for barrel racing: 118 cases (2000-2003). To identify types of musculoskeletal problems associated with lameness or poor performance in horses used for barrel racing. Methods: Retrospective case series. Methods: 118 horses. Methods: Medical records were reviewed for information on signalment, history, physical and lameness examination findings, diagnostic tests performed, diagnosis, and treatment. Results: Most horses were examined because of lameness (n = 72 [61%]) rather than poor performance (46 [39%]), but owner complaint was not significantly associated with age or body weight of the horse. The most common performance change was ...
Intra-articular injections for joint disease in horses. Lameness remains an important source of reduced performance in many types of horses. Pain referable to joints is among the most common causes, and intra-articular injections remain a common and important means of addressing lameness referable to joints in horses.
Extracorporeal shock wave therapy for treatment of osteoarthritis in the horse: clinical applications. Veterinarians have begun using extracorporeal shock wave therapy (ESWT) for treatment of osteoarthritis (OA) in horses, although relatively little information has been published about its efficacy or mechanism of action. As a clinician, it can be difficult to know if and when ESWT should be recommended. Case studies in which ESWT is used to treat advanced OA in horses are discussed. ESWTseems to be a valuable adjunct for management of equine OA. It is the purpose of this article to discuss indications and techniques as well as to share clinical experiences using ESWT in the treatment of OA in ...
The use of nutraceuticals for osteoarthritis in horses. In horses, lameness is often attributable to some degree of osteoarthritis (OA), a complex disease process that is highlighted by eventual degradation of articular cartilage. Conventional therapies for OA in horses are designed to relieve pain and discomfort and often include pharmacologic intervention with nonsteroidal anti-inflammatory drugs or intra-articular steroids. Oral administration of nutraceutical products to the horse is common and easy and is perceived to be a benign treatment for OA in horses. The main goal for use of nutraceuticals is to use them in OA cases to attempt to lower ...
Equine rehabilitation therapy for joint disease. The principles of physical rehabilitation therapy can be applied to the horse to provide a reduction in discomfort and dysfunction associated with the various forms of joint disease. Physical agents,such as ice, heat, electricity, sound, light, magnetic fields, compression, and movement, can be used by the rehabilitation therapist to attempt to control pain, reduce swelling, and restore optimal movement and function in the affected joint. The equine therapist's attention is focused not only on the affected joint but on the body as a whole to manage secondary or compensatory problems.
Systemic therapies for joint disease in horses. Systemic therapies for joint disease may be prescribed when a single joint is involved or when multiple sites are affected. The precise therapeutic regimen recommended depends on the duration,cause, and site(s) of injury and is often an adjunct to intra-articular or supportive therapies. If the clinical signs of joint disease are acute and moderate in severity, nonsteroidal anti-inflammatory drugs are often administered to alleviate pain and inflammation. When aiming for more of a generalized maintenance or chondro-protective regimen, an alternative medication, such as hyaluronan,polysulfated ...
Association between subjective lameness grade and kinetic gait parameters in horses with experimentally induced forelimb lameness. To evaluate the association between subjective lameness grades and kinetic gait parameters and assess the variability in kinetic parameters in horses with experimentally induced forelimb lameness. Methods: 32 horses. Methods: Forelimb lameness was induced in each horse via injection of lipopolysaccharide into 1 metacarpophalangeal joint (40 experimental trials). Subjective lameness grading and 13 kinetic gait parameters (force plate analysis) were assessed before (baseline) and at 12, 18, and 24 hours after lipopolysaccharide injection. While horses were trotting, kinetic gait analysis was per...
Evaluation of analgesia resulting from extracorporeal shock wave therapy and radial pressure wave therapy in the limbs of horses and sheep. To identify the duration and potential mechanisms of analgesia following extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) in limbs of horses and sheep. Methods: 6 horses and 30 sheep. Methods: An electrical stimulus was used to identify the nociceptive threshold for each horse daily for 3 days before treatment (baseline) with ESWT or RPWT, 8 hours after treatment, and at 24-hour intervals for 7 days after treatment. Testing was conducted for the treatment field (midmetacarpus or midmetatarsus) and nerve field (medial and lateral forelimb heel bulbs) distal to a ...
[Digital semiological anesthesia in horses: technique and elements of interpretation]. Digital semiological anesthesia in horses: Technique and elements of interpretation. Semiological anesthesia of the pes is used during examinations for lameness in horses. Recent research data on the distal digital, distal interphalangeal articular, and podotrochlear intrathecal nerve blocks indicate that they are less than specific when considered in isolation. They should be used in combination to localize pain in the pes. A positive response to anesthesia of the distal interphalangeal articulation could also indicate that the source of the pain was in the podotrochlear apparatus or the dors...
Comparison of three methods for arthrodesis of the distal intertarsal and tarsometatarsal joints in horses. To evaluate the effects of diode laser surgery (LS), surgical drilling (SD), and intraarticular sodium monoiodoacetate (MIA) as methods for fusing the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses. Methods: Experimental study. Methods: Adult horses (15) without radiographic signs of osteoarthritis (OA) of the DIT and TMT joints. Methods: Group 1 (n=3) had LS performed bilaterally on DIT and TMT joints; 1 horse was evaluated for 1 week and 2 horses were evaluated for 2 weeks. Group 2 (n=6) had LS on DIT and TMT joints of 1 tarsus and MIA administration into the contralater...
Epidural migration of new methylene blue in 0.9% sodium chloride solution or 2% mepivacaine solution following injection into the first intercoccygeal space in foal cadavers and anesthetized foals undergoing laparoscopy. To determine the relationship between epidural cranial migration and injectate volume of an isotonic solution containing dye in laterally recumbent foal cadavers and evaluate the cranial migration and dermatome analgesia of an epidural dye solution during conditions of laparoscopy in foals. Methods: 19 foal cadavers and 8 pony foals. Methods: Foal cadavers received an epidural injection of dye solution (0.05, 0.1, 0.15, or 0.2 mL/kg) containing 1.2 mg of new methylene blue (NMB)/mL of saline (0.9% NaCl) solution. Length of the dye column and number of intervertebral spaces cranial and caudal t...
