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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.
Chip fractures from the distal lateral trochlear ridge of the talus of a quarter horse gelding: a veterinary medicine clinical report. An eighteen-month old quarter horse gelding was diagnosed with chip fractures from the distal lateral trochlear ridge of the talus. The horse presented with the symptom of persistent synovitis. The diagnosis was based on radiographic evidence. The horse was treated initially with arthroscopic surgery. He was given a non-steroidal anti-inflammatory agent, and a chondroprotective agent to prevent further damage to, and aid in the healing of, the damaged joint.
Intraoperative pain responses following intraovarian versus mesovarian injection of lidocaine in mares undergoing laparoscopic ovariectomy. To compare intraoperative pain responses following intraovarian versus mesovarian injection of lidocaine in mares undergoing laparoscopic ovariectomy. Methods: Randomized controlled trial. Methods: 15 mares between 4 and 20 years old. Methods: Standard bilateral laparoscopic ovariectomy was performed. Prior to manipulation of the ovary, 2% lidocaine (10 mL) was injected into the ovary and saline (0.9% NaCI) solution (10 mL) was injected into the mesovarium on 1 side, with saline solution (10 mL) injected into the ovary and 2% lidocaine (10 mL) injected into the mesovarium on the other side. Pr...
Elimination of arthritis pain and inflammation for over 2 years with a single 90 min, topical 14% gallium nitrate treatment: case reports and review of actions of gallium III. Arthritis is inflammation in a joint often with joint damage, usually accompanied by pain, swelling and stiffness, resulting from infection, trauma, degenerative changes, metabolic disturbances, autoimmune or other causes. It occurs in various forms, including rheumatoid arthritis, osteoarthritis, bacterial arthritis and gout. Gallium III can inhibit the production of inflammatory cytokines, such as IL-1beta, produced by macrophage-like cells in vitro. A dose-dependent inhibition of IL-1beta and TPA stimulated MMP activity by gallium nitrate at increasing concentrations occurs, demonstrating t...
Evaluation of electroacupuncture treatment of horses with signs of chronic thoracolumbar pain. To evaluate use of electroacupuncture for treatment of horses with signs of chronic thoracolumbar pain. Methods: Prospective study. Methods: 15 horses with signs of chronic thoracolumbar pain. Methods: Horses were randomly allocated to 1 of 3 treatment groups. Horses in group 1 received electroacupuncture stimulation (once every 3 days for 5 treatments), those in group 2 received phenylbutazone (2.2 mg/kg [1 mg/lb], PO, q 12 h, for 5 days), and those in group 3 received saline (0.9% NaCl) solution (20 mL, PO, q 12 h, for 5 days). Thoracolumbar pain scores (TPSs) were evaluated before (baseline...
[Kick injuries of veterinarians during examination and treatment of horses: a retrospective study in Switzerland]. The risk of injury to veterinarians treating horses is high, particularly when performing painful procedures. The present retrospective study investigated this risk, including the frequency and severity of kick injuries, by submitting questionnaires to 700 veterinary practitioners in Switzerland. Evaluation of 216 completed questionnaires revealed that the frequency of kick injuries was affected by the professional experience of the veterinarian, veterinarians being an owner of a horse, the season, the type of procedure, the percentage of equine patients in the practice population, the treatme...
Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy. Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. Objective: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery. Methods: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical colic c...
Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications. Few studies have assessed short- and long-term complication rates of horses following surgical treatment of colic, a potentially fatal condition. Complications can lead to patient discomfort and increased costs; knowledge of predisposing factors may help to reduce complication rates. Objective: To document and analyse short-term complications in 300 horses undergoing colic surgery, and to assess some of the possible predisposing factors. Methods: History, clinical findings, surgical findings and procedures, and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were ...
Use of web-based data collection to evaluate analgesic administration and the decision for surgery in horses with colic. There is no current veterinary information with regard to data entry on a website. We therefore completed a prospective study on use of analgesics in relation to the need for abdominal surgery using a web-based survey instrument. Objective: To establish an internet-based data entry system that could be used to record prospective data on horses with colic. Objective: Failure of horses to respond to the initial administration of an analgesic is an indicator of the need for abdominal surgery. Methods: A survey was developed to determine if the response to administration of an analgesic during a v...
Evaluation of iatrogenic hemarthrosis of the metacarpophalangeal joint as a method of induction of temporary reversible lameness in horses. To determine whether iatrogenic hemarthrosis of the metacarpophalangeal joint could be used as a model for temporary reversible joint pain in horses. Methods: 8 adult horses. Methods: Each horse was evaluated on a treadmill before and after injection of 1 metacarpophalangeal joint with 10 mL of autogenous blood. Horses were evaluated subjectively and objectively by use of a computerized force measurement system at intervals until lameness abated. The mean force difference between injected and noninjected limbs at all time periods after injection was compared with the difference between limbs a...
Investigation of the EEG effects of intravenous lidocaine during halothane anaesthesia in ponies. To record the electroencephalographic changes during castration in ponies anaesthetized with halothane and given intravenous (IV) lidocaine by infusion. The hypothesis tested was that in ponies, IV lidocaine is antinociceptive and would therefore obtund EEG changes during castration. Methods: Ten Welsh mountain ponies referred to the Department of Clinical Veterinary Medicine, Cambridge for castration under general anaesthesia. Methods: Following pre-anaesthetic medication with intramuscular acepromazine (0.02 mg kg(-1)) anaesthesia was induced with IV guaiphenesin (60 mg kg(-1)) and thiopenta...
The minimum infusion rate (MIR) of propofol for total intravenous anesthesia after premedication with xylazine in horses. To investigate an adequate infusion rate of propofol for total intravenous anesthesia (TIVA) in horses, the minimum infusion rate (MIR) comparable to the minimum alveolar anesthetic concentration (MAC) of inhalation anesthetic was determined under constant ventilation condition by intermittent positive pressure ventilation (IPPV). In addition, arterial propofol concentration was measured to determine the concentration corresponding to the MIR (concentration preventing reaction to stimulus in 50% of population, Cp(50)). Further, 95% effective dose (ED(95)) was estimated as infusion rate for acq...
Recent advances in equine abdominal surgery. Laparoscopy is a minimally invasive procedure that has applications as a diagnostic, therapeutic and prognostic technique. Specialized equipment is necessary to perform equine laparoscopy, and there is a large range of instruments, both disposable and non-disposable available. Laparoscopic procedures described include ovariectomy, cryptorchidectomy, adhesiolysis and herniorrhaphy. Laparoscopy can be performed in a standing or dorsally recumbent position, depending on surgeon preference, patient status and the procedure to be performed. Stapling equipment is frequently used in gastrointestinal ...
Intravascular hemolysis associated with severe cutaneous burn injuries in five horses. Five horses were evaluated because of severe cutaneous burn injuries following a barn fire. Gross hemolysis and morphologic changes in RBCs consistent with oxidative damage were detected in all of the horses. Of these horses, 4 became azotemic. The overall goals of treatment included wound care, correction of dehydration and provision of diuresis, control of inflammation, pain management, and prophylaxis against sepsis. After treatment, 2 horses survived and were discharged from the hospital. Red blood cell damage and hemolysis following cutaneous burn injury have been investigated in other sp...
L-Bupivacaine 0.5% vs. racemic 0.5% bupivacaine for caudal epidural analgesia in horses. Bupivacaine is available as a racemic mixture of its enantiomers, d-bupivacaine and l-bupivacaine (LB). The aim of this randomized, double-blind study was to investigate the clinical efficacy and safety of S(-)-bupivacaine compared with standard racemic bupivacaine (RB) in horses under caudal epidural analgesia. Two treatments were administered to each horse, with a 2-week interval between subsequent treatments. Treatment 1 consisted of 0.5% LB at a dose of 0.06 mg/kg of body weight, and treatment 2 consisted of 0.5% RB at a dose of 0.06 mg/kg of body weight. Epidural injections were given in ...
Comparison of topical lidocaine/prilocaine anesthetic cream and local infiltration of 2% lidocaine for episioplasty in mares. Local anesthesia and tissue inflammation associated with lidocaine infiltration and lidocaine/prilocaine topical anesthetic cream for episioplasty in mares were compared. Twenty-two mares were randomly assigned to lidocaine or lidocaine/prilocaine topical anesthetic cream treatment groups. Perineum and vulva were cleaned, 8-12 g (approximately 1 g/cm per side of vulva) of topical anesthetic cream was applied, and the area was covered by plastic wrap 30 min prior to beginning procedure. Alternately, lidocaine was injected (1 mL) every centimeter just prior to the procedure. Episioplasty was con...
Electroencephalographic and cardiovascular variables as nociceptive indicators in isoflurane-anaesthetized horses. To evaluate Fourier-transformed electroencephalographic (EEG) variables, mean arterial blood pressure (MAP) and pulse rate as nociceptive indicators in isoflurane-anaesthetized horses. Methods: Five standardbred and three Norwegian cold-blooded trotter stallions undergoing castration, aged 2-4 years, mass 378-538 kg. Methods: All horses received intravenous (IV) detomidine (10 microg kg(-1) IV) and butorphanol (0.01 mg kg(-1) IV). Additional detomidine (4 microg kg(-1) IV) was administered in the induction area. Anaesthesia was induced with ketamine (2.5 mg kg(-1) IV) and diazepam (40 microg k...
Scintigraphic evaluation of the distal tarsal region in horses with distal tarsal pain. Distal tarsal pain is a common reason for hind limb lameness, but diagnosis cannot always be made on radiographic examination. Scintigraphy may allow detection of subtle changes undetected by other diagnostic methods. We hypothesized that (1) distal tarsal pain would be associated with a loss of the expected pattern of radiopharmaceutical uptake (RU) detected in normal horses, (2) distal tarsal RU would be greater in limbs with tarsal pain than without pain, (3) RU in painful tarsi with radiographic evidence of osteoarthritis (OA) would be greater than in distal tarsal pain with no radiographi...
Neovascularisation in chronic tendon injuries detected with colour Doppler ultrasound in horse and man: implications for research and treatment. Recent research on chronic painful Achilles tendons in humans using ultrasonography and immunohistochemistry, has demonstrated an association between neurovascular ingrowth and tendon pain. In horses, chronic debilitating tendon conditions are well-known to be very difficult to treat, and the background to impaired function and pain is not scientifically clarified. In a collaborative research project between the Sports Medicine Unit in Umeå and Strömsholm Equine Hospital, grey-scale ultrasonography (US) and colour Doppler (CD) examination were performed in ten horses with chronic tendon inju...
Hereditary equine regional dermal asthenia in three related Quarter horses in Brazil. Hereditary equine regional dermal asthenia belongs to a group of inherited, congenital connective tissue dysplasias usually described as hyperelastosis cutis, cutaneous asthenia, dermatosparaxis, or Ehlers-Danlos-like syndrome. This report presents the clinical and histological features of three related Quarter horses affected with regional dermal asthenia. These horses had bilateral asymmetric lesions of the trunk and lumbar regions, where the skin was hyperextensible. Handling of the skin elicited a painful response and superficial trauma led to skin wounds. The skin was thinner than normal ...
Lameness associated with foot pain: results of magnetic resonance imaging in 199 horses (January 2001–December 2003) and response to treatment. The diagnosis of foot-related lameness often remains elusive and it can be difficult to offer rational treatment, or to predict outcome. Objective: To describe the spectrum of injuries of the foot identified using magnetic resonance imaging (MRI), to determine their relative prevalence among MRI diagnoses and to establish the long-term results of treatment. Methods: The MR images of horses examined from January 2001--December 2003 were reviewed. Horses were selected for MRI if the pain causing lameness was localised to the foot using perineural analgesia but any clinical, radiological or ultra...
Effect of systemic lidocaine on visceral and somatic nociception in conscious horses. Commonly used analgesics (nonsteroidal anti-inflammatory agents, opioids and alpha2-agonists) have unwanted side effects. An effective alternative with minimal adverse effects would benefit clinical equine pain management. Objective: To compare the effect of lidocaine or saline on duodenal and rectal distension threshold pressure and somatic thermal threshold in conscious mature horses. Objective: Systemically administered lidocaine would increase somatic and visceral nociceptive thresholds. Methods: Lidocaine (2 mg/kg bwt bolus followed by 50 microg/kg bwt/min for 2 h) or saline was administe...
Concentration of methylprednisolone in the centrodistal joint after administration of methylprednisolone acetate in the tarsometatarsal joint. The centrodistal (CD) and tarsometatarsal (TMT) joints are often injected individually with a corticosteroid to resolve lameness caused by osteoarthritis (OA). There are no data available regarding diffusion of methylprednisolone (MP) from the TMT joint to the CD joint. Objective: A therapeutic concentration of MP diffuses into the CD joint after methylprednisolone acetate (MPA) is administered into the TMT joint. Objective: To measure the concentration of MP in the CD joint after MPA was administered into the TMT joint. Methods: MPA was administered into a TMT joint of 16 horses. At different...
Splenic haemangiosarcoma with metastasis to the cervical musculature in an aged pony. An aged pony gelding presented with sudden onset of neck pain, depression and ataxia and weakness of the hindlegs, together with longer-term weight loss. Diagnostic procedures failed to isolate the cause of these signs and, despite symptomatic treatment, the animal's condition deteriorated until it required euthanasia. Unassigned: Post mortem examination revealed the presence of multiple splenic and hepatic haemangiosarcomata, with metastases to the lung and dorsal cervical muscles overlying C1 and C2 vertebrae. No lesions were present in the spinal cord, spinal column or brain. Conclusions: T...
Use of force plate analysis to compare the analgesic effects of intravenous administration of phenylbutazone and flunixin meglumine in horses with navicular syndrome. To use force plate analysis to evaluate the analgesic efficacies of flunixin meglumine and phenylbutazone administered i.v. at typical clinical doses in horses with navicular syndrome. Methods: 12 horses with navicular syndrome that were otherwise clinically normal. Methods: Horses received flunixin (1.1 mg/kg), phenylbutazone (4.4 mg/kg), or physiologic saline (0.9% NaCI; 1 mL/45 kg) solution administered IV once daily for 4 days with a 14-day washout period between treatments (3 treatments/horse). Before beginning treatment (baseline) and 6, 12, 24, and 30 hours after the fourth dose of each...
A review of equine dental disorders. Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incis...
Evaluation of the analgesic effects of phenylbutazone administered at a high or low dosage in horses with chronic lameness. To compare analgesic effects of phenylbutazone administered at a dosage of 4.4 mg/kg/d (2 mg/lb/d) or 8.8 mg/kg/d (4 mg/lb/d) in horses with chronic lameness. Methods: Controlled crossover study. Animals-9 horses with chronic forelimb lameness. Methods: Horses were treated i.v. with phenylbutazone (4.4 mg/kg/d or 8.8 mg/kg/d) or saline (0.9% NaCl) solution once daily for 4 days. All horses received all 3 treatments with a minimum of 14 days between treatments. Mean peak vertical force (mPVF) was measured and clinical lameness scores were assigned before initiation of each treatment and 6, 12, ...
Injury of the collateral ligaments of the distal interphalangeal joint diagnosed by magnetic resonance. We describe the clinical, imaging, and necropsy findings of two horses with severe injury of the collateral ligaments of the distal interphalangeal (DIP) joint diagnosed using magnetic resonance (MR) imaging. In MR images it was possible to examine the collateral ligaments of the DIP joint from the origin at the middle phalanx to the insertion on the distal phalanx. Both horses in this report had abnormal high signal intensity within the collateral ligaments of the DIP joint, and one horse had abnormal high signal intensity within the bone of the distal phalanx on short tau inversion recovery ...
Management of burn injuries in the horse. Extensive thermal injuries in horses can be difficult to manage. The large surface of the burn dramatically increases the potential for loss of fluids,electrolytes, and calories. Burns are classified by the depth of injury: first-degree burns involve only the most superficial layers of the epidermis;second-degree burns involve the entire epidermis and can be superficial or deep; third-degree burns are characterized by loss of the epidermal and dermal components; and fourth-degree burns involve all the skin and underlying muscle, bone, and ligaments. Burns cause local and systemic effects. Rout...
Comparison of morphine and butorphanol as pre-anaesthetic agents in combination with romifidine for field castration in ponies. The aim of this study was to compare two different alpha2 agonist-opioid combinations in ponies undergoing field castration. Methods: Prospective double-blind randomized clinical trial. Methods: Fifty-four ponies undergoing field castration. Methods: The ponies were randomly allocated to receive one of three different pre-anaesthetic medications [intravenous (IV) romifidine 100 microg kg(-1) and butorphanol 50 micro kg(-1); romifidine 100 microg kg(-1) and morphine 0.1 mg kg(-1) IV, or romifidine 100 microg kg(-1) and saline IV] before induction of anaesthesia with ketamine 2.2 mg kg(-1) IV. F...
