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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.
Management of gastrointestinal pain. Choice of an analgesic for gastrointestinal pain requires consideration of the cause of the pain, desired duration of pain relief, need for sedation, and potential side effects and toxicity, particularly in light of other drugs being used and effects on the gastrointestinal tract. It is imperative that close monitoring be continued to ensure that surgical lesions or worsening conditions are detected. Recent research in the field may lead to new drugs, drug combinations, and avenues of treatment that minimize the side effects of these drugs while maximizing their efficacy.
The role of complementary techniques in managing musculoskeletal pain in performance horses. The locomotor system requires normal movement for normal function. Movement restrictions of soft tissues and joints stimulate nociceptive pathways in the corresponding vertebral segment. Reflex-induced alterations of sensory and motor neuron activity within the segment lead to detrimental changes within many of the tissues associated with and distant from the area. Manual therapy is utilized in both diagnosis and treatment of tissue and joint movement restrictions. Early recognition and treatment of dysfunction in the equine athlete prevents permanent pathology and facilitates performance exce...
Diagnosing and treating pain in the horse. Where are we today? This chapter begins by providing an overview of current philosophies relevant to equine pain management. Objective and subjective techniques for assessing pain and the limitations of these are then described in depth. The conclusion emphasizes the need for an evidence based approach to managing pain in the horse and sets the stage for subsequent chapters in this edition.
Alpha-2 adrenergic agonists as analgesics in horses. Administration of alpha-2 agonists to horses produces a variety of behavioral effects (sedation, somnolence, analgesia), and physiological effects. One of the most significant beneficial effects of administering alpha-2 agonists is the degree of analgesia they provide. Alpha-2 agonists have been the mainstay of analgesia for colic pain in horses since their introduction to clinical veterinary medicine. The increased potency of the more recently introduced alpha-2 agonists allows the provision of analgesia for conditions not previously relieved by other drugs. Unfortunately, there are significa...
Management of equine orthopedic pain. Pain management is an extremely vital part of equine orthopedic surgery. Providing optimum analgesia for the patient will decrease recovery time, decrease physiologic stress on the animal, and provide maximum comfort during the post-operative period. The major analgesic drug categories and routes covered are nonsteroidal anti-inflammatory drugs, local anesthetics, intra-articular drugs, and epidurals.
Use of opioids for pain and anesthetic management in horses. REGIONAL ADMINISTRATION: There is limited, but convincing, evidence that epidural administration of morphine and some other mu-agonist opioids consistently relieves regional pain in horses. In addition, this effect is not accompanied by notable undesirable effects. On the other hand, a clinically important analgesic action has not been demonstrated for similarly administered kappa-agonist opioids. There has been little objective data presented to support the analgesic effectiveness of intra-articularly administered opioids in horses. However, the evidence of local opioid receptors legitimately...
Nontraditional approaches to pain management. The word nontraditional in the context of this article implies those modalities not normally taught in veterinary medical schools. This word has the same definition of Complementary and Alternative Medicine (CAM) as put forth by the Harvard medical school. CAM is a field of medicine that has enjoyed a recent increase in popularity in both human and equine medicine, particularly in regard to pain management. Some of the more recognized modalities include acupuncture, herbalism, and homeopathy. A brief discussion regarding the theory, scientific evidence and use of these therapies in the treatme...
Epidural morphine and detomidine decreases postoperative hindlimb lameness in horses after bilateral stifle arthroscopy. To determine whether preoperative epidural administration of morphine and detomidine would decrease postoperative lameness after bilateral stifle arthroscopy in horses. Methods: Prospective clinical controlled study. Methods: Eight adult horses that had bilateral arthroscopic procedures, including drilling of cartilage and subchondral bone within the femoropatellar joints. Methods: Horses were randomly separated into 2 groups. Preoperatively, 4 horses were administered a combination of epidural morphine (0.2 mg/kg) and detomidine (30 microg/kg), and 4 horses were administered an equivalent vol...
Osteoarthrosis of the antebrachiocarpal joint of 7 riding horses. Osteoarthrosis (OA) of the antebrachiocarpal joint from 7 riding horses is described. The horses were old mares and developed severe OA, with ankylosis in some of the joints. The lesions were bilateral, and the owners noticed the lameness in a late event. The cause of severe OA in these mares is not clear. The fact that OA was bilateral indicates that a single traumatic injury is unlikely as an etiologic factor. Considering the severe joint lesions it took long time before the horse-owners noticed the lameness. It is discussed if the threshold of pain is higher in the antebrachiocarpal joint c...
Subjective and quantitative scintigraphic assessment of the equine foot and its relationship with foot pain. It was hypothesised that in solar bone images of the front feet of clinically normal horses, or horses with lameness unrelated to the front feet, there would be less than a 10% difference in the ratio of uptake of radiopharmaceutical in either the region of the navicular bone, or the region of insertion of the deep digital flexor tendon (DDFT), compared to the peripheral regions of the distal phalanx. Nuclear scintigraphic examination of the front feet of 15 Grand Prix show jumping horses, all of which were free from detectable lameness, was performed using dorsal, lateral and solar images. Th...
Treatment of experimental equine osteoarthritis by in vivo delivery of the equine interleukin-1 receptor antagonist gene. Osteoarthritis in horses and in humans is a significant social and economic problem and continued research and improvements in therapy are needed. Because horses have naturally occurring osteoarthritis, which is similar to that of humans, the horse was chosen as a species with which to investigate gene transfer as a potential therapeutic modality for the clinical treatment of osteoarthritis. Using an established model of equine osteoarthritis that mimics clinical osteoarthritis, the therapeutic effects resulting from intra-articular overexpression of the equine interleukin-1 receptor antagonis...
Listeria keratitis in a horse. Listeria monocytogenes is ubiquitous in the environment but is rarely reported as a cause of keratitis in animals. In this case, a mare was presented with epiphora and evidence of pain in the right eye. Listeria monocytogenes was isolated from a corneal lesion, and bacteria were also seen in the cytologic evaluation. This is the first reported case of ulcerative keratitis associated with L. monocytogenes in a horse.
Determination of a gravity and shock score for prognosis in equine surgical colic. A retrospective study evaluated 200 surgical colic cases. A gravity score (GS) based on four clinical parameters estimating intestinal obstruction (rectal palpation, borborygmi, abdominal distension, pain) and classified into three categories was established and tested to determine if it could evaluate prognosis. A shock score (SS) based on six parameters was also attributed to each case. The overall survival rate was 54%. The statistical analysis showed a significant (P < 0.01) difference in the survival rate in the different categories of the GS, as well as in the categories of the SS. A ...
Arthroscopic anatomy of the equine temporomandibular joint. To develop an arthroscopic approach to, and describe the arthroscopic anatomy of, the equine temporomandibular joint (TMJ). Methods: Cadaveric study, after which the technique was tested in horses. Methods: Ten cadaveric equine heads and 5 normal horses (age, 5-13 years; weight, 425-545 kg). Methods: Specimens or horses were positioned in right lateral recumbency. After fluid distention of the TMJ, arthroscopic portals were made in the dorsal compartment over the most prominent portion of the joint outpouching (caudodorsal approach) and in rostral and intermediate locations. The joint was expl...
Laparoscopic ovariectomy using sequential electrocoagulation and sharp transection of the equine mesovarium. To describe in horses and ponies a laparoscopic ovariectomy technique facilitated by electrosurgical instrumentation. Methods: Elective ovariectomy was performed in 23 mares using laparoscopic electrosurgical instrumentation. Methods: Twenty-three mares (13 horses, 10 ponies), aged from 2 to 21 years and weighing 90 to 545 kg. Methods: Food was withheld for a minimum of 12 hours. Mares were sedated with detomidine hydrochloride (0.02 to 0.03 mg/kg) or xylazine hydrochloride (0.5 to 1.0 mg/kg). Excluding the pony mares, all other mares were restrained in stocks. Portal sites in the paralumbar f...
Use of the Accusport semi-automated analyser to determine blood lactate as an aid in the clinical assessment of horses with colic. The most useful diagnostic methods in the initial evaluation of horses with colic assess the morphological and functional status of the gastrointestinal tract and cardiovascular status. This evaluation is best achieved using a combination of clinical and laboratory data. Blood lactate concentration (BL) is one of these variables. BL rises mainly due to poor tissue perfusion and anaerobic glycolysis associated with shock, providing an indicator of both the severity of disease and its prognosis. A hand-held lactate meter, Accusport, provides a rapid (60 seconds), inexpensive dry-chemical-based d...
Voluntary limb-load distribution in horses with acute and chronic laminitis. To compare limb-load distribution between horses with and without acute or chronic laminitis. Methods: 10 horses with carbohydrate-induced acute laminitis, 20 horses with naturally occurring chronic laminitis, and 20 horses without foot abnormalities (controls). Methods: Limb-load distribution was determined, using a custom-designed system that allowed simultaneous quantification of the mean percentage of body weight voluntarily placed on each limb (ie, mean limb load) and the SD of the mean load over a 5-minute period (ie, load distribution profile [LDP]). Load distribution profile was used a...
Evaluation of opioid receptors in synovial membranes of horses. To evaluate mu-opioid receptors in synovial membranes of horses and determine whether these receptors are up-regulated in nerve endings during inflammation. Methods: Synovial tissue obtained from 39 client-owned horses during arthroscopy and 14 research horses during necropsy; brain and synovial tissues were obtained during necropsy from 1 horse, and control tissues were obtained from a mouse. Methods: Horses were classified into 7 groups on the basis of histologically determined degree of inflammation. Binding of primary rabbit antibody developed against mu-opioid receptors in equine synovial...
Analgesic effect of butorphanol and levomethadone in detomidine sedated horses. The analgesic potency of butorphanol 25 microg/kg bodyweight (BW) and levomethadone 100 microg/kg BW, administered together with detomidine 10 microg/kg BW, was measured in twelve Warmblood horses in a randomized, blinded cross-over study. Detomidine with saline 10 ml 0.9% was used as placebo. The nociceptive threshold was determined using a constant current and a pneumatic pressure model for somatic pair Detomidine alone and in combination with butorphanol or levomethadone caused a significant temporary increase (P < 0.05) of the nociceptive threshold with a maximum effect within 15 min and a...
The influence of lameness on equine stride length consistency. The aim of this study was to assess the influence of orthopaedic pain on the variation of stride length as a kinematic system-parameter in 21 horses with forelimb lameness. Data were collected while the horses were trotting on a treadmill during a minimum of 12 motion cycles, both before and after intra-articular or perineural anaesthesia. Stride length was assessed for each motion cycle, and the mean and standard deviation were calculated for each condition. Forelimb lameness was documented as percentage of asymmetry of vertical head movement. With significant decrease of forelimb lameness af...
A comparison of the effects of local analgesic solution in the navicular bursa of horses with lameness caused by solar toe or solar heel pain. We hypothesised that analgesia of the navicular bursa is not selective for the navicular apparatus; and that solar pain in some horses can be temporarily abolished or attenuated by analgesia of the navicular bursa. To test this hypothesis, we caused lameness in horses by inducing pain in the dorsal margin or the angles of the sole and then evaluated the ability of a local analgesic solution administered into the navicular bursa to attenuate lameness. The response of horses with solar pain in the dorsal or palmar aspect of the foot to 3.5 ml local analgesic solution administered into the navicu...
Analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares. To determine the analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares. Methods: 7 healthy mares. Methods: Each mare received meperidine (5%; 0.8 mg/kg of body weight) or saline (0.9% NaCl) solution via caudal epidural injection on 2 occasions. At least 2 weeks elapsed between treatments. Degree of analgesia in response to noxious electrical, thermal, and skin and muscle prick stimuli was determined before and for 5 hours after treatment. In addition, cardiovascular and respiratory variables were measured and degree of se...
Penile amputation and sheath ablation in the horse. To report a surgical technique for penile amputation and sheath ablation in horses. Study Design-Retrospective study. Animals or Sample Population-Twenty-five adult geldings of various breeds with conditions requiring penile amputation and sheath ablation. Methods: The medical records of horses that had penile amputation and sheath ablation were reviewed. Briefly, the technique involved en bloc resection of the skin and subcutaneous tissues of the inner and outer lamina of the prepuce and penile shaft. Resection of the penile shaft, proximal to diseased segments, and spatulation of the urethra...
