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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.
Pharmacologic and alternative therapies for the horse with chronic laminitis. This article deals with treatment of the chronically foundered horse. The first section of this article is focused on aspects of the traditional pharmacologic approaches to management of digital pain and sepsis, dietary management, and thyroid supplementation. A second section introduces the concepts, principles, and agents that are used in homeopathic treatments for laminitis. Lastly, a third section of this article reviews the use of acupuncture and traditional Chinese medicine approaches to treatment of chronic laminitis.
Trimming and shoeing the chronically affected horse. Several of the technical approaches applied to the foot overlap with regard to intent. Frog or solar support, for example, may be provided either to stabilize the distal phalanx within the hoof capsule or in an effort to unload regional pain arising from the solar surface of the foot. It is likewise obvious that some techniques such as lowering the heels to achieve phalangeal realignment and raising the heels to relieve deep digital flexor tendon tension are contradictory. In these instances, it is not that one technique is always correct but that differences exist among horses. Currently, it ...
The pathophysiology of chronic laminitis. Pain and anatomic pathology. The potential pathologic manifestations of chronic laminitis are just as varied, and possibly more so, than the list of possible inciting agents of the disease itself. The extent to which rehabilitation and return to normal function can be attained, cannot always be accurately determined by physical examination. It should be remembered that significant physiologic and pathologic alterations occur in chronic laminitis; thus, even if radiographically the patient returns to a normal appearance, residual morphologic and structural defects are likely to remain.
Anatomy of the thoracolumbar vertebral region. A thorough understanding of the structure and function of the equine vertebral column can provide a clearer understanding of thoracolumbar spinal disorders. Three primary functions of the vertebral column include protection of the spinal cord, support for weight bearing, and flexibility for locomotion. Osseous structures provide structural support and vary from one vertebral region to another as functional requirements change. The spinal musculature produces complex vertebral movements while the spinal ligaments provide stability to the vertebral column. Proprioception and nociception are two ...
Medical management of back pain. The most common causes of back pain and their medical treatment are discussed. These include: dermatologic problems and conditions resulting from saddle trauma; discomfort and stiffness owing to injured paraspinal muscles; pain associated with supraspinous ligament damage; osseous pain and nerve dysfunction related to the spine and sacroiliac area; and neurologic diseases that can manifest as back pain. Bitting problems, cervical pain, and coexisting lameness are also considered.
Physical examination of horses with back pain. The diagnosis of back pain is often a diagnosis of exclusion of other problems in the face of poor performance. It requires careful observation, thought, an open mind, and experience. The signs of back pain can be extremely variable and range from subtle to obvious. Obvious forelimb or hind limb lameness is not usually a sign of back pain. The most common differential diagnosis may be back pain secondary to degenerative joint disease of the hocks, fetlocks, or stifle. These diseases can mimic signs of back pain including lack of impulsion, shortening of the stride length, and change in the str...
Thermographic diagnostics in equine back pain. Infrared thermographic imaging (ITI) is the most sensitive objective imaging currently available for the detection of back disease in horses. It is, however, only a physiological study primarily of vasomotor tone overlying other superficial tissue factors. Interpretation requires extreme care in imaging protocol and in understanding the significance of altered sympathetic nervous tone and the sympathetic distribution. Most discussions on back pain have centered on nociception and inflammatory events. ITI provides information and localization for more significant than diagnosing areas of hot sp...
Acupuncture as a treatment modality for back problems. Concepts of acupuncture in traditional Chinese medicine are presented for clarity and contrast to Western medical concepts. Various acupuncture techniques and methods are discussed including dry needling, electroacupuncture, acupuncture using hypodermic needles, and injecting various solutions into the acupuncture sites. Potential complications and precautions are also presented. A type of chronic back pain is discussed that is possibly associated with a radiculopathically induced, hypersensitivity myofascial syndrome that presents as a fibromyalgia-like syndrome. Effective acupuncture treatme...
Lack of local anaesthetic efficacy of fentanyl in the abaxial sesamoid block model. Fentanyl and other opioid drugs have their effect in the central nervous system; however, activity at peripheral sites has also been demonstrated. Pain-suppression activity at peripheral sites raises the possibility of skilled individuals producing local anaesthetic effects with small doses of opioid drugs that would be difficult to detect forensically and could be used to affect the outcome of a race. Therefore, the local pain-suppression effect (peripheral nerve inhibition) of fentanyl was tested using an abaxial sesamoid block/hoof withdrawal model. With this model, fentanyl did not produce...
Incarceration of the small colon through a rent in the gastrosplenic ligament in a pony. A 10-year-old castrated male pony was examined for intermittent signs of abdominal pain of 3 days' duration. An incarceration of the small colon through a rent in the gastrosplenic ligament was found. Resection and end-to-end anastomosis were performed on the affected portion of the small colon. The pony recovered and returned to its previous degree of activity. Incarceration of the small intestine and large colon through rents in the gastrosplenic ligament are documented, although involvement of the small intestine is more common. To the best of our knowledge, incarceration of the small colon...
Endoscopy of the intertubercular bursa in horses. Forelimbs from 3 anesthetized horses and 16 fresh cadaver horses were used to describe the endoscopic anatomy of the intertubercular bursa and outline the surgical portals that provide the greatest access to structures within the bursa. A lateral arthroscopic portal was made proximal to the deltoid tuberosity of the humerus into the distal bursal recess. A second portal was created proximal to the humeral tubercles that entered the proximal bursal space. These approaches provided consistent viewing and instrument access to the lateral intertuberal groove, the greater and intermediate humeral t...
Innervation of the equine mature and immature proximal sesamoid bone by calcitonin gene-related peptide and substance P-containing nerves. To localize and determine relative frequency of occurrence of calcitonin gene-related peptide (CGRP) and substance P (SP) fibers in the proximal sesamoid bones (PSB) and adjacent structures in sound horses. Methods: 4 foals and 3 adult horses. Methods: Medial PSB and adjacent ligaments of both forelimbs were collected, flushed, and fixed in buffered 4% formalin. The left PSB were cut into 5 longitudinal, sagittally oriented slabs, and the right PSB were cut into 5 transverse slabs. After decalcification in EDTA, slices were transferred to a 30% sucrose solution, deep frozen, sectioned (80 micr...
Characterization of the antinociceptive and sedative effect of amitraz in horses. Amitraz, an acaricide used to control ectoparasites in animals has a complex pharmacological activity, including alpha2-adrenergic agonist action. The purpose of this research was to investigate the possible antinociceptive and/or sedative effect of amitraz in horses. The sedative effect of the intravenous (i.v.) injection of dimethylformamide (DMF, 5 mL, control) or amitraz (0.05, 0.10, 0.15 mg/kg), was investigated on the head ptosis test. The participation of alpha2-adrenergic receptors in the sedative effect provoked by amitraz was studied by dosing yohimbine (0.12 mg/kg, i.v.). To measure...
Epidural injection of ketamine for perineal analgesia in the horse. To determine the analgesic, sedative, and cardiopulmonary effects of epidural ketamine in the horse. Methods: Six healthy horses (three males and three females) weighing between 350 and 450 kg. Methods: Three doses of ketamine were selected (0.5, 1, 2 mg/kg). Two months before the beginning of experiments, the carotid artery was exteriorized, and 1 week before experiments began, an epidural catheter was placed percutaneously in all animals with the tip located 12 cm cranially in the midsacrum. One week later, either saline (control) or one of three doses of ketamine was injected epidurally. Ea...
[The proximal sesamoid bone of the horse; vascular and neurologic characteristics]. Sesamoiditis is characterized clinically by repeated lameness and radiologically by changes in the proximal sesamoid bones. This thesis, which was defended in June 1997, investigated two characteristics of sesamoiditis, namely the arterial blood supply and the innervation of the proximal sesamoid bones, in order to gain more insight into the etiopathogenesis of sesamoiditis. Experiments with patient material showed that the proximal sesamoid bones have an enormous arterial reserve, due in part to the formation of an arterial shift. Moreover, the sesamoid bones have their own sensory innervatio...
HPLC on Chiralcel OJ-R for enantiomer separation and analysis of ketoprofen, from horse plasma, as the 9-aminophenanthrene derivative. Racemic ketoprofen is a non-steroidal anti-inflammatory drug used to treat musculoskeletal and colic conditions in horses. The enantioselective chiral inversion of ketoprofen administered to horses has been studied by use of cellulose tris(4-methylbenzoate), also known as Chiralcel OJ-R, as chiral stationary phase; acetonitrile - 0.02 M perchlorate buffer (pH 2.0)-methanol, 60:15:25 (v/v/v) was used as mobile phase. Before chromatography, to effect adequate chiral interaction with the chiral stationary phase ketoprofen was derivatized with 9-aminophenanthrene, under acid conditions, after soli...
[Marking of horses]. The author informs on up to date identification methods of horses. The implantation of passive transponders is a practicable method for marking of horses. Because it gives less pain to horses, this method is to prefer. Stress inflicted on horse is minimal, it compares to a intramuscular injection. The reliability of the system in use has so far been very high. Members of ISO have voted overwhelmingly in favor of a standard for electronic identification of animals. From now on, countries and user organizations can make use of this technique to identify animals and if used can rely on the fact t...
Role of prokinetic drugs for treatment of postoperative ileus in the horse. All horses undergoing coeliotomy for an acute abdominal crisis are at risk of developing ileus and should receive therapy aimed at promoting gastrointestinal function by restoring fluid and electrolyte balance. Adequate analgesia and prevention against peritonitis, bacteraemia and endotoxaemia should be provided. Horses that at the time of surgery have a strangulating or non-strangulating small intestinal obstruction should be considered to be at greater risk of developing a persistent ileus that is refractory to treatment than those horses with lesions involving the large intestine. In horses...
Influence of atipamezole on effects of midsacral subarachnoidally administered detomidine in mares. To examine effects of atipamezole on detomidine midsacral subarachnoidally-induced analgesia, cardiovascular and respiratory activity, head ptosis, and position of pelvic limbs in healthy mares. Methods: 10 healthy mares. Methods: Using a randomized, blinded, crossover study design, mares received detomidine (0.03 mg/kg of body weight, diluted in 3 ml of CSF) midsacral subarachnoidally, followed by atipamezole (0.1 mg/kg [test]) or sterile saline (0.9% NaCl) solution (control), i.v. 61 minutes later and saline solution (3 ml, midsacral subarachnoidally) on a separate occasion, at least 2 weeks...
Use of laparoscopic equipment to divide abdominal adhesions in a filly. Exploratory laparoscopy of the right dorsal portion of the abdominal cavity was performed on a Standardbred filly because of signs of mild abdominal pain of 7 days' duration. On the basis of clinical examination, diagnosis was suppurative peritonitis, abdominal adhesions in the area of the right ovary, and right displacement and impaction of the pelvic flexure of the ascending colon. During laparoscopy, an abdominal adhesion between the right uterine horn, the cecum, and the pelvic flexure was identified. The abdominal adhesions were either stretched with laparoscopic forceps used as a probe o...
Laparoscopic adhesiolysis in a horse. The purpose of this report was to describe the use of laparoscopy as a method of treatment for abdominal adhesions in the horse. Methods: Unilateral ovariectomy for removal of a granulosa cell tumor was performed through a diagonal paramedian approach in a 14-year-old Arabian mare. Progressive incisional swelling and hemorrhage culminated in acute incisional dehiscence with herniation of ileum on the sixth postoperative day. Septic peritonitis that responded to parenteral antibiotic therapy was identified 7 days after hernia repair. Seven days later, the mare had signs of abdominal pain, and a...
Ovarian torsion associated with granulosa-theca cell tumor in a mare. A 12-year-old Morgan mare was examined because of stallion-like behavior of 45 days' duration. Palpation per rectum and transrectal ultrasonographic examination revealed a large left ovary with multiple cystic areas and crepitus. A granulosa-theca cell tumor was suspected. During hospitalization for further evaluation of the affected ovary, the mare developed signs of abdominal pain. Exploratory surgery revealed a large left ovary, which was black with a necrotic and friable surface, and a 720 degrees clock-wise torsion of the ovarian pedicle. Torsion was corrected, and oophorectomy was perfor...
Effect of high volume epidural morphine, ketamine and butorphanol on halothane minimum alveolar concentration in ponies. This study determined the effects of epidurally administered morphine, ketamine and butorphanol on halothane minimum alveolar concentration (MAC) in ponies. Seven ponies were anaesthetised with thiopentone and succinylcholine, intubated and anaesthesia maintained with halothane. Ventilation was controlled and blood pressure was maintained within normal limits. Following the determination of baseline halothane MAC for the pelvic and thoracic limbs the ponies were given morphine (0.1 mg/kg bwt), ketamine (0.8 or 1.2 mg/kg bwt), butorphanol (0.05 mg/kg bwt) or saline, epidurally, to a final volum...
Use of tenoscopy for management of septic tenosynovitis caused by a penetrating porcupine quill in the synovial sheath surrounding the digital flexor tendons of a horse. A 6-year-old Quarter Horse gelding with acute onset of a grade-4/5 lameness of the left forelimb 21 days after an encounter with a porcupine was examined. Quills had been removed by the referring veterinarian, and the horse had been treated with antibiotics and hydrotherapy for 14 days. The horse was pyretic and had effusion in the digital synovial sheath. Signs of pain were elicited on palpation of the area. A tentative diagnosis of septic tenosynovitis caused by a porcupine quill was made. Exploratory tenoscopy revealed large amounts of fibrin in the sheath and a 1.2-cm quill. Bacteriologic ...
