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.
The effect of the high palmar nerve block and the ulnar nerve block on lameness provoked by a collagenase-induced tendonitis of the lateral branch of the suspensory ligament. Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulna...
Treatment and outcome of chronic tenosynovitis in three horses. Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for ...
Ventral abdominal approach for laparoscopic ovariectomy in horses. Eleven mares and four mules were ovariectomized by a ventral abdominal laparoscopic technique. This approach required tilting the operative table about 30 degrees elevating the pelvis to allow observation of the ovaries. A triangulation technique with a single laparoscopic portal and four instrument portals was used. The ovarian pedicles were ligated and the ovaries were removed through a single enlarged instrument portal. Females ranged in age from 5 months to 18 years. Mean operative time was 44 minutes (range 20 to 90 minutes); mean operative time of the last seven animals was 26 minutes. S...
Comparison of polysulphated glycosaminoglycan and sodium hyaluronate with placebo in treatment of traumatic arthritis in horses. A randomised double blind and placebo controlled clinical study was carried out. Standardbred trotters (n=77), age 3-4 years) with moderate to severe lameness were grouped according to number of affected joints and, within each group, were randomised for treatment with polysulphated glycosaminoglycan (PSGAG), sodium hyaluronate (SH) or placebo for 3 weeks. The horses were inspected weekly with a final examination 2-4 weeks after the end of treatment. Mean initial lameness score was significantly reduced during treatment and at the last examination in all 3 groups (P<0.01). Additionally, the...
Bilateral lameness in horses–a kinematic study. The kinematic pattern of mild bilateral lameness was studied by inducing a supporting limb lameness in both fore-limbs of 11 sound Dutch Warmblood horses. The kinematics of the horses were recorded while they trotted (3.5 m/s) on a treadmill. The locomotion analysis system CODA-3 was used to determine the temporal stride patterns, limb movements as well as head and trunk movement patterns. The transient lameness model, by which pressure-induced pain is evoked on the hoof sole, was used. Differences between left and right limbs as well as between the sound and the lame condition were tested usi...
Tendonitis of the deep digital flexor tendon in the distal metacarpal/metatarsal region associated with tenosynovitis of the digital sheath in the horse. Twenty-four horses with ultrasonographic evidence of tendonitis of the deep digital flexor tendon in the metacarpal/metatarsal region were seen over a 7 year period. Most horses had mild to moderate lameness and distension of the digital flexor tendon sheath in the affected limb. Intrasynovial analgesia of the digital flexor tendon sheath consistently improved the degree of lameness. Ultrasonography most commonly revealed small, distinct, often circular, focal hypoechoic areas within the deep digital flexor tendon which usually extended less than 1 cm proximodistally. The degree of lameness an...
Uterine torsion associated with small intestinal incarceration in a mare at 126 days of gestation. A mare at 126 days of gestation was examined because of signs of abdominal pain. The cause of abdominal pain could not be determined by physical examination. Lack of response to analgesics and small intestinal distention on palpation per rectum prompted exploratory celiotomy. Small intestine was found to be entrapped by the uterus, which had undergone torsion. The uterus was returned to its correct position, and the small intestine was decompressed. After surgery, the mare was treated with orally administered progestin to prevent abortion. The mare recovered and delivered a live foal at 354 da...
Effects of ketoprofen and phenylbutazone on chronic hoof pain and lameness in the horse. The analgesic effects of the nonsteroidal anti-inflammatory drugs, ketoprofen (2.2 and 3.63 mg/kg bwt) and phenylbutazone (4.4 mg/kg bwt) were compared in 7 horses with chronic laminitis. Hoof pain was quantified objectively by means of an electronic hoof tester and lameness was subjectively graded on a modified Obel scale. Ketoprofen at a dose of 3.63 mg/kg bwt (phenylbutazone equimolar dose) reduced hoof pain and lameness to a greater extent than the 2.2 mg/kg dose and phenylbutazone. These effects were still present at 24 h in 3 of the 4 pain tests, including lameness grade. These data sugg...
Evaluation of tissue adhesive to contain axonal regeneration in horses. Bilateral palmar and plantar digital neurectomies were completed in 10 horses (a total of 80 neurectomies) using one of three methods: (1) simple transection (guillotine method); (2) epineural capping; (3) n-butyl cyanoacrylate injected into the epineural sheath to act as a nerve sealant. Horses were regularly evaluated clinically for tenderness in and around the surgical site, as well as skin sensation at the coronary band in the heel region, during the 12-week course of the study. None of the surgical sites exhibited any signs of drainage or infection. Horses were then euthanatized, the nerv...
Sedative and analgesic effects of detomidine and romifidine in horses. In a double blind study, eight horses were treated intravenously at seven-day intervals with detomidine at doses of 10, 20 and 40 micrograms/kg, or with romifidine at doses of 40, 80 and 120 micrograms/kg, or with a placebo solution. Their sedative and analgesic effects were evaluated by objective measurements and by a clinician at 15-minute intervals for three hours and the horses' instability in stocks, locomotor ataxia and heart rate were recorded simultaneously. The administration of both drugs at all doses resulted in sedation. The sedation achieved with romifidine was significantly shall...
Eicosanoid concentrations in digital venous blood from horses with chronic laminitis. The eicosanoids are a family of lipid-derived autocoids that are released in response to a variety of physical and hormonal stimuli. In this study, prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) were measured in the digital veins of clinically normal horses and horses with chronic laminitis to determine whether these arachidonic acid metabolites have a role in mediating signs of hoof pain and lesions associated with chronic laminitis. Horses were evaluated at rest and after a brief exercise period, to determine whether eicosanoids are released into the circulation after mild concussion. Dig...
Pheochromocytoma in two horses. A 12-year-old Standard-bred mare and a 21-year-old Quarter Horse gelding were treated for signs of abdominal pain and sweating. The mare also had muscle fasciculations, azotemia, and ataxia, and was euthanatized after signs of pain became refractory to analgesics. The gelding died when ventricular tachycardia developed during general anesthesia for exploratory celiotomy. Adrenal pheochromocytomas (bilateral in the mare), associated with retroperitoneal and intra-abdominal hemorrhage, were found on postmortem examination. Pheochromocytoma should be considered in older horses with signs of abdom...
Large colon impaction in horses: 147 cases (1985-1991). Medical records from all horses with large colon impaction admitted between 1985 and 1991 were examined. Large colon impaction was diagnosed in 147 of 1,100 (13.4%) horses with colic. One hundred thirty horses were admitted for further evaluation of acute onset of abdominal pain after having been examined and treated by referring veterinarians, and 17 horses that were hospitalized for unrelated medical problems developed large colon impaction. Female horses (92/147; 62.6%) were more commonly affected than males. The age ranged from 1 to 29 years (median, 7.1 years). Mean duration of clinical s...
Quantitative electroencephalographic evaluation to determine the quality of analgesia during anesthesia of horses for arthroscopic surgery. We compared the anesthetic combination of detomidine, ketamine, and halothane in control horses not undergoing apparently painful procedures with that in horses during arthroscopic surgery. The effectiveness of this regimen in suppressing neurologic response to surgery was, thus, evaluated. In this study, significant differences were not observed in electroencephalographic total amplitude, spectral edge, or beta-to-delta frequency ratio between surgically treated and nonsurgically treated (control) horses. On the basis of its attenuation of encephalographic responses, we conclude that detomidi...
Ovariohysterectomy in six mares. Six mares had ovariohysterectomy performed for chronic pyometra associated with cervical abnormalities, uterine neoplasia, or removal of a macerated fetus. Ovariohysterectomy was performed through a ventral midline incision with access to the ovarian and uterine vessels aided by traction on the uterus and retraction of abdominal viscera. Abdominal pain, the most common complication after surgery, occurred in four mares but resolved within 36 hours. Peritonitis occurred in two mares; one mare was subsequently euthanatized. Other complications that resolved with treatment included infection of t...
[Publication of a valid determination–cauterization in horses]. Cauterization in horses is a painful method to enable the identification of horses. This method is not allowed (section 17 Nr. 2b Tierschutzgesetz, FRG), because recent findings have found a painless method to identify horses.
Use of sodium monoiodoacetate to fuse the distal hock joints in horses. Intra-articular injection of sodium monoiodoacetate (MIA) was investigated as an agent for chemical arthrodesis of the distal hock joints in the horse. Five horses diagnosed with either spavin (three horses), a small tarsal bone fracture or a failed surgical arthrodesis, had 150 mg of MIA injected into the tarsometatarsal (TMT) joint of the affected hock(s). Eight joints were treated in the five horses. Follow-up evaluation by clinical and radiological examination took place over 9 to 14 months. Two of the five horses were sound at the conclusion of the study and one horse, although lame after...
Acute laminitis. Laminitis is an inflammation of the sensitive laminae along the dorsal aspect of the digit and is considered to be a secondary complication of several predisposing or primary factors. Affected horses are usually very lame, have increased digital pulses, are painful to hoof testers along the toe of the foot, and have evidence of downward rotation or distal displacement of the distal phalanx present on radiographs. Treatments for acute laminitis include anti-inflammatory drugs, anti-endotoxin therapy, vasodilators, antithrombotic therapy, corrective trimming and shoeing, and surgical procedures....
Emergency analgesia and chemical restraint in the horse. Clinical examination of the equine patient with acute abdominal pain should identify the affected body system and yield a provisional diagnosis. Determination of signalment, history, physical examination, and basic laboratory tests should assist in classification of the gastrointestinal disorder and direct the therapeutic plan. Determination of the definitive diagnosis of abdominal pain based on clinical examination is not crucial. For a successful outcome, efforts should be directed toward early recognition of the need for surgery and treatment of cardiovascular compromise in horses with seve...
Management of orthopedic emergencies. Initial management of injuries includes safely gaining control of the animal and assessing and treating systemic shock. If hemorrhage is life threatening, it must be controlled. If the limb is nonfunctional it should be stabilized. Any open orthopedic injury should be treated by cleaning the tissues, protecting the exposed tissues, and administering systemic antibiotics. A commercial splint is available (Equine Regular Leg Saver Splint, Kimzey Welding Works, Woodland, CA) that can immobilize and relieve weightbearing for cases of phalangeal fracture, flexor tendon rupture, fetlock breakdown, a...
Plasma concentrations and therapeutic efficacy of phenylbutazone and flunixin meglumine in the horse: pharmacokinetic/pharmacodynamic modelling. The purpose of the present study was to establish in the horse the relationship between plasma concentration profiles of phenylbutazone (PBZ) and flunixin meglumine (FM) and their pharmacological effects in order to build a predictive pharmacokinetic/pharmacodynamic (PK/PD) model. In five horses, an experimental arthritis was induced by injecting Freund's adjuvant into a carpal joint. PBZ (4 mg/kg) and FM (1 mg/kg) were injected by the intravenous route as a single intravenous dose in two different trials. Five pharmacodynamic end-points were regularly measured after test article injection usi...
Comparison of the cranial and a new lateral approach to the femoropatellar joint for aspiration and injection in horses. The genual joint in horses is complex, making synovial fluid aspiration and injection of the femoropatellar joint difficult. Horses commonly have signs of resentment to needle penetration at this site. We compared the safety and efficacy of a new technique, using a lateral approach to the femoropatellar joint, with that of the standard cranial approach in 12 horses. A significantly greater amount of fluid was obtained with the lateral approach (2.0 +/- 0.5 ml, mean +/- SEM) than with the cranial approach (0.9 +/- 0.2 ml). Significant differences were not observed in color, nucleated cell count...
Acute effects of perineural administration of sodium hyaluronate on palmar digital neurectomy sites in horses. Biaxial palmar digital neurectomy of all limbs was performed on 6 mixed-breed castrated adult male horses, using a standard guillotine method. Using a Teflon catheter, 20 mg (2 ml) of sodium hyaluronate (group 1), 2 ml of phosphate-buffered saline solution (group 2), or catheter placement with no infusion (group 3) was applied to 4 (group 1) or 2 (groups 2 and 3) of 8 incisions/horse. Treatments were administered after closure of the neurectomy incision, and the catheter was removed. Horses were evaluated daily for 1 week, then weekly over a 9-week period for evidence of lameness, swelling, an...
Lead foreign body arthropathy in a horse. A diagnosis of degenerative joint disease secondary to an intra-articular metallic foreign body in the right metacarpophalangeal joint was made in a Quarter Horse gelding. Arthroscopy, performed to evaluate the joint and remove the foreign body, revealed yellow discoloration of the articular cartilage and synovium, and blunting and proliferation of the synovium. The foreign body was identified as a lead sphere. Microscopic examination of synovium revealed chronic synovitis, with accumulation of hemosiderin and multifocal, mild mineralization. Another pigment was evident extracellularly in the ...
Bilateral tibial metaphyseal stress fractures associated with physitis in a foal. A 7-month-old Appaloosa foal had bilateral hind limb lameness and was unable to rise from recumbency without assistance. Lameness could be exacerbated by tarsal flexion and a firm swelling at the distomedial aspect of the tibias was associated with a marked pain response when palpated. Radiography revealed enlargement of the distal tibial metaphysis physis (compared with normal), and radiolucent fissure lines extending proximally from the physis into the metaphysis at its medial aspect. Treatment included rest and dietary adjustment. Although clinical signs initially resolved following treatme...
Comparative effects of mu and kappa opiate agonists on the cecocolic motility in the pony. The electrical and mechanical activity of the large intestine and its response to administration of opiate mu and kappa agonists were assessed from electrodes and inductograph coils chronically implanted on the cecocolic segment in six ponies given a diet of hay and concentrates. Before the drugs were given, migrating complexes propagating from the cecum into the colon occurred at the rate of 1.5 to 16/hour. During this propulsive activity, the cecocolic sphincter opened and closed allowing the outflow of cecal contents and preventing the backflow of colic contents. Each pony was used as its o...
Nerve supply of the proximal sesamoid bone in the horse. In chronical proximal sesamoid bone lameness it is difficult to localise the exact site of pain. A specific diagnostic analgesia is not available because of a deficiency of detailed information about the nerve supply to the proximal sesamoid bones and surrounding area. A macroscopic study of the nerve distribution to the proximal sesamoid bones of 10 foals and 5 adult horses revealed that these bones are innervated by two branches, in this study called the medial and lateral sesamoidean nerve, respectively, originating from the medial and lateral palmar nerve. Histology of the left forelimbs o...
Anesthesia and sedation of foals. Physiologic similarities and differences between foals and adult horses, including response to pain, cardiopulmonary function, ability to compensate for dehydration and hemorrhage, and response to anesthetic drugs, are considered in this article. Preanesthetic evaluation, choice of anesthetic drugs, technique, and monitoring support requirements through to anesthetic recovery are based on these physiologic considerations. Anesthetic techniques discussed include drugs for premedication, parenteral or inhalational anesthetic induction, and maintenance using inhalational and parenteral anesthesia...