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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.
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 ...
Lack of local anaesthetic efficacy of Sarapin in the abaxial sesamoid block model. Sarapin is a distillate of the pitcher plant that has long been used in human and veterinary medicine for 'regional analgesia'. The mechanism of the reported analgesic response is unknown; however, the agent is purported to provide more effective analgesia for slow, chronic pain than for sharp, acute pain. Reportedly, Sarapin is also widely used as an analgesic agent in the horse, generally in combination with corticosteroids and other agents. To determine its local anaesthetic efficacy in the horse, we tested Sarapin in a unilateral abaxial sesamoid block model at two dose levels, 2 mL and 10...
Diaphragmatic hernia repair in three young horses. This clinical report describes surgical correction of diaphragmatic hernia in three young horses. Methods: Retrospective investigation of medical records and subsequent racing performance. Methods: Three young horses with diaphragmatic hernia. Results: Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All ...
Postanesthetic hemorrhagic myelopathy or myelomalacia. Hemorrhagic myelopathy or myelomalacia is an uncommon cause of failure to stand after general anesthesia. Affected horses are usually young and have been anesthetized for relatively short times in dorsal recumbency. Clinical signs involve the hind limbs and include loss of deep pain perception. Etiology of this condition is not known. Differentiation from other forms of neuropathy and myopathy is important to the prognosis.
Preliminary investigations of pain and analgesia assessment in horses administered phenylbutazone or placebo after arthroscopic surgery. Twenty-five horses undergoing arthroscopic surgery were studied to develop a scheme for assessing pain in horses while investigating the effects of phenylbutazone (PBZ) analgesia. Fifteen of the 25 horses received PBZ 4 mg/kg intravenously (IV) before surgery and 2 mg/kg (IV) every 12 hours thereafter until 60 hours; the remaining 10 (placebo group) were given a corresponding volume of saline. In both groups, venous blood samples were collected for catecholamine, beta-endorphin, and cortisol assays before premedication and up to 72 hours after surgery. Postoperative pain was evaluated by measu...
Systemic and local effects associated with long-term epidural catheterization and morphine-detomidine administration in horses. The purpose of this study was to determine the systemic and local effects associated with long-term epidural catheterization and epidural morphine-detomidine administration in horses. Methods: Development of systemic or local effects was assessed by placing caudal epidural catheters in study horses and administering injections through the catheters every 12 hours for 14 days. Methods: Ten horses with epidural catheters that received daily injections; six uncatheterized horses presented for euthanasia. Methods: Horses received either 0.2 mg/kg morphine sulfate and 30 micrograms/kg detomidine hy...
Determination of an effective dose of eltenac and its comparison with that of flunixin meglumine in horses after experimentally induced carpitis. To titrate a clinically effective eltenac dosage (0.1, 0.5, and 1.0 mg/kg of body weight), compared with vehicle only, and to compare efficacy of the most effective eltenac dosage with that of 1.1 mg of flunixin meglumine/kg. Methods: 40 healthy horses, ranked after model induction on the basis of lameness severity, were randomly assigned to 5 treatment groups, with 4 replicates of 10 horses each. Methods: On day -5, after surgical preparation of the left carpal region, 0.7 ml of Freund's complete adjuvant was injected into the intercarpal space. Horses were observed daily, from the day of car...
Intra-articular anesthesia of the distal interphalangeal joint alleviates lameness associated with the navicular bursa in horses. To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses. Methods: Experimental investigation. Methods: Six clinically normal horses. Methods: Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL of 2% mepivacaine hydrochloride. All video recordings we...
Effects of anesthesia of the palmar digital nerves on kinematic gait analysis in horses with and without navicular disease. To determine the effect of local anesthesia of the palmar digital nerves on forelimb kinematics in Quarter Horses with and without navicular disease. Methods: 12 adult Quarter Horses; 5 clinically normal (sound) and 7 with navicular disease. Methods: Kinematic measurements were made on adult horses trotting on a treadmill, before and after palmar digital nerve block (PDNB). Twenty-three displacement, joint angle, and temporal gait measurements of the right forelimb and head were made for 5 strides in each horse. Initial (before local anesthesia) right forelimb measurements were obtained after ...
Electrically induced blink reflex in horses. The electrically induced blink reflex was studied electromyographically in 21 healthy adult, detomidine-sedated horses. Using surface electrodes, the supraorbital nerve was electrically stimulated at the supraorbital foramen. The responses were recorded from the ipsilateral and contralateral orbicularis oculi muscles with concentric needle electrodes inserted in the lateral aspect of the ventral eyelids. Ipsilateral and contralateral recordings were made on successive stimulations of the same side of the face, maintaining a constant stimulus intensity. The electromyographically recorded respon...
Efficacy of an epidural combination of morphine and detomidine in alleviating experimentally induced hindlimb lameness in horses. Amphotericin B-induced synovitis of the left tarsocrural joint was used to create a grade 3 of 4 lameness in 11 horses. Caudal epidural catheters were placed and advanced to the lumbosacral region. Baseline heart and respiratory rates were recorded and horses were videotaped at a walk and trot. Morphine sulphate (0.2 mg/kg) and detomidine hydrochloride (30 micrograms/kg) were administered to treated horses (n = 8) through the epidural catheter; an equivalent volume of physiologic saline solution was administered to control horses (n = 3) through the catheter. At hourly intervals after epidural...
[Use of a mix of lidocaine and butorphanol as a caudal epidural anesthesia in a mare]. Loss of rear motor control is the main limiting factor in the use of caudal epidural anesthesia in the horse. In man and laboratory animals, a small dose of an opiate combined with a local anesthetic enhances analgesia without impairing motor function. Thus, the amount of local anesthetic administered may be reduced. Butorphanol is an opiate widely used in horses. It has a good margin of safety and few cardiorespiratory effects. The effects of lidocaine (0.25 mg/kg) and lidocaine-butorphanol (0.25 mg/kg, and 0.04 mg/kg, respectively) were compared in 2 groups of 5 healthy unsedated mares. Hors...
Comparison of antinociceptive, cardiovascular, and respiratory effects, head ptosis, and position of pelvic limbs in mares after caudal epidural administration of xylazine and detomidine hydrochloride solution. To examine and compare effects of 2 alpha 2-adrenergic receptor agonists, xylazine and detomidine, administered into the sacrococcygeal epidural space to induce safe and effective perineal analgesia on cardiovascular and respiratory functions, head ptosis, and position of pelvic limbs in healthy mares. Methods: 8 healthy mares. Methods: Blood samples were drawn and systemic hemodynamics were determined, including cardiac output and pulmonary arterial, systemic arterial, and right atrial pressures. Two-way ANOVA with repeated measures was used to detect significant (P < 0.05) differences bet...
Evaluation of detomidine-induced analgesia in horses with chronic hoof pain. Detomidine (10, 20 and 40 micrograms/kg i.v.) and saline were administered to eight adult horses with hoof pain and lameness associated with chronic laminitis. Mechanical noxious stimulation was applied to 16 loci over the solar surface of each forefoot by means of an electronic hoof tester to determine chronic pain thresholds. Horses were evaluated before and at 25, 55 and 120 min after treatment for lameness and to determine hoof compression thresholds (HCTs), the percentage of responsive loci and the subjective grade of hoof withdrawal response at each responsive locus. Detomidine produced ...
Effects of pretreatment with ketoprofen and phenylbutazone on experimentally induced synovitis in horses. To compare the analgesic and anti-inflammatory effects of the nonsteroidal anti-inflammatory drugs (NSAID), ketoprofen (2.20 and 3.63 mg/kg of body weight) and phenylbutazone (4.40 mg/kg), in an acute equine synovitis model. Methods: 4 groups of 6 horses received NSAID or saline solution in a randomized design. Methods: 24 clinically normal mares and geldings. Methods: Left intercarpal joints were injected with sterile carrageenan to induce synovitis at the same time as IV administration of NSAID or saline solution. Clinical assessments were made and synovial fluid was withdrawn at 0, 1, 3, 6,...
Differences in quantitated electroencephalographic variables during surgical stimulation of horses anesthetized with isoflurane. The effects of noxious surgical stimulation on the electroencephalogram (EEG) in 15 horses anesthetized with isoflurane were evaluated during orthopedic (group 1) and soft tissue (group 2) procedures. The quantitative EEG variables theta/delta ratio (T/D), alpha/delta ratio (A/D), beta/delta ratio (B/D), median power frequency (MED), and 80% spectral edge frequency (SEF 80) recorded during Surgeries at 1.7% end-tidal concentration of isoflurane (ET(iso)) were compared with values from five nonstimulated control horses anesthetized at 1,7% ET(iso). The EEG variables T/D, A/D, MED, and SEF 80 fr...
Infection of the intertubercular bursa in horses: four cases (1978-1991). To determine the clinical outcome of horses treated for infection of the intertubuercular bursa (infectious bicipital bursitis). Methods: Retrospective analysis of case records. Methods: Four horses referred for treatment of infectious bicipital bursitis. Methods: Medical records of horses that were severely lame on admission were reviewed. Results: In 3 horses, palpation over the bicipital bursa as well as flexion and extension of the scapulohumeral joint were resented. Ultrasonography performed in 1 horse revealed that the bicipital bursa was large and that excessive amounts of fluid contain...
Local distribution of mepivacaine after distal interphalangeal joint injection in horses. To evaluate the distribution of mepivacaine hydrochloride after distal interphalangeal (DIP) joint injection in horses. Methods: Prospective, uncontrolled study. Methods: 10 adult horses. Methods: 30 minutes before euthanasia, 8 ml of 2% mepivacaine hydrochloride was injected into the dorsal pouch of a forelimb DIP joint. Synovial tissue from the DIP joint and podotrochlear (navicular) bursa and bone tissue from the medullary cavity of the distal sesamoid (navicular) bone were taken from both forelimbs immediately after death. All synovial and bone specimens were analyzed for tissue concentrat...
Scintigraphic evaluation of 99mTc-methylene diphosphonate uptake in the navicular area of horses with lameness isolated to the foot by anesthesia of the palmar digital nerves. To evaluate distribution and intensity of 99mTc-methylene diphosphonate (99mTc-MDP) uptake in the navicular area in horses with forelimb lameness isolated to the palmar aspect of the foot. Methods: Prospective, case-controlled study. Methods: 7 horses with clinical signs of navicular syndrome and 7 control horses. Methods: Palmar view, soft tissue-phase scintigraphic images of the foot were obtained between 7 and 12 minutes after injection of 120 to 170 mCi of 99mTc-MDP. Lateral and palmar view, bone-phase images were obtained at 30 minutes and 1, 2, and 4 hours after injection. Palmar views w...
[Acute pain in the horse and one possibility for its objective evaluation]. To judge acute processes of pain objectively the results are told of a determination of adrenaline and noradrenaline in the plasma of 30 horses suffering from pain. Besides a scheme basing on an awarding of points is developed to ascertain changes of physiological and ethological parameters caused by pain. These results in changes of behaviour are compared to results determined by laboratory experiments. Concerning pain of medium and high level a relation to the concentration of catecholamines is noticed. Therefore the total of certain clinical observations is suitable for graduating acute pai...
