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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 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...
Medical treatment of horses with ileal impactions: 10 cases (1990-1994). To evaluate clinical and laboratory findings for horses treated medically for ileal impactions. Methods: Retrospective case series. Methods: 10 horses with primary ileal impaction that were treated successfully with medical treatment alone. Methods: Medical records were reviewed for all horses with naturally developing ileal impaction seen at our hospital between 1990 and 1994. Results: Transrectal palpation revealed an impaction in the midabdominal area in all horses. Generalized distention of the small intestine was evident in 6 horses, whereas 4 horses were examined early in the course of t...
Analgesic, hemodynamic, and respiratory effects of caudal epidurally administered xylazine hydrochloride solution in mares. To examine effects of 0.25 mg of xylazine/kg of body weight diluted to a total volume of 6 ml/450 kg with sterile 0.9% NaCl, administered into the epidural space of the sacrococcygeal joint on perineal analgesia, sedation, ataxia, and respiratory and cardiovascular function in standing mares. Methods: Randomized, blinded study, using xylazine (treatment) and 0.9% NaCl (controls). At least 2 weeks elapsed between the treatments. Methods: Eight healthy mares. Methods: Blood samples were drawn. Systemic hemodynamics were determined, including cardiac output and pulmonary arterial, systemic arteri...
Surgical treatment of navicular syndrome in the horse using navicular suspensory desmotomy. Seventeen horses diagnosed as having navicular syndrome on the basis of history, clinical findings, regional local anaesthesia and radiography were subjected to bilateral navicular suspensory desmotomy. Before surgery, the duration of navicular lameness ranged from 6 weeks to 4 years. Previous unsuccessful treatments prior to surgery included nonsteroidal anti-inflammatories, corrective shoeing, rest and isoxsuprine. For the seventeen horses subject to surgery, twelve horses were sound, one horse was improved and four horses were lame at a minimum of 6 months after surgery.
Determination of highest no effect dose (HNED) for local anaesthetic responses to procaine, cocaine, bupivacaine and benzocaine. The highest no effect doses (HNEDs) for the local anaesthetic (LA) effects of procaine, cocaine, bupivacaine and benzocaine were determined using the heat lamp/hoof withdrawal model of Kamerling et al. (1985b) and the abaxial sesamoid block model of local anaesthesia. The heat lamp rapidly (4 or 5 s) increased the temperature of the superficial skin layers of the pastern to about 90 degrees C, at which point the animal sharply withdrew its hoof. Effective LA blockade precluded this response and superficial skin temperatures exceeded 120 degrees C. Thermal stimulus experiments were routinely te...
A comparison of N-butylscopolammonium bromide and butorphanol tartrate for analgesia using a balloon model of abdominal pain in ponies. The analgesic effect of N-butylscopolammonium bromide (0.3 mg/kg) using a balloon-induced model of colic in ponies was evaluated and compared with butorphanol tartrate (0.1 mg/kg). Eight adult ponies were used and each received both treatments during the two different trials. The order in which the treatment was received was randomly assigned. At the start of each trial, moderate abdominal pain was induced by inflation of a balloon placed in the lumen of the caecum. The ponies were evaluated every 5 minutes, and a cumulative pain score (CPS) was assigned. Two baseline measurements were recorde...
The diagnostic nerve block of the sesamoidean nerve: desensitized structures and possible clinical applications. The sesamoidean nerve branches from the palmar nerve and runs towards the proximal sesamoid bone. To study the structures innervated by this nerve, a technique for blocking it was developed. The effect of this nerve block was determined in ponies with an induced lameness located in the lateral proximal sesamoid bone (5 ponies) or in the distal part of the lateral branch of the suspensory ligament (5 ponies), and in 10 horses with clinical sesamoidosis. A lameness provoked by the implantation of an expansion plug in the proximal sesamoid bone could, to a large extent, be anaesthetized by a sesa...
The effect of diagnostic regional nerve blocks in the fore limb on the locomotion of clinically sound horses. The practice of applying diagnostic nerve blocks relies on the assumption that the blocks in themselves do not alter the horse's gait. This assumption has recently been challenged. In the present paper a series of sequential nerve blocks (low palmar digital block, abaxial sesamoid block, high palmar block) was applied to clinically sound horses. Before and after each block the gait was clinically scored and Ground Reaction Forces (GRF) were measured. Clinical scoring did not change after any of the nerve blocks. None of the GRF variables changed significantly except for a slight alteration of ...
Head and trunk movement adaptations in horses with experimentally induced fore- or hindlimb lameness. The kinematic patterns of head and trunk were studied in horses during induced supporting limb lameness to understand the mechanisms horses use to compensate for lameness and to evaluate different symmetry indices for their significance as lameness indicators. Using the locomotion analysis system CODA-3 the kinematics of 11 clinically nonlame Dutch Warmblood horses were recorded while walking (1.6 m/s) and trotting (3.5 m/s) on a treadmill. A transient lameness model, evoking pressure induced pain on the hoof sole, was used to induce 3 degrees of fore- and hindlimb lameness. Peak vertical disp...
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...
