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.
Dyson SJ, Kidd L.The normal gastrocnemius tendon may contain some muscular tissue proximally. This results in a patchy echogenicity ultrasonographically where it lies caudal or lateral to the superficial digital flexor tendon (SDFT). When it has assumed a position dorsal (cranial) to the SDFT the gastrocnemius tendon has a more uniform echogenicity and its margins are well defined. Five horses had lameness associated with lesions identified ultrasonographically in the gastrocnemius tendon in the latter region. Lameness ranged from mild to severe and was characterised by reduced hock flexion, lowered arc of foo...
Haugland LM, Collier MA, Panciera RJ, Bellamy J.In an attempt to prevent neuroma formation and digital reinnervation after sharp palmar digital neurectomy in 10 adult horses with navicular disease, 18,426 W/cm2 of CO2 laser energy was applied to the proximal nerve stump. Clinical follow-up was 4 to 23 months. In two horses, palmar digital nerve biopsies were taken at month 4 (four nerves) and month 7 (two nerves). Nine horses were sound immediately and at all follow-up examinations. None had clinical evidence of painful neuroma or digital reinnervation. Histologically, there was minimal scar tissue at the surgical site; axonal sprouts were ...
Laverty S, Pascoe JR, Williams JW, Funk KA.A 10-year-old Appaloosa stallion was referred for evaluation of colic. At admission, the heart rate, capillary refill time, respiratory rate, and rectal temperature were high. Fifteen liters of reflux was obtained by nasogastric intubation. Palpation of an abdominal mass per rectum elicited signs of pain. At exploratory laparotomy, a mass was palpated in the ascending portion of the duodenum. The small intestine ruptured at the site of obstruction during manipulation. The horse was euthanatized. A large cholelith was the cause of the duodenal obstruction. At necropsy, multiple choleliths of va...
Ross MW, Martin BB.Seven Standardbred horses, all pacers, with a mean age of 2.9 years (range, 2 to 4 years), had dorsomedial articular fracture of the proximal aspect of the third metacarpal bone. Fracture caused acute, unilateral, severe lameness after training or racing. Lameness was abolished by midcarpal joint anesthesia in 4 horses. Six horses had a palpable bony swelling, which caused signs of pain. Radiography revealed a nondisplaced, articular, oblique fracture extending distad toward the dorsomedial cortex for a mean distance of 28 mm (range, 15 to 40 mm). In all horses, chronic periosteal proliferativ...
Seahorn TL, Hall G, Brumbaugh GW, Honnas CM, Lovering SL, Snyder JR.Mammary gland adenocarcinoma in 4 horses was characterized by firm swelling of the gland and serosanguineous discharge from the teat orifice. Two of the mares had ulcerative lesions of the mammary gland. Palpation of the affected gland typically elicited signs of pain. Diagnosis was assisted by cytologic evaluation of the fluid discharge, but definitive diagnosis was based on histologic examination. Treatment included mastectomy and lymphadenectomy.
Keg PR, van den Belt AJ, Merkens HW, Barneveld A, Dik KJ.The influence of regional nerve blocks on lameness resulting from tendon injury was studied in six horses. Tendonitis was induced in the midmetacarpal region of the Superficial Digital Flexor Tendon (SDF), Deep Digital Flexor Tendon (DDF) and the Suspensory Ligament (SL) through collagenase injections. The results were evaluated through sequential clinical examinations, ultrasonographic imaging and kinetic gait analysis (force plate) during a period of 144 days post injury and subsequently compared with gross and microscopic findings. The lameness corresponding to the SDF and DDF tendon lesion...
Clabough DL, Duckett W.An 8-year-old Arabian gelding with septic cholangitis and peritonitis was successfully treated with trimethoprim/sulfadiazine. The gelding was referred for evaluation of signs of abdominal pain, icterus, fever, and weight loss. Peritoneal fluid analysis revealed septic and suppurative peritonitis. Culture of the peritoneal fluid yielded Escherichia coli and Klebsiella pneumoniae, which were sensitive to trimethoprim/sulfadiazine. On the basis of results of hepatic ultrasonography, a diagnosis of septic cholangitis also was made. The horse was treated with 30 mg of trimethoprim/sulfadiazine/kg,...
McDonnell SM, Love CC, Martin BB, Reef VB, Kenney RM.Two mature breeding stallions were evaluated because of specific ejaculatory dysfunction, and each was found to have aortic-iliac thrombosis occluding 60 to 70% of the aortic lumen. In each case, the stallion had strong libido, normal mounting, and vigorous initial thrusting. With continued exertion, thrusting became weak and dismount was awkward. Treatment aimed at maximizing sexual arousal before mounting and reducing hind limb pain and exertion during breeding allowed these stallions to continue breeding. A program of gradually increasing daily exercise also was associated with improved bre...
Honnas CM, Schumacher J, Kuesis BS.A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an att...
Greet TR.The paper describes the outcome of 16 cases of short-ileal-ileal intussusception in young Thoroughbred horses. The intussusception was often associated with chronic or intermittent low grade abdominal pain. At laparotomy, only the intussusception was reduced in one horse; in another, a myotomy of the thickened stenosed intussusception was carried out after reduction. In 11 cases as ileocaecal bypass anastomosis was performed proximal to the intussusception after its reduction. One horse was subjected to euthanasia during operation because of irreversible intestinal wall damage and another beca...
Waterman AE, Amin A.The plasma concentration of pethidine was measured in 16 horses, after its administration intravenously (i.v.) at a dose rate of 1 mg/kg bodyweight (bwt). In eight animals studied before surgery, the plasma levels of the drug decreased in a bi-exponential manner with a distributive half life of 3 mins and an elimination half life of 57.7 mins. Total body clearance was 17.7 ml/kg bwt/min. The remaining horses were investigated immediately after a period of anaesthesia and surgery and in these animals the drug exhibited smaller volumes of distribution (V1 cand Vdarea) and a significantly lower c...
McClure JT, Kobluk C, Voller K, Geor RJ, Ames TR, Sivula N.Four miniature foals admitted with signs of progressive nonresponsive abdominal pain and no fecal production had fecalith impaction of the small colon. Duration of clinical signs ranged from 10 hours to 5 days. Removal of the fecalith via small colon enterotomy was a successful treatment in all 4 cases. Miniature foals may be predisposed to fecalith impaction of the small colon. If a miniature foal has signs of progressive nonresponsive abdominal pain, fecalith impaction needs to be considered. Surgical correction may be required.
Ross MW, Bayha R.A 2-year-old Standardbred colt was examined because of signs of abdominal pain of 12 hours' duration. Clinical signs of disease, including tachycardia and abdominal distention, and rectal palpation findings of distention and thickening of the ventral colon, were consistent with displacement or early strangulation obstruction of the large colon. Surgical exploration revealed volvulus of the large colon around an axis formed by the dorsal mesenteric attachment of the transverse colon. The cecum could be completely exteriorized and lacked the cecocolic ligament and dorsal mesenteric attachments. ...
Jensen H, Mikkelsen R, Paulsen ET.Therapeutic riding for somatic disabled has been established as one of the treatment modalities at Beitostølen Health Sports Centre ever since it opened in 1970. The accumulated experience indicates positive effects of the treatment, on empirical grounds, but there is a need of further evaluation and controlled studies. The authors briefly review the principle of the treatment and present the results of a study on the level of pain in patients with Bechterew's disease before and after treatment.
Sullins KE.Indications for performing orthopedic surgery on the standing horse include inability to tolerate general anesthesia, risk of worsening an injury during recovery from anesthesia, and cost. The surgeon should be aware that performing surgery in the standing horse can be more demanding and require more experience than the same procedures when the time and convenience of general anesthesia are available. Improved sedatives and analgesics have allowed more latitude because the horses now are more tolerant than when older agents were used. Common sense should be applied to each situation before the...
DeBowes RM.A variety of rectal, perirectal, and coccygeal surgeries can be performed in the standing equine patient if appropriate chemical and physical restraints are available and adequate regional anesthesia can be achieved. Some rectal tears and most rectal prolapses, mass lesions, perirectal abscesses, rectal biopsies, and selected injuries of the tail can be managed without prohibitive difficulty. Severe injuries that compromise the small colon cranial to the peritoneal reflection may require flank laparotomy, midline celiotomy, or humane euthanasia to manage the disease process effectively and app...
Savage CJ, Jeffcott LB, Melsen F, Ostblom LC.Two hundred and five bone biopsies from the wing of ilium were taken from 52 growing and 70 older horses. The method was initially evaluated in 4 horses at post mortem and then performed in 26 horses under general anaesthesia. The technique was later developed for biopsying horses in the standing position under local anaesthesia (n = 70 adults; n = 22 foals). The core of the bone biopsy consisted of a central cancellous portion between two cortices. This type of sample allowed a complete histomorphometrical analysis. An integral part of the procedure was intravital bone labelling using fluoroc...
LeBlanc PH.Chemical restraint can be a useful pharmacologic tool to assist the veterinarian performing surgery in the standing horse. The agents discussed impose minimal adverse side effects and are considered relatively safe when administered in the doses described. Acetylpromazine, the most widely used tranquilizer, produces mild sedation but no analgesia. The use of tranquilizers for surgical procedures requires the combined use of either a local anesthetic technique or a sedative-hypnotic or opiate to provide analgesia. Sedative-hypnotics such as xylazine and detomidine or opiates such as morphine an...
Ford TS.Although most surgical procedures of the head are technically easier to perform with the horse under general anesthesia, other factors will influence whether a surgical procedure is performed with the horse standing or recumbent under the influence of general anesthesia. The accessibility of the head lends itself to many standing surgical procedures if the proper combination of analgesia and physical and chemical restraint is used. Traumatic injuries of the head (lacerations, facial bone fractures, and oral fractures) may involve vital structures, and a thorough examination is indicated. Failu...
Ross MW.Safe, effective surgery can be performed in the standing, conscious horse using a combination of mechanical and chemical restraint. Clear indications for performing standing abdominal surgery exist, but many procedures are best performed under general anesthesia. The preferred approach involves a modified grid incision of the left paralumbar fossa. Flank celiotomy allows the surgeon to thoroughly explore the abdominal cavity, but few structures can be exteriorized, and visibility of abdominal contents is poor. Indications for standing abdominal surgery include diagnosis of abdominal masses, dr...
Roelvink ME, Goossens L, Kalsbeek HC, Wensing T.The analgesic and spasmolytic effects of dipyrone (Novalgin) (2500 mg/100 kg bodyweight) hyoscine-N-butylbromide (Buscopan) (20 mg/100 kg bodyweight) and a combination of both drugs were evaluated in a balloon-induced model of colic, using five ponies with caecal fistulae. The drugs were given intravenously and 0.9 per cent sodium chloride solution (5 ml/100 kg bodyweight) was used as a control. The physiological saline solution and dipyrone had no effect on caecal contractions. After the injection of hyoscine-N-butylbromide and the drug combination caecal contractions ceased within 30 seconds...
Reeves MJ, Trotter GW.A 14-year-old Quarter Horse x Thoroughbred gelding was admitted to the teaching hospital because of inability to bear weight on its right hind limb, associated with a severe deviation of the tarsus. The provisional diagnosis was tarsal joint luxation or fracture. Radiography revealed complete luxation of the tarsocrural joint. The luxation was reduced, using minimal force. The horse was confined to a box stall and was maintained in a full-length hind-limb cast for 33 days. Box stall confinement was continued for 3 months after removal of the cast. On reexamination 18 months after the injury, t...
Heinrich B.This research article corrects a common misconception about the energy metabolism in horses during short sprinting and long-distance running events, emphasizing that short sprints are primarily powered by anaerobic activity, […]
Gardner SY, Reef VB, Spencer PA.Medical records of 46 horses with jugular vein thrombophlebitis that were evaluated ultrasonographically were reviewed. The ultrasonographic appearance of the thrombus within the jugular vein was classified as noncavitating if it had uniform low to medium amplitude echoes, or as cavitating if it was heterogenous with anechoic to hypoechoic areas representing fluid or necrotic areas within the thrombus, and/or hyperechoic areas representing gas. Signs of pain on palpation of the affected vein (P less than 0.001), heat over the vein (P = 0.001), and swelling of the vein (P less than 0.05) were s...
Keller J, Hassenstein MJ, Jung K, Geburek F.Ground reaction forces are accepted as gold standard for objective assessment of weightbearing lameness but measurements at the hoof are limited to experimental devices. This study aimed to evaluate whether innovative instrumented hoof boots (IHBs) could detect and monitor lameness in horses during diagnostic anaesthesia. Twenty-six horses referred for lameness examination (15 front limbs, 17 hindlimbs) were equipped with IHBs and body mounted inertial sensors. Data were collected simultaneously before and after diagnostic anaesthesia until objectively considered positive. Recorded IHB data i...
Lieberth S, Thieme K, Dancker C, Merle R, Eule JC.Retrobulbar anaesthesia (RBA) is relevant for ocular surgery in standing sedated horses. Objective: Gathering insights on experiences with RBA techniques. Methods: Cross-sectional survey. Methods: An online survey collected information on the respondents' professional background, indications, injection methods, use of ultrasound assistance, medication, and complications associated with RBA in horses. Results: Two-hundred and thirty-eight veterinarians from 25 countries contributed. 86.1% were members of veterinary specialty colleges. RBA indications were enucleation (97.8%), corneal surgery (2...
Emmerich IU.In 2014, no new active pharmaceutical ingredients were released on the German market for horses and food producing animals. One established veterinary active pharmaceutical ingredient is avaibable for an additional species. The analgetic buprenorphine (Buprenodale® Multidose) has additionally been authorized for horses. Furthermore, four new preparations with a new pharmaceutical form, one drug with a new formulation, new galenics and a new indication, respectively, have recently been released to the market. Furthermore, the prostaglandin F2α analoque luprostiol is available again.
Prügner W, Huber R, Lühmann R.Two controlled studies to determine efficacy in the horse were performed with eltenac, a new injectable, non-steroidal anti-inflammatory drug (NSAID). Clinical trials were carried out with a dose rate of 1 mg/kg body weight in a randomized, placebo-controlled, double-blind design to assess therapeutic efficacy in acute inflammatory disorders and in animals with orthopaedic conditions. In a preliminary pharmacokinetic investigation in six horses mean elimination half-life was 1.7 h after i.v. administration. In the first clinical study, analgesic activity on pain-related lameness was determined...
Morisset S, Hawkins JF, Kooreman K.A 6-year-old Paint mare undergoing treatment for a degloving injury of the right metatarsus developed a non-weight-bearing lameness 19 days after admission. Diagnostic nerve blocks localized the source of pain to the area between the tarsus and the metatarsophalangeal joint. Radiography of the metatarsus and metatarsophalangeal joint, arthrocentesis of the metatarsophalangeal joint, and ultrasonography of the flexor tendons, flexor tendon sheath, and suspensory ligament failed to identify the cause of the lameness. The horse was anesthetized and intraosseous pressure was measured in the left a...
Groves L.An eighteen-month old quarter horse gelding was diagnosed with chip fractures from the distal lateral trochlear ridge of the talus. The horse presented with the symptom of persistent synovitis. The diagnosis was based on radiographic evidence. The horse was treated initially with arthroscopic surgery. He was given a non-steroidal anti-inflammatory agent, and a chondroprotective agent to prevent further damage to, and aid in the healing of, the damaged joint.
Webbon PM.A series of experimental tendon biopsies is described. Three biopsies were taken from the lateral digital extensor tendon (LDET) and three from the superficial flexor tendon (SFT). The LDET biopsies resulted in little discomfort whereas the SFT biopsies led to temporary lameness. The tendons were examined histologically up to 99 days after the biopsies were removed. In all of the tendons the defect filled with granulation tissue which subsequently became organised as a longitudinally orientated collagenous scar tissue. In this small series of biopsies the histological effects of the biopsy per...
White A, Cullen P, Hinchion J.A stablehand in his 20s presented with increasing dyspnoea on exertion and chest pain months after being kicked directly in the chest by a horse. Further investigations revealed severe isolated, primary tricuspid regurgitation due to partial avulsion of the anterior leaflet. Open surgical repair was successfully performed from which he recovered uneventfully with resolution of his symptoms and minimal residual tricuspid regurgitation. Although uncommon, blunt force trauma to the chest is becoming increasingly recognised as a rare cause of tricuspid regurgitation. Symptoms may be insidious, and...
Sardari K, Kazemi H.To evaluation of clinical examination for differential diagnosis of navicular region pain from other forms of palmar heel pain in the forelimb in horses the present study was undertaken. Thirty four horses with lameness referable to the palmar aspect of the hoof based on their response to the palmar digital nerves analgesia were divided into 2 groups based on their response to both distal interphalangeal joint and navicular bursa analgesia. Horses that were profoundly improved by both analgesic blocks (distal interphalangeal joint and navicular bursa) were considered to have navicular region p...
Voigt G.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...
Samy A, Elmetwally M, El-Khodery SA.The aim of the present study was to establish appropriate doses for both lidocaine hydrochloride (Hcl) and mepivacaine in intravenous regional analgesia (IVRA) and to assess their intraoperative and postoperative analgesic effects in horses with distal limb surgeries. A total of 55 draft horses were included in the present study. Six clinically healthy horses were selected randomly for establishing the doses of lidocaine Hcl and mepivacaine in IVRA in horse limbs. After selection, 32 horses suffered from various distal limb surgical affections were randomly allocated into three groups: thiopen...
Freeman DE, Bauck AG.Repeat celiotomy can be lifesaving in horses with a surgically treatable postoperative obstruction, although guidelines for its use are lacking, except for uncontrollable postoperative pain. Overdiagnosis of ileus as the cause of postoperative obstruction could delay a second surgery so the disease progresses beyond a manageable level of severity. Although many horses respond favorably to repeat celiotomy, complications can be severe and life threatening, such as incisional infection and adhesions. Repeat celiotomy does not seem to exacerbate postoperative ileus, despite additional surgical ma...
Rhoads WS, Parks AH.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...
Brooks DE, Millichamp NJ, Peterson MG, Laratta LJ, Morgan RV, Dziezyc J.Five horses with severe nonulcerative keratouveitis had corneal lesions characterized by a pink stromal infiltrate that initially appeared in the stroma near the limbus. Unremitting iridocyclitis also was evident. In 3 horses, microscopic lesions consisted of marked corneal stromal fibrosis, with mild to severe inflammatory cellular infiltration. Corticosteroids and mydriatic/cycloplegics applied topically and corticosteroids and nonsteroidal anti-inflammatory medications administered parenterally were used with varying degrees of success to control pain and retain vision.
McCann ME, Hunt RJ.Femoral fractures in young horses can occur as a result of severe trauma and generally have a poor prognosis despite treatment. Four young horses with femoral diaphyseal fractures were managed with conservative treatment consisting of prolonged rest, analgesics, hind limb support, and corrective farriery. A favorable outcome in the form of pasture soundness with potential for limited athletic usefulness was obtained in 3 out of the 4 cases. This report supports the use of conservative treatment of selected diaphyseal femoral fractures in young horses.
Duarte PC, Paz CFR, Oliveira APL, Maróstica TP, Cota LO, Faleiros RR.To investigate the nociceptive and clinical effects of buffering a lidocaine-epinephrine solution with sodium bicarbonate in caudal epidural block in mares. Methods: Prospective randomized controlled trial. Methods: Six mixed-breed mares weighing 350-440 kg. Methods: Each animal was administered two caudal epidural injections, 72 hours apart, using different solutions prepared immediately before injection. The control solution was 7 mL 2% lidocaine hydrochloride with epinephrine hemitartrate (1:200,000) added to 3 mL sterile water for injection (pH 2.9). The alkalinized solution was 7 mL o...
Biedrzycki AH, Grant BD, Nemke B, Markel MD, Morello SL.To describe a technique for surgical placement of a modified kerf-cut cylinder for the purpose of arthrodesis across the equine centrodistal and tarsometatarsal joints. Methods: Each horse (n = 4) underwent unilateral placement of a single kerf-cut cylinder spanning the centrodistal and tarsometatarsal joints with the placement of an autologous cancellous bone graft. Horses were evaluated via lameness examination and radiography postoperatively and euthanatization of each horse was performed at four different time points up to 12 weeks post-surgery to evaluate for lameness, implant stability a...
Gibson KT, Burbidge HM.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 ...
Finno CJ.Hoof wall separation disease (HWSD) is a genetic defect in Connemara ponies characterised by separation and cracking of the dorsal hoof wall. The disease can result in chronic inflammation, severe lameness and laminitis. Affected ponies typically show clinical signs within the first six months of life. The disease is inherited as an autosomal recessive trait. The genetic mutation is a frameshift mutation in the gene SERPINB11, (c.504_505insC). Carriers are completely normal, only ponies that are homozygous for the mutation will have clinical signs of the disease. Within the Connemara breed, ca...
Still J.This case series describes clinical findings in 100 horses displaying pain patterns resembling the anatomical course of the gall bladder meridian. The palpatory pain (tenderness) was detected in individual points, as well as along entire sections of the meridian. A few tender points and areas were also diagnosed outside of the meridian. These data are clinically relevant in terms of the diagnosis and classification of musculoskeletal pain in horses. Therapeutic trials will be reported in a subsequent study.
Stashak TS.The causes, clinical signs and various approaches to treatment of injuries involving the foot and pastern regions are reviewed, and the prognosis for each type of injury is discussed.
Sullins KE.Indications for performing orthopedic surgery on the standing horse include inability to tolerate general anesthesia, risk of worsening an injury during recovery from anesthesia, and cost. The surgeon should be aware that performing surgery in the standing horse can be more demanding and require more experience than the same procedures when the time and convenience of general anesthesia are available. Improved sedatives and analgesics have allowed more latitude because the horses now are more tolerant than when older agents were used. Common sense should be applied to each situation before the...
Kendall A, Lützelschwab C, Lundblad J, Skiöldebrand E.Nerve growth factor (NGF) is a neurotrophin that is increased in osteoarthritic joints of horses. In humans, NGF has been associated with pain, and both synovial and serum NGF concentrations are increased in osteoarthritic patients. Studies in humans also have shown that serum NGF concentration can increase with stress. Serum NGF concentration should be evaluated in horses with osteoarthritis-associated lameness. Objective: Quantify and compare serum NGF concentration in horses with osteoarthritis-associated lameness and sound horses. Additionally, the impact of short-term stress on serum NGF ...
Suann CJ, Horney FD.Circumcision (or reefing operation) was performed on an aged pony stallion to remove excessive granulation tissue involving the preputial integument following an injury and subsequent paraphimosis. Postoperative swelling of the penis and prepuce was reduced daily with gentle massage. Initially, an improvised suspensory was used to support the penis postoperatively. The pony was able to voluntarily retract its penis six months following surgery.
