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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.
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...
[Basic principles and effects of hippotherapy within the comprehensive treatment of paraplegic patients]. A total of 67 patients, both paraplegic and quadriplegic, had participated in a hippotherapy programme over a study period of almost 18 months, with positive effects found relative to spasticity, certain pain syndromes, as well as contraction syndromes associated with impaired joint mobility. Frequently the only effective measure at all, and moreover of astonishingly lasting effect, the spasticity-reducing treatment turned out especially beneficial. Along with these statistically supported findings, a number of associated effects were noted in the physiotherapy and, especially, the nursing sec...
Incarceration of the jejunum in the epiploic foramen of a four month old foal. A 4-month Arabian filly presented for abdominal pain of 30 hours duration was found to have tachycardia, tachypnea, congested mucous membranes and gross abdominal distension. Further examination disclosed gastric reflux and small intestinal distension. Dehydration, prerenal azotemia, electrolyte abnormalities and metabolic alkalemia were observed. There was a progressive nonresponse to analgesic medication and deterioration in the foal's physiologic condition consistent with a small intestinal strangulating obstruction. Surgical exploration was declined. Necropsy examination revealed incarcera...
Substance P innervation of equine synovial membranes: joint differences and neural and nonneural receptor localizations. Substance P (SP) immunocytochemistry and receptor autoradiography were used to define the innervation of the equine synovial membrane of joints equivalent to the wrist and knuckle of man. SP-immunoreactive fibers were mainly concentrated around blood vessels in the subsynovial layer, although not exclusively, while in the more distal joint, SP fibers were more frequently seen in the synovial surface layer. Iodinated SP receptor autoradiography studies revealed silver grain concentrations in the advential layer of blood vessels associated with the vasa vasorum, on the vascular endothelium and i...
Immunocytochemical and dye distribution studies of nerves potentially desensitized by injections into the distal interphalangeal joint or the navicular bursa of horses. To determine whether the distal interphalangeal (DIP) joint directly or indirectly communicates with the navicular bursa (bursa podotrochlearis) and to identify sensory nerves in these synovial structures that might be desensitized by intra-articular injections of anesthetics, Evans blue dye in physiologic saline solution, Luxol fast blue dye with mepivicaine, or commercial latex was injected into the DIP joint (5 ml) or the navicular bursa (3 ml) of 152 digits obtained from horses or ponies at necropsy. The digits were frozen, cut with a band saw, and examined for distribution of dye or latex...
Assessment of drug effects on performance. Few definitive studies have been performed that unequivocally demonstrate the ability of a drug to alter the performance of a horse. Nonetheless, the use of drugs in competing horses is regulated worldwide. Drugs have been categorized according to their abuse potential. However, there is still some confusion over what is meant by the terms "performance" and "drug." In the racing community, performance means speed, and fatigue and pain are among its greatest detractors. Speed is most appropriately measured on the racetrack. There are a multiplicity of internal and external variables that influe...
Narcotics and local anesthetics. The recognition and alleviation of animal pain is a growing veterinary and public concern. Pain can be of an acute or chronic nature with different behavioral manifestations. Physiologically, pain is a dynamic and complex phenomenon that produces changes in the central and autonomic nervous systems as well as in the endocrine system. Horses and other animals appear to possess an endogenous pain-suppressing system involving the brainstem and spinal cord. This system can modulate pain perception and the responses to it. The recently discovered endogenous opioid peptides (endorphins and enkephali...
Sensory receptors in the equine foot. Two types of sensory receptors were located in the equine foot, using anatomic techniques. Histologic examination of stained hoof sections revealed lamellated corpuscles in the hoof dermis, which had many of the morphologic characteristics of Pacinian corpuscles. These sensory receptors were restricted to the palmar (caudal) aspects of the solar dermis of the heel. A second type of receptor was detected by use of immunocytochemistry, indicating apparently naked nerve endings containing the neuropeptide calcitonin gene-related peptide-like immunoreactivity in skin, solar dermal tubules, and the...
A study of 118 cases of navicular disease: clinical features. The clinical features are reported from 118 horses (mean age 9.2 years) which were diagnosed as suffering from navicular disease using predetermined criteria. The animals were used for a variety of purposes and had been lame for periods between 1 and 72 months. The majority of cases (84.7%) had been treated using various techniques before evaluation. The severity of lameness was related to the duration of clinical signs: 78% of horses were bilaterally affected but there was no left:right limb predominance. Broken foot/pastern axes were recorded in 75% of horses while 45% also exhibited mediola...
Postoperative analgesia using phenylbutazone, flunixin or carprofen in horses. Horses undergoing surgery were randomly assigned to one of three groups to receive phenylbutazone at 4 mg/kg (n = 72), flunixin at 1 mg/kg (n = 68) or carprofen at 0.7 mg/kg (n = 63) by slow intravenous injection at the end of surgery, just before they were disconnected from halothane. Pain was assessed by either of two resident surgical clinicians (who did not know which non-steroidal anti-inflammatory drug had been given) when the horses first stood up, two and four hours later and the next morning. If repeated doses of analgesic drugs were given the time was recorded and taken as an end poi...
[Experiences with long-term intravenous therapy using teflon catheters in 80 horses]. In a retrospective study the tolerance to Teflon coated catheters in long-term intravenous medication was evaluated in 80 horses. Catheters were inserted into the jugular vein and remained there for 3 to 30 days (average 8.6 days). Catheters were flushed using an heparinized solution after each medication administration. The site of catheter placement was evaluated daily for swelling, pain and venous distensibility respectively. Swelling at the site of insertion was noted in 10 horses, a small subcutaneous abscess formation was identified in one horse. Fourteen sonographic evaluations were per...
Effects of exercise and polysulfated glycosaminoglycan on the development of osteoarthritis in equine carpal joints with osteochondral defects. This study assessed the effects of postoperative exercise and intra-articular polysulfated glycosaminoglycan (PSGAG) on the repair of osteochondral defects in the carpal joints of ponies. Eighteen ponies with normal carpi had osteochondral defects (mean dimensions 2.4 cm x 0.9 cm) created arthroscopically on the dorsal aspect of the distal articular surface of the radial carpal bone. The ponies were randomized (while balancing for age [range, 2 to 15 years; median, 5.0 years]) to two groups--nine ponies were exercised and nine were stall confined. Beginning at surgery, six ponies in each group...
