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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.
Electroencephalography of detomidine-ketamine-halothane and detomidine-ketamine-isoflurane anesthetized horses during orthopedic surgery. A comparison. This study was done to compare the electroencephalographic (EEG) response evoked by orthopedic surgery in halothane- and isoflurane-anesthetized horses. Eight horses scheduled for bilateral arthroscopic surgery of the stifle were premedicated with detomidine (20 micrograms/kg) intravenously and five minutes later induced to anesthesia with ketamine (2.2 mg/kg) intravenously. Anesthesia was maintained with either halothane or isoflurane. Assignment of inhalation anesthetic was done randomly. The multiple of minimal alveolar concentration (MAC) of halothane required for anesthesia was significan...
Effects of hylan on amphotericin-induced carpal lameness in equids. In this double-blind study, the effectiveness of and dose response to intra-articular administration of modified hyaluronan (hylan) was determined in an equine carpal lameness model over a 23-day period, using a computerized three-dimensional motion analysis system, synovial fluid variables, and synovial histologic examination. In 24 clinically sound horses, baseline motion data was acquired from horses trotting at 4 m/s on a high-speed treadmill. Then, to induce lameness, 25 mg of amphotericin B in 5 ml of sterile water was injected into the left middle carpal joint of each horse every other ...
Computer-assisted three-dimensional gait analysis of amphotericin-induced carpal lameness in horses. Motion of 6 clinically sound horses trotting at a speed of 4 m/s on a treadmill was captured by video cameras before and 9, 16, and 23 days after amphotericin-induced lameness to determine the quantitative variables of three-dimensional computer-assisted image analysis that objectively describe carpal lameness. Amphotericin-B was used to induce lameness, and phenylbutazone (2.2 mg/kg of body weight, PO, once) and butorphanol tartrate (0.1 mg/kg IM, q 6 h, to effect) were used to control discomfort. Four 60-Hz cameras were symmetrically placed around the treadmill to capture 6 seconds of images...
Forelimb lameness associated with radiographic abnormalities of the cervical vertebrae. Eight horses had forelimb lameness which was considered unrelated to primary forelimb pain, but was associated with radiographic abnormalities of one or more cervical vertebrae. There was no evidence of ataxia or weakness. The degree and character of the forelimb lameness varied between horses. In 4 horses, selective local analgesic techniques were used to rule out lameness associated with pain in the forelimb. In the other 4 horses, radiographic examination of the cervical region was performed on the basis of forelimb lameness seen in conjunction with neck stiffness and/or neck pain. Three ho...
Seminal vesiculitis as a cause of signs of colic in a stallion. A 5-year-old stallion was referred because of signs of abdominal pain. During the initial examination, signs of pain were elicited when the right seminal vesicle was palpated per rectum. Signs of pain were also elicited during sexual arousal and attempts at semen collection. The right seminal vesicle was subsequently determined to be abnormal by ultrasonographic and endoscopic examination. The stallion was treated with trimethoprim/sulfamethoxazole for 6 weeks. Five months later, there had been no recurrence of the condition.
Intraarticular hyaluronan injections in the treatment of osteoarthritis: state-of-the-art review. Viscosupplementation (restoring the rheological properties of a tissue matrix) by injection of hyaluronan into the joints has been in use for 2 decades, mostly for osteoarthritis (OA) of the knee, using doses of 20-25 mg of hyaluronan of 500,000 to 2,500,000 M(r), in sequences of 2 to 10 weekly injections. Pain relief appears in a few days, progresses over a few weeks, and often lasts several months. Some data suggest the benefit can last 6 months to one year. Tolerance is universally reported as very good. Those responding to hyaluronan are 65-80%, compared to 30-35% responding to control. Co...
Paravertebral thoracolumbar anaesthesia in 10 horses. The caudal border of the last rib was used as a reliable point of orientation while performing paravertebral thoracolumbar anaesthesia (PTLA) on 10 horses undergoing standing flank laparotomy. The local anaesthetic in all horses was 2% lidocaine. The PTLA procedure was completed in 9.8 +/- 1.8 mins (mean +/- sd). Sedation was provided by a combination of intravenous morphine with xylazine or detomidine. Overall analgesia, provided by the combination of PTLA and sedation, was rated as excellent in 2 horses and good in 6 horses. In the remaining 2 horses, overall analgesia was rated as fair beca...
Palmar digital neurectomy in horses. 57 cases (1984-1990). The medical records of 57 horses that had palmar digital neurectomy performed between 1984 and 1990 were reviewed. Neurectomies were performed either by transection and electrocoagulation (47 horses) or by the guillotine technique (10 horses). Middle-aged geldings, Quarter Horses, and Thoroughbreds were significantly over-represented when compared with the hospital population. Horses used as hunter/jumpers also appeared to be over-represented. Complications occurred in 17 (34%) of the 50 horses for which follow-up information was obtained. Recurrence of heel pain was the most common complicati...
Clinical effects of detomidine with or without atropine used for arthrocentesis in horses. The effectiveness of detomidine with or without atropine sulfate premedication in producing sedation and analgesia for arthrocentesis was studied in 12 horses. The effects were evaluated by monitoring heart and respiratory rates, borborygmi, distance from the lower lip to the floor, systolic blood pressure, and response to needle insertion. Either atropine or saline (as a placebo) was administered immediately prior to detomidine. All drugs were administered intravenously. Measurements were taken prior to drug injection and at 1, 5, 10, 15, 20, 25, 30, 40, 50, 60, 120, 180 and 240 minutes posti...
[Pain prevention and pain treatment in small and large domestic animals]. The aim of this article is to emphasize the need for analgesic medication in animals in possibly painful situations, especially in the postoperative period. The two large groups of compounds used as analgesics--the opiates and the nonsteroidal antiinflammatory drugs (NSAIDs)--are described with special reference to their pharmacokinetics, side-effects and toxicity, their mechanism of action, their indications and contraindications. Recommended doses of the different drugs available are given for the dog, the cat, the horse, the swine and the small and large ruminants.
Conservative management of femoral diaphyseal fractures in four foals. 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.
A comparison of responses to analgesia of the navicular bursa and intra-articular analgesia of the distal interphalangeal joint in 59 horses. Analgesia of the distal interphalangeal (DIP) joint and of the navicular bursa was performed independently in the lame or lamer forelimb of 59 horses, in which lameness was significantly improved by perineural analgesia of either the palmar digital or palmar (abaxial sesamoid) nerves. In 3 horses no improvement was detected. Lameness was improved by analgesia of the DIP joint but there was no response to analgesia of the navicular bursa in 3 horses. In 12 horses, lameness was improved by analgesia of the navicular bursa but intra-articular analgesia resulted in no change. Forty-one horses resp...
Arthroscopy of the coxofemoral joint of foals. An arthroscopic procedure for examination of the coxofemoral joint was developed in nine foals (four cadavers, five anesthetized) to determine if access was sufficient for evaluation and surgical treatment of intra-articular lesions. The joint was distended and the arthroscope inserted through the notch (incisura trochanterica) between the cranial and caudal parts of the greater trochanter. This portal allowed examination of the cranial, lateral, and caudal aspects of the joint. Mechanical distraction of the joint through an instrument portal located 2 to 4 cm cranial and 1 to 2 cm ventral to ...
Choledocholithiasis attributable to a foreign body in a horse. Cholelithiasis is the most common cause of biliary obstruction in horses. Proposed mechanisms include ascariasis, biliary stasis, ascending biliary infection, and changes in bile composition. In this horse, a foreign body acted as the nidus for bile-salt deposition and ascending cholangitis. Clinical signs (intermittent abdominal pain, icterus, and pyrexia) in conjunction with high serum activity of enzymes indicative of obstructive biliary disease led to a tentative diagnosis of cholelithiasis. Ultrasonography was used to confirm the diagnosis. Postmortem examination revealed a 7-cm wooden st...
A retrospective evaluation of laminitis in horses. Case records of 202 horses treated for laminitis were reviewed with the intent of determining the long-term outcome and correlating this with digital radiographic findings and with the degree of pain associated with the laminitis. At long-term follow-up 57 horses had returned to athletic soundness (Group 1), 20 horses were intermittently lame (Group 2), 19 horses had permanent severe lameness (Group 3), 97 were dead (Group 4), and 9 were lost to follow up. Using simple regression analysis, functional outcome did not correlate with the degree of rotation (R2 = 0.004) or the presence of distal d...
Analgesic effects of detomidine in thoroughbred horses with chronic tendon injury. This study was undertaken to assess the analgesia provided by detomidine (20 micrograms kg-1 intravenously) in thoroughbred horses. Pain thresholds to a mechanical noxious stimulus were measured before and after a period of mild chronic pain in one foreleg. Detomidine was a good analgesic in control animals; their pain thresholds were significantly elevated for about 60 minutes. After injury, the injured leg had a significantly lower pain threshold and the intensity and duration of analgesia provided by detomidine were significantly reduced. The analgesia in the opposite (sound) leg was also r...
An investigation of injection techniques for local analgesia of the equine distal tarsus and proximal metatarsus. A positive radiographic contrast agent was injected into the tarsometatarsal (TMT) joints of both hindlimbs of 10 horses. Lateromedial radiographic views were obtained at 5, 15 and 30 mins after injection. Injection was successful in 19 of 20 limbs. Communication between the centrodistal (CD) and TMT joints was identified in 7 limbs (35%). Contrast agent extended around the tendons of tibialis cranialis (TC) and fibularis tertius (FT) in 18 limbs, and in 7 limbs some contrast entered the tarsal sheath. Slight to moderate plantar and/or distal extension of contrast agent was identified in 13 li...
Diurnal variation in plasma ir-beta-endorphin levels and experimental pain thresholds in the horse. Diurnal variation in nociceptive sensitivity and plasma immunoreactive beta-endorphin (ir-BEND) concentrations was examined in eight healthy Thoroughbred horses. Pain thresholds, ir-BEND concentrations, rectal temperature, heart rate, respiratory rate and pupil diameter were measured over a 24 hour period. Nociceptive sensitivity was determined using two objective measures of pain: the skin-twitch reflex latency and the hoof withdrawal reflex latency. Significant variation in both nociceptive thresholds and ir-BEND concentrations were noted over the 24 hour period, with elevated pain threshold...
Muscle histopathology and plasma aspartate aminotransferase, creatine kinase and myoglobin changes with exercise in horses with recurrent exertional rhabdomyolysis. Six horses with a history of recurrent exertional rhabdomyolysis (RER) (Horses A-F) and 7 control horses performed a submaximal and later a near-maximal treadmill exercise test. Blood samples were obtained before, during and after exercise and muscle biopsies were taken before and after exercise. At rest, plasma aspartate aminotransferase (AST) activities in horses with RER were above 95% confidence intervals for control horses. During submaximal exercise, 3 horses with RER (A, B and C) had much greater increases in plasma AST, creatine kinase (CK) and myoglobin concentrations than did Horses ...
Mesothelioma in horses. Pleural mesothelioma and pericardial mesothelioma with spread to the pleural cavity were diagnosed in 2 horses. Clinical signs included respiratory distress, depression and pleural pain. The affected body cavities contained copious, serous effusions containing very large neoplastic mesothelial cells with densely-staining cytoplasm, hyperchromic nuclei and prominent, often multiple, nucleoli. Ultrastructurally, the neoplastic cells appeared as solid aggregates, with profuse microvillous borders and neolumen formation. Cytological examination, together with confirmative ancillary diagnostic test...
Comparison of lidocaine, xylazine, and xylazine/lidocaine for caudal epidural analgesia in horses. Caudal epidural analgesia was achieved in 6 adult horses on 3 successive occasions at weekly intervals by injection of lidocaine, xylazine, and a combination of lidocaine/xylazine through indwelling epidural catheters. Analgesia was defined as a lack of response to pinprick and hemostat pressure in the skin of the perineal area. A significant (P < 0.05) difference was not found for time of onset of analgesia between lidocaine (4.3 +/- 0.8 minutes, mean +/- SEM) and the lidocaine/xylazine combination (5.3 +/- 1.3 minutes). Time to onset of analgesia after administration of xylazine was signi...
Five cases of gastrocnemius tendinitis in the horse. 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...
The effect of CO2 laser neurectomy on neuroma formation and axonal regeneration. 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 ...
Cholelith causing duodenal obstruction in a horse. 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...
Dorsomedial articular fracture of the proximal aspect of the third metacarpal bone in standardbred racehorses: seven cases (1978-1990). 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...
Mammary adenocarcinoma in four mares. 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.
The effect of regional nerve blocks on the lameness caused by collagenase induced tendonitis in the midmetacarpal region of the horse: a study using gait analysis, and ultrasonography to determine tendon healing. 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...
