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.
This article provides an overview of initial assessment and management of common emergency presentations in donkeys and mules. The principles are similar to those in horses (and ponies), but clinicians must be aware of differences in recognition of signs of pain/disease, approach to handling, pharmacology of some drugs, and subtle differences in the physiology and local anatomy in donkeys and mules. The epidemiology of common disease presentations will vary between pet/companion or working/farmed donkeys and mules. Regular dental checks, deworming, vaccination, and monitoring of behavior and q...
This study presents the validation of two recently described pain scales, the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP), in horses with acute colic. A follow-up cohort study of 46 adult horses (n = 23 with acute colic; n = 23 healthy control horses) was performed for validation and refinement of the constructed scales. Both pain scales showed statistically significant differences between horses with colic and healthy control horses, and between horses with colic that co...
Initial treatment of colic is aimed at maintaining hydration and acid-base balance, controlling pain and reestablishing peristalsis. A poor response to medical treatment in the first 12-18 hours suggests the need for laparotomy. Other indications for surgery include: rising pulse rate, exceeding 60/minute for several hours; congested mucosae; delayed capillary refill; silent abdomen; gastric reflux; distended or displaced loops of bowel on rectal examination; intractable pain; and adverse laboratory findings. Postoperative care should consist of hand-walking for 30 days, followed by confinemen...
The objective of this study was to compare effects of butorphanol (BUT) or buprenorphine (BUP), in combination with detomidine and diazepam, on the sedation quality, surgical conditions, and postoperative pain control after cheek tooth extraction in horses, randomly allocated to 2 treatment groups (BUT: = 20; BUP: = 20). A bolus of detomidine (15 μg/kg, IV) was followed by either BUP (7.5 μg/kg, IV) or BUT (0.05 mg/kg, IV). After 20 min, diazepam (0.01 mg/kg, IV) was administered and sedation was maintained with a detomidine IV infusion (20 μg/kg/h), with rate adjusted based on scores to ...
The research article describes the treatment, recovery process, and prognosis of a 2-month old Quarter Horse, who suffered from severe lameness in the left forelimb due to an avulsion-type fracture [...]
Sunderland KA, Affolter VK, Cassano JM, Berryhill EH, Morgan JM.To determine the main causes of death in aged horses residing at a retirement facility in California. Unassigned: A retrospective cross-sectional study design was utilized to evaluate signalment, medical history, and necropsy reports of horses aged 20 years or older at death and housed at a single retirement facility. All cases underwent a standard post mortem evaluation from 2010 through 2020 by the University of California-Davis William R. Pritchard Veterinary Medical Teaching Hospital. Euthanasia decisions were made by the retirement facility staff in consultation with a veterinarian. The m...
Weeks RA, McLAUGHLIN PA, Vaughan BR.Equestrians (horse riders) are more susceptible to low back pain than the general population due to loads placed on their bodies during the activity. A specific eight-week exercise intervention program targeting the muscles used during horse riding was implemented for a group of equestrians with low back pain. Methods: Volunteers were invited to participate in the study through social media posts in Melbourne, Australia. The participants were required to complete an exercise screening test prior to enrolment in the study to ensure they were suitable to participate in the iteration program. Par...
Patterson HE, Yocom AF, Seabaugh KA, Kawcak CE, Contino EK.Recent evidence has shown that perineural analgesia may be less specific than previously thought. Objective: To compare the effects of four distal limb perineural analgesia techniques on resolving synovitis-induced lameness of the equine metacarpophalangeal joint (MCPJ). Methods: Nine horses had one MCPJ injected with 75ng of recombinant equine interleukin-1β (reIL-1β). Ten hours later, horses underwent one of two blocking patterns: (1) a palmar digital (PDNB) followed by an abaxial sesamoidean (ASNB) nerve block or (2) a palmar metacarpal (PMNB) followed by a palmar (PaNB) nerve block. Skin...
Pye E, Marcilla MG, Duncan JC.Regional anaesthesia of the equine anogenital tract is limited to local infiltration, extradural, blind palpation and nerve stimulator-guided techniques which risk iatrogenic damage, recumbency and ataxia. This study aimed to describe and assess the feasibility of transcutaneous ultrasound-guided (USG) pudendal nerve staining in equine cadavers. An initial pilot phase used two fresh equine cadavers and one standing unsedated horse to image the intrapelvic anatomy using ultrasound. One fixed equine cadaver specimen was also dissected to identify the pudendal nerve and refine the dissection appr...
Benetti E, Tambella AM, Andreis SN, Witte S, Di Bella C, Spadavecchia C.Osteoarthritis (OA) is a prevalent cause of chronic pain and lameness in horses. Whereas lameness can be quantified using objective measures, the assessment of OA-associated pain remains challenging. This study aimed to evaluate the applicability of the Client-Specific Outcome Measure (CSOM), a tool widely used in small animals, for the assessment of chronic OA pain in horses through caretaker evaluation. Unassigned: Seventeen privately owned horses with confirmed OA were enrolled in a 20-week randomized, double-blind, placebo-controlled study. For each horse, three individual pain-related ind...
Story MR, Nout-Lomas YS.Recognizing possible causes of equine head and neck problems requires a careful and systematic evaluation. While for some disorders reaching a diagnosis and treatment plan is relatively straightforward, for others this can be a complicated road requiring extensive diagnostic techniques, treatment trials, and management strategies. The ability to determine whether the patient is in a painful state, experiencing functional deficits, or in a combination of pain and dysfunction is critical to developing an effective treatment plan. Frequently, behavioral concerns often associated with pain must be...
Curti F, Marsocci A, Massarelli D, Magnifica F.Several studies have highlighted the association between low back pain (LBP) and horse riding, but none have specifically analyzed the underlying causes. Furthermore, there is a lack of literature addressing LBP in equestrian athletes, as the focus is often placed on the health of the horse rather than that of the rider. This study aims to determine if surface electromyography can identify changes in spinal erector activation pre- and post-training in an equestrian athlete with recurring nonspecific LBP by measuring the flexion relaxation phenomenon (FRP). The patient, an equestrian athlete, e...
Geibel MA, Kildal D, Geibel AM, Ott S.Dysfunctions and disorders of the craniomandibular system are accompanied by pathophysiological changes of muscle groups in the throat/neck and facial area, e.g., pain in the jaw and muscles of mastication and disturbance of occlusion, leading to teeth injury (loss of dental hard tissue, fractures/sensibility disorders, etc.). For muscular dysfunctions, even in the context of psychosomatic disorders and chronic stress, hippotherapy is particularly suitable, since it helps actively to relieve muscle tensions. In the current project we combined hippotherapy with progressive muscle relaxation (PM...
Orsini JA, Stefanovski D.This study evaluated the clinical application, outcomes, and prognostic indicators of deep digital flexor tenotomy (DDFT) in horses with chronic laminitis. Unassigned: A computer-generated search identified all possible cases of laminitis for horses referred to the George D. Widener Hospital for Large Animals at the University of Pennsylvania between 2010 and 2022. Medical records were reviewed for a diagnosis of laminitis by clinical examination and radiographs. The population was characterized by breed, age, clinical features, and radiographic findings. Poisson regression was performed to id...
Kareskoski AM.Behavioral issues, such as persistent or strong estrus, non-specific pain, and performance challenges in mares are frequently attributed to the estrous cycle. Objective: The objectives of this study were to analyze retrospective data on mares presented for estrus-related behavioral complaints, and to propose a structured diagnostic framework for categorizing cases during work-up at different levels of care. Methods: A retrospective study was conducted using patient records of a total of 14993 mares. Results: In this data set, behavioral problems, pain, or poor performance were not repeatably v...
Lap A, Gudden DDM, Lashley MJJO, van Loon JPAM, Naoum E.Pain assessment can support monitoring welfare in working equids. Objective: To assess agreement of structured pain scores before and after training observers and to assess differences in pain scores between working equids with or without acute or chronic pain and to compare them to non-working equids. Methods: In part 1, eleven veterinarians and nine technicians performed pain scores before and after training. Agreement with reference scores was analyzed with Intra Class Correlation (ICC) analysis. In part 2, pain assessments were performed in 96 donkeys (n=40 fit-to-work, n=21 acute pain, n=...
Mart S, Flynn H, Barter LS, Pypendop BH, Kilcoyne I, Nelligan K, Fernandez-Barrientos M, Pusterla N.To investigate the effect of applying ice to the skin overlying the infraorbital canal on the compliance of healthy adult horses to infraorbital nerve block placement during standing sedation. Methods: Blinded, randomized crossover trial. Methods: Thirty healthy adult horses [16 ± 3.9 years old (mean ± standard deviation), weighing 594 ± 63 kilograms (kg)]. Methods: Each horse acted as its own control with a minimum of 7 days between treatments. Horses were sedated using detomidine hydrochloride, and sedation level was evaluated using a published simple descriptive scale. Horses were random...
Giancola SC, Ellis KL.Treating primary back pain in horses can be challenging and often necessitates a multimodal approach. Whole-body vibration therapy (WBV) has been used in both horses and humans to alleviate pain and strengthen muscles. A recent study showed worsening back pain following a 30-minute session of WBV; however, the immediate effects of WBV were not evaluated. The purpose of this study was to assess the immediate effects of whole-body vibration therapy on horses with back pain after a single session of WBV. Objective: The objective of the current study was to determine the immediate effects on mecha...
Quintão NLM, Moffa EB, Kroier M, Goldoni RC, Bundgaard L, Jensen AL, Fernandes ES.Osteoarthritis (OA) is a chronic and progressive joint disease that can cause permanent loss of joint function. OA is highly prevalent in horses, dogs, and cats, affecting different joints and leading to reduced mobility and chronic pain. Different risk factors for animal OA have been identified, including trauma and breed. Inflammation is a hallmark of the disease, with various underlying mechanisms such as cyclooxygenase and metalloproteinase activation, nerve growth factor, cytokine, and prostaglandin upregulation, among others. Although disease complexity makes OA difficult to treat, eno...
Gasco J, Sauvage A, Monclin SJ, Narinx F.Bilateral enucleation in horses represents a challenging decision for owners, undertaken to relieve chronic, untreatable ocular pain. Emotional distress and uncertainty regarding postoperative welfare often lead to euthanasia instead of surgery. Objective: To evaluate owner perceptions of equine quality of life before and after bilateral enucleation, and to assess satisfaction with the procedure. Methods: Retrospective case series. Methods: Medical records from 21 horses that underwent bilateral enucleation between 2016 and 2024 were reviewed. Owners completed a structured survey assessing sat...
Carvalho Seabra J, Hess T, Finnestead T, Grandin T.Equine-Assisted Service (EAS) horses can be exposed to stressors that affect their behavior and welfare. Previous studies investigated behavioral and physiological indicators (PI) only during therapy sessions. This study evaluated the frequency of stress and pain behaviors (FSPB) in horses with different riders, while assessing welfare through housing, management, and PI. Ten horses were observed during EAS sessions with three rider groups: able-bodied, clients with significant physical impairment, and clients with no significant physical impairment, totaling twenty-six riders. Behavioral data...
de Chiara M, De Matteis A, Del Prete C, Costanza D, Montano C, Auletta L, Marinelli VG, Buono F, Pasolini MP.Although lateral palmar digital artery (LPDA) flow velocity does not differ between forelimbs, horses with lameness typically reduce loading of the affected limb during the weight-bearing phase. This study aimed to assess whether Pulsed-Wave (PW) Doppler indices of the (LPDA) blood flow differ between the two forelimbs in horses with unilateral forelimb lameness, and whether these differences correlate with lameness severity. Twenty-seven lame and 15 healthy horses were enrolled. All Doppler ultrasonographic examinations were performed by a single operator, blinded to both the presence or abse...
Scheibenpflug M, Haussler KK.Equine lameness diagnosis is dominated by a joint- and tendon-centric paradigm. The standard diagnostic algorithm relies on gait observation, perineural and intrasynovial anesthesia, and cross-sectional imaging. It is directed almost exclusively at skeletal and articular structures. Myofascial trigger points (MTrPs) are hypersensitive, hyperirritable loci within taut bands of skeletal muscle. They produce local and referred pain on compression or contraction. In horses, MTrPs are a clinically relevant but systematically overlooked source of primary lameness. This review synthesises evidence fr...
Lewis N, Dini P, Spanner J, Claes A, De Grauw J, Morganti M, Daels P, Cuervo-Arango J.Ovum pick-up (OPU) is a procedure that is now performed in mares worldwide to harvest oocytes for in vitro embryo production. There is a lack of consensus surrounding best practices for various procedural elements of the technique and recently there has been an increasing focus on the welfare aspects of the procedure. Our objective was to summarize current practice and to develop guidelines for OPU in the mare, using a modified GRADE approach to optimize efficiency and mare welfare. Published evidence on various aspects of the procedure was compiled, and to supplement the relative lack of publ...
Resano-Zuazu M, Carmona JU, Argüelles D.Myofascial pain syndrome (MPS) is considered highly prevalent in horses, yet it is frequently underdiagnosed due to limited understanding of its clinical presentation and functional consequences, as well as the inherent challenges associated with its clinical assessment and objective measurement. In equines, the relationship between palpation-based MPS indicators, gait asymmetries, and pain-related behaviours during ridden work remains unclear. The primary aim of this study was to evaluate the association between thoracolumbar palpation pain scores and gait asymmetries measured in-hand and dur...
McGinley TNA, Reardon RJM.Significant force is often applied when elevating equine teeth from the alveolus during extraction. No previous studies have investigated these forces. Objective: To develop a method to allow measurement of elevation forces (EF) applied during extraction, and to record forces during extraction of cheek teeth in both cadaver specimens and clinical cases, evaluating factors that might affect this and comparing differences between tooth positions and horse signalments. Methods: In vitro experimental study of cadavers and observational study of a convenience sample of clinical cases. Methods: Stra...
