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.
Zielińska P, Śniegucka K, Kiełbowicz Z.The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 month...
Vullo C, Crupi R, Di Paola R, Cuzzocrea S, Gugliandolo E, Biondi V, Catone G.The aim of this study was to evaluate the impact of intratesticular or intrafunicular lidocaine to reduce perioperative nociception and cytokine release in ponies undergoing field castration under total intravenous anaesthesia. Before castration, one group was injected with intrafunicular (FL) lidocaine and the other received intratesticular (TL) lidocaine. All ponies were premedicated with acepromazine (0.05 mg/kg) intramuscularly. Twenty minutes after the administration of acepromazine, xylazine (1 mg/kg) and butorphanol (0.02 mg/kg) were administered intravenously. Lidocaine 2% was given 1 ...
Koh RB, Harrison TM.Over the past years, the concept of pain management in veterinary medicine has evolved and led to the establishment of a new concept of multimodal approach to pain management, as the current standard of care. The use of multimodal analgesia combining pharmacologic and nonpharmacologic techniques not only helps optimize the quality and efficacy of analgesia but also may prevent the development of chronic or persistent pain. During the past decade, acupuncture has become more popular and evolved into one of the most used forms of integrative medicine interventions and nonpharmacologic therapeuti...
Boström A, Bergh A, Hyytiäinen H, Asplund K.Extracorporeal shockwave therapy (ECSWT) is increasingly used to treat different types of musculoskeletal conditions in sport and companion animals. To explore the scientific basis for the treatment, we conducted a systematic review of the literature on ECSWT used in horses, dogs, and cats. Methods: Relevant articles published in 1980-2020 were identified from three major databases. Each article was assessed for risk of bias. Results: The review identified 27 relevant articles on the effects of ECSWT in horses, nine in dogs, but none in cats. Typically, ECSWT involved one to three treatment se...
Johnson SA, Richards RB, Frisbie DD, Esselman AM, McClure SR.Over the past three decades, electrohydraulic extracorporeal shock wave therapy (ESWT) as a treatment modality for equine orthopaedic disorders has sparked exponential interest among practitioners, but its clinical applications are quickly evolving and a current review highlighting modernised equine clinical use is lacking. The objective of this review is to summarise the most current ESWT technology, evidence for its use, proposed mechanisms of action and clinical applications in horses while also highlighting the areas requiring further investigation. The three ways to generate a shock wave ...
Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K.The placement of caudal epidural catheters in horses has become more frequent as a multi-modal analgesic strategy. Despite its integration into clinical practice, there are limited reports describing the use of caudal epidural catheterization for prolonged use in horses. The purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes. Medical records of hospitalized equine patients that underwent pla...
Flood J, Stewart AJ.Effective pain management in horses can be a challenge despite the understanding that appropriate analgesia improves animal welfare and increases treatment success. The administration of NSAID drugs, particularly phenylbutazone and flunixin, are common practice in equine veterinary patients. Known for their analgesic and anti-inflammatory properties, NSAIDs are used for the treatment of a variety of conditions in horses, from gastrointestinal to orthopedic pain. Despite extensive usage, NSAIDs have a narrow margin of safety and the body of literature documenting the efficacy and side effects o...
Tnibar A.Recent clinical and experimental trials have demonstrated that intra-articular 2.5% Polyacrylamide hydrogel (PAAG) is highly effective (82.5% free of lameness horses at 2 year follow-up), lasting and safe for the treatment of equine osteoarthritis (OA). Over the last decade, intra-articular 2.5% PAAG has shown to be a potent and promising drug in the medication of OA in horses, as no other single medical treatment for OA has such prolonged efficacy. Most of these studies were presenting some limitations. Preliminary observations on the mechanisms of action of intra-articular 2.5% PAAG support ...
Maldonado MD, Parkinson SD, Story MR, Haussler KK.Chiropractic care is a common treatment modality used in equine practice to manage back pain and stiffness but has limited evidence for treating lameness. The objective of this blinded, controlled clinical trial was to evaluate the effect of chiropractic treatment on chronic lameness and concurrent axial skeleton pain and dysfunction. Two groups of horses with multiple limb lameness (polo) or isolated hind limb lameness (Quarter Horses) were enrolled. Outcome measures included subjective and objective measures of lameness, spinal pain and stiffness, epaxial muscle hypertonicity, and mechanical...
Cerullo A, Gandini M, Giusto G.Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scien...
King MR.Physiotherapeutic exercises aimed at stimulating motor control, flexibility, and stability are regularly employed in human physical therapy programs. Specifically, the use of such exercises has been shown to reduce both pain and reinjury. Pursuant to the equine patient, several core strengthening exercises and their role in activating deep epaxial musculature to subsequently improve postural motor control and alter thoracolumbar kinematics have been investigated. Both baited and passive exercises offer opportunities to facilitate stretching during dynamic phases and strengthening during static...
Repac J, Mangan E, Xie H.Acupuncture is an inexpensive nonpharmacological modality that has a variety of musculoskeletal, neurologic, and internal medicine applications for the equine practitioner. Common uses include back pain colic, laminitis, laryngeal hemiplegia, and suprascapular neuropathy. Although there is a growing body of literature supporting the use of acupuncture in equids, there remains a need for further robust, double-blinded, placebo-controlled clinical efficacy trials.
Story MR.Equine cervical pain and dysfunction may be difficult to diagnose and effectively manage. Understanding techniques in integrative medicine often allows the practitioner to observe and palpate areas of pain and dysfunction in the horse being evaluated in ways often not taught or used in conventional medicine. There are many integrative therapies that also may be utilized to more effectively manage these horses, resulting in a more comfortable and functional horse.
Haussler KK, Holt TN.There is a growing body of evidence to support the use of spinal mobilization and manipulation techniques in equine practice. Outcome parameters reported across studies include measures of joint motion, nociception, muscle tone, and performance. Spinal examination procedures include static and dynamic assessments of the quantity and the quality of both active and passive movements. Tiered treatment approaches are recommended to stage the application of various therapies based on ease, cost, and efficacy.
Luomala T.Fascia is a complex and intriguing tissue, which can take on structural properties of being loose or dense, irregular or regular. Fascia functions by connecting, separating, and uniting different structures of the body. Myofascial dysfunction can be a significant source of pain and can be categorized as densification, adhesion, and fibrosis. Digital palpation and treatment of myofascial disorders can be provided via superficial or deep techniques. Different myofascial treatment techniques include slow and fast techniques, which can be applied at different depths, angles, and rhythms.
Adair S.This article serves as an introduction into integrative case management as it applies to the horse's mental health, pain management, and tissue healing. The integrative philosophy pertains to the combination of conventional Western medicine and complementary and alternative therapies to provide the best patient care possible using currently available evidence. The goal is to improve the health of the patient in a more holistic manner.
Boldt E.Horses 15 years of age and older now account for a significant portion of the equine population. Integrative therapies can provide important diagnostic and treatment tools for managing and maintaining the health of geriatric horses. Aged horses are often afflicted with chronic disease processes that are difficult to effectively manage with conventional medicinal approaches, such as laminitis and osteoarthritis. Diagnostic and therapeutic approaches using integrative therapies, such as acupuncture and spinal manipulation, are presented in this article for managing aged horses with metabolic dis...
Goff L.This article provides the equine practitioner with a review of sacroiliac joint pain and dysfunction and outlines the importance of providing a specific prescription for a safe and effective therapeutic exercise program. The continuum of clinical dysfunction associated with the sacroiliac region is presented with prescribed interventions. The intent is to encourage the practitioner to perform a thorough assessment of the sacroiliac joint and the adjacent soft tissues and to use sound clinical reasoning to formulate a therapeutic exercise plan.
Marunova E, Hoenecke K, Fiske-Jackson A, Smith RKW, Bolt DM, Perrier M, Gerdes C, Hernlund E, Rhodin M, Pfau T.Evaluation of diagnostic anesthesia during equine lameness examination requires comparison of complex movement patterns and can be influenced by expectation bias. There is limited research about how changes in movement asymmetries after successful analgesia are affected by different exercise conditions. Movement asymmetry of head, withers and pelvis was quantified in N = 31 horses undergoing forelimb or hindlimb diagnostic anesthesia. Evaluation on a straight line and a circle was performed with subjective diagnostic anesthesia outcome and quantitative changes recorded. Mixed linear mode...
Gandini M, Cerullo A, Franci P, Giusto G.Reducing postoperative incisional infection is the main reason to administer postoperative antimicrobials (AMD) after emergency laparotomy in horses, while reducing inflammation and providing analgesia are the reasons to administer anti-inflammatory drugs (AID). The basis for postoperative AMD and AID administration is empirical and only recently has been questioned. Empirical approaches can be changed, and these changes, along with the description of their outcomes, can help produce appropriate stewardship. The aim of this study is to report the changes in AMD and AID regimens in horses under...
Clarke EJ, Lima C, Anderson JR, Castanheira C, Beckett A, James V, Hyett J, Goodacre R, Peffers MJ.Equine osteoarthritis is a chronic degenerative disease of the articular joint, characterised by cartilage degradation resulting in pain and reduced mobility and thus is a prominent equine welfare concern. Diagnosis is usually at a late stage through clinical examination and radiographic imaging, whilst treatment is symptomatic not curative. Extracellular vesicles are nanoparticles that are involved in intercellular communication. The objective of this study was to investigate the feasibility of Raman and Optical Photothermal Infrared Spectroscopies to detect osteoarthritis using plasma-derive...
Carlson A, Johnson PJ, Lei Z, Keegan KG.Soluble epoxide hydrolase (sEH) inhibitors are novel anti-inflammatory and analgesic agents that could improve pain management in horses. The objective of the present study was to evaluate the anti-nociceptive effect of a single-dose intravenous administration of the sEH inhibitor trans-4-{4-[3-(4-trifluro-methoxy-phenyl)-ureido]-cyclohexyloxy}-benzoic acid (t-TUCB) using an adjustable heart bar shoe (a-HBS) model of lameness. We hypothesized that t-TUCB would improve objective and subjective lameness measures compared to the control. Methods: Reversible lameness was induced in 8 horses for 24...
Hoffmann JR, Geburek F, Hagen J, Büttner K, Cruz AM, Röcken M.Kinetic examinations of horses with induced lameness as well as the effect of perineural anaesthesia in sound horses have shown promise, but clinical studies regarding the effect of diagnostic anaesthesia during the different stance phases are rare. Fourteen horses with unilateral forelimb lameness were examined with the Hoof™ System during trot to assess vertical force distribution (in kg) affecting both front hooves before and after diagnostic anaesthesia during landing, midstance, and breakover. For statistical analysis, a covariance analysis with repeated measurements regarding the limb ...
Carvalho JRG, Trindade PHE, Conde G, Antonioli ML, Funnicelli MIG, Dias PP, Canola PA, Chinelatto MA, Ferraz GC.Facial-expression-based analysis has been widely applied as a pain coding system in horses. Herein, we aimed to identify pain in horses undergoing subcutaneously polylactide-based polymer implantation. The sham group was submitted only to surgical incision. The horses were filmed before and 24 and 48 h after implantation. Five statistical methods for evaluating their facial expressions (FEs) were tested. Primarily, three levels of scores (0, 1, and 2) were applied to the seven FEs (ear movements, eyebrow tension, orbicularis tension, dilated nostrils, eye opening, muzzle tension, and masticato...
Rovel T, Duchateau L, Saunders J, Vandenberghe F, Vanderperren K.Narrowing of the equine cervicothoracic intervertebral foramina (IF) has the potential to cause forelimb lameness and/or neck pain although limited information is available on CT of the IF. The aims of this retrospective, analytical study were to describe a protocol for quantifying CT cervicothoracic IF size; evaluate the repeatability of IF size measures; test associations between IF size and adjacent articular process (AP) size, ventral extent, and anatomic location; and determine the proportion of IF with narrowing. Computed tomographic images were acquired in 20 Warmblood horses that prese...
Ekstrand C, Michanek P, Gehring R, Sundell A, Källse A, Hedeland M, Ström L.Atropine is an essential part of the treatment protocol for equine uveitis. Topical atropine administration has been associated with decreased intestinal motility and abdominal pain in horses. Experimental studies have indicated that frequent dosing is associated with a higher risk than dosing every 6 h. Unfortunately, no quantitative pharmacodynamic data for inhibition of the equine gut are published. Unassigned: Eight standardbred horses were assigned to receive either atropine or saline (control) to be infused over 30 min in a two-treatment cross-over design. Atropine concentrations in plas...
Miagkoff L, Girard CA, St-Jean G, Richard H, Beauchamp G, Laverty S.Osteoarthritis (OA) is a major cause of equine lameness. Cannabinoid (CB) receptors are now considered to be promising therapeutic targets in human rheumatology for pain and inflammation, however, little is known about the equine endocannabinoid system. Objective: The primary goal was to assess the presence and expression pattern of CB1 and CB2 in the synovium of healthy joints. A secondary goal was to explore the relationship between the CB expression, degree of synovitis and OA pathology. Methods: Ex vivo experimental study. Methods: Metacarpophalangeal joints (n = 25) from a tissue bank w...
Ask K, Andersen PH, Tamminen LM, Rhodin M, Hernlund E.This study investigated the relationship between orthopedic pain experienced at rest, and degree of movement asymmetry during trot in horses with induced reversible acute arthritis. Orthopedic pain was assessed with the Horse Grimace Scale (HGS), the Equine Utrecht University Scale of Facial Assessment of Pain (EQUUS-FAP), the Equine Pain Scale (EPS), and the Composite Orthopedic Pain Scale (CPS). Reliability and diagnostic accuracy were evaluated with intraclass correlation coefficients (ICC) and area under the curve (AUC). Unassigned: Eight healthy horses were included in this experimental s...
La Rosa L, Twele L, Duchateau L, Gasthuys F, Kästner SB, Schauvliege S.A bolus of 50 mg kg MgSO (treatment Mg) or the same volume of saline (treatment S) was infused over 15 minutes in 5 adult healthy horses. T0 was the end of the infusion. Physiological parameters were recorded throughout the study period. Measurements of electrical, thermal, and mechanical nociceptive thresholds were performed at the pelvic limbs at baseline (before T0), and at specific timepoints. Blood samples were taken at fixed timepoints before, during and until 12 hours after the infusion. For statistical analysis, the 95% confidence intervals (CI's) for the differences in nociceptive th...
Cullier A, Cassé F, Manivong S, Contentin R, Legendre F, Garcia Ac A, Sirois P, Roullin G, Banquy X, Moldovan F, Bertoni L, Audigié F, Galéra P....Osteoarthritis (OA) is a degenerative and heterogeneous disease that affects all types of joint structures. Current clinical treatments are only symptomatic and do not manage the degenerative process in animals or humans. One of the new orthobiological treatment strategies being developed to treat OA is the use of drug delivery systems (DDS) to release bioactive molecules over a long period of time directly into the joint to limit inflammation, control pain, and reduce cartilage degradation. Two vasoactive peptides, endothelin-1 and bradykinin, play important roles in OA pathogenesis. In this ...
Videla R, Andrews FM.Equine gastric ulcer syndrome (EGUS) is common in horses. A history of mild intermitted recurrent colic signs after eating is noted in many horses. Management of horses with abdominal pain caused by gastric ulcers is especially difficult, because non-steroidal anti-inflammatory agents, typically used to control abdominal pain, may exacerbate this condition. Effective pharmacologic agents are available to treat EGUS and eliminate abdominal pain, but more comprehensive measures of environmental and dietary management are needed to manage horses with EGUS and prevent recurrence. This article focu...
Gozalo-Marcilla M, Gasthuys F, Schauvliege S.To review the literature with regard to the use of different intravenous agents as supplements to inhalational anaesthesia in horses. These drugs include lidocaine, ketamine, opioids and α2 -agonists. The Part 1 of this review will focus in the use of lidocaine and ketamine. Methods: Pubmed & Web of Science. Search terms: horse, inhalant anaesthesia, balanced anaesthesia, partial intravenous anaesthesia, lidocaine, ketamine. Conclusions: Different drugs and their combinations can be administered systemically in anaesthetized horses, with the aim of reducing the amount of the volatile agen...
Greve L, Dyson S, Pfau T.Lameness, thoracolumbosacral pain and reduced range of motion (ROM) often coexist; better understanding of their relationship is needed. The objectives were to determine if thoracolumbosacral movement of horses changes when pain causing lameness is improved by diagnostic analgesia. We hypothesised that reduction of lameness will increase ROM of the thoracolumbosacral region. Thirteen horses with different types of hind limb lameness were trotted in straight lines and lunged on a 10m diameter circle on left and right reins before and after lameness was subjectively substantially improved by dia...
Murray RC, Schramme MC, Dyson SJ, Branch MV, Blunden TS.Palmar foot pain is a common cause of lameness. Magnetic resonance imaging (MRI) has the potential to detect damage in all tissues of the equine foot, but an understanding of the differences in magnetic resonance (MR) images between feet from horses with and without palmar foot pain is required. This study aimed to describe MR findings in feet from horses with no history of foot-related lameness, and to compare these with MR findings in horses with lameness improved by palmar digital local analgesia. Thirty-four limbs from horses euthanized with a clinical diagnosis of navicular syndrome (amen...
Hassel DM, Hill AE, Rorabeck RA.Glucose homeostasis is dysregulated in critically ill humans resulting in hyperglycemia and decreased survival. Hyperglycemia is common in horses presenting with abdominal crisis, and this might be associated with a worse prognosis for survival. Objective: To determine if hyperglycemia in horses with acute abdominal disease is associated with increased odds of failure to survive to hospital discharge. Methods: Two hundred and twenty-eight adult horses with acute gastrointestinal disease. Methods: Observational retrospective study. Records of horses > 1 year of age presenting for treatment o...
Galiazzo G, De Silva M, Giancola F, Rinnovati R, Peli A, Chiocchetti R.The activation of cannabinoid and cannabinoid-related receptors by endogenous, plant-derived or synthetic cannabinoids may exert beneficial effects on pain perception. Of the cannabinoids contained in Cannabis sativa, cannabidiol (CBD) does not produce psychotropic effects and seems to represent a molecule having great therapeutic potential. Cannabidiol acts on a great number of cannabinoid and cannabinoid-related G-protein-coupled receptors and ionotropic receptors which have, to date, been understudied in veterinary medicine particularly in equine medicine. Objective: To localise the cellula...
Pongratz U, Licka T.The aim of this study was to provide information on algometric transmission of pressure through the dorsal thoracolumbar tissues of the equine back. Using a commercially available algometer, measurements were carried out with six different tips (hemispheric and cylindrical surfaces, contact areas 0.5 cm2, 1 cm2, and 2 cm2). In nine live horses the threshold of pressure that lead to any reaction was documented. In postmortem specimens of five euthanized horses the transmission of algometer pressure onto a pressure sensor placed underneath the dorsal thoracolumbar tissues at the level of the ...
Rédua MA, Valadão CA, Duque JC, Balestrero LT.To evaluate the pre-emptive analgesic effect of pre-incisional epidural ketamine. Methods: A blinded, randomized experimental study. Methods: Sixteen mixed breed mares, 7.6 ± 2.8 years old, weighing 352 ± 32 kg. Methods: In a pilot study, an incision was made on one lateral thigh using a lidocaine block and no further analgesics, and it was verified that the nociceptive threshold was lower on the incised side than nonincised side (p ≤ 0.05), and that von Frey filaments evoked a pain response. The 16 animals were divided into group A (ketamine, n = 9) and B (saline, n = 7). An epidural cath...
Ryan T, Smith R.Low level laser therapy (LLLT) is frequently used in the treatment of wounds, soft tissue injury and in pain management. The exact penetration depth of LLLT in human tissue remains unspecified. Similar uncertainty regarding penetration depth arises in treating animals. This study was designed to test the hypothesis that transmission of LLLT in horses is increased by clipping the hair and/or by cleaning the area to be treated with alcohol, but is unaffected by coat colour. A LLLT probe (810 nm, 500 mW) was applied to the medial aspect of the superficial flexor tendon of seventeen equine forelim...
Contino EK.Joint disease is one of the most common issues effecting sport horses. Because there is no cure for joint disease, treatment goals surround slowing progression of the disease, minimizing pain, increasing function, and optimizing performance. Accomplishing these goals often requires a multimodal approach that combines systemic medications or supplements; intra-articular therapies, such as corticosteroids or biologics; management considerations; and physical therapy exercises.
Pezzanite LM, Chow L, Phillips J, Griffenhagen GM, Moore AR, Schaer TP, Engiles JB, Werpy N, Gilbertie J, Schnabel LV, Antczak D, Miller D, Dow S....Rapid development of antibiotic resistance necessitates advancement of novel therapeutic strategies to treat infection. Mesenchymal stromal cells (MSC) possess antimicrobial and immunomodulatory properties, mediated through antimicrobial peptide secretion and recruitment of innate immune cells including neutrophils and monocytes. TLR-3 activation of human, canine and equine MSC has been shown to enhance bacterial killing and clearance in vitro, in rodent Staphylococcal biofilm infection models and dogs with spontaneous multi-drug-resistant infections. The objective of this study was to determi...
van Eps AW.Acute laminitis is a serious complication of many primary conditions in the horse. This article summarizes the most appropriate approach to management of the horse with acute laminitis, based on current information.
Science (New York, N.Y.)September 14, 1984
Volume 225, Issue 4667 1172-1174 doi: 10.1126/science.6089344
Lagerweij E, Nelis PC, Wiegant VM, van Ree JM.The twitch procedure in horses attenuates the increase in the heart rate evoked by pain-inducing stimuli and the reaction of the animals to such stimuli. Endorphin systems are probably involved in the effectiveness of the twitch, since its action is blocked by naloxone and its application increases plasma concentrations of immunoreactive beta-endorphin. The mode of action of the twitch cannot be explained by the generally accepted theory of divertive pain and may resemble that of classical acupuncture.
Alonso Jde M, Alves AL, Watanabe MJ, Rodrigues CA, Hussni CA.Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular...
Peham C, Licka T, Girtler D, Scheidl M.The aim of this study was to assess the influence of orthopaedic pain on the variation of stride length as a kinematic system-parameter in 21 horses with forelimb lameness. Data were collected while the horses were trotting on a treadmill during a minimum of 12 motion cycles, both before and after intra-articular or perineural anaesthesia. Stride length was assessed for each motion cycle, and the mean and standard deviation were calculated for each condition. Forelimb lameness was documented as percentage of asymmetry of vertical head movement. With significant decrease of forelimb lameness af...
Blunden A, Dyson S, Murray R, Schramme M.Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Objective: Abnormalities of the collateral sesamoidean ligaments (CSLs), distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), navicular bone, navicular bursa, distal interphalangeal (DIP) joint or collateral ligaments (CLs) of the DIP joint may contribute to palmar foot pain. Methods: Feet were selected from horses with a history of unilateral or bilateral forelimb lameness of at least 2 months' duration that was improv...
Roberts VL, McKane SA, Williams A, Knottenbelt DC.REASONS FOR DESIGNING AND REPORTING TECHNIQUE: Idiopathic headshaking has remarkable similarities to human neuropathic facial pain syndromes associated with post herpetic and trigeminal neuralgia. These derive from abnormal sensory function within the peripheral or central pathways of the trigeminal nerve (TgN). Limiting input from the TgN can be helpful in controlling the perception of pain. Rhizotomy of the infraorbital branch of the TgN as it emerges from the infraorbital canal has been reported but has a poor efficacy. A novel technique involves compression of the nerve at a more caudal lo...
Blunden A, Dyson S, Murray R, Schramme M.Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Objective: Abnormalities of the deep digital flexor tendon (DDFT) may contribute to palmar foot pain; ageing degenerative changes may be seen in horses free from lameness; and horses with lameness are likely to have a greater severity of abnormalities than age-matched horses with no history of foot pain. Methods: Feet were selected from horses with a history of uni- or bilateral forelimb lameness of at least 2 months' duration. Histology of th...
Meehan L, Dyson S, Murray R.Clinical, radiographic and scintigraphic signs associated with spondylosis of the equine thoracolumbar spine have been poorly documented. Objective: To establish an objective radiographic and scintigraphic grading system for spondylosis lesions; to estimate the prevalence of spondylosis in a population of horses with back pain; and to compare the results of radiography and scintigraphy. Methods: Radiographic images of the thoracolumbar spine from 670 horses with clinical signs of back pain were graded. Scintigraphic images from horses with spondylosis lesions underwent subjective and objective...
Kim T, Lee J, Oh S, Kim S, Yoon B.A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Methods: A randomized controlled trial. Methods: Community and university campus. Methods: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Methods: The exercises were performed for 30 minutes, 2 days p...
Kristoffersen M, Ohberg L, Johnston C, Alfredson H.Recent research on chronic painful Achilles tendons in humans using ultrasonography and immunohistochemistry, has demonstrated an association between neurovascular ingrowth and tendon pain. In horses, chronic debilitating tendon conditions are well-known to be very difficult to treat, and the background to impaired function and pain is not scientifically clarified. In a collaborative research project between the Sports Medicine Unit in Umeå and Strömsholm Equine Hospital, grey-scale ultrasonography (US) and colour Doppler (CD) examination were performed in ten horses with chronic tendon inju...
Ceroni D, De Rosa V, De Coulon G, Kaelin A.We report 4 cases of nutcracker fractures of the cuboid resulting from equestrian sport in pediatric population. These lesions are often consistent with a trauma in forced abduction of the forefoot. The particular mechanism of the cuboid fracture due to horseback riding in children is discussed. The methods used to radiographically evaluate the compression fracture of the cuboid and its associated injuries are presented. Left untreated, these fractures can lead to severe alterations in foot mechanics and function, such as to severe pain. In addition, the surgical treatment to correct the nutcr...
Maliye S, Voute L, Lund D, Marshall JF.In order for changes in lameness to be accurately and repeatably detected and recorded during diagnostic investigations, an objective measure of lameness is required. Objective: To ascertain whether an inertial sensor-based system can distinguish between a positive and negative response to diagnostic anaesthesia of the foot and objectively assess the effect of a positive response on the trot. Methods: Restrospective clinical study. Methods: Data obtained during lameness investigations undertaken between August 2011 and December 2012 in which either a palmar digital or abaxial sesamoid nerve bl...
Coomer RP, McKane SA, Smith N, Vandeweerd JM.To compare the results of a novel minimally invasive surgical technique with intralesional corticosteroid medication, as treatment for overriding dorsal spinous processes (ORDSP) in horses. Methods: Retrospective controlled clinical case series. Methods: Horses (n = 68) with ORDSP. Methods: ORDSP was diagnosed based on history, clinical, and radiographic examination. All narrowed spaces were treated. Horses undergoing medical treatment had methylprednisolone acetate injected directly in the affected space under radiographic control. Surgical cases had interspinous ligament desmotomy (ISLD) usi...
Story MR, Haussler KK, Nout-Lomas YS, Aboellail TA, Kawcak CE, Barrett MF, Frisbie DD, McIlwraith CW.Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous s...
Dyson S, Murray R, Schramme M, Branch M.The differential diagnosis of foot pain has long proved difficult and the use of magnetic resonance imaging (MRI) offers the opportunity to further the clinical understanding of the subject. Objective: To determine the incidence of deep digital flexor tendon (DDFT) injuries in a series of 75 horses with lameness associated with pain localised to the digit, with no significant detectable radiographic or ultrasonographic abnormalities, using MRI; and to describe a variety of lesion types and relate DDF tendonitis with anamnesis, clinical features, response to local analgesic techniques and nucle...
Guedes A.There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach...
Powell SE, Ramzan PH, Head MJ, Shepherd MC, Baldwin GI, Steven WN.The proximal metacarpal region is a common site of origin of lameness in the performance horse. A number of disease entities are recognised as causes of proximal metacarpal lameness but a definitive diagnosis is often elusive. Magnetic resonance imaging (MRI) is hypothesised to offer advantages over traditional imaging modalities in the investigation of proximal metacarpal pain. Objective: To describe clinical and imaging features of cases of lameness in racehorses arising from the proximal metacarpal region in which standing MRI identified 'bone marrow oedema-type' (BMO-type) signal patterns....
Gibson KT, Curtis CR, Turner AS, McIlwraith CW, Aanes WA, Stashak TS.Medical records of 210 horses that survived ventral midline celiotomy for at least 4 months were examined and owners were queried to determine factors contributing to incisional hernia formation. The incidence rate of incisional hernias within 4 months was 16%. Factors significantly associated with occurrence of incisional hernias were incisional drainage, closure of the linea alba with chromic gut suture material, previous midline celiotomy, excessive incisional edema, castrated male sex, postoperative leukopenia, and postoperative pain (colic). Factors not significantly associated with occur...
