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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.
Non-steroidal anti-inflammatory drugs in equine orthopaedics.
Equine veterinary journal    February 10, 2022   Volume 54, Issue 4 636-648 doi: 10.1111/evj.13561
Jacobs CC, Schnabel LV, McIlwraith CW, Blikslager AT.Orthopaedic disorders are commonly encountered in equine veterinary medicine, and non-steroidal anti-inflammatory drugs (NSAIDs) play an important role in the management of many equine orthopaedic disorders. There are multiple NSAIDs available for use in horses, including both non-selective and selective NSAIDS, and the body of literature evaluating the efficacy of these medications, their effects on normal and inflamed musculoskeletal tissues, and their side effects is broad. This review aims to summarise the current literature on the use of NSAIDs for equine orthopaedic disorders and examine...
Pain severity scores for common equine disorders as provided by horse owners and equine veterinarians.
Equine veterinary journal    February 7, 2022   Volume 54, Issue 6 1094-1102 doi: 10.1111/evj.13559
Sellon DC, Sanz M, Kopper JJ, Mattei D.Understanding factors influencing assessment of pain in horses will facilitate communication between veterinarians and horse owners. Objective: To compare estimates of pain experienced by horses as provided by veterinarians and horse owners and to determine factors associated with individuals who perceive horses to be experiencing extreme pain or minimal pain. Methods: Cross-sectional study. Methods: Internet-based questionnaires for horse owners and veterinarians included items related to recognition of pain in horses, estimated degree of pain experienced by horses, and demographic informatio...
Infectious Uveitis in Horses and New Insights in Its Leptospiral Biofilm-Related Pathogenesis.
Microorganisms    February 7, 2022   Volume 10, Issue 2 doi: 10.3390/microorganisms10020387
Wollanke B, Gerhards H, Ackermann K.Uveitis is a sight-threatening eye disease in equids known worldwide that leads to considerable pain and suffering. By far the most common type of uveitis in Germany and neighboring countries is classical equine recurrent uveitis (ERU), which is caused by chronic intraocular leptospiral infection and is the main cause of infectious uveitis in horses. Other infectious causes are extremely rare and are usually clinically distinguishable from ERU. ERU can be treated very effectively by vitreous cavity lavage (vitrectomy). For proper indications of this demanding surgery, it is necessary to differ...
Liposomal bupivacaine provides longer duration analgesia than bupivacaine hydrochloride in an adjustable sole-pressure model of equine lameness.
American journal of veterinary research    January 28, 2022   Volume 83, Issue 4 298-304 doi: 10.2460/ajvr.21.08.0132
Moorman VJ, Pezzanite LM, Griffenhagen GM.To compare the efficacy and duration of action for perineural analgesia with liposomal bupivacaine (LB) versus bupivacaine hydrochloride (BHCl) in a sole-pressure induced model of forelimb lameness in horses. Methods: 6 healthy adult research horses. Methods: In 1 randomly assigned forelimb, grade 3/5 lameness was induced by use of a sole-pressure lameness model. Objective lameness (vector sum [VS]) was determined with an inertial sensor system at 0, 1, 6, and 24 hours after lameness induction to evaluate the model. Mechanical nociceptive thresholds (MNTs) and objective lameness (VS and force ...
Effects of a Bio-Electromagnetic Energy Regulation Blanket on Thoracolumbar Epaxial Muscle Pain in Horses.
Journal of equine veterinary science    January 23, 2022   Volume 111 103867 doi: 10.1016/j.jevs.2022.103867
King MR, Seabaugh KA, Frisbie DD.Back pain and inflammation of the epaxial musculature is a significant problem in all equine athletes. Treatment of back pain can be challenging and often requires a multimodal approach. In humans, bio-electromagnetic energy regulation therapy (BEMER) has been reported to be effective in pain modulation. With its increased use in people comes a similar robust application in veterinary medicine unfortunately, there is unsubstantiated evidence for this type of therapy in horses. Objectives of this study were to assess analgesic responses and biomechanical outcome variables using a bio-electromag...
Caecal microbiota in horses with trigeminal-mediated headshaking.
Veterinary medicine and science    January 21, 2022   Volume 8, Issue 3 1049-1055 doi: 10.1002/vms3.735
Aleman M, Sheldon SA, Jospin G, Coil D, Stratton-Phelps M, Eisen J.Trigeminal-mediated headshaking (TMHS) in horses is a form of neuropathic pain of undetermined cause that often results in euthanasia. The role of microbiota in TMHS has not been investigated in diseased horses. To investigate if gastrointestinal microbiota in the cecum is different in horses with TMHS compared to a control population, during a summer season with clinical manifestations of disease. Ten castrated horses: five with TMHS and five neurologically normal controls. All horses were sourced from our institution and kept under the same husbandry and dietary conditions. All horses were f...
How to perform a percutaneous cecal or colonic trocarization in horses with severe abdominal tympany.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    January 20, 2022   Volume 32, Issue S1 57-62 doi: 10.1111/vec.13123
Schroeder EL, Gardner AK, Mudge MC.Cecal or colonic gas tympany of any cause may result in increased intraabdominal pressure, causing a significant decrease in venous return and cardiac output. Trocarization of the large colon or cecum in the event of large intestinal tympany may resolve gas distension and accompanying increased intraabdominal pressures sufficiently enough to promote resolution of a displaced large colon. Furthermore, trocarization of the medical colic may decrease morbidity and mortality associated with severe intraabdominal hypertension. Methods: This how-to description details the technique of transcutaneous...
CT is a feasible imaging technique for detecting lesions in horses with elbow lameness: A study of 139 elbows in 99 horses. Zimmerman M, Schramme M, Barthélemy A, Mariën T, Thomas-Cancian A, Ségard-Weisse E.Computed tomography (CT)is increasingly available in veterinary referral practices; however, published studies describing CT lesions of the equine elbow are currently lacking. In this single-center, retrospective, observational study, horses undergoing elbow CT at Equitom between July 2015 and October 2018 were reviewed. Subchondral bone sclerosis; resorption of the radius, ulna, and humerus; osteophyte; and enthesophyte lesions were graded. One hundred thirty-nine elbows of 99 horses (16 with elbow pain and 123 control elbows) were included (median age, 9 years). Osseous cyst-like lesions (nÂ...
Safety and Synovial Inflammatory Response After Intra-articular Injection of Botulinum Toxin Type A in Healthy Horses.
Journal of equine veterinary science    January 10, 2022   Volume 110 103865 doi: 10.1016/j.jevs.2022.103865
Beck AA, Paz LB, Frank MI, Engelmann AM, Krause A, Côrte FD.Botulinum toxin type A (BoNT-A) is a promising alternative for patients suffering from chronic joint pain. The aim of this study was to investigate whether a single injection of BoNT-A would produce adverse effects on clinical parameters and synovial parameters as well as lameness. One randomly selected radiocarpal joint was treated with 50 U of BoNT-A in eight horses, and the contralateral joint received saline solution. All horses received injections at day 0 and were re-evaluated twice daily for 7 days for heart rate (HR), respiratory rate (RR), rectal temperature (RT), mucous membrane colo...
Comparison of 2% mepivacaine and a solution of 2% lidocaine/epinephrine administered for median and ulnar nerve blocks in horses with naturally occurring forelimb lameness.
Veterinary surgery : VS    December 29, 2021   Volume 51, Issue 2 279-285 doi: 10.1111/vsu.13754
Boorman S, DeGraves F, Schumacher J, Hanson RR, Boone LH.To compare a 2% lidocaine solution containing 5 μg/ml (1:200 000) epinephrine with 2% mepivacaine for reducing lameness in horses after use in proximal nerve blocks. Methods: Experimental randomized crossover. Methods: Six adult horses with naturally occurring forelimb lameness. Methods: Horses were evaluated using an inertial gait sensor system. Lameness was measured as a vector sum (VS). Following baseline lameness examination, median and ulnar nerve blocks were performed with lidocaine/epinephrine (0.5 mg epinephrine added to 50 ml of 2% lidocaine immediately prior to administration)...
Comparison of two doses of ketamine for induction of anaesthesia in ponies undergoing field castration.
Open veterinary journal    December 23, 2021   Volume 11, Issue 4 747-754 doi: 10.5455/OVJ.2021.v11.i4.27
Wise IK, Klöppel H, Leece EA.Ketamine-based total intravenous anaesthesia techniques are commonly used in equine practice for ponies requiring short procedures such as castration in field conditions. When a longer duration of recumbency than provided by the initial dose of anaesthetic agents is required, administration of supplementary 'top-up' doses of anaesthetic agents is required. Ideally, a single dose of anaesthetic agents would reliably achieve a longer duration of action whilst maintaining adequate anaesthetic, surgical and recovery qualities. Objective: This prospective, randomised and blinded study aimed to comp...
Ultrasound-guided tenoscopic decompression of digital sheath synoviocoeles in 10 horses.
Veterinary surgery : VS    December 20, 2021   Volume 51, Issue 2 311-319 doi: 10.1111/vsu.13751
Hawkins A, Chapman L, Meter M, Smith RK.To report the diagnostic features and clinical outcome of horses with digital flexor tendon sheath (DFTS) synoviocoeles treated tenoscopically under ultrasonographic guidance. Methods: Retrospective case series. Methods: Client-owned horses (n = 10). Methods: Medical records were searched for horses with lameness localized to the region of the DFTS and clinical evidence of a fluid-filled mass (synoviocoele) associated with the DFTS. Diagnostic imaging and surgical findings, together with long-term outcome, were reported. Results: Lameness and synoviocoeles were unilateral (5 forelimbs, 5 hin...
Phenylbutazone pharmacokinetics in southern white rhinoceros (Ceratotherium simum simum) after oral administration.
Journal of veterinary pharmacology and therapeutics    December 11, 2021   Volume 45, Issue 2 196-202 doi: 10.1111/jvp.13036
Houck EL, Papich MG, Delk KW.Southern white rhinoceros (Ceratotherium simum simum) frequently develop painful conditions, such as traumatic injuries or osteoarthritis, necessitating the administration of pain-relieving medications. One of the preferred treatments is the nonsteroidal anti-inflammatory drug phenylbutazone because of the availability of oral formulations and the familiarity of its use in horses. For the main study, a single oral dose of phenylbutazone at 2 mg/kg was administered to healthy adult rhinoceros (n = 33) housed at six North American zoological institutions. Each rhinoceros had up to four blood ...
Dangerous Behavior and Intractable Axial Skeletal Pain in Performance Horses: A Possible Role for Ganglioneuritis (14 Cases; 2014-2019).
Frontiers in veterinary science    December 10, 2021   Volume 8 734218 doi: 10.3389/fvets.2021.734218
Story MR, Nout-Lomas YS, Aboellail TA, Selberg KT, Barrett MF, Mcllwraith CW, Haussler KK. Dangerous behavior is considered an undesired trait, often attributed to poor training or bad-tempered horses. Unfortunately, horses with progressive signs of dangerous behavior are often euthanized due to concerns for rider safety and limitations in performance. However, this dangerous behavior may actually originate from chronic axial skeleton pain. This case series describes the medical histories and clinical presentations of horses presented for performance limitations and dangerous behavior judged to be related to intractable axial skeleton pain. Fourteen horses that developed severe pe...
Dexmedetomidine prolongs the duration of action of mepivacaine on anesthesia of the palmar digital nerves of horses.
American journal of veterinary research    November 30, 2021   Volume 83, Issue 2 114-118 doi: 10.2460/ajvr.20.10.0188
Nichols CL, Doherty TJ, Schumacher J, Jones PD, Sun X.To determine whether palmar digital nerve (PDN) blockade in horses with a combination of dexmedetomidine and mepivacaine would block the response to mechanical force applied to the digit longer than would anesthetizing these nerves with mepivacaine alone or dexmedetomidine alone. Methods: 8 mares with no signs of lameness. Methods: In a randomized, crossover, blinded, experimental study, both PDNs of the same forelimb of each horse were anesthetized by perineural injection with either 30 mg mepivacaine alone, 250 µg of dexmedetomidine alone, or 30 mg mepivacaine combined with 250 µg of dexme...
Using Short Term of High Power Laser Therapy in Horse’s Tendon Injuries.
Archives of Razi Institute    November 30, 2021   Volume 76, Issue 5 1437-1444 doi: 10.22092/ari.2021.356105.1779
Jaafar SE, Al-Bayti AAH, Abdullah SI.High-power laser therapy has been used as a treatment to cure sports injuries; however, there are no controlled standardized studies on its efficacy. Moreover, high-power laser therapy has been applied for the sport horses field. This study aimed to investigate whether high-power laser therapy can cure tendon disorders and reduce the pain in tendon lesions in injured horses and also to examine the effect of laser therapy on injured horses. This retroactive experiential clinical research was performed on50 racing horses between 5 and 15 years old. They were diagnosed with neither superficial di...
Comparison of Threshold and Tolerance Nociceptive Withdrawal Reflexes in Horses.
Animals : an open access journal from MDPI    November 26, 2021   Volume 11, Issue 12 3380 doi: 10.3390/ani11123380
Mühlemann S, Leandri M, Risberg ÅI, Spadavecchia C.The nociceptive withdrawal reflex (NWR) is used to investigate nociception in horses. The NWR threshold is a classical model endpoint. The aims of this study were to determine NWR tolerance and to compare threshold and tolerance reflexes in horses. In 12 horses, the NWR was evoked through electrical stimulation of the digital nerve and recorded via electromyography from the deltoid. Behavioral reactions were scored from 0 to 5 (tolerance). First, the individual NWR threshold was defined, then stimulation intensity was increased to tolerance. The median NWR threshold was 7.0 mA, whereas NWR tol...
Nociceptive pain and anxiety in equines: Physiological and behavioral alterations.
Veterinary world    November 26, 2021   Volume 14, Issue 11 2984-2995 doi: 10.14202/vetworld.2021.2984-2995
Hernández-Avalos I, Mota-Rojas D, Mendoza-Flores JE, Casas-Alvarado A, Flores-Padilla K, Miranda-Cortes AE, Torres-Bernal F, Gómez-Prado J....Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxi...
Multimodal therapy for treatment of equine back pain: a report of 15 cases.
Brazilian journal of veterinary medicine    November 22, 2021   Volume 43 e003321 doi: 10.29374/2527-2179.bjvm003321
de Melo UP, Ferreira C.Back pain and diseases of the spine are considered significant problems in equine sports and veterinary medicine. This article reports a multimodal approach to the treatment of equine back pain using ozonized platelet rich plasma (PRP), dynamic mobilization exercises, and therapeutic shoeing in 15 horses involved in the vaquejada discipline. Fifteen American Quarter Horses of both sexes engaged in vaquejada in the state of Rio Grande do Norte, Brazil, with a mean age of 8.61 ? 1.73 years were examined at a training center for lower performance diagnostics or back pain. A complete clinical exam...
Surgical removal of intra-articular loose bodies from the cervical articular process joints in 5 horses.
Veterinary surgery : VS    November 17, 2021   Volume 51, Issue 1 173-181 doi: 10.1111/vsu.13744
Tucker R, Parker RA, Meredith LE, Hughes TK, Foote AK.To describe the surgical removal of intra-articular loose bodies (LBs) from the cervical articular process joints (APJs) in five horses and to describe the outcome of the surgery. Methods: Short case series. Methods: Five client-owned horses with naturally occurring LBs within the cervical APJs. Methods: Medical records were reviewed of horses that were diagnosed with LBs of the cervical APJs on computed tomography (CT), where the LBs were subsequently removed surgically. Details of case selection and surgical technique were reviewed along with postoperative complications and clinical outcome....
Recovery of horses from general anaesthesia: A systematic review (2000-2020) of the influence of anaesthetic protocol on recovery quality.
Equine veterinary journal    November 12, 2021   Volume 54, Issue 2 219-261 doi: 10.1111/evj.13524
Loomes K, Louro LF.The recovery phase after equine general anaesthesia (GA) is a time of considerable risk and therefore has been the subject of extensive research over the last 20 years. Various pharmacological interventions have been developed and studied with the objective of improving recovery quality and reducing anaesthetic-related mortality and morbidity. Nevertheless, some controversy remains regarding the influence of anaesthetic protocol choice on recovery quality from GA and its implications for recovery-related mortality and morbidity. A systematic review of the literature investigating the influenc...
Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report.
Frontiers in veterinary science    November 4, 2021   Volume 8 749713 doi: 10.3389/fvets.2021.749713
Watkins AR, Hopster K, Levine D, Hurcombe SD.A 20-year-old Quarter Horse gelding was presented with severe right forelimb lameness (5/5 AAEP Lameness Scale) due to a tear of the superficial digital flexor muscle which was diagnosed via palpation of swelling and ultrasonography revealing major muscle fiber disruption and hematoma formation. When traditional systemic therapy (non-Steroidal anti-inflammatories) did not restore clinically acceptable comfort and the risk of supporting limb laminitis became a reasonable concern, a cervical epidural catheter was placed between the first and second cervical vertebrae in the standing, sedated pat...
Development and preliminary validation of a pain scale for ophthalmic pain in horses: The Equine Ophthalmic Pain Scale (EOPS).
Veterinary journal (London, England : 1997)    November 3, 2021   Volume 278 105774 doi: 10.1016/j.tvjl.2021.105774
Ortolani F, Scilimati N, Gialletti R, Menchetti L, Nannarone S.The purpose of this study was to describe the development and preliminary validation of a composite pain scale, called the Equine Ophthalmic Pain Scale (EOPS), to assess ocular pain in horses. Indicators associated with ocular pain were selected and classified as behavioural, physiological or ocular expressions. Eight horses diagnosed with ocular or adnexa diseases that required medical or surgical treatment were enrolled in the study (group P). The developed EOPS was applied at the baseline (T0) and 1 week later (T7). Moreover, the EOPS was applied twice, 1 week apart, to 15 healthy control h...
Animal Model of Video-Assisted Cecum and Ileum Instrumentation for Equine Visceral Pain Study.
Journal of equine veterinary science    October 29, 2021   Volume 108 103799 doi: 10.1016/j.jevs.2021.103799
Monteiro FDO, Borges LPB, Cardoso TDS, Teixeira PPM, Filho DZ, Sartori VC, Pereira RN, Flores FN, Coelho CMM, Silva MAM, Valadão CAA.This study aimed to describe an animal model for studying equine visceral pain using minimally invasive and video-assisted cecum and ileum instrumentation. The access to the cecum and ileum was affected because of a previous typhlostomy. For video-assisted distention of the cecum and ileum, a distention device, which we developed using an endotracheal Rusch probe, was used, adapted, and coupled to a cuffometer to inflate and measure the pressure of the cuff attached to its distal portion. In a video-assisted manner, the distal portion of the device was introduced into the cecum and ileum, whic...
Pain assessment in horses using automatic facial expression recognition through deep learning-based modeling.
PloS one    October 19, 2021   Volume 16, Issue 10 e0258672 doi: 10.1371/journal.pone.0258672
Lencioni GC, de Sousa RV, de Souza Sardinha EJ, Corrêa RR, Zanella AJ.The aim of this study was to develop and evaluate a machine vision algorithm to assess the pain level in horses, using an automatic computational classifier based on the Horse Grimace Scale (HGS) and trained by machine learning method. The use of the Horse Grimace Scale is dependent on a human observer, who most of the time does not have availability to evaluate the animal for long periods and must also be well trained in order to apply the evaluation system correctly. In addition, even with adequate training, the presence of an unknown person near an animal in pain can result in behavioral ch...
Pharmacology of the Equine Foot: Medical Pain Management for Laminitis.
The Veterinary clinics of North America. Equine practice    October 19, 2021   Volume 37, Issue 3 549-561 doi: 10.1016/j.cveq.2021.08.004
Hopster K, Driessen B.One of the biggest challenges in managing laminitis in horses remains the control of pain. The best analgesic approach is a multimodal approach, including nonsteroidal anti-inflammatory drugs, opioids, and/or constant rate infusions of α-2 agonists, ketamine, and lidocaine. Recent literature indicates that amitriptyline and soluble epoxide hydrolase inhibitor might be beneficial. Clinically oriented studies will be needed if they have a place in laminitis pain management. The systemic pain control can be combined with local techniques such as long-acting local anesthetics or epidural catheter...
Neosaxitoxin, a Paralytic Shellfish Poison phycotoxin, blocks pain and inflammation in equine osteoarthritis.
Toxicon : official journal of the International Society on Toxinology    October 16, 2021   Volume 204 5-8 doi: 10.1016/j.toxicon.2021.10.006
Montero C, Riquelme G, Del Campo M, Lagos N.The Osteoarthritis is a chronic disease characterized by a progressive deterioration of the articular cartilage producing a strong inflammatory activity and chronic pain in patients. Horses also show osteoarthritis. Since the activation and progression of the disease are similar to that of human we developed a study model in horses. In this study, we test the effect of Neosaxitoxin, a phycotoxin from Paralytic Shellfish Poison, in the remediation of osteoarthritis equine clinical symptoms such as pain (showed in lameness) and inflammation quantifying the amounts of pro-inflammatory markers lik...
Pharmacokinetics of paracetamol in the Thoroughbred horse following an oral multi-dose administration.
Journal of veterinary pharmacology and therapeutics    October 13, 2021   Volume 45, Issue 1 54-62 doi: 10.1111/jvp.13024
Pesko B, Habershon-Butcher J, Muir T, Gray B, Taylor P, Fenwick S, Hincks P, Scarth J, Paine S.Paracetamol is a widely used, non-opioid analgesic and antipyretic drug. Scientific evidence suggests that it is an effective pain treatment in equine medicine. However, there is very little published information about the pharmacokinetics of the drug in the horse. The aim of the research was to determine the pharmacokinetics of paracetamol in equine plasma and urine to inform treatment of Thoroughbred racehorses. In this multi-dose study, paracetamol was administered orally at 20 mg/kg to six Thoroughbred horses. Pre- and post-administration urine and plasma samples were collected and analys...
Standing flank laparotomy for colic: 37 cases.
Equine veterinary journal    October 6, 2021   Volume 54, Issue 5 934-945 doi: 10.1111/evj.13511
Lopes MAF, Hardy J, Farnsworth K, Labens R, Lam WYE, Noschka E, Afonso T, Cruz Villagrán C, Santos LCP, Saulez M, Kelmer G.Standing flank laparotomy can be an alternative to ventral midline laparotomy in horses with colic. Standing flank laparotomy avoids general anaesthesia, provides excellent access to some regions of the abdominopelvic cavity and costs less than ventral midline laparotomy. Objective: To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy. Methods: Retrospective case series. Methods: Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis w...
Minimally invasive cranial ostectomy for the treatment of impinging dorsal spinous processes in 102 standing horses.
Veterinary surgery : VS    October 4, 2021   Volume 51 Suppl 1 O60-O68 doi: 10.1111/vsu.13736
de Souza TC, Crowe OM, Bowles D, Poore LA, Suthers JM.To describe a minimally invasive cranial ostectomy for the treatment of impingement of dorsal spinous processes (DSPs) in the standing horse. Methods: Retrospective study. Methods: One hundred two horses with impinging DSPs. Methods: The case records of all horses that had the described technique between 2011 and 2019 were reviewed. All sites of impinging DSPs were treated under standing sedation and local anesthesia. The minimally invasive cranial ostectomy of the caudal DSP was performed with bone rongeurs through multiple small incisions. Results: Of the 102 horses treated with this techniq...
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