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Home / Equine Research Bank / Equine Vet J / Objective evaluation for analgesia of the distal interphalan...
Equine veterinary journal2022; 55(2); 253-260; doi: 10.1111/evj.13583

Objective evaluation for analgesia of the distal interphalangeal joint, the navicular bursa and perineural analgesia in horses with naturally occurring forelimb lameness localised to the foot.

Abstract: The outcome and interpretation of intra-synovial diagnostic analgesia of the distal interphalangeal joint (DIPJ) and the navicular bursa (NB) remain in dispute, and no objective studies have been carried out to establish the percentage of improvement over time from these two analgesia techniques. Objective: To investigate the qualitative and time-dependent outcome of DIPJ-A and NB-A in naturally occurring forelimb lameness. Methods: Case series. Methods: Twenty-three clinical cases with forelimb lameness were evaluated objectively using a body mounted inertial sensor system (BMIS). Lameness was localised to the foot with a palmar digital nerve block and/or an abaxial sesamoidean nerve block on day 1, and analgesia of the DIPJ (DIPJ-A) and NB (NB-A) were performed on days 2 and 3. Improvement following perineural analgesia was measured after 10 min and intra-synovial blocks after 2-, 5- and 10-min. Horses with at least 70% improvement measured objectively after diagnostic analgesia were included in the study. Results: There was no significant association between improvement following perineural analgesia and the DIPJ-A and NB-A. The mean improvement in the lameness differed between DIPJ-A and NB-A at 2 min (p < 0.001) and at 5 min (p = 0.04), and it was no longer observed after 10 min (p = 0.06). A positive NB-A produced a high degree of improvement that remained stable, whereas the DIPJ-A improved over time. Conclusions: Perineural and intra-synovial analgesia were performed without contrast medium to assess the diffusion of mepivacaine. Conclusions: Our results suggest that perineural analgesia is not reliable enough to differentiate pain originating from DIPJ and NB. Early evaluation of the DIPJ-A and NB-A can determine the origin of the pain. An improvement following NB-A was constant over time, but an improvement following DIPJ-A varied by up to 10 min. Unassigned: Das Ergebnis und die Interpretation der intra-synovialen diagnostischen Analgesie des distalen Interphalangealgelenks (DIPJ) und des Strahlbein-Schleimbeutels (NB) sind nach wie vor umstritten, und es wurden bisher keine objektiven Studien an Pferden durchgeführt, um den Prozentsatz der Verbesserung im Laufe der Zeit durch diese beiden Analgesietechniken zu ermitteln. Unassigned: Untersuchung der qualitativen und zeitabhängigen Ergebnisse von DIPJ-A und NB-A bei natürlich auftretenden Lahmheiten der Vordergliedmaßen. Methods: Prospektive klinische Studie METHODEN: 23 klinische Fälle mit Lahmheiten der Vordergliedmaßen wurden objektiv mit einem am Körper montierten Inertialsensor-System (BMIS) bewertet. Die Lahmheit wurde am Tag 1 mit einer tiefen Palmarnervenanästhesie und/oder mittleren Palmarnervenanästhesie auf den Fuß beschränkt, und die Analgesie des DIPJ (DIPJ-A) und des NB (NB-A) wurden an Tag 2 und 3 durchgeführt. Die Verbesserung nach einer perineuralen Analgesie wurde nach 10 Minuten und nach intra-synovialen Blockaden nach 2, 5 und 10 Minuten gemessen. Pferde mit einer objektiv gemessenen Verbesserung von mindestens 70 % nach diagnostischer Analgesie wurden in die Studie aufgenommen. Unassigned: Es bestand kein signifikanter Zusammenhang zwischen der Verbesserung nach Perineuralanalgesie und dem DIPJ-A und NB-A. Die mittlere Verbesserung der Lahmheit war zwischen DIPJ-A und NB-A nach 2 Minuten (p<0,001) und nach 5 Minuten (p=0,04) unterschiedlich und wurde nach 10 Minuten (p=0,06) nicht mehr beobachtet. Eine positive NB-A zeigte einen hohen Grad der Verbesserung, die stabil blieb, während sich die DIPJ-A im Laufe der Zeit verbesserte. Unassigned: Die perineurale und intra-synoviale Analgesie wurde ohne Kontrastmittel durchgeführt, um die Diffusion von Mepivacain zu beurteilen. Unassigned: Unsere Ergebnisse deuten darauf hin, dass die perineurale Analgesie nicht zuverlässig genug ist, um Schmerzen zu unterscheiden, die von DIPJ und NB ausgehen. Durch eine frühzeitige Untersuchung des DIPJ-A und NB-A kann die Ursache des Schmerzes ermittelt werden. Die Verbesserung von NB-A war über die Zeit konstant, aber die Verbesserung von DIPJ-A variierte um bis zu 10 Minuten.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2022-06-06 PubMed ID: 35488427DOI: 10.1111/evj.13583Google Scholar: Lookup
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Summary

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This study investigates the effectiveness and time-dependent outcome of analgesia techniques, specifically the distal interphalangeal joint (DIPJ) and navicular bursa (NB) in naturally occurring forelimb lameness in horses.

Research Methodology

  • The study involved a case series method where 23 clinical cases with forelimb lameness were assessed using a body mounted inertial sensor system (BMIS).
  • Initially, lameness was localized to the foot using a palmar digital nerve block and/or an abaxial sesamoidean nerve block on the first day. On the second and third day, analgesia of the DIPJ (DIPJ-A) and NB (NB-A) were carried out.
  • The improvement was measured after 10 minutes in case of perineural analgesia and at intervals of 2, 5 and 10 minutes for intra-synovial blocks. Only horses with at least 70% improvement measured objectively after diagnostic analgesia were included in the study.

Findings

  • There was no substantial relationship identified between improvement following perineural analgesia and the DIPJ-A and NB-A analgesia.
  • The mean improvement in lameness was observed to differ between DIPJ-A and NB-A at 2 minutes (p < 0.001) and at 5 minutes (p = 0.04). This difference was no longer observed after 10 minutes (p = 0.06).
  • A substantial level of improvement remained stable in horses that reacted positively to NB-A analgesia, while improvement in cases of DIPJ-A increased over time.

Conclusions

  • Both perineural and intra-synovial analgesia were performed without contrast medium in order to assess the diffusion of mepivacaine, an anesthetic.
  • The study concluded perineural analgesia as a standalone may not be reliable to differentiate pain originating from DIPJ and NB. Hence, early evaluation of DIPJ-A and NB-A is crucial to determine the pain origin.
  • Improvement in lameness following NB-A analgesia remained constant over time, whereas improvement following DIPJ-A differed by up to 10 minutes.

Cite This Article

APA
Katrinaki V, Estrada RJ, Mählmann K, Kolokythas P, Lischer CJ. (2022). Objective evaluation for analgesia of the distal interphalangeal joint, the navicular bursa and perineural analgesia in horses with naturally occurring forelimb lameness localised to the foot. Equine Vet J, 55(2), 253-260. https://doi.org/10.1111/evj.13583

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 2
Pages: 253-260

Researcher Affiliations

Katrinaki, Vasiliki
  • Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Estrada, Roberto J
  • Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
  • Large Animal Hospital, School of Veterinary Medicine, National University, Heredia, Costa Rica.
Mählmann, Kathrin
  • Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Kolokythas, Panagiotis
  • Service of Statistic AD HOC Studies, Chalkis, Greece.
Lischer, Christophorus J
  • Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.

MeSH Terms

  • Animals
  • Horses
  • Lameness, Animal / diagnosis
  • Lameness, Animal / drug therapy
  • Injections, Intra-Articular / veterinary
  • Pain / veterinary
  • Analgesia / veterinary
  • Forelimb
  • Horse Diseases / diagnosis
  • Horse Diseases / drug therapy

References

This article includes 41 references
  1. Colles C. Navicular disease and its treatment.. In Pract 1982;4(2):29-36.
  2. Gibson K, McIlwraith CW, Park R. A radiographic study of the distal interphalangeal joint and navicular bursa of the horse.. Vet Radiol 1990;31:22-5.
  3. Jann H, Henry G, Berry A, Cash L. Arthrographic observations of the equine distal interphalangeal joint (Articulationes Interphalangeae Distalis Manus) and navicular bursa (Bursa Podotrochlearis).. Anat Histol Embryol 1991;20(1):30-6.
  4. Bowker RM, Rockershouser SJ, Vex KB, Sonea IM, Caron JP, Kotyk R. Immunocytochemical and dye distribution studies of nerves potentially desensitized by injections into the distal interphalangeal joint or the navicular bursa of horses.. J Am Vet Med Assoc 1993;203(12):1708-14.
  5. Borges EM, de Souza MV, de Paula TAR. Anatomical study of the innervation of the distal portion of the thoracic limb in horse.. Cienc Rural 1997;27(1):67-73.
  6. Manfredi JM, Boyce M, Malone ED, Anderson C, Anderson LB, Trumble TN. Steroid diffusion into the navicular bursa occurs in horses affected by palmar foot pain.. Vet Rec 2012;171(25):642.
  7. Hontoir F, Rejas E, Falticeanu A, Nisolle JF, Simon V, Nicaise C. Communication between the distal interphalangeal joint and the navicular bursa in the horse at computed tomography arthrography.. Anat Histol Embryol 2019;48(2):133-41.
  8. Pleasant RS, Moll HD, Ley WB, Lessard P, Warnick LD. Intra-articular anesthesia of the distal interphalangeal joint alleviates lameness associated with the navicular bursa in horses.. Vet Surg 1997;26(2):137-40.
  9. Dyson SJ, Kidd L. A comparison of responses to analgesia of the navicular bursa and intra-articular analgesia of the distal interphalangeal joint in 58 horses.. Equine Vet J 1993;25:93-8.
  10. Keegan KG, Wilson DA, Kreeger JM, Ellersieck MR, Kuo KC, Li Z. Local distribution of mepivacaine after distal interphalangeal joint injection in horses.. Am J Vet Res 1996;57(4):422-6.
  11. Schumacher J, Steiger R, Schumacher J, De Graves F, Schramme M, Smith R. Effects of analgesia of the distal interphalangeal joint or palmar digital nerves on lameness caused by solar pain in horses.. Vet Surg 2000;29(1):54-8.
  12. Schumacher J, Schumacher J, Graves D, Schramme M, Smith R, Coker M. A comparison of the effects of local analgesic solution in the navicular bursa of horses with lameness caused by solar toe or solar heel pain.. Equine Vet J 2001;33(4):386-9.
  13. Schumacher J, Schumacher J, Schramme MC, De Graves FJ, Smith R, Coker M. Diagnostic analgesia of the equine forefoot.. Equine Vet J 2004;16(3):159-65.
  14. Schumacher J, Schumacher J, Gillette R, Graves D, Schramme M, Smith R. The effects of local anaesthetic solution in the navicular bursa of horses with lameness caused by distal interphalangeal joint pain.. Equine Vet J 2003;35(5):502-5.
  15. Schramme MC, Schumacher J, De Graves FJ. Diagnostic analgesia of the equine digit.. CE 2013;25(8):408-21.
  16. Gough MR, Mayhew IG, Munroe GA. Diffusion of mepivacaine between adjacent synovial structures in the horse. Part 1: forelimb foot and carpus.. Equine Vet J 2002;34(1):80-4.
  17. Rungsri PK, Staecker W, Leelamankong P, Estrada RJ, Schulze T, Lischer CJ. Use of body-mounted inertial sensors to objectively evaluate the response to perineural analgesia of the distal limb and intra-articular analgesia of the distal interphalangeal joint in horses with forelimb lameness.. J Equine Vet 2014;34(8):972-7.
  18. Leelamaknong P, Estrada RJ, Rungsi P, Wolfgang S, Müller CDVS, Lischer CJ. Objective evaluation of the response to perineural analgesia of the deep branch of the lateral plantar nerve and intra-articular analgesia of the tarsometatarsal joint in horses with suspected proximal metatarsal pain using body-mounted inertial sensors.. J Equine Vet 2018;1-18:91-5.
    doi: 10.1016/j.jevs.2018.07.004google scholar: lookup
  19. Maliye S, Voute L, Marshall JF. Naturally-occurring forelimb lameness in the horse results in significant compensatory load redistribution during trotting.. Vet J 2015;204(2):208-13.
  20. T Laurie. USER MANUAL Lameness Locator 2017.. 2017; 7-9.
  21. Keegan KG, Yonezawa Y, Pai PF, Wilson DA, Kramer J. Evaluation of a sensor-based system of motion analysis for detection and quantification of forelimb and hind limb lameness in horses.. Am J Vet Res 2004;48(5):608-12.
    doi: 10.1111/evj.12491google scholar: lookup
  22. Maliye S, Voute L, Lund D, Marshall JF. An inertial sensor-based system can objectively assess diagnostic anaesthesia of the equine foot.. Equine Vet J 2013;45(Suppl. 45):26-30.
  23. Keegan KG, MacAllister CG, Wilson DA, Gedon AC, Kramer J, Yonezawa Y. Comparison of an inertial sensor system with a stationary force plate for evaluation of horses with bilateral forelimb lameness.. Am J Vet Res 2012;73(3):368-74.
  24. Moyer W, Schumacher J, Schumacher J. A Guide to equine injection and regional anesthesia. Yardley, PA: Veterinary Learning Systems; 2009. p. 1-110.
  25. Verschooten F, Desmet P, Peremans K, Picavet T. Navicular disease in the horse: the effect of controlled intrabursal corticoid injection.. J Equine Vet 1990;10(4):316-20.
  26. Moyer W, Schumacher J, Schumacher J. Equine joint injection and regional anesthesia. Yardley, PA: Veterinary Learning Systems; 2013. p. 1-143.
  27. Schramme MC, Boswell JC, Hamhougias K, Toulson K, Viitanen M. An in vitro study to compare 5 different techniques for injection of the navicular bursa in the horse.. Equine Vet J 2000;32(3):263-7.
  28. Zubrod CJ, Farnsworth KD, Oaks JL. Evaluation of arthrocentesis site bacterial flora before and after 4 methods of preparation in horses with and without evidence of skin contamination.. Vet Surg 2004;33(5):525-30.
    doi: 10.1111/j.1532-950x.2004.04074.xgoogle scholar: lookup
  29. Keegan KG, Kramer J, Yonezawa Y, Maki H, Pai F, Dent EV. Assessment of repeatability of a wireless, inertial sensor-based lameness evaluation system for horses.. Am J Vet Res 2011;72(9):1156-63.
  30. Keegan KG, Dent EV, Wilson DA, Janicek J, Kramer J, LaCarrubba A. Repeatability of subjective evaluation of lameness in horses.. Equine Vet J 2010;42(2):92-7.
  31. Keegan KG, Wilson DA, Kramer J, Reed SK, Jonezawa Y, Maki H. Comparison of a body-mounted inertial sensor system-based method with subjective evaluation for detection of lameness in horses.. Am J Vet Res 2013;74(1):17-24.
  32. Tyrrell-Schroeder L. Straight line AIDEs: a detailed look at evidence and amplitude. Broadway, CO: online article by Equinosis; 2018. p. 1-3.
  33. Tyrrell-Schroeder L. USER MANUAL Lameness Locator 2016.. LL2016, v.1.0 2016, 24-30.
  34. Ross MW. Diagnosis and Management of Lameness in the horse. 2nd ed.. Louis, MO: ELSEVIER SAUNDERS; 2011: Chapter 10. p. 100-107.
  35. Easter JE, Watkins JP, Stephens SL, Carter GK, Hauge BA, Dutton DW. Effects of regional anesthesia on experimentally induced coffin joint synovitis.. Proc AAEP 2000;46:214-6.
  36. Schumacher J, Livesey L, Graves FJ, Schramme MC, Hathcock J, Taintor J. Effect of anaesthesia of the palmar digital nerves on proximal interphalangeal joint pain in the horse.. Equine Vet J 2004;36(5):409-14.
  37. Nagy A, Bodó G, Dyson SJ, Szabo F, Barr ARS. Diffusion of contrast medium after perineural injection of the palmar nerves: an in vivo and in vitro study.. Equine Vet J 2009;41(4):379-83.
  38. Covino BG. Clinical pharmacology of local anesthetic agents.. In: Cousins MJ, Bridenbaugh PO, editors. Neural blockade in clinical anesthesia and Management of Pain. 2nd ed. Philadelphia: J.B. Lippincott Co; 1988. p. 111-44.
  39. Salinas FV, Malik K, Benzon HT. Local anesthetics for regional anesthesia and pain management.. In: Benzon H, Rathmell JP, Wu CL, Turk DC, Argoff CE, editors. Raj's practical management of pain. Philadelphia: Mosby Elsevier; 2008. p. 811-38.
  40. Dyson SJ. Lameness due to pain associated with the distal interphalangeal joint: 45 cases.. Equine Vet J 1991;23(2):128-35.
    doi: 10.1111/j.2042-3306.1991.tb02737.xgoogle scholar: lookup
  41. Bowker RM, Linder K, Van Wulfen KK, Perry RL, Ocello PJ. Distribution of local anesthetics injected into the distal interphalangeal joint and podotrochlear bursa: an experimental study.. Pferdeheilkunde 1996;12:1-4.
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