Objective pain assessment in horse (2014-2018)

In recent decades, much effort has been invested in scientific studies of objective and reliable assessment of pain in horses. Various types of pain assessment tools have been described and (partly) validated for different types of pain in horses. Currently, composite pain scales and facial expression-based pain scales seem to be the most promising tools for pain assessment in horses and numerous studies have recently been published on the use of these pain scales in horses. Therefore, this narrative review mainly focusses on these two types of pain scales and on the studies that have appeared describing these type of pain scales in horses. The extent to which these pain scales have been validated (sensitivity, specificity, inter-observer reliability etc.) and their potential use for clinical pain states is discussed. Possible future directions for new studies and their possible aid in assessing pain in hospitalised and ridden horses are presented. In this way, improved pain scoring could improve criteria used to evaluate the clinical efficacy of new analgesic drugs and techniques, potentially benefiting equine welfare

Objective pain assessment in horse (2014-2018)

In recent decades, much effort has been invested in scientific studies of objective and reliable assessment of pain in horses. Various types of pain assessment tools have been described and (partly) validated for different types of pain in horses. Currently, composite pain scales and facial expression-based pain scales seem to be the most promising tools for pain assessment in horses and numerous studies have recently been published on the use of these pain scales in horses. Therefore, this narrative review mainly focusses on these two types of pain scales and on the studies that have appeared describing these type of pain scales in horses. The extent to which these pain scales have been validated (sensitivity, specificity, inter-observer reliability etc.) and their potential use for clinical pain states is discussed. Possible future directions for new studies and their possible aid in assessing pain in hospitalised and ridden horses are presented. In this way, improved pain scoring could improve criteria used to evaluate the clinical efficacy of new analgesic drugs and techniques, potentially benefiting equine welfare

Use of epidurally derived evoked potentials for quantification of caudal nociception in ponies

Am J Vet Res. 2009 Jul;70(7):813-9. Use of epidurally derived evoked potentials for quantification of caudal nociception in ponies. van Loon JP, Stienen PJ, Doornenbal A, Hellebrekers LJ. Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, 3508 TD Utrecht, The Netherlands. OBJECTIVE: To determine whether epidurally derived evoked potentials (EPs) can be used to reliably assess nociception and antinociception in ponies. ANIMALS: 7 ponies. PROCEDURES: EPs and electromyograms (EMGs) from the quadriceps femoris muscles were recorded simultaneously, following electrical stimulation applied to the distal portion of the hind limb. The effect of increasing stimulus intensity, conduction velocities of the stimulated nerves, effect of epidurally applied methadone, and effect of systemically administered propofol were evaluated. RESULTS: In the EP and EMG waveforms, 2 distinct complexes, the EP N25 and P50 and the EMG P27 and N62, respectively, were identified. On the basis of their latency and calculated conduction velocities, the EP P50 and EMG N62 were considered to be related to nociception (AD-mediated). All complexes increased significantly in amplitude with increasing stimulus intensity and decreased significantly following epidural administration of methadone or systemic administration of propofol. CONCLUSIONS AND CLINICAL RELEVANCE: Although the experimental setup allowed successful discrimination between tactile- and nociceptive-associated responses, the identified EPs, considered to reflect activity in the spinal cord, could not be definitively differentiated from activity in the lumbosacral epaxial musculature. Further research is required to refine measurement techniques to allow for discrimination between these 2 signals. Similar to other species, neurophysiologic variables such as EPs could potentially become a useful additional tool in quantifying nociception in equidae. PMID: 19566465 [PubMed - indexed for MEDLINE

Intra-articular opioid analgesia is effective in reducing pain and inflammation in an equine LPS induced synovitis model.

Reasons for performing study: Intra-articular administration of morphine as a local analgesic and anti-inflammatory drug is widely used in human medicine. In equids, little is known about its clinical analgesic and anti-inflammatory efficacy. Objectives: To use an inflammatory orthopaedic pain model to investigate the analgesic and anti-inflammatory effects of intra-articularly administered morphine as a new treatment modality in horses with acute arthritis. Methods: In a crossover study design, synovitis was induced in the left or right talocrural joint by means of intra-articular injection of 0.5 ng lipopolyssacharide (LPS). The effect of 120 mg morphine, intra-articularly administered at 1 h after induction of synovitis, was evaluated using both physiological and behavioural pain variables. Synovial fluid was sampled at 0, 4, 8, 28 and 52 h after induction of synovitis and analysed for total protein concentration, leucocyte count and for prostaglandin E(2), bradykinin and substance P concentrations by ELISA. Ranges of motion of metatarsophalangeal and talocrural joints were measured as kinematic variables with the horses walking and trotting on a treadmill under sound and lame conditions. Clinical lameness scores and several behavioural variables related to the perception of pain were obtained. Results: LPS injection caused marked transient synovitis, resulting in increased concentrations of inflammatory synovial fluid markers, clinical lameness, joint effusion and several behavioural changes, such as increased time spent recumbent, decreased limb loading at rest and decreased time spent eating silage. Intra-articular morphine resulted in a significant decrease in synovial white blood cell count, prostaglandin E(2) and bradykinin levels and improvement in clinical lameness, kinematic and behavioural parameters, compared to placebo treatment. Conclusions: Intra-articular morphine offers potent analgesic and anti-inflammatory effects in horses suffering from acute synovitis. Potential relevance: Local administration of opioids may be useful for horses with acute inflammatory joint pain and offers possibilities for multimodal analgesic therapies without opioid-related systemic side effects