Horses

What are signs of pain in horses?

What causes pain in horses?

What are some treatments for pain in horses?

NSAID information for the horse owner

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What are signs of pain in the horse?

A horse's behavior and interactions can be unique to the type of pain it is experiencing. A horse's reaction to pain is dependent upon its personality and the degree of pain it is experiencing. The characteristics listed below do not include everything that you may see, but the list gives you a general idea of what to look for if you think a horse is in pain. Some of these characteristics (marked with an asterisk *) are also things you will see when a horse is anxious or nervous or in poor health. Remember that there is no substitute for being familiar with an individual horse in order to recognize how it shows pain.

Acute pain

  • Reluctance to be handled *

  • Restlessness *

  • Prolonged pain may cause behavior to change from restlessness to depression with lowered head

  • Rigid stance

  • Head pressing

  • Interrupted feeding (food held in mouth uneaten)

  • Anxious appearance *

  • Dilated pupils and glassy eyes

  • Flared nostrils *

  • Muscle tremors *

  • Profuse sweating *

  • Increased respiratory rate and pulse rate *

Pain Associated with Musculoskeletal Injury (may also include signs listed under acute pain)

  • Reluctance to move

  • Limbs held in unusual positions

  • Alterations in weight bearing, including weight-shifting from one limb to another

  • Head and neck in a fixed position

  • Head "bob" (change from neutral head position during walking, trotting, running; head moves up from neutral with forelimb pain, and head moves down from neutral with hindlimb pain)

  • Changes in recumbency time (increased or decreased)

  • Abnormal gait

  • Decrease in eating and drinking

Abdominal Pain (may also include signs listed under acute pain)

  • Look, bite, or kick at abdomen

  • Straining and splinting of the abdomen

  • Get up and lie down frequently

  • Walking in circles

  • Sweating

  • Rolling/thrashing

  • Standing rigid and unmoving when near collapse

  • Groaning, teeth grinding, and "calling" to herd members

Chronic Pain

  • Weight loss

  • Changes in eating and drinking

  • Changes in sleeping/recumbency times

  • Changes in social behavior

  • Changes (decreases) in responses to outside stimuli

Adapted from:

National Research Council: Recognition and Alleviation of Pain and Distress in Laboratory Animals. National Academy Press, Washington, 1992.

Mathews NS: A review of equine pain models. In: Animal Pain eds: Short CE, Van Poznak A. Churchill Livingstone, NewYork, 1992.

What causes pain in the horse?

Just like in people, different kinds of stimuli or injury can cause different levels of pain in the horse. Below are some examples of things that may cause pain. These items are listed according to what level of pain characterizes them. This list does not include all things that cause pain, but it will give you an idea of what to look for when you are working with horses. Remember that not every horse reacts the same way, and these categories are not concrete separations of how pain is felt. We can only try to anticipate, based on clinical experience, what the horse is feeling.

Irritating or mild pain

  • Intravenous (IV) catheterization

  • Full bladder, needing to urinate or defecate

  • Minor cuts or scrapes

  • Fly bites or "strike"

  • Improper shoeing

Mild to moderate pain

  • Endoscopy with biopsy

  • Arterial catheterization (A-line)

  • Muscle biopsies

  • Castration

  • Hernia repair

  • Joint strain

  • Osteochondrosis dissecans (OCD)

  • Bowed tendon

  • Arthroscopy procedures (chip fractures)

Moderate to severe pain

  • Small areas of burns or ulcerations

  • Corneal ulcers

  • Cellulitis

  • Joint infections

  • Arthroscopy procedures (severe ligament injury)

  • Stabilization of fractures (any part of leg or foot)

  • Surgeries of the abdomen (colic)

Severe pain

  • Large areas of burns or ulcerations

  • Infections within the abdomen (peritonitis)

  • Surgeries of the neck, including disc surgery

  • Laminitis

  • Founder

  • Rhabdomyolysis

Adapted from:

Hendrickson DA. Personal communication. 2004. Carroll GL. Small Animal Pain Management. AAHA Press, 1998.

What are some treatments for pain in horses?

Treatments can vary from simple physical therapy to complicated drug regimens. Working together with your research or health care team will be important in determining the most appropriate treatment plan for the horses in your care. Remember that there are two major categories of pain that you will encounter: acute and chronic. Acute pain occurs with trauma and surgery while chronic pain is associated with things like arthritis and cancer. The types of therapy you can use will often depend on whether the horse is experiencing acute or chronic pain as well as the level or degree of pain. Listed below are some of the treatments available. Drug classes are followed by examples of specific drug names in parentheses.

Acute pain treatments (associated with surgery or trauma)

  • Non-steroidal anti-inflammatory drugs or NSAIDS (Bute, Banamine®, Ketofen®)

  • Steroids (dexamethasone, prednisilone)

  • Local anesthetics (lidocaine, bupivicaine)

  • Opiates and their derivatives (morphine, Torbugesic®, fentanyl patches)

  • Alpha-2 agonists (Rompun®, detomidine)

  • Dissociatives (ketamine)

  • Acupuncture

  • Shockwave therapy

  • Plenty of comfortable stall bedding and quiet area for recovery

Bandaging or padding for protection of traumatized tissue

  • Splinting or support of fractured legs

  • Urinary catheterization for animals unable to move or urinate normally

  • General nursing care including cleaning and grooming

Chronic pain treatments (associated with arthritis, cancer, etc.)

  • Non-steroidal anti-inflammatory drugs or NSAIDS (Bute, Banamine®, Ketofen®)

  • Opiates and their derivatives (intra-articular or epidural morphine)

  • Neurectomy or therapeutic surgery

  • Acupuncture

  • Shockwave therapy

  • Physical therapy (massage, range-of-motion exercises, etc.)

Nutriceuticals (food supplements that protect bone and cartilage like glucosamine, etc.)

  • Injectable joint protectants (Legend®, Adequan®)

  • Heat or cold packs or hydrotherapy

  • Limited low-impact exercise when appropriate

  • Comfortable stall bedding with plenty of support

  • General nursing care including cleaning and grooming

  • Regular floating of teeth

Adapted from:

Dobromylskyj P. et al. Management of postoperative and other acute pain. And Brearly JC and Brearley MJ. Chronic pain in animals. In: Pain Management in Animals. Eds: Flecknell P. and Waterman-Pearson A. WB Saunders, London, 2000.

Mama KR and Hendrickson DA, eds.. Vet. Clin. North Amer. Eq. Pract. Pain Management and Anesthesia. 2002.