When treating horses in pain, the more veterinarians know about nociception—the perception of pain—in horses, the more successful they can be. Today’s new, deeper understanding of pain in horses also gives veterinarians more to consider when choosing treatment options. Below, Dr. Cynthia Baker Cole offers her thoughts on the subject.
New Thoughts on Pain Management in Horses
by Cynthia Baker Cole, DVM, PhD, DACVCP, IDEXX Laboratories
Originally titled New Analgesic and New Thoughts on Old Analgesics in the Horse; presented at the North American Veterinary conference, January 2006.
In the past several years we have gained new understanding into the physiological and pathological pathways of nociception. It is important for veterinarians to appreciate how the body responds to painful stimuli and the physiological ramifications of those responses.
As a species, the horse presents unique difficulties in terms of pain management. Because of their size and disposition, analgesic therapy in the painful horse is essential, but it can also be prohibitively expensive. In addition, the use of opioid agents, which form the basis for relief of severe pain in most other species, does not appear to be particularly useful in the horse.
Although recent studies demonstrate that mu agonists can be used safely in horses without fear of unwarranted CNS stimulation, objective data demonstrating their efficacy in this species is noticeably lacking. Therefore, it is necessary to find new ways to use more traditional analgesic agents, such as alpha-2 agonists and nonsteroidal anti-inflammatory agents, to provide pain relief.
In addition, veterinarians should be aware of new analgesic agents under development as compounds such as resiniferatoxin and conotoxin may prove useful in the future to treat the painful equine patient.
About the author:
 Dr. Baker Cole received her DVM from the College of Veterinary Medicine at the University of Florida in Gainesville, completed an internship at Tufts University in large-animal surgery and medicine (with an emphasis in equine sports medicine) and completed a PhD and post-doctoral fellowship in cardiovascular pharmacology at the University of Florida. She was an associate professor of equine clinical pharmacology at the School of Veterinary Medicine at the University of California, Davis for seven years before becoming the director of the Racing Laboratory at the University of Florida. She is the author and co-author of many published works, and has taught veterinary and graduate students for sixteen years. Dr. Baker Cole joined IDEXX in 2006.
A New Technology Helps You Target and Eliminate Pain and Inflammation
 Wisdom™ liposomal technology works like a needle-less injection, keeping the medicine where it’s applied, lowering the risk of the systemic side effects that can occur with other pain relievers.
Liposomes are proven to facilitate the topical delivery of drugs, putting the drug in the right place—much like an injection (sans the needle)—and allowing powerful relief with minimal toxicity. Liposomes are microscopic spheres made up of hundreds of layers. About half of the layers are aqueous, and the rest—the phospholipid layers—hold the drug in place.
After the cream is applied topically, the liposomes pass through the body’s tissues, directly on their way to the site of the pain—not via the horse’s vital organs. As the phospholipid bilayers begin to degrade, the diclofenac secured in them is slowly released into the inflamed tissue.
 This drawing of the right frontal section of a carpus illustrates how Wisdom liposomal technology works to reduce swelling in a horse’s joints.
SURPASS&3174; (1% diclofenac sodium) topical cream is the only FDA-approved veterinary use of diclofenac, widely recognized as a potent analgesic and anti-inflammatory agent. SURPASS is available by prescription only.
Client Education Tools
The more your clients understand about pain and inflammation, the easier it is for you to gain compliance and follow-through for the most effective treatment of their horses. IDEXX offers materials that can help you talk with your clients and pave the way toward better understanding and trust.
To receive our horse owner brochure, call 1-800-374-8006.
Direct your clients to www.surpasshorse.com for more information on osteoarthritis, testimonials from veterinarians and horse owners and more.
The IDEXX VetStat® Analyzer: Providing Better Insights
Determination of electrolytes and blood gases is extremely valuable in many differenct clinical situations.
 Horses undergoing general anesthesia for any prolonged period of time, particularly if placed in dorsal recumbency, will become hypoxemic.1
Premature foals and those suffering from pneumonia may experience hypercapnia and hypoxemia, as well as electrolyte disturbances.2 Enteritis and colitis in both foals and adult horses can cause numerous abnormalities in electrolytes, such as hypocalcemia, hypokalemia, increased anion gap and metabolic acidosis or alkalosis.3 Horses undergoing intense exercise can lose large amounts of water and cations causing hypocalcemia, hyponatremia and metabolic alkalosis.1
The VetStat® Electrolyte and Blood Gas Analyzer easily and rapidly tests for these critical electrolytes and blood gases:
Having the capacity to rapidly access blood gas and electrolyte parameters can improve the quality of care for critically ill patients, but may also be extremely useful in horses undergoing intense athletic training.
The IDEXX VetStat® from the IDEXX VetLab® Analyzer suite
References:
- Day, TK, et al. Blood gas values during intermittent positive pressure ventilation and
spontaneous ventilation in 160 anesthetized horses positioned in lateral or dorsal recumbency. Vet
Surg. 1995;24(3):266–76.
- Lakritz, J, et al. Bronchointerstitial pneumonia and respiratory distress in young horses:
clinical, clinicopathologic, radiographic and pathological findings in 23 cases (1984–1989). J Vet
Intern Med. 1993;7(5):277–88.
- Freeman, D. Duodenitis-proximal jejunitis. Equine Veterinary Education. 2000;2:415.
- White, SL. Fluid, electrolyte and acid-base balances in three-day, combined-training
horses. Vet Clin North Am Equine Pract. 1998;14(1):137–45.
IDEXX EquiView® System the Best Choice for Littleton Large Animal Clinic
There are a lot of choices in the market for digital radiography. Here’s what Dr. Terry Swanson at Littleton Large Animal Clinic has to say about the IDEXX EquiView® DR Digital Radiography System:
"Our clients' time is becoming more and more valuable and they appreciate
the convenience of us being able to come to the horse to take radiographs and
have the results immediately. As we anticipated, we are now getting requests
for prepurchase exams and radiographs at the stables. With the IDEXX
EquiView, we are able to meet our needs as practitioners, as well as the
needs of our clients and patients by providing quality radiographs and a
diagnosis at the stable.
When we were looking to purchase a DR system to better serve our clients, we did an in-depth comparison of imaging systems. The quality of the images from the IDEXX-EquiView System were by far the best and the main reason why we chose the IDEXX system."
Dr. Terry Swanson
Littleton Large Animal Clinic
Littleton, Colorado
The IDEXX EquiView® Digital Radiography System
The IDEXX EquiView Digital Radiography System is a portable, direct-digital radiography system designed specifically for the equine practitioner.
Both the portable and inhouse systems are user-friendly and provide fast and reliable radiographic images:
 Preview image in four seconds
DICOM-compatible PACS image enhancement software Daylight readable monitors Archiving and database storage
The IDEXX EquiView Digital Radiography System is the newest addition to the IDEXX Digital Radiography product line, which also includes two computed radiography (CR) products, the IDEXX Digital Radiography Compact System for equine practitioners and the IDEXX Digital Radiography System for companion animals. With the addition of the IDEXX EquiView system, IDEXX offers you quality choices in digital imaging solutions based on your needs.
For more information about IDEXX digital radiography products, call
1-877-433-9922 or simply contact us online.
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IDEXX Laboratories Is Now an AAEP Educational Partner
 IDEXX is proud to announce that it is now an Educational Partner of the American Association of Equine Practitioners (AAEP). This new relationship will create additional educational choices for AAEP member veterinarians, veterinary students and horse owners.
IDEXX has long been focused on equine care and the practitioners who provide it—with everything from diagnostics and consulting to treatment and follow-up monitoring. IDEXX products and services include in-hospital diagnostic instruments, rapid assay tests, imaging technology, telemedicine, pharmaceuticals, reference laboratories and practice management software.
IDEXX has supported the AAEP through veterinary education, and this unique opportunity will allow us to add to that curriculum, effectively targeting the goals and needs of AAEP members.
IDEXX-sponsored AAEP Convention Events
IDEXX is sponsoring several events at the upcoming 52nd annual AAEP Convention in San Antonio, Texas, December 3–5 at the San Antonio Convention Facilities, covering a broad range of equine topics. From foot pain to neurology, you won’t want to miss these presentations.
Also, be sure to visit IDEXX booth numbers 351, 352 and 354 and see how we can help your practice!
Monday, December 4
In-Depth: Palmer Foot Pain
Moderator—Stephen E. O'Grady, BVSc |
Structure and Function of the Equine Digit in Relation to Palmer Foot Pain
Andrew Parks, VMD |
1:30 p.m. |
Clinical Evaluation and Diagnosis of Palmer Foot Pain
Robert J. Hunt, DVM, DACVS |
2:00 p.m. |
Therapeutic Considerations for Horses with Palmer Foot Pain
G. Kent Carter, DVM |
2:30 p.m. |
Strategies for Shoeing the Horse with Palmer Foot Pain
Stephen O'Grady, BVSc |
3:00 p.m. |
| Panel Discussion |
3:30 p.m. |
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Case-Based Dry Labs with Experts
Registration for each lab is $50 and each is limited to 100 attendees. Please contact AAEP for registration information.
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Friday, December 1 |
2:30–6:30 p.m. |
Cardiology
Michelle Henry Barton, DVM, PhD, and Steve Giguére, DVMD
Imaging of the Neonate
Thomas L. Seahorn, CVM, MS, DACVIM, and Robert P. Franklin, DVM
Upper Airway
Norm G. Ducharme, DVM, Rolf M. Embertson, DVM, and Rick M. Arthur, DVM |
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| Wednesday, December 6 |
1:00–4:30 p.m. |
Cytology
Carol K. Clark, DVM, Edward D. Voss, DVM, and Heather Wamsley, DVM, DACVP
Dentistry
Jack Easley, DVM, and Thomas J. Johnson, DVM
Imaging
Mark J. Martinelli, DVM, Midge Leitch, VMD, Norm W. Rantanen, DVM, MS, and Michael C. Schramme, DVM, PhD
Sport Horse Lameness: East Meets West
Jerry B. Black, DVM, and Richard D. Mitchell, DVM
Neurology
Stephen M. Reed, DVM, and Robert J. MacKay, BVSc
Ophthalmology
Dennis E. Brooks, DVM, and Ann E. Dwyer, DVM |
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