Pain management for laminitis in the horse

Abstract

Summary The inability to control pain is the most common reason for cessation of treatment and euthanasia in cases of laminitis, yet pain also serves a unique protective function in these cases, particularly in the acute phase when lamellar integrity is weakened. Successful analgesia requires an understanding of the disease pathophysiology, the sources of pain in laminitis, methods of serial pain evaluation, and methods of analgesia including systemic and regional techniques. This review discusses the approach to analgesia including detail of traditional and novel analgesic medications and techniques with specific reference to the laminitis case.

Update in advances in pain management for the equine practitioner

“…They have the benefits of a relatively wide variety of licenced products and routes of administration as well as being familiar to owners. There is increasing evidence of different effect profiles between the different licenced NSAIDs (Hopster and van Eps ; McFadzean and Love ) but although there are potential deleterious side effects (Andrews and McConnico ; McFadzean and Love ) this does not appear to preclude their widespread use in horses.…”

“…Local anaesthetics are the only agents that completely block sensory input and loco‐regional anaesthesia adds significantly to multimodal analgesia. Although as yet published evidence for significant benefit is limited to case reports (Hopster and van Eps ; McFadzean and Love ), most clinicians appreciate the added value of loco‐regional anaesthesia when it is included in pain management protocols. Evidence for the analgesic efficacy of systemic local anaesthetics is weaker and side effects can occur (McFadzean and Love ).…”

“…). The review by Hopster and van Eps () illustrates how pain is both individual to the animal and also to the disease process, including its chronicity. Some agents may be more suitable for treating one type of pain than another (e.g.…”

“…Four articles published in this issue of EVE demonstrate recent advances in equine pain management; they also highlight some issues around these developments (Bruniges et al . ; Hopster and van Eps ; McFadzean and Love ; van Loon ). This editorial aims to summarise these advances and enlarge on the practical implications for the equine clinician.…”

“…These equine advances fall into three categories: increasing evidence of the benefits of multimodal analgesia (Bruniges et al . ; Hopster and van Eps ; van Loon ), the use of ‘new’ analgesic agents (Bruniges et al . ; Hopster and van Eps ; McFadzean and Love ; van Loon ) and the development of pain scoring systems (Hopster and van Eps ; McFadzean and Love ; van Loon ).…”