Pain Management in Horses
Rossdales Veterinary Surgeons have been in practice for 60 years and they share some thoughts on pain management in horses:
“Pain can have a negative impact on behaviour and performance. Freedom from pain is an essential part of horse welfare and pain management plays an important role in recovery from injury or illness.
If we can’t detect pain we can’t manage it effectively. However, recognising pain in horses can be challenging. Horses are prey animals and are instinctively programmed to hide their vulnerability to predators. Horses are also known for their individual variation in displaying signs of pain.
Manifestations of pain in horses can be subtle and non-specific, but signs you should look for include:
- Behavioural changes
- Change in posture or movement
- Change in appetite
- Change in facial expression
Sometimes signs of pain can be more specific and can relate to the underlying problem:
- Colic pain: rolling, pawing, stretching, groaning
- Lameness: weight-shifting between limbs, abnormal movement, and reluctance to move or work. Horses with laminitis have a typical stance of leaning backwards.
- Ocular pain: holding the eye closed, increased tear production or discharge from the eye, sensitivity to bright light.
- Dental Pain: dropping food, slow chewing, reluctance to eat, pocketing or pouching of food in the cheeks.
Pain management will depend on the duration, type and severity of the pain. A short course of pain relief is often required. In cases of chronic pain, longer term or indefinite treatment may be needed. The most common example of this is horses with osteoarthritis. In horses undergoing long term treatment, health checks must be performed every 6 months (or more frequently in some cases) to ensure that the dose is still appropriate and check for adverse side effects.
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drug for pain management in horses. However, side effects of NSAIDs include gastrointestinal disease (such as stomach ulcers, colon ulcers and diarrhoea) and kidney damage.
Other pain relief options are available and are often used in combination with NSAIDs. Some of these can be given orally whereas others can only be given by injection from your veterinary surgeon. Using multiple classes of drugs can improve pain relief while decreasing the risk of side effects. In addition to medical therapy, methods such as physiotherapy, weight management, acupuncture and remedial shoeing can all play a role in the management of pain in your horse.” 
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