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Managing Post-Operative Pain in Horses


Pet Column for the week of October 12, 2009

Related information:

Related site - American College of Veterinary Anesthia

Office of Public Engagement
2001 S. Lincoln Ave.
Urbana, Illinois 61802
Phone: 217/333-2907
Ashley Mitek
Information Specialist

Source - Stuart Clark-Price, DVM, MS, DACVIM, DACVA
Whether a horse is on the operating table for colic or a broken bone, pain management after surgery is critical. In recent years research has clearly shown that making horses as comfortable and pain-free as possible post-operatively leads to shorter hospital stays and better healing.

Despite leaping strides in the field of veterinary anesthesia in the past decade, there is still a lot of ground to cover. One person who is doing his best to progress the profession is Dr. Stuart Clark-Price, a veterinary anesthesiologist at the University of Illinois Veterinary Teaching Hospital in Urbana. From managing pain in a racehorse that just came out of emergency colic surgery, to making sure an older arthritic pony is comfortable enough to live out his days on pasture, it's all in a day's work.

But determining exactly how much pain an animal is in is difficult. "There is no one single indicator of pain in horses," he notes. Certainly if a horse refuses to eat, has an elevated heart rate or remains recumbent in its stall, pain medication would be indicated. However, some horses may be more stoic than others and hide their discomfort without a clinician being able to pick up on their state.

"After surgery, we assume horses feel pain although they can't tell us," explains Dr. Clark-Price. Knowing that, all patients receive carefully monitored pain management regimens post-operatively at the Veterinary Teaching Hospital. But providing analgesia (pain control) to a horse is tricky. Because they have to remain standing and be able to walk one hour after surgery for proper recovery, veterinary anesthesiologists are limited to the dose and type of medications they can give.

For example, if a human underwent an invasive abdominal surgery, he or she might receive pain medication, such as morphine, that has the side effect of making them want to lie in bed all day. "We can't give horses that much morphine," explains Dr. Clark-Price, "or they will lie down all night." To assure adequate blood flow to all parts of the body and stimulate proper gut movement, a horse cannot be recumbent for more than a few hours.

Because of the unique challenges in providing post-operative analgesia to horses, anesthesiologists have had to be creative. One innovative way to administer post-operative pain medications is to use a continuous drip of drugs in their IV fluids. This way the horse receives a steady rate of pain control, instead of one large dose of medication that will wear off over time.

Fentanyl patches are also gaining popularity. These are alcohol gels infused with an opioid called fentanyl, which is several times more potent than morphine. They have the unique ability to stick to skin and provide constant control for severe pain over 48 hours.

Dr. Clark-Price is also investigating the best way to wake horses up after general anesthesia. As one might expect, waking up to a room with bright lights may be a bit jarring. Perhaps horses may prefer recovering in a slightly darker room. Though Dr. Clark-Price investigated this and found that horses didn't seem to care whether they woke up in a light or dark room, he currently is investigating other ways to make the recovery process more peaceful for equine patients.

If you have concerns regarding equine pain management contact your local veterinarian. You can also find a list of board certified veterinary anesthesiologists available for consultation by visiting http://www.acva.org/dipdir/diplomates.asp.