Health & Welfare - including

Vet Watch PAIN MANAGEME

IN HORSES By Stephanie Fitzgerald MVB MRCVS

Presented by

ROSSDALES HERTFORDSHIRE

Unit 7, Saltmore Farm New Inn Road, Hinxworth Hertfordshire SG7 5EZ T: 01462 790221 (24 hrs) E: hertfordshire@rossdales.com

www.rossdales.com

Freedom from pain is an essential part of horse welfare and, as horses can’t talk, it’s essential that their owners or carers can recognise when there is a problem.

The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” The IASP adds, “Verbal description is only one of several behaviours to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain.”

Why is pain management Important? Pain management plays an important role in recovery from injury or illness. In humans, the benefits of adequate management include fewer complications, earlier discharge from hospital and reduction in the development of chronic pain syndromes. In humans and in horses, pain can have a negative impact on behaviour and performance.

How do you know if your horse is in pain? Early detection of pain is crucial so it can be managed effectively. In lameness cases, for example, early diagnosis can play an important role in successful treatment and resolution of the problem, resulting in a better prognosis for long-term soundness. 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. For example, highly anxious or temperamental horses may be more likely to

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demonstrate intense pain than horses of a calmer disposition. Evaluation of pain in horses therefore requires careful interpretation of abnormal, pain related behaviour. Signs that your horse is in pain Manifestations of pain in horses can be subtle and non-specific, but signs you should look for include:

• Behavioural changes:

restlessness, agitation, sweating, headshaking, dullness or depression, signs of aggression, tail swishing, snorting, whinnying frequently, or decreased interaction with surroundings

• Change in posture or

movement: altered stance, arched back, reluctance to move, lowered head carriage, • Dental pain: dropping food, slow chewing, reluctance to eat, pocketing or pouching of food in the cheeks, head tilting or nodding or an abnormal head carriage, problems with acceptance of the bit.

How can your vet help manage your horse’s pain? The methods used to manage your horse will depend on the duration, type and severity of the pain. Diagnosis and treatment of the underlying problem is the first step and a short course of pain relief is often required while this is undertaken. However, in cases of chronic pain, longer term or indefinite treatment may be needed to manage the patient’s comfort and improve their quality of life. The most common example of this is horses with osteoarthritis. In horses undergoing long term treatment, health checks must be performed every six months (or more frequently in some cases) to ensure that the prescribed pain relief is still appropriate and to check for adverse side effects. Non-steroidal antiinflammatory drugs (NSAIDs) NSAIDS are the most commonly used drug for pain management in horses. Examples include phenylbutazone (bute) (e.g. Equipalazone or Danilon), flunixin (e.g. Equinixin or Finadyne) and meloxicam (e.g. Metacam). These medications relieve pain and help in the reduction of inflammation and fever.

A horse with colic showing signs of being in pain

stretching, weight shifting or pawing • Change in appetite: loss of interest in food, playing with water, slow chewing or dropping feed

• Change in facial expression:

fixed stare with wide nostrils and clenched facial muscles, glassy eyes or an anxious expression

Sometimes signs of pain can be more specific and can relate to the underlying problem: • Colic pain: rolling, flank watching, kicking at the abdomen, pawing, stretching, groaning • Lameness: weight-shifting between limbs, abnormal weight distribution, pointing, hanging and rotating of the limbs, abnormal movement, and reluctance to move or work. Horses with laminitis have a typical stance of leaning backwards and have a ‘pottery’ gait • Ocular pain: holding the eye closed, upper eyelashes pointing downwards, increased tear production or discharge from the eye, sensitivity to bright light

VET PROFILE

STEPHANIE FITZGERALD

MVB MRCVS

Stephanie joined the Rossdales Hertfordshire veterinary team in 2020. She qualified from University College Dublin in 2017 and then completed a twelve month internship at an equine clinic in Gloucestershire. This was followed by ambulatory work in Australia and in Somerset. She spent the 2020 breeding season at Twemlows Hall Stud Farm AI and ET centre in Shropshire, before joining Rossdales. Stephanie enjoys all aspects of ambulatory work and has a particular interest in stud medicine. She is currently studying towards the Certificate in Advanced Veterinary Practice in Equine Stud Medicine. When she’s not working, Stephanie is a keen follower of horseracing.

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They can be given orally as well as by injection and are frequently used in the management of osteoarthritis, among many other conditions. However, as with any medication, NSAIDs can have side effects and it is important to balance the benefits of treatment with the risk of side effects, which can include gastrointestinal disease (such as stomach ulcers, colon ulcers and diarrhoea) and kidney damage. The risk of side effects is increased in sick or dehydrated horses. Clinical signs of toxicity include loose droppings, colic, ulceration of the gastrointestinal tract (seen as low protein and/or anaemia on blood work, or as ulcers on an endoscopic examination), poor hair coat, increased drinking or urination and weight loss. If you notice any of these signs in your horse then the medication should be stopped and you should speak to your vet. Other Options Other pain relief options are available and are often used in combination with NSAIDs. Some of these can be given orally whereas others can be given only by injection by your veterinary surgeon. Using multiple classes of drugs can improve pain relief while decreasing the risk of side effects. Many horses suffer from acute or chronic pain that requires careful treatment. The goal is to alleviate the pain as quickly as possible with the least side effects. For horses with chronic

Hydrotherapy can be useful as part of a rehabilitation programme

pain, it is often necessary to try different medications to see which one is most effective for that particular horse. Some nutraceuticals are reported by horse owners to provide beneficial health effects – a good example being joint supplements and there are a myriad of products available that are marketed as helping to improve joint function. However, there may be considerable variation in the composition of these products and it can be difficult to weigh up the real benefits if they have not been scientifically tested. In addition to medical therapy, methods such as physiotherapy, weight management, acupuncture, remedial shoeing and laser therapy can all play a role in the management of pain in your horse. The latter can be helpful in the management of acute inflammation, as well as speeding up wound healing and tendon/ligament injuries. Cold water and hydrotherapy are also useful for acute injuries, helping to reduce swelling, inflammation, and pain. Ice may also be used to relieve pain. Combination therapies are often the most successful in maintaining a quality of life for horses with chronic pain conditions; using variations of traditional medications, adjunctive therapies and nutraceuticals as appropriate.

Medication and Competing Many horses with chronic pain are still able to perform, but need to be medicated. Make sure that you check with your vet to make sure that you are not violating any association rules when you medicate a performance horse that is competing. There are mandatory withdrawal times for certain medications and these are in place for the health and welfare of your horse. Some medications may appear in the horse’s blood or urine for a period of time; so if your horse is competing, you need to discuss with your vet about the length of time that the drug will still be detected in testing. (For a list of prohibited and controlled medications in FEIsanctioned events, see prohibitedsubstancesdatabase. feicleansport.org) Careful use of the correct medications at the appropriate time can greatly improve your horse’s comfort whether he is recovering from an injury or surgery, easing the aches and pains of competition, or keeping comfortable in retirement.

BETA’S

SUMMER OF SAFETY CAMPAIGN

The British Equestrian Trade Association has launched its Summer of Safety – a three-month awareness-raising initiative designed to demonstrate how equestrian products play a frontline role in keeping horses and riders as safe as possible.

It replaces BETA’s annual Safety Week and highlights a wider range of products involved in equestrian activities. While Safety Week’s primary focus was on riding hats, body protectors, air vests, hi-viz and footwear, the BETA Summer of Safety will feature tack; yard, biosecurity, horse and rider safety; horse health; riding and road safety; feed room safety plus much more. The campaign runs until mid-September. BETA’s Summer of Safety will be promoted across social media using the #BSOS21 hashtag. There will be a regular stream of helpful, informative content, such as posts from safety experts, rider tips, live sessions, competitions, video clips and podcasts to help share the key messages.