Analgesia

Abstract

Managing pain in horses afflicted by laminitis is often a great challenge because it is the dreadful suffering of the animals that frequently forces the veterinarian to end the battle with this disease. This chapter highlights the mechanisms likely involved in generating and amplifying nociception in laminitis, thereby creating a state of maladaptive pain that is greatly resistant to conventional anti-inflammatory drug therapy. Based on this information, the concept of a multimodal approach to analgesia in the horse with laminitis is presented and targets for drug treatment are discussed. The chapter also discusses anti-hyperalgesic pain therapeutics, anti-neuropathic pain therapeutics, and loco-regional anesthesia. Pain therapy in acute and chronic laminitis has largely been based on the proposed etiopathogenetic mechanisms underlying the disease, and consisted predominantly of NSAID administration. Three different pharmacological classes of drugs are commonly administered systemically to treat pain in horses affected with laminitis: NSAIDs, opioids, and lidocaine.