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 postoperatively leads to shorter hospital stays and better healing.

Despite leaping strides in the field of veterinary anesthesia over the past decade, there is still a lot of ground to cover. One person doing his best to progress the profession is Stuart Clark-Price, DVM, Dipl. ACVIM, ACVA, 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 explained. 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 might 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," Clark-Price said. Knowing that, all patients receive carefully monitored pain management regimens postoperatively at the Veterinary Teaching Hospital. But providing analgesia (pain control) to a horse is tricky. Because horses 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. But 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.

So anesthesiologists have had to be creative. One innovative way to administer postoperative 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.

Clark-Price is also investigating the best way to wake horses up after general anesthesia.

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 acva.org. --Ashley Mitek

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.

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