Managing Pain: Thinking Outside the Box

There are so many questions yet to be answered when discussing the management of pain in horses, both in terms of the recognition of pain, and the efficacy and suitability of the huge variety of drugs and administration routes available. Many techniques of pain management utilised in other species, including humans, are being adapted for use in equine pain management, although there are some, e.g. the use of α2agonists and ketamine, which are more specific for veterinary and in particular, equine use. This session will aim to discuss some of the emerging drugs and techniques which may feature in analgesic strategies – particularly in those cases with intractable or difficult to manage pain syndromes. It will also challenge the way in which we think about pain which may help with analgesic planning. However it is important to realise, that although there are reports of the use of novel analgesic drugs and techniques in horses, there is little evidence to support this, both in terms of efficacy and potential side effects. Additionally, all of these drugs, either because of the drug itself, or because of the change in dose or route of administration, are administered to horses off label and this has implications for the veterinary practitioner. [...]