Question about pain management

[Foxglove]

Older OTTB came in 3-legged lame. Vet came out and picked around on the hoof. He said he was sure it was an abscess but was unable to open it. Asked me to have the farrier out ASAP. Two days later, the farrier came out, found and drained the abscess. Horse is now on the mend, So here’s my question:
My horse was in PAIN --I asked the vet to give me something to give the horse for pain. The vet said, “There’s a pain killer in the antibiotics I gave him IV. He’ll feel better as soon as that abscess is drained.” I asked again for something for his pain, and was again told, “He’ll be fine.” I was given antibiotics --but nothing for pain.

Why not? What do we give horses that are in pain? Not talking about 'bute --but is there a horse equivalent to morphine or codeine or something similar that would make my old horse feel better?

I can see why the vet wouldn’t leave me a bottle of morphine, but is that the only pain relief for horses?

[Highflyer]

There are a number of different kinds of pain medication for horses. But no, an average abscess doesn’t justify the equivalent of morphine or codeine, and even an NSAID like Bute or Banamine isn’t usually given because reducing inflammation can actually prevent the abscess from opening. Most vets don’t give antibiotics most of the time either.

[Scribbler]

I have dealt with abscess several times, and I find that as soon as it drains, the horse feels a lot better. If the horse still has extreme pain, you might want to investigate further and see if there is more going on than just an abscess.

As far as pain killers, Bute is the equivalent of the human NSAIDs like tylenol and advil. It seems to be quite powerful on horses. Banamine is the other pain killer, but it is more for muscle relaxant, so it is useful in colics.

For humans the opioids you mention are a whole other level of pain killer, and they do impair function to a noticeable effect, at least for me; they may be easier to take for those who are adapted to them. I don’t think you want to give a horse anything that impairs function, as you need to watch them closely if they are tranqued or coming out of it.

I have to say, I undermedicate myself as well. I see advice to take a tylenol or advil after a big workout for muscle stiffness, and just shake my head.

[Princess_Sparkles]

I call bullshit on there being painkiller mixed in with antibiotics–never seen that done, usually antibiotics and painkillers are administered in two separate shots.

Bute is generally the go-to painkiller for horses. Stronger stuff is really rare unless an injury is severe or a there are extenuating circumstances.

When I was working at a breeding farm, one of the broodmares who had had a freak pasture accident and was on stall rest forever was on bute and omeprazole (to protect her stomach) for ages. She finally healed up and about a year later got a really bad abscess. The vet was able to try something new with her and put a fentanyl patch on her. Shaved down a spot of hair on her neck and stuck it on like a nicotine patch. Worked WONDERS for this mare, who was spending most of her time lying down prior to that (as of course the abscess was in her bad foot/leg she had injured previously).

This was close to 10 years ago, but it was fairly new at the time. The owner of the mare wanted to know why the vet hadn’t done it for the mare’s previous injury, and the vet said they didn’t have it at that time.

All that being said, a lot of vets don’t provide adequate pain medication for horses in my opinion. They seem to think that horses should just be able to suffer through it, or maybe think the pain isn’t that bad, because horses are such stoic creatures. I have watched equine dentists dig out teeth without pain relief/numbing (just because the horse is sedated does NOT mean they can’t feel it) and I was disgusted. I promptly hired a vet who specializes in equine dentistry and who uses novocaine/lidocaine before extractions. My vet provides pain relief as par for the course when a horse is injured, though thankfully (knocking on all the wood around me) I haven’t needed anything other than bute, banamine or previcox yet.

You could push your vet for pain relief but be prepared that they may not give it. I know plenty of old-school vets in my area that would brush an owner off completely in a case like this or tell them to give the horse bute for 3 days. At least with an abscess, if it is draining, the horse should get a lot of relief pretty quickly.

[pAin_t_Misbehavin]

I am sure this is NOT the case with you, but vets are very very wary about giving owners any form of opioid because of the potential for the owner to abuse it. There are actually people harming their own pets to get drugs from their veterinarian after they’ve been cut off by their own doctors.

[animaldoc]

There are lots of options for pain management for horses, so I’m generally with you, no reason to NOT give something for pain. There are those that think that giving analgesics to a horse with a foot abscess brewing will make the timeline longer, but it likely depends how painful they are (and how sure you are it is “just” an abscess). A few doses around the time the abscess was dug out (or while waiting for the farrier) likely wouldn’t cause any harm, and would help the horse be more comfortable.

Which analgesics to give depends on what you are treating (fracture, abscess, muscle soreness, arthritis, ect.).

Options for pain management include drugs like NSAIDs (bute, banamine etc.), opioids/narcotics (butorphanol/morphine etc.), alpha2 agonists (xylazine, detomidine)- usually used for sedation, but have some analgesia as well, local anesthetics (lidocaine etc.), gabapentin, PSGAGs (adequan) and other therapies such as physical therapy, acupuncture, shockwave, laser, massage, chiropractic etc.

So plenty of things can be used in horses for analgesia…

[Simkie]

My vets have been of the “treat their pain and gentle movement” school of thought for abscesses. Now I just give banamine and turn them out. Very rarely do they require a second dose–the movement alone gets it to pop, and the meds allow the movement.

Do you have bute and banamine on hand? Can you ask to have them on hand? If you’re not comfortable with how your vet is treating your horse–and I would not be comfortable with a vet allowing a horse to stand around three legged for two days, either–do you have other vets available?

[Scribbler]

Thank you animal doc, that was a very useful summing up! I haven’t really needed a pain management strategy so didn’t know all the options.

[tazycat]

I’ve heard giving bute for a horse with a hoof abscess. Only slows down the process of abscess popping and draining. Few times my horses had abscesses I just left them out. No bute no banamine.

[Larbear]

[QUOTE=Foxglove;n9842089I asked again for something for his pain, and was again told, “He’ll be fine.” I was given antibiotics --but nothing for pain.
[/QUOTE]

What antibiotic did he give?

[beowulf]

perhaps what your vet meant was that the antibiotics are anti-inflammatory, which yes, when reducing inflammation will subsequently lessen the amount of pain associated with the inflammation?

I do not agree on with-holding bute/banamine when there is an abscess involved. Some people believe that giving bute will make the abscess draw out longer, but I have not had that be the case. Treat the pain and the horse will move around more, which will push the abscess to the surface to drain. In my experience, anyway.

I would rather treat the pain ASAP than have them hobble around, compensate on other limbs, for a few days at a time until they finally put enough pressure on the leg to have it rupture. Just my experience but when my guy gets an abscess I keep him out and give him banamine - the abscess rarely lasts more than 24hr after the banamine is given. Moving around reduces inflammation which helps the abscess drain faster, IME.

[Scribbler]

I find my horse moves OK after the abscess has burst. Last time I had her poulticed and eating hay in her stall. I left the stall guard down while I filled her water bucket assuming she wasn’t going to step off the stall mats onto the concrete barn aisle. Wrong! I turned my back and she made a break for freedom striding down the aisle to the great outdoors hobbling three legged lame like somebody’s senile granny making a dash out of extended care. With the poultice it even sounded a bit like flspping slippers.

Anyhow I find she’s usually able to handwalk fine a day or two after the burst.

Also pain meds are not entirely neutral. Certainly people report gut ulcers after short doses of Bute.

The other thing is I’m never really convinced pain meds work. They don’t always work on me.

[Foxglove]

The old gentleman is fine and walking well now. I wanted something to ease what I perceived as his suffering. I do have 'bute and banamine on hand at all times, but nothing stronger. I wanted something strong that would make him feel better. The vet did not suggest 'bute or banamine --he’s been my vet for almost 40 years --yes there is another vet here, an equine specialist --actually, I called him and he saw the horse first. (My usual vet was booked for three days) --Equine specialist came out --did a quick look and feel --and said “ringbone” --previcox. The next day the horse was MUCH worse and I called my regular vet and paid for an emergency visit rather than see the old boy in such pain. In all fairness to the equine specialist --that horse does have really terrible legs --4 bowed tendons, arthritis, and yes probably ring bone --he’s a retired event horse who did a great job so now he lives his life in peace and quiet. Anyway --he’s fine now.

[Second_Star_To_The_R]

Opioids aren’t used often for abcess type pain. Dexter had a dose during his last colic and it literally knocked him off his feet but only lasted about an hour then was gone.

Anti inflammatories are typically enough. Even with surgery that was all Dexter got and was doing daily therapy. He is on a small amt of equioxx now and there really is a noticeable difference when he takes it.

I dont generally medicate for an abcess as draining and warm soaks seem to maintain them comfortably enough.

As someone who has a horse in terrible shape possibly from NSAIDS, use with caution and with some sort of gastric support.

Im so glad to hear things are improved. Please if you see signs of lameness returning, have the vet do a more intensive work up. I would not wish Dexter’s situation for anyone.