Pain management for laminitis in the horse
Authors: Hopster K., van Eps A. W.
Journal: Equine Veterinary Education
Summary
# Pain Management for Laminitis in the Horse Laminitis represents one of the most challenging pain management scenarios in equine practice, yet paradoxically, the pain itself serves a critical protective function—particularly early on when lamellar tissue integrity is compromised and weight-bearing must be restricted. Hopster and van Eps's 2019 review synthesised current evidence on analgesic approaches for laminitis, examining both systemic and regional pain control techniques alongside emerging pharmacological options, whilst emphasising the necessity of understanding disease pathophysiology to inform treatment decisions. The authors highlighted that inadequate pain control remains the leading driver of treatment abandonment and euthanasia decisions in affected horses, underscoring why a nuanced, multimodal approach tailored to disease stage is essential rather than simply maximising analgesia. For practitioners managing laminitic cases, the key takeaway is that pain assessment must be serial and objective, pain control must be balanced against the protective immobilisation that discomfort provides during acute lamellar failure, and the analgesic toolkit—including novel agents and regional techniques—should be individualised to the clinical presentation and phase of disease. Understanding these principles allows farriers, veterinarians and rehabilitation specialists to collaborate more effectively on cases where inadequately managed pain has historically dictated poor outcomes.
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Practical Takeaways
- •Balance pain relief with the protective role of pain in acute laminitis—over-analgesia may increase lamellar damage through excessive movement
- •Use serial pain assessment methods to guide treatment decisions and recognize when euthanasia becomes the humane choice
- •Employ multimodal analgesia combining systemic medications with regional techniques for optimal pain control while preserving protective mechanisms
Key Findings
- •Pain control failure is the most common reason for treatment cessation and euthanasia in laminitis cases
- •Pain serves a protective function in acute laminitis by limiting movement when lamellar integrity is compromised
- •Effective analgesia requires understanding disease pathophysiology and identifying specific pain sources
- •Both systemic and regional analgesic techniques are available for managing laminitis pain