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chronic pain and pain management approach

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  • chronic pain and pain management approach

    if you have a horse with chronic pain condition that requires continuing lifetime pain management, do you believe it is best use the pain management to alleviate all pain (to the extent possible), or do you "leave" some pain untreated to both, prevent the horse from overdoing it, and to have room to up the treatment as the pain progresses?
    http://www.eponashoe.com/
    TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique

  • #2
    I can't imagine intentionally keeping a horse in pain the rest of its life. I suppose it depends on the situation, and since you haven't given us much in the way of details that's about as much as I can say close to answering your question.

    I can give specifics related to my own situation, though.
    I have a mare who was already crippled when she was rescued off a truck headed to Mexico. Her right front leg essentially acts as a cane/crutch, moving from the shoulder muscles and not bending when she moves. She gives no appearance of being in pain at all, and someday I am sure she will be and I will have hard decisions to make. She likes to run and play, and she has the space to be able to do so. I suspect the scar tissue holding her leg together will give out one day from her playing, and I will then have to make a tough phone call - but I would not want to pen her up and lower her quality of life. Right now she's happy and loves life.

    So that's how I would judge. I think if you don't need long-term use of pain medication you're better off without it. However, if the horse is clearly in pain and its quality of life is affected, do what you can to stop the pain. Lame when moving versus in pain just hanging out are two different things, and I wouldn't want in pain just hanging around to be the situation for one of my horses.
    Originally posted by Silverbridge
    If you get anything on your Facebook feed about who is going to the Olympics in 2012 or guessing the outcome of Bush v Gore please start threads about those, too.

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    • #3
      If it's chronic pain I want to make them as comfortable as possible. Now if it's an injury that needs to heal without reinjuring because they are acting a fool I will try to let them feel it some so hopefully they don't injury themselves worse. Usually just bute. With the chronic pain ones I'll go to previcox and other treatments.
      Horses aren't our whole life, but makes our life whole

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      • Original Poster

        #4
        my question was intended to be general, not specific to my situation, which is why i did not provide personal details.

        the theory, as it has been explained to me, is that rather than give the maximum amount of analgesic, you give a bit less so that (1) you can increase the amount as the pain increases (of course this applies to situations when it is expected that the condition will continue to worsen with time), and (2) the horse doesn't feel too good.

        and yes, i'm talking about chronic pain condition.
        http://www.eponashoe.com/
        TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique

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        • #5
          Originally posted by marta View Post
          my question was intended to be general, not specific to my situation, which is why i did not provide personal details.

          the theory, as it has been explained to me, is that rather than give the maximum amount of analgesic, you give a bit less so that (1) you can increase the amount as the pain increases (of course this applies to situations when it is expected that the condition will continue to worsen with time), and (2) the horse doesn't feel too good.

          and yes, i'm talking about chronic pain condition.
          I agree with 1, in that I only want to give the minimum needed if I have to give pain medicine. But intentionally making a horse not feel good? Not my cup of tea, ever.

          Again, as I said - if the horse is lame but not in pain when hanging out, and it means little enough that if the horse is running around it feels the pain and stops, that's different from letting the horse always be in pain.

          I think chronic pain is a really hard, personal decision on how to handle - eventually, the answer is probably putting the animal to sleep. But knowing how to handle everything until that time, and even knowing when it is that time, is a very hard personal decision people will usually disagree on because of differing perspectives on how to do the best thing for the horse.
          Originally posted by Silverbridge
          If you get anything on your Facebook feed about who is going to the Olympics in 2012 or guessing the outcome of Bush v Gore please start threads about those, too.

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          • #6
            You keep the animal comfortable by whatever means possible and when you can no longer do that you let them go. Anything short of that is inhumane.
            McDowell Racing Stables

            Home Away From Home

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            • Original Poster

              #7
              Laurierace,

              I tend to agree with you. I'm kind of polling this opinion b/c this approach has now been mentioned to me by several different people.
              http://www.eponashoe.com/
              TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique

              Comment


              • #8
                I give what is needed to alleviate the pain that is presented at the time. Once that stops working, we will either up the pain meds, or make the decision to bring things to a close.

                Comment


                • #9
                  If you have a horse with an injury you can keep them a little less than 100% comfortable while it is healing so they don't do too much. Definitely not the same with a chronic condition. Giving a lower dose so you can go to a higher does doesn't make any sense to me either as you often have to change meds as things progress. It's not like there is only one drug out there and then you are screwed. I dealt with a lab with severe pain issues from acl surgery that healed with calcium instead of scar tissue. Quality over quantity was my motto and I became quite the chemist as a result. Gave her five very happy years though.
                  McDowell Racing Stables

                  Home Away From Home

                  Comment


                  • #10
                    I'll hove you my situation I had. Old barrel/jumper horse I had and loved dearly. I rode him a couple years and then decided to buy him. 6 months after buying he went lame. Not bad, just a little off. Normal vet out, then sport horse vet out, and then finally to the university. At the university they did more xrays that were more clear. Showed DJD, really bad in the knee and a bone spur. Vet there couldn't believe horse wasn't dead lame. Horse also had a touch of navicular going on. Anyways, horse was in pain but still willing and happy and not as much pain was showing then what vet though should be. Decided to do knee surgery, removed spur, removed the best they could of arthritis out of the joints by shaving it off. My boy was still off but seemed comfortable after healed so he got nothing except joint injections in that knee. If he seemed to have a bad day I'd give him bute. Stem cell therapy came about so back to the university and had that done over a years time. Seemed more comfortable so still no need for meds. Horse played, bucked, run, but was off. Over the next couple years you could tell he stopped playing much, stiff all around. I started him on Bute and then surpass came out so started that. Seemed comfortable. Knee fused and he was good but the toll it took on the rest of his body and compensating for all those years and the DJD all over in his joints he was stiff and slower. Didn't play as much but was still bright, alert, and happy. We then started previcox and massage and chiro. At this time he was 34 years old. He did well for the next 2 years. He also had corrective shoeing for all these years for the knee and navicular. Wedges and pads. Anyways, at 36 years old he started having a hard time getting up when he laid down. He started not laying down and sleeping as much. He was still alert and seemed happy but you could tell the spark was fading from his eye. . I then had to make the decision to pts. It was the hardest decision at that time I had to do. Tore me apart because he was looking so good the day the vet came but I knew it was what I needed to do for him.

                    That said, with this story. I will do whatever it takes to take care and keep comfortable a horse that to care of me. It doesn't always have to be drugs per say. There are medical procedures that help also sometimes. My boy I believe had a comfortable happy life for another 9 years after he was diagnosed and I'd do it again.
                    Horses aren't our whole life, but makes our life whole

                    Comment


                    • #11
                      When they are in pain, you do the most you can do to limit that pain. Unfortunately sometimes there is a limit, in that you don't want to overdose and create a different set of problems, but you do not underdose so that you have room to increase dosage if things get worse. You do the best you can as long as you can.
                      Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.

                      Remember the horse does all the work, we just sit there and look pretty.

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                      • #12
                        I would not keep a horse in chronic pain if I could not manage their pain in a reasonable way, period. To keep a horse in pain is cruel. I've known people with unmanageable chronic pain and what they go through is excruciating and heart breaking.

                        I have a horse now that has arthritis in her neck that makes her lame. It seems to be a mechanical/nerve issue and she does not seem to be in pain. I watch her very carefully for signs of pain and will euthanize her if she becomes painful in a way that cannot be managed. Thankfully, she's not at all stoic, so I do believe it will be apparent when she's hurting.

                        I don't know why people insist on keeping a horse in pain alive for as long as they can. I have a very low tolerance for allowing any of my animals to live in pain and believe euthanasia is far, far kinder.

                        Comment


                        • #13
                          I would not want a pulse going to the foot, so I would alleviate pain in that circumstance to avoid foundering or other secondary pain

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                          • #14
                            Originally posted by Atlas Shrugged View Post
                            I would not want a pulse going to the foot, so I would alleviate pain in that circumstance to avoid foundering or other secondary pain
                            Pretty sure blood flow is needed everywhere in the body including the foot.
                            McDowell Racing Stables

                            Home Away From Home

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                            • #15
                              I think alter probably means a hard pulse. Of course there is a pulse down there but it's very very hard to feel unless you know what and where your feeling for it. Now if you put your hand in the area and can feel it easily, well thats not so good.
                              Horses aren't our whole life, but makes our life whole

                              Comment


                              • #16
                                I have a retired mare with a list of lameness problems longer than your arm. I can make her sound on high doses of pain meds. I choose to keep her on a low dose of the meds that is safer long term, even though the analgesia is not as good and yes, she is lame every day. If that lameness seemed to really hinder her quality of life, I would increase her meds and deal with side effects later. As it is she has bad days when I have to do that transiently. I'm sure I'll get to the point eventually that I have to stay at a higher dose. Until then I do as much as I can with shoeing, supplements, topicals (liniment, cold, etc) and low doses of NSAIDs.
                                As Peter, Paul, and Mary say, a dragon lives forever.

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