Pain Medicine Options for Horses

Veterinary information provided by Kirk E. Pollard, DVM
Veterinarian examining horse

Horses are powerful, beautiful animals who unfortunately are at risk for many types of injuries. These can happen to horses used in equestrian sports and racing, but surprisingly research has found that horses get hurt more often in the pasture. When it comes time to treat your horse's pain, there are a number of options to discuss with your veterinarian.

Corticosteroids

These drugs are used to treat joint pain in horses such as arthritis, bursitis, and tendonitis as well as allergic reactions. Common steroids are Dexamethasone (Azium, Dexaject, Dexasone, Dexium), Prednisolone (Methyl Prednisolone, Delta Albaplex, Prednis, Temeril), and Triamcinalone (Vetalog, Triamtabs). All can be administered orally or injected directly into the afflicted area.

Risks of Corticosteroid Use

Equine veterinarian Kirk E. Pollard, DVM, cautions to be aware that: "Steroids in horses always carry a risk of inducing laminitis in sensitive individuals, overweight horses, EMS (equine metabolic syndrome) patients and Cushing's Syndrome patients." He notes that Triamcinalone is "used cautiously in the horse for insect hypersensitivity, but again consider the laminitis risk versus the long-term benefit and quality of life for the allergy suffering horse."

Non-steroid Anti-inflammatory Drugs

Non-steroid Anti-inflammatory Drugs

NSAIDs encompass several medications for the treatment of pain, including some analgesic drugs.

  • Flunixin meglumine (Banamine, Flu-Nix, FluMeglumine), an analgesic, is available in an injectable version or an oral paste.
  • Phenylbutazone (Bute, Buta, Equi-Phar) is another analgesic medication available in oral paste, tablets and an injection form.
  • Firocoxib (Equoixx) analgesic is available as an injectable or in tablets. It is the same as Previcox tablets for dogs, but only Equioxx can be used with horses.
  • Ketoprofen (Ketofen) is a NSAID used for pain and inflammation and is particularly effective for hoof pain from chronic laminitis. It is also used to treat fevers and colic. It is administered with an injection.
  • Naproxen (Aleve, Anaprox, EC Naprosyn, Equiproxen) is a very effective NSAID for treating pain related to muscles and soft tissue but does not do as well for horses suffering from joint injuries. It is administered either via injection or oral tablets or powder.

Risks of NSAID Use

One concern regarding NSAIDs is the potential for negative side effects including colic, diarrhea, ulcers, colitis and NSAID toxicity. Dr. Pollard agrees that "gastric ulcers and hind gut ulcers can be a sequel to over use of NSAIDs." However, he notes that: "NSAIDs are really an individual thing. Some horses live on them and never have an issue while others are hospitalized with ulcers and require long-term treatment with Ranitidine/Omeprazole or Sucralfate."

Prescription Sedatives and Tranquilizers

These types of prescription medications can be considered separate categories, but both are used for the same purposes. Dr. Pollard states: "the debate between what is a tranquilizer and what is a sedative goes round and round. Technically a sedative provides a deeper state of relaxation and mentation than a tranquilizer."

  • Detomidine (Dormosedan) and Xylazine (Sedazine, Tranquived, Xlya-Ject) are both considered sedatives that induce a short-term period of sedation. Detomidine is available both orally and with an injection whereas Xylazine is injectable only.
  • Acepromazine (AceProject, Aceprotabs) and Promazine are considered tranquilizers that induce sedation and relaxed muscles. They are both available orally or via injection. Acepromazine is more widely used than Promazine.

Risks of Xylazine and Detomidine

There are issues related to use of sedatives and tranquilizers. According to Dr. Pollard: "Xylazine, and to a lesser extent detomidine, may make the horse more sensitive to being touched or stimulated, especially on their abdomen and hind legs and they will react violently by kicking with their hind legs, then go right back to sleep like it never happened." This can cause a person to become seriously hurt trying to work on their horse thinking he's sedated and safe. He reports that xylazine can also cause the horse to have a heart block or arrhythmia.

Risks With Using Acepromazine

Regarding acepromazine, Dr. Pollard states, "it cannot be given to an intact male colt or stallion due to a rare but well-known side effect of permanent paralysis of the retractor muscle of the penis." It also caused older horses to have a sudden drop in blood pressure where "they will collapse but seem to recover if allowed a few minutes of not being stimulated."

Caring for Your Horse

It never is easy to see our equine friends suffering from chronic pain. Work with your veterinarian to discuss different pain management strategies available and make sure you know the benefits and risks of each medicine option.

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Pain Medicine Options for Horses