Equine pain management still hinges on better assessment

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Equine pain management remains a practical challenge, and the latest coverage from Vet Times underscores a familiar but important point: horses should be assumed to have some degree of postoperative pain, with analgesia adjusted early and often based on ongoing assessment. The article reviews a multimodal toolbox that includes NSAIDs, opioids, local anesthetics, alpha-2 agonists, ketamine, lidocaine infusions, gabapentin in select cases, and regional techniques such as epidural analgesia, while stressing that pain recognition in horses is often complicated by subtle behavioral signs rather than dramatic clinical changes alone. (vettimes.com)

Why it matters: For veterinary professionals, the biggest takeaway is that equine analgesia is still constrained less by lack of options than by imperfect pain detection, case selection, and tradeoffs around adverse effects. Vet Times notes concerns such as gastrointestinal and renal risks with NSAIDs, sedation and ileus with alpha-2 agonists, and practical limitations around opioids, while newer literature suggests the evidence base remains thin in some common scenarios: a 2023 systematic review found sparse, bias-prone evidence for determining whether one NSAID is superior to another for equine abdominal pain, and a 2025 editorial in Frontiers in Pain Research said pain assessment tools exist but are still used inconsistently in practice. (vettimes.com)

What to watch: Expect continued focus on standardizing pain scoring, refining multimodal protocols, and translating newer assessment tools into everyday equine practice. (cdpm.vetmed.ufl.edu)