EquineReview

Failure to adequately control pain is one of the primary reasons laminitic horses are subject to euthanasia. A recent review by Hopster and Driessen (2021) outlined several options for medical pain management of laminitis. Non-steroidal anti-inflammatories (NSAIDs) are the most commonly used first-line options and recent findings suggest that non-selective NSAIDS are more effective for analgesic therapy compared with COX-2 selective NSAIDS. To avoid causing further lamellar damage through excessive movement, the dose should be titrated based on the comfort level of the patient. In cases of chronic laminitis, high doses of NSAIDs are often required and the effect may not be seen for up to 3 days after start of treatment. This is important to consider when assessing the clinical response to NSAIDs. Paracetamol (20 mg/kg twice daily) is a commonly used analgesic in humans and may be considered as an adjunctive analgesic in horses that require additional pain relief. Although evidence for the efficacy of its use in horses is limited, the use of paracetamol in one laminitic pony has been previously described (West et al, 2011).