When your horse’s arthritis is acting up, your veterinarian might recommend a dose of anti-inflammatory. Or if his heaves is worsening, maybe the vet will prescribe a bronchodilator. For mild colic signs, many reach for non-steroidal anti-inflammatory drugs (NSAIDs).

But veterinarians can’t manage all colic pain—especially severe pain—with NSAIDs alone. Fortunately, veterinarians have other options for treating visceral (intestinal) pain. L. Chris Sanchez, DVM, PhD, Dipl. ACVIM, reviewed these medications at the 2015 American College of Veterinary Internal Medicine Forum, held in June in Indianapolis.

Pain Scoring

When evaluating a painful horse, veterinarians often use scoring systems to gauge their pain levels and judge improvement or deterioration following treatment.

“In order to be useful, a pain scoring system should include clearly defined assessment criteria, be suitable for all observers, be simple and quick to use, be sensitive, have identified strengths and weaknesses, and be validated,” said L. Chris Sanchez, DVM, PhD, Dipl. ACVIM, an associate professor and director of the University of Florida School of Veterinary Medicine’s Hofmann Equine Neonatal Intensive Care Unit. “One of the most useful clinical applications of integrated pain scoring systems is the assessment of interventions: Assess pain score, apply treatment, then reassess pain scores at various intervals.”

Sanchez said it’s important to take several factors into account when evaluating pain scores, including the horse’s signalment (his age, breed, sex, etc.), th