Easing horses' silent suffering is Ana Rangel’s goal as she brings specialized expertise in pain management

The donkey arrived as a routine colic case, but Ana Rangel could see something wasn't right. 

The patient showed signs that didn't fit typical stomach pain. What followed was a complex medical puzzle spanning multiple organ systems. "The donkey had a lot of issues we discovered, from heart problems to kidney issues," said Rangel, a new assistant professor in the Virginia-Maryland College of Veterinary Medicine's Department of Large Animal Clinical Sciences. "We went through almost everything — neurology, cardiology, respiratory. It was a very challenging case, but I learned a lot." 

Although not every case ends in recovery, each puzzle reinforces why Rangel chose internal medicine and brought her expertise from Mexico City to Virginia Tech, where she focuses on equine medicine, with a particular expertise in pain management — critical in a field where horses' stoic nature often masks their suffering. 

The unexpected path to horses

Growing up in a family of engineers, marketers, and designers, she was "the weirdo in my family" and had no farm background. 

Her parents, seeking an outlet for their hyperactive daughter, tried every sport imaginable before horses finally captured her interest.

"I got my first horse when I was around 14 years old, and it was a game changer for me," Rangel said. "I started getting good grades at school because I knew I had to have good grades so I could have some time to see my horse." 

Horses also introduced her to veterinary medicine. 

"Horses love to get sick all the time, so we ended up in the hospital a couple of times because of colic," she said. "I was pretty amazed by the hospital and how everything worked."

That fascination led her to veterinary school in Mexico, where she graduated in 2018. She then worked in private practice and academia, including private practice and racetrack medicine in Mexico City, Veterinary College of Louisiana State University and Washington State University. The experience taught her to navigate different budgets and expectations—lessons that would prove crucial when she later developed cost-effective pain management solutions.

Reading faces that don't speak 

Animal welfare drives Rangel's passion for internal medicine. "I prioritize welfare and minimize pain in horses," she said. "They're sensitive creatures. They don't tell you anything, but you learn to read their expressions."

Horses' inability to communicate pain makes internal medicine challenging and rewarding. "It's rewarding seeing a horse arrive super painful with that face — they don't know what's happening — then watching them go home as a different horse."

In equine internal medicine, practitioners handle everything surgical that cannot be treated: neurology, cardiology, and dermatology. Unlike small animal medicine, which has developed specialized fields, horse medicine is divided between surgery and internal medicine, making internists like Rangel true generalists.

Research born from budget constraints 

Rangel's new role will also have a research focus on ketamine for pain management which emerged from a real clinical challenge during her residency at Washington State University. 

While treating a horse for laminitis with only a very limited budget, traditional pain medications like butorphanol — costing $40 to $60 per dose and needed every three to four hours — quickly became prohibitively expensive.

"We were trying to find other ways to provide pain relief to this horse," she said. Ketamine, known for its anesthetic properties and emerging applications in human medicine for pain and depression treatment, offered a cost-effective alternative. Instead of $40 to $60 per dose, ketamine costs just $10 to $20.

While veterinarians have observed ketamine's effectiveness for pain management, formal pharmacokinetic studies in horses were lacking. Rangel's research established proper dosing protocols based on scientific data. Her paper has been accepted for publication. 

From geriatric medicine to student mentorship

Rangel's residency spanned different horse populations, from racetrack horses to elderly pleasure horses. Each setting taught her to adapt based on clients' expectations and budgets.

At the veterinary college, Rangel balances clinical work with teaching and research. Her mentoring philosophy recognizes that students entering large animal rotations have diverse career goals and varying experience with horses.

"If I have small animal-oriented students, I do rounds on topics applicable to other species," she said. "If students want large animals, I focus on large animal topics." 

Outside veterinary medicine, Rangel maintains connections to her artistic family — her parents met in a music group and still play the guitar together — by pursuing piano lessons, a childhood interest that was interrupted by her veterinary training. She also hikes with her 3-year-old tabby cat, who travels on a leash and thinks "she's a fancy cat" despite being decidedly unfancy in her treat preferences.

Looking ahead

Rangel brings an international perspective and specialized training to Virginia Tech, with research focused on practical solutions for horse welfare. Her teaching centers on inspiring future veterinarians.

"I want to be that person for someone else," she said, remembering impactful teachers. For horses that cannot express pain, advocates like Rangel represent hope for improved treatment through research and innovation.