NEW WAY TO AS­SESS PAIN

EQUUS - - Eq Medicalfro­nt -

A new method of as­sess­ing pain in horses of­fers an eas­ier, safer and more hu­mane way of eval­u­at­ing cases of acute lamini­tis.

Caused by phys­i­cal or phys­i­o­logic in­jury, lamini­tis is an ex­cru­ci­at­ing in­flam­ma­tion of the soft is­sue within the hoof. Walk­ing or jog­ging a horse with acute lamini­tis to gauge lame­ness or sore­ness can be dif­fi­cult and may ex­ac­er­bate dam­age to in­ter­nal struc­tures of the feet. Now, how­ever, a group of col­lab­o­rat­ing re­searchers at Havel­land Equine Clinic in Ger­many, Univer­sity of Milan in Italy and New­cas­tle Univer­sity in United King­dom have de­vel­oped a so-called “gri­mace scale,” which uses the in­ten­sity of spe­cific fa­cial char­ac­ter­is­tics to es­ti­mate a horse’s level of pain.

The tech­nique, which orig­i­nated in hu­man medicine, has pre­vi­ously been adapted to eval­u­ate pain in mice, rats, rab­bits, cats, sheep and other an­i­mals, says Emanuela Dalla Costa, DVM, PhD. “Fa­cial ex­pres­sions are com­monly used to as­sess pain and other emo­tional states in hu­mans who are un­able to com­mu­ni­cate co­her­ently

with their clin­i­cians, such as ba­bies,” she says, adding, “In par­tic­u­lar, fa­cial ex­pres­sions seem to be use­ful in an­i­mals that tend to hide signs of pain in the pres­ence of preda­tors.”

To de­ter­mine the ef­fi­cacy of the Horse Gri­mace Scale (HGS), re­searchers video­taped 10 horses ad­mit­ted to the Havel­land clinic be­tween 2012 and 2014 for acute lamini­tis. The horses were recorded for 20 min­utes on the day they were ad­mit­ted and again seven days into their treat­ment, which con­sisted of anti-in­flam­ma­tory med­i­ca­tions, sub­mer­sion in ice wa­ter, padded hoof ban­dages with frog sup­port and restricted move­ment in a stall with deep bed­ding.

Next, the re­searchers ran­domly se­lected two still frames of each horse from both film­ing ses­sions and asked four un­af­fil­i­ated vet­eri­nar­i­ans to score them ac­cord­ing to the HGS. The still im­ages clearly showed the horse’s faces and the vet­eri­nar­i­ans were in­structed to as­sess six dif­fer­ent fa­cial ac­tions as­so­ci­ated with pain, in­clud­ing pinned ears, ten­sion around the eye area, and strained chew­ing mus­cles, nos­trils and mouth. Each ac­tion was scored on a two-point scale, 0 for “not present,” 1 for “mod­er­ately present,” and 2 “ob­vi­ously present.” They also gave a fi­nal score for over­all in­ten­sity of pain, from 0 for no pain to 3 for se­vere.

For com­par­i­son, each horse was also given an Obel score on the first and sev­enth day of treat­ment. The Obel grad­ing sys­tem as­signs a num­ber based on the amount of lame­ness a horse shows as he is be­ing walked or jogged, from 0 to in­di­cate no gait ab­nor­mal­i­ties to 4, in­di­cat­ing non-weight bear­ing or sig­nif­i­cant re­luc­tance to move.

When re­searchers com­pared the two sets of scores, they found that the HGS was very re­li­able in iden­ti­fy­ing horses with high Obel scores, which vet­eri­nar­i­ans clas­si­fied as be­ing in more se­vere pain. The re­searchers note that us­ing HGS to eval­u­ate pain could im­prove the wel­fare of horses with acute lamini­tis by elim­i­nat­ing move­ment nec­es­sary for other as­sess­ments.

Dalla Costa em­pha­sizes that HGS is sim­ple enough for horse own­ers to use and an in­struc­tional ap­pli­ca­tion for An­droid de­vices can help guide them.

Ref­er­ence: “Us­ing the Horse Gri­mace Scale (HGS) to as­sess pain as­so­ci­ated with acute lamini­tis in horses (Equus ca­bal­lus),” An­i­mals, Au­gust 2016

A group of col­lab­o­rat­ing re­searchers have de­vel­oped a so-called “gri­mace scale,” which uses the in­ten­sity of spe­cific fa­cial char­ac­ter­is­tics to es­ti­mate a horse’s level of pain.

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