New Equine Pain Scoring System Could Provide Quicker, More Effective Intervention

A new stall-side pain scoring system for horses could help veterinarians better determine the need for analgesics in lame horses, according to Kirsten Wegner, DVM, Dipl. ACVA (veterinary anesthesiology), an assistant professor of anesthesia at the University of Pennsylvania's New Bolton Center.

In order to properly manage pain in lame horses, veterinarians must measure how much pain the horse is experiencing as objectively as possible. This can become challenging due to unique behavioral and physiologic qualities of the horse (horses tend to be very stoic), the nature of the pain, and the ability of one or more observers to produce consistent, specific results, Wegner said.

Veterinarians have used the Obel laminitis pain scale and the graded lameness scale adopted by the American Association of Equine Practitioners for many years to provide quick, simple, generalized lameness scores. However, the complexity of equine pain behavior and the broad categories in both scoring systems might limit their practical use in detecting clinically relevant changes in pain or response to therapy.

Validated pain scoring systems exist for small animals and have gained popularity in clinical use. These systems incorporate both an observational and an interactive component, and they are simple to use. However, a similar scoring system for horses was not developed until recently.

The new equine pain scoring system is based upon these small animal composite pain scoring systems, and it incorporates both the Obel interactive scale and a detailed observational scale related to common equine pain behaviors. The dynamic Obel portion of the scale involves asking the horse to move, with scores assigned for ability and willingness to respond, while the static, observational scale lists categories of increasing pain severity and commonly associated behaviors within each category.

This new system simplifies actual scoring with a numeric score of 1-4 for interactive, dynamic behaviors, and a 1-10 scale for observed, static behaviors in both acute and chronically lame horses. With basic training, multiple observers can use the system for consistent scoring of the same patient. Total scoring time is under three minutes in most cases and is minimally disruptive to the horse.

"By changing the behaviors listed in the observational scale and incorporating interactive procedures relevant to, say, back pain or abdominal discomfort, the basic composite scoring system can easily be adapted to many pain states," commented Wegner.

"The key is to define clearly the observed and interactive behaviors of the patient, and make sure all scorers are 'on the same page' where the behaviors are concerned," she added. While researchers have not experimentally validated this pain scoring system, they have used it to follow the response to therapy in horses suffering both acute and chronic lamenesses.

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