Laminitis: Better Methods of Assessing Pain Needed

Can you or your veterinarian accurately assess lameness and/or pain in your laminitic horse?

This is the question a research team led by Ignacio Viñuela-Fernández, DVM, MSc, asked, knowing how important it is to manage the pain in horses that develop laminitis. "Laminitis is a common and potentially devastating condition that is a major welfare concern when ineffectively managed," explained Viñuela-Fernández from the Royal (Dick) School of Veterinary Studies at the University of Edinburgh, Scotland.

While most laminitic horses recover, many are at-risk for developing laminitis again in the future. It is also well-known that standard doses of traditional anti-inflammatory drugs such as phenylbutazone (Bute) might not adequately control the pain experienced by these horses.

Because accurate assessment of pain in laminitic horses is so important, Viñuela-Fernández and colleagues invited 12 veterinarians and final-year veterinary students to evaluate lameness associated with laminitis in 14 horses on two different occasions. The vets and students used three separate scoring systems to assess lameness. They were:

  1. The Obel score, which assessed pain on a scale of 0-5 in terms of the horses' locomotory features;
  2. The clinical grading system (CGS), which also assessed pain on a scale from 0-5 in terms of athletic function and therapy required; and
  3. The visual analogue scale (VAS): a line that represents the limits of pain from "no pain" to "worst possible pain."

According to Viñuela-Fernández, "All three methods were reasonably reliable tools for assessing lameness in horses with laminitis, particularly when assessed by the same observer over time. But reliability was suboptimal between observers and, not surprisingly, the students were less reliable than the experienced veterinarians."

This highlights the role of experience when using these scales and the importance of reliable scales when re-evaluation is done by different clinicians.

The researchers concluded, "Given the importance of accurately assessing pain in horses afflicted with laminitis, objective ways to measure pain in these horses would be an asset."

The study, "Comparison of subjective scoring systems used to evaluate equine laminitis," will be published in an upcoming edition of The Veterinary Journal.

The abstract is currently available on PubMed.

About the Author

Stacey Oke, DVM, MSc

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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