Development and validation of the facial scale (FaceSed) to evaluate sedation in horses.
Abstract: Although facial characteristics are used to estimate horse sedation, there are no studies measuring their reliability and validity. This randomised controlled, prospective, horizontal study aimed to validate a facial sedation scale for horses (FaceSed). Seven horses received detomidine infusion i.v. in low or high doses/rates alone (DL 2.5 μg/kg+6.25 μg/kg/h; DH 5 μg/kg+12.5 μg/kg/h) or combined with methadone (DLM and DHM, 0.2 mg/kg+0.05 mg/kg/h) for 120 min, or acepromazine boli i.v. in low (ACPL 0.02 mg/kg) or high doses (ACPH 0.09 mg/kg). Horses' faces were photographed at i) baseline, ii) peak, iii) intermediate, and iv) end of sedation. After randomisation of moments and treatments, photos were sent to four evaluators to assess the FaceSed items (ear position, orbital opening, relaxation of the lower and upper lip) twice, within a one-month interval. The intraclass correlation coefficient of intra- and interobserver reliability of FaceSed scores were good to very good (0.74-0.94) and moderate to very good (0.57-0.87), respectively. Criterion validity based on Spearman correlation between the FaceSed versus the numerical rating scale and head height above the ground were 0.92 and -0.75, respectively. All items and the FaceSed total score showed responsiveness (construct validity). According to the principal component analysis all FaceSed items had load factors >0.50 at the first dimension. The high internal consistency (Cronbach´s α = 0.83) indicated good intercorrelation among items. Item-total Spearman correlation was adequate (rho 0.3-0.73), indicating homogeneity of the scale. All items showed sensitivity (0.82-0.97) to detect sedation, however only orbital opening (0.79) and upper lip relaxation (0.82) were specific to detect absence of sedation. The limitations were that the facial expression was performed using photos, which do not represent the facial movement and the horses were docile, which may have reduced specificity. The FaceSed is a valid and reliable tool to assess tranquilisation and sedation in horses.
Publication Date: 2021-06-01 PubMed ID: 34061878PubMed Central: PMC8168851DOI: 10.1371/journal.pone.0251909Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Research Support
- Non-U.S. Gov't
- Validation Study
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research article presents a study aimed at developing and validating a facial scale called FaceSed for evaluating sedation levels in horses.
Research Objective and Methodology
- The aim of the study was to prove the reliability and validity of the FaceSed scale as an evaluation tool for horse sedation.
- The research was a randomised controlled, prospective, horizontal study conducted on seven horses.
- Each horse received either a low or high dosage of detomidine infusion intravenously, either alone or combined with methadone, or acepromazine, for 120 minutes.
- Faces of horses were photographed at different stages of sedation: baseline, peak, intermediate, and end.
- These photos, after being randomised, were assessed by four evaluators based on the FaceSed items: ear position, orbital opening, and relaxation of the upper and lower lip.
Observations and Findings
- The study found that the FaceSed scale’s intra-observer and interobserver reliability scores were good (0.74-0.94) and moderate to very good (0.57-0.87), respectively.
- The criterion validity, evidenced by the Spearman correlation between the FaceSed versus the numerical rating scale and the head height above the ground, were found to be 0.92 and -0.75, respectively.
- All elements of the FaceSed total score showed construct validity, indicating its responsiveness.
- The principal component analysis revealed that all FaceSed items had load factors >0.50 at the first dimension, implying good intercorrelation among items.
- The FaceSed scale had a high internal consistency, with a Cronbach’s alpha of 0.83, which points to good interrelation among items.
- All items exhibited sensitivity (0.82-0.97) in detecting sedation, although only orbital opening (0.79) and upper lip relaxation (0.82) were specific to detect absence of sedation.
Limitations and Conclusions
- Some identified limitations of the study include the use of photographs for assessing facial expressions, which may not accurately represent facial movement, and the docile nature of the horses that might have reduced the scale’s specificity.
- Despite these limitations, this study concludes that FaceSed is a valid and reliable tool for assessing tranquilisation and sedation levels in horses.
Cite This Article
APA
de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Esteves Trindade PH, Prospero Puoli Filho JN, Luna SPL.
(2021).
Development and validation of the facial scale (FaceSed) to evaluate sedation in horses.
PLoS One, 16(6), e0251909.
https://doi.org/10.1371/journal.pone.0251909 Publication
Researcher Affiliations
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Midlothian, United Kingdom.
- Department of Clinical Diagnostics and Services, Section Anaesthesiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
MeSH Terms
- Anesthesia
- Animals
- Horses
- Male
Conflict of Interest Statement
The authors have declared that no competing interests exist.
References
This article includes 81 references
- Potter JJ, MacFarlane PD, Love EJ, Tremaine H, Taylor PM, Murrell JC. Preliminary investigation comparing a detomidine continuous rate infusion combined with either morphine or buprenorphine for standing sedation in horses.. Vet Anaesth Analg 2016 Mar;43(2):189-94.
- Johnston GM, Steffey E. Confidential enquiry into perioperative equine fatalities (CEPEF).. Vet Surg 1995 Nov-Dec;24(6):518-9.
- Johnston GM, Eastment JK, Wood J, Taylor PM. The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.. Vet Anaesth Analg 2002 Oct;29(4):159-170.
- Ringer SK, Portier KG, Fourel I, Bettschart-Wolfensberger R. Development of a romifidine constant rate infusion with or without butorphanol for standing sedation of horses.. Vet Anaesth Analg 2012 Jan;39(1):12-20.
- Ringer SK, Portier K, Torgerson PR, Castagno R, Bettschart-Wolfensberger R. The effects of a loading dose followed by constant rate infusion of xylazine compared with romifidine on sedation, ataxia and response to stimuli in horses.. Vet Anaesth Analg 2013 Mar;40(2):157-65.
- Medeiros LQ, Gozalo-Marcilla M, Taylor PM, Campagnol D, de Oliveira FA, Watanabe MJ, de Araujo Aguiar AJ. Sedative and cardiopulmonary effects of dexmedetomidine infusions randomly receiving, or not, butorphanol in standing horses.. Vet Rec 2017 Oct 14;181(15):402.
- Benredouane K, Ringer SK, Fourel I, Lepage OM, Portier KG, Bettschart-Wolfensberger R. Comparison of xylazine-butorphanol and xylazine-morphine-ketamine infusions in horses undergoing a standing surgery.. Vet Rec 2011 Oct 1;169(14):364.
- Bryant CE, England GCW, Clarke KW. A comparison of the sedative effects of medetomidine and xylazine in the horse.. Vet Anaesth Analg 1991;18: 55–57.
- Gozalo-Marcilla M, Luna SP, Crosignani N, Filho JNP, Possebon FS, Pelligand L, Taylor PM. Sedative and antinociceptive effects of different combinations of detomidine and methadone in standing horses.. Vet Anaesth Analg 2017 Sep;44(5):1116-1127.
- Clutton RE. Opioid analgesia in horses.. Vet Clin North Am Equine Pract 2010 Dec;26(3):493-514.
- Gozalo-Marcilla M, de Oliveira AR, Fonseca MW, Possebon FS, Pelligand L, Taylor PM, Luna SPL. Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses.. Equine Vet J 2019 Jul;51(4):530-536.
- Schauvliege S, Cuypers C, Michielsen A, Gasthuys F, Gozalo-Marcilla M. How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm.. Vet Anaesth Analg 2019 Jan;46(1):4-13.
- Clarke KW, England GCW, Goossens L. Sedative and cardiovascular effects of romifidine, alone and in combination with butorphanol, in the horse.. Vet Anaesth Analg 1991;18: 25–29.
- Ringer SK, Portier KG, Fourel I, Bettschart-Wolfensberger R. Development of a xylazine constant rate infusion with or without butorphanol for standing sedation of horses.. Vet Anaesth Analg 2012 Jan;39(1):1-11.
- Costa GL, Cristarella S, Quartuccio M, Interlandi C. Anti-nociceptive and sedative effects of romifidine, tramadol and their combination administered intravenously slowly in ponies.. Vet Anaesth Analg 2015 Mar;42(2):220-5.
- L'Ami JJ, Vermunt LE, van Loon JP, Sloet van Oldruitenborgh-Oosterbaan MM. Sublingual administration of detomidine in horses: sedative effect, analgesia and detection time.. Vet J 2013 May;196(2):253-9.
- Ranheim B, Risberg ÅI, Spadavecchia C, Landsem R, Haga HA. The pharmacokinetics of dexmedetomidine administered as a constant rate infusion in horses.. J Vet Pharmacol Ther 2015 Feb;38(1):93-6.
- Hamm D, Jöchle W. Sedation and analgesia with dormosedan® (Detomidine hydrochloride) or acepromazine for suturing of the vulvar lips in mares (Caslick’s surgery).. J Equine Vet Sci 1991;11: 86–88.
- England GC, Clarke KW, Goossens L. A comparison of the sedative effects of three alpha 2-adrenoceptor agonists (romifidine, detomidine and xylazine) in the horse.. J Vet Pharmacol Ther 1992 Jun;15(2):194-201.
- Solano AM, Valverde A, Desrochers A, Nykamp S, Boure LP. Behavioural and cardiorespiratory effects of a constant rate infusion of medetomidine and morphine for sedation during standing laparoscopy in horses.. Equine Vet J 2009 Feb;41(2):153-9.
- McDowell I. Measuring health: A guide to rating scales.. Sociology of Health & Illness New York: Oxford University Press; 2006.
- Love EJ, Murrell J, Whay HR. Thermal and mechanical nociceptive threshold testing in horses: a review.. Vet Anaesth Analg 2011 Jan;38(1):3-14.
- Waltz C, Strickland O, Lenz E. Measurement in nursing and health research.. New York: Springer Publishing Company; 2010.
- Clarke KW, Taylor PM. Detomidine: a new sedative for horses.. Equine Vet J 1986 Sep;18(5):366-70.
- Holton LL, Scott EM, Nolan AM, Reid J, Welsh E, Flaherty D. Comparison of three methods used for assessment of pain in dogs.. J Am Vet Med Assoc 1998 Jan 1;212(1):61-6.
- Marly C, Bettschart-Wolfensberger R, Nussbaumer P, Moine S, Ringer SK. Evaluation of a romifidine constant rate infusion protocol with or without butorphanol for dentistry and ophthalmologic procedures in standing horses.. Vet Anaesth Analg 2014 Sep;41(5):491-7.
- Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S. Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses.. Vet Anaesth Analg 2019 May;46(3):325-334.
- Mama KR, Grimsrud K, Snell T, Stanley S. Plasma concentrations, behavioural and physiological effects following intravenous and intramuscular detomidine in horses.. Equine Vet J 2009 Nov;41(8):772-7.
- Grimsrud KN, Mama KR, Steffey EP, Stanley SD. Pharmacokinetics and pharmacodynamics of intravenous medetomidine in the horse.. Vet Anaesth Analg 2012 Jan;39(1):38-48.
- Darwin C. General principles of expression. Expression of the emotion in man and animals.. London: John Murray; 1872. p. 374.
- Dalla Costa E, Minero M, Lebelt D, Stucke D, Canali E, Leach MC. Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration.. PLoS One 2014;9(3):e92281.
- VanDierendonck MC, van Loon JP. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A validation study.. Vet J 2016 Oct;216:175-7.
- Gleerup KB, Forkman B, Lindegaard C, Andersen PH. An equine pain face.. Vet Anaesth Analg 2015 Jan;42(1):103-14.
- Mellor DJ. Mouth Pain in Horses: Physiological Foundations, Behavioural Indices, Welfare Implications, and a Suggested Solution.. Animals (Basel) 2020 Mar 29;10(4).
- Figueiredo J, Muir W, Smith J, Wolfrom G. Sedative and analgesic effects of romifidine in horses.. Int J Appl Res Vet Med 2005;3: 249–258.
- Sacks M, Ringer SK, Bischofberger AS, Berchtold SM, Bettschart-Wolfensberger R. Clinical comparison of dexmedetomidine and medetomidine for isoflurane balanced anaesthesia in horses.. Vet Anaesth Analg 2017 Sep;44(5):1128-1138.
- Freeman SL, England GC. Investigation of romifidine and detomidine for the clinical sedation of horses.. Vet Rec 2000 Oct 28;147(18):507-11.
- Brondani JT, Mama KR, Luna SP, Wright BD, Niyom S, Ambrosio J, Vogel PR, Padovani CR. Validation of the English version of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats.. BMC Vet Res 2013 Jul 17;9:143.
- Taffarel MO, Luna SP, de Oliveira FA, Cardoso GS, Alonso Jde M, Pantoja JC, Brondani JT, Love E, Taylor P, White K, Murrell JC. Refinement and partial validation of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in horses.. BMC Vet Res 2015 Apr 1;11:83.
- de Oliveira FA, Luna SP, do Amaral JB, Rodrigues KA, Sant'Anna AC, Daolio M, Brondani JT. Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle.. BMC Vet Res 2014 Sep 6;10:200.
- Luna SPL, de Araújo AL, da Nóbrega Neto PI, Brondani JT, de Oliveira FA, Azerêdo LMDS, Telles FG, Trindade PHE. Validation of the UNESP-Botucatu pig composite acute pain scale (UPAPS).. PLoS One 2020;15(6):e0233552.
- Silva NEOF, Trindade PHE, Oliveira AR, Taffarel MO, Moreira MAP, Denadai R, Rocha PB, Luna SPL. Validation of the Unesp-Botucatu composite scale to assess acute postoperative abdominal pain in sheep (USAPS).. PLoS One 2020;15(10):e0239622.
- Evangelista MC, Watanabe R, Leung VSY, Monteiro BP, O'Toole E, Pang DSJ, Steagall PV. Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale.. Sci Rep 2019 Dec 13;9(1):19128.
- van Loon JP, Van Dierendonck MC. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A scale-construction study.. Vet J 2015 Dec;206(3):356-64.
- Häger C, Biernot S, Buettner M, Glage S, Keubler LM, Held N, Bleich EM, Otto K, Müller CW, Decker S, Talbot SR, Bleich A. The Sheep Grimace Scale as an indicator of post-operative distress and pain in laboratory sheep.. PLoS One 2017;12(4):e0175839.
- Streiner DL, Norman GR, Cairney J. Health measurement scales: A practical guide to their development and use.. New York: Oxford University Press; 2015.
- DeVellis RF. Scale development theory and applications.. SAGE Publ 2016;4: 256.
- de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Trindade PHE, Puoli Filho JNP, Luna SPL. Development, Validation, and Reliability of a Sedation Scale in Horses (EquiSed).. Front Vet Sci 2021;8:611729.
- Gozalo-Marcilla M, Moreira da Silva R, Pacca Loureiro Luna S, Rodrigues de Oliveira A, Werneck Fonseca M, Peporine Lopes N, Taylor PM, Pelligand L. A possible solution to model nonlinearity in elimination and distributional clearances with α(2) -adrenergic receptor agonists: Example of the intravenous detomidine and methadone combination in sedated horses.. J Vet Pharmacol Ther 2019 Nov;42(6):738-744.
- Gozalo-Marcilla M, Luna SPL, Moreira da Silva R, Crosignani N, Lopes NP, Taylor PM, Pelligand L. Characterisation of the in vivo interactions between detomidine and methadone in horses: Pharmacokinetic and pharmacodynamic modelling.. Equine Vet J 2019 Jul;51(4):517-529.
- Stats to do. 2017 [cited 3 Apr 2017]. https://www.statstodo.com/SSizUnpairedDiff_Pgm.php.
- de Oliveira FA, Pignaton W, Teixeira-Neto FJ, de Queiroz-Neto A, Puoli-Filho JNP, Scognamillo MVR. Antinociceptive and behavioral effects of methadone alone or in combination with detomidine in conscious horses.. J Equine Vet Sci 2014;34: 380–386.
- https://sorteador.com.br/. 2017 [cited 2 Feb 2017].
- Wathan J, Burrows AM, Waller BM, McComb K. EquiFACS: The Equine Facial Action Coding System.. PLoS One 2015;10(8):e0131738.
- Mullard J, Berger JM, Ellis AD, Dyson S. Development of an ethogram to describe facial expressions in ridden horses (FEReq).. J Vet Behav Clin Appl Res 2017;18: 7–12.
- Brondani JT, Luna SP, Padovani CR. Refinement and initial validation of a multidimensional composite scale for use in assessing acute postoperative pain in cats.. Am J Vet Res 2011 Feb;72(2):174-83.
- Miot HA. Análise de concordância em estudos clínicos e experimentais.. J Vasc Bras 2016 Apr-Jun;15(2):89-92.
- Altman D. Some commom problems in medical research.. In: Hall C&, editor. Pratical statistics for medical research. London; 1991. pp. 404–408.
- Kaiser HF. The varimax criterion for analytic rotation in factor analysis.. Psychometrika 1958;23: 187–200.
- Hair J, Black W, Babin BJ, Anderson R, Tatham R. Multivariate data analysis.. Upper Saddle River: Prentice hall; 1998.
- Cronbach L. Coefficient alpha and the internal structure of tests.. Psychometrika 1951;16: 297–333.
- Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency.. J Pers Assess 2003 Feb;80(1):99-103.
- Bussières G, Jacques C, Lainay O, Beauchamp G, Leblond A, Cadoré JL, Desmaizières LM, Cuvelliez SG, Troncy E. Development of a composite orthopaedic pain scale in horses.. Res Vet Sci 2008 Oct;85(2):294-306.
- Streiner DL, Cairney J. What's under the ROC? An introduction to receiver operating characteristics curves.. Can J Psychiatry 2007 Feb;52(2):121-8.
- Mallat J, Meddour M, Durville E, Lemyze M, Pepy F, Temime J, Vangrunderbeeck N, Tronchon L, Thevenin D, Tavernier B. Decrease in pulse pressure and stroke volume variations after mini-fluid challenge accurately predicts fluid responsiveness†.. Br J Anaesth 2015 Sep;115(3):449-56.
- Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, Tesoro EP, Elswick RK. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients.. Am J Respir Crit Care Med 2002 Nov 15;166(10):1338-44.
- de Lemos J, Tweeddale M, Chittock D. Measuring quality of sedation in adult mechanically ventilated critically ill patients. the Vancouver Interaction and Calmness Scale. Sedation Focus Group.. J Clin Epidemiol 2000 Sep;53(9):908-19.
- Ashkenazy S, DeKeyser-Ganz F. Assessment of the reliability and validity of the Comfort Scale for adult intensive care patients.. Heart Lung 2011 May-Jun;40(3):e44-51.
- Roughan J V., Flecknell PA. Training in behaviour-based post-operative pain scoring in rats—An evaluation based on improved recognition of analgesic requirements.. Appl Anim Behav Sci 2006;96: 327–342.
- Zhang EQ, Leung VS, Pang DS. Influence of Rater Training on Inter- and Intrarater Reliability When Using the Rat Grimace Scale.. J Am Assoc Lab Anim Sci 2019 Mar 1;58(2):178-183.
- Mich PM, Hellyer PW, Kogan L, Schoenfeld-Tacher R. Effects of a pilot training program on veterinary students' pain knowledge, attitude, and assessment skills.. J Vet Med Educ 2010 Winter;37(4):358-68.
- Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory and application.. Am J Med 2006 Feb;119(2):166.e7-16.
- Martin Paul, Bateson P. Measuring Behaviour: An Introductory Guide.. 3rd editio. Cambridge: University Press; 2007.
- de Vet HCW, Terwee CB, Mokkink LB., Knol DL. Measurement in Medicine A Practical Guide.. Cambridge: University Press; 2011.
- Hays RD, Hadorn D. Responsiveness to change: an aspect of validity, not a separate dimension.. Qual Life Res 1992 Feb;1(1):73-5.
- Plichta SB, Kelvin EA. Munro’s statistical methods for health care research.. 6th ed. Philadelphia: Wolters Kluwer Health; 2011.
- Correia-Caeiro C, Guo K, Mills DS. Perception of dynamic facial expressions of emotion between dogs and humans.. Anim Cogn 2020 May;23(3):465-476.
- Kano F, Tomonaga M. Face scanning in chimpanzees and humans: continuity and discontinuity.. Anim Behav 2010;79: 227–235.
- Schanz L, Krueger K, Hintze S. Sex and Age Don't Matter, but Breed Type Does-Factors Influencing Eye Wrinkle Expression in Horses.. Front Vet Sci 2019;6:154.
- Finka LR, Luna SP, Brondani JT, Tzimiropoulos Y, McDonagh J, Farnworth MJ, Ruta M, Mills DS. Geometric morphometrics for the study of facial expressions in non-human animals, using the domestic cat as an exemplar.. Sci Rep 2019 Jul 8;9(1):9883.
- Mathis MW, Mathis A. Deep learning tools for the measurement of animal behavior in neuroscience.. Curr Opin Neurobiol 2020 Feb;60:1-11.
Citations
This article has been cited 3 times.- Pinho RH, Justo AA, Cima DS, Fonseca MW, Minto BW, Rocha FDL, Leach MC, Luna SPL. Effects of Human Observer Presence on Pain Assessment Using Facial Expressions in Rabbits.. J Am Assoc Lab Anim Sci 2023 Jan 1;62(1):81-86.
- Carvalho JRG, Trindade PHE, Conde G, Antonioli ML, Funnicelli MIG, Dias PP, Canola PA, Chinelatto MA, Ferraz GC. Facial Expressions of Horses Using Weighted Multivariate Statistics for Assessment of Subtle Local Pain Induced by Polylactide-Based Polymers Implanted Subcutaneously.. Animals (Basel) 2022 Sep 13;12(18).
- Cock G, Blakeney Z, Hernandez JA, DeNotta S. Opioid-free sedation for atlantoaxial cerebrospinal fluid collection in adult horses.. J Vet Intern Med 2022 Sep;36(5):1812-1819.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists