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Animals : an open access journal from MDPI2025; 15(23); 3454; doi: 10.3390/ani15233454

Introducing an Innovative Pain Scale for Assessing Postpartum Pain in Mares: Preliminary Clinical Evaluation.

Abstract: Pain after giving birth is commonly observed in horses, yet there has not been a specific tool developed for assessing this pain in postpartum mares. The goal was to adapt existing equine pain scales and to preliminarily validate a practical pain scale for use by veterinarians and caregivers after foaling. Methods: The pain scale was developed by adapting items from other pain scales, including established orthopedic and colic equine pain scales, and incorporating caregiver feedback. The final scale includes eight areas for assessing pain: behavior, facial expressions, vital signs, udder examination, gastrointestinal function, hoof temperature, response to food, and movement. Observations were conducted on ten heavy draft mares that experienced dystocia, with pain scores recorded twice daily for 1 to 4 days postpartum. Simultaneous saliva samples were collected to measure cortisol levels. Results: The pain scale proved feasible for use at the stall and allowed for partial scoring when certain assessments were deemed risky. Pain scores were highest on the first day after foaling and decreased as the mares recovered. In a case of clinical deterioration, a substantial increase in pain score was noted. Increased pain scores were associated with elevated cortisol levels, supporting the biological relevance of the scale. In clinical practice, if a pain score exceeded 40% of the maximum score, the mare was identified as a patient requiring analgesic treatment. Conclusions: This postpartum-specific pain scale provides a standardized method for assessing pain in mares after foaling and may assist in guiding appropriate pain management. Although the proposed pain scale shows promise as a clinical tool, the present results are preliminary and require confirmation in larger studies.
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Publication Date: 2025-11-30 PubMed ID: 41375512PubMed Central: PMC12691225DOI: 10.3390/ani15233454Google Scholar: Lookup
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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.

Overview

  • This research introduces a new pain scale specifically designed to assess postpartum pain in mares (female horses) after giving birth, adapting existing equine pain scales and validating its preliminary clinical use.

Introduction and Objective

  • Postpartum pain in mares is a common but under-assessed condition in equine medicine.
  • Prior to this study, no specialized tool existed to objectively measure pain specifically linked to foaling in mares.
  • The objective was to create and preliminarily validate a practical and reliable postpartum pain scale that veterinarians and caregivers could use in clinical settings.

Development of the Pain Scale

  • The scale was created by adapting items from existing equine pain scales, notably orthopedic and colic scales, which assess pain related to bone/joint issues and abdominal pain, respectively.
  • Additional input was collected from caregivers who regularly handle postpartum mares to ensure practicality and relevance.
  • The finalized scale consists of eight key assessment areas:
    • Behavioral changes (e.g., restlessness, posturing)
    • Facial expressions (specific grimacing or tension signs)
    • Vital signs (heart rate, respiratory rate, temperature)
    • Udder examination (signs of pain, heat, swelling)
    • Gastrointestinal function (motility and digestive activity)
    • Hoof temperature (as an indirect sign of systemic distress)
    • Response to food (appetite and eating behavior)
    • Movement (willingness to move, gait abnormalities)

Methodology

  • The study involved observing 10 heavy draft mares that had experienced dystocia, a difficult or abnormal labor, making pain assessment especially important.
  • Pain scoring was conducted twice daily covering 1 to 4 days following foaling.
  • Saliva samples were collected simultaneously to measure cortisol—a hormone commonly linked to stress and pain—to biologically validate the pain scores.
  • The scale allowed for partial scoring if some assessments could not be safely performed in the stall environment.

Results

  • The pain scale was feasible and practical for use at the stall, facilitating regular pain assessment without requiring special facilities.
  • Pain scores peaked on the first day postpartum, which aligns with the expected highest pain period after foaling, and progressively decreased as mares recovered.
  • In one mare whose health worsened clinically, a sharp increase in pain score was recorded, demonstrating the scale’s sensitivity to changes in condition.
  • There was a positive correlation between higher pain scores and elevated cortisol levels, supporting the biological relevance and validity of the scale.
  • A threshold was proposed: pain scores exceeding 40% of the maximum score indicated that analgesic intervention might be necessary.

Conclusions and Implications

  • The study presents the first specifically designed, standardized pain scale for postpartum mares, addressing a previously unmet clinical need.
  • This scale can help veterinarians and caregivers objectively monitor pain and inform decisions about pain management following foaling.
  • The preliminary results are promising, showing the scale’s practical applicability and biological correlation through cortisol measurements.
  • Further research with a larger sample size and diverse horse populations is necessary to fully validate and refine the scale.

Significance

  • Provides a tool to improve welfare and clinical care of postpartum mares by ensuring timely and appropriate analgesic treatment.
  • Enhances understanding of postpartum pain patterns in mares, potentially improving recovery outcomes and reducing complications.
  • Sets a foundation for future advancements in equine pain assessment and management tailored to different clinical scenarios.

Cite This Article

APA
Bolesławska-Szubartowska J, Kucharczuk M, Skrabska A, Zbysław A, Adamowicz J, Alszko A, Domagalska-Stomska K, Durska M, Dziekcierów A, Janiszewska Z, Korzeniowska R, Kraujutowicz K, Kulesza K, Marciniak P, Pacyna Z, Przeborowska J, Siwek Z, Leonard M, Rapacz-Leonard A. (2025). Introducing an Innovative Pain Scale for Assessing Postpartum Pain in Mares: Preliminary Clinical Evaluation. Animals (Basel), 15(23), 3454. https://doi.org/10.3390/ani15233454

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 15
Issue: 23
PII: 3454

Researcher Affiliations

Bolesławska-Szubartowska, Julia
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Kucharczuk, Magdalena
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Skrabska, Aleksandra
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Zbysław, Aneta
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Adamowicz, Julia
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Alszko, Agnieszka
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Domagalska-Stomska, Klementyna
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Durska, Marta
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Dziekcierów, Agata
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Janiszewska, Zuzanna
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Korzeniowska, Roksana
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Kraujutowicz, Karolina
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Kulesza, Karolina
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Marciniak, Patrycja
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Pacyna, Zofia
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Przeborowska, Julia
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Siwek, Zuzanna
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.
Leonard, Mark
  • Leonard Data Lab, 10-719 Olsztyn, Poland.
Rapacz-Leonard, Anna
  • Students' Scientific Club 'Equine Reproduction', Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719 Olsztyn, Poland.

Conflict of Interest Statement

Author Mark Leonard is the owner of Leonard Data Lab. All authors declare that the research was conducted in the absence of any other commercial or financial relationships that could be construed as a potential conflict of interest.

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