Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma.
Abstract: Objective pain assessment is important to guide and tailor therapy in clinical practice. This study describes the clinical applicability and validity of two pain scales, the Composite Pain Scale (CPS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) in horses with orthopaedic trauma or after orthopaedic surgery. A cohort follow-up study was performed using 77 adult horses (n=43 with orthopaedic trauma or injury; n=34 controls). Composite and facial expression-based pain scores were assessed by direct observations of pairs of two independent observers. All horses were assessed at arrival, and on the first and second day after arrival or after surgery. Both CPS and EQUUS-FAP scores demonstrated high inter-observer reliability (Crohnbach's alpha=0.97 for CPS; Crohnbach's alpha=0.93 for EQUUS-FAP; P<0.001), with low bias (0.07 and -0.08 respectively) and limits of agreement of -1.9 to 1.9 for CPS and -1.9 to 1.9 for EQUUS-FAP. Both CPS and EQUUS-FAP scores showed significant differences between control horses and orthopaedic cases (P<0.001). Trauma cases had significantly higher pain scores compared to postoperative cases for both CPS (P<0.05) and for EQUUS-FAP (P<0.01) and both pain scores significantly decreased after nonsteroidal anti-inflammatory drug (NSAID) administration. In accordance with the findings in other types of equine pain, the CPS and FAP proved useful and valid for objective and repeatable assessment of pain in horses with orthopaedic trauma or after orthopaedic surgery. This can further aid treatment of horses in clinical practice and might improve equine welfare.
Copyright © 2019 Elsevier Ltd. All rights reserved.
Publication Date: 2019-02-10 PubMed ID: 30902195DOI: 10.1016/j.tvjl.2019.02.001Google Scholar: Lookup
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- Journal Article
- Validation Study
Summary
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This research tested the effectiveness of two standardised pain scales, the Composite Pain Scale (CPS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP), in assessing pain in horses that had suffered orthopaedic trauma or had undergone surgery. The study found both scales were highly consistent between different observers and could effectively identify differences in pain levels, providing useful tools in improving equine welfare and treatment.
Objective
- The main objective of the study was to evaluate the clinical applicability and validity of two established pain scales, namely the Composite Pain Scale (CPS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP), in the context of horses suffering from orthopaedic trauma or having undergone orthopaedic surgery.
Methodology
- A cohort follow-up study was conducted involving 77 adult horses, 43 of them being with orthopaedic trauma or injury, and 34 as control subjects.
- The horse’s composite and facial-expression based pain scores were assessed by two independent observers. This was done at the time of their arrival, and on the first and second days thereafter or post-surgery.
Results
- The CPS and EQUUS-FAP scores showed high inter-observer reliability, scoring 0.97 and 0.93 respectively under Crohnbach’s alpha which measures consistency/reliability among observers. The observed bias was low (0.07 and -0.08 respectively), implying the classifications were largely unprejudiced.
- Both scales could effectively differentiate between control horses and orthopaedic cases, with trauma cases having significantly greater pain scores than postoperative cases. Both scales showed a significant decrease in pain scores following NSAID (nonsteroidal anti-inflammatory drug) administration, affirming their effectiveness in tracking changes in pain intensity over time.
Conclusion
- The study concluded that both CPS and EQUUS-FAP are valid pain assessment tools that can be reliably used for observing and quantifying pain in horses suffering from orthopaedic trauma or undergoing orthopaedic surgery.
- This advances the capability of equine caregivers to better comprehend and respond to instances of pain in horses, thereby promoting more effective treatment strategies and improving equine welfare overall.
Cite This Article
APA
van Loon JPAM, Van Dierendonck MC.
(2019).
Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma.
Vet J, 246, 85-91.
https://doi.org/10.1016/j.tvjl.2019.02.001 Publication
Researcher Affiliations
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, NL-3584 CM, Utrecht, the Netherlands. Electronic address: j.p.a.m.vanloon@uu.nl.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, NL-3584 CM, Utrecht, the Netherlands; Veterinary Faculty Ghent University, Salisburylaan 133, 9820, Merelbeke, Ghent, Belgium; Department of Veterinary Sciences Antwerp University, Universiteitsplein 1, 2610, Wilrijk, Antwerp, Belgium.
MeSH Terms
- Animals
- Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
- Bone and Bones / injuries
- Face
- Female
- Horses / injuries
- Horses / surgery
- Male
- Observer Variation
- Orthopedic Procedures / veterinary
- Pain Measurement / methods
- Pain Measurement / veterinary
- Pain, Postoperative / drug therapy
- Pain, Postoperative / veterinary
- Reproducibility of Results
Citations
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