FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Vet Rec / Preliminary investigation of equine veterinary hospital staf...
The Veterinary record2025; doi: 10.1002/vetr.6122

Preliminary investigation of equine veterinary hospital staff attitudes towards pain assessment in a single centre.

Abstract: Despite the availability of several equine pain assessment tools, their use in equine veterinary practice appears limited compared to small animal practice. This study explores potential barriers to equine pain assessment, as reported by staff at a single UK equine teaching hospital. Methods: Nine hospital staff members were interviewed using semi-structured interviews. Key themes were identified through reflexive thematic analysis. Results: Participants acknowledged the importance of pain assessment, yet highlighted limitations in current methods and their inconsistent use. Key challenges included limited observer confidence, subjective interpretations and discrepancies between staff and owner perceptions. Variability in horse temperament and pain presentation further complicated the assessment. Staff expressed a desire for improvements in pain assessment tools and clearer protocols. Conclusions: The study was limited by its single-hospital design, short interview duration and small sample size. Conclusions: The study highlights the complexity of equine pain assessment in clinical practice, including tool limitations, knowledge gaps and contextual barriers. Despite valuing pain assessment, staff reported difficulties applying currently available methods. Findings suggest a need for improved tools, training and institutional support.
© 2025 The Author(s). Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
Get Full Text
Publication Date: 2025-12-04 PubMed ID: 41346135DOI: 10.1002/vetr.6122Google 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.
LinkedInCopy
  • Journal Article

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 study investigates the attitudes of veterinary staff at a UK equine teaching hospital towards assessing pain in horses.
  • It identifies challenges with current pain assessment tools and practices, highlighting a need for better methods, training, and guidelines.

Background and Context

  • Equine pain assessment tools exist but are less commonly used in equine veterinary settings compared to small animal practice.
  • Understanding staff attitudes towards pain assessment is important to improve pain management for horses in clinical settings.
  • The study focuses on staff at a single UK equine teaching hospital to explore perceived barriers and challenges.

Methods

  • Nine hospital staff members were interviewed using semi-structured interviews to gather qualitative data.
  • Reflexive thematic analysis was applied to identify key themes from the interview transcripts.
  • The small sample size and single-centre design limited the generalizability of the findings.

Key Findings

  • All participants recognized the importance of assessing pain in horses for effective treatment and welfare.
  • Despite this, there was inconsistent use of available pain assessment methods across the hospital staff.
  • Staff reported several challenges:
    • Limited confidence in their ability to accurately assess pain.
    • Subjectivity and variability in interpreting clinical signs of pain.
    • Differences between staff perceptions and horse owners’ views on pain presence and severity.
    • Variability in horses’ temperament and how they express pain, complicating assessment.
  • Staff expressed a strong desire for:
    • More objective, reliable, and user-friendly pain assessment tools tailored for horses.
    • Clearer protocols and guidelines to standardize pain assessment practices.
    • Improved training and education on recognizing and evaluating equine pain.

Limitations

  • The study was conducted at a single equine hospital, limiting applicability to other settings.
  • Small sample size (nine staff members) restricts the breadth of perspectives captured.
  • Interview durations were short, potentially limiting depth of responses.

Conclusions and Implications

  • Equine pain assessment in clinical practice is complex and currently hindered by tool limitations and knowledge gaps.
  • Hospital staff value pain assessment but face practical barriers that reduce its consistent application.
  • Improved pain assessment requires development of better tools, more comprehensive training, and institutional support such as clear protocols.
  • Addressing these issues may lead to enhanced recognition and management of pain in horses, improving patient outcomes and welfare.

Cite This Article

APA
Curry O, Everett A, Pearson G, Dwyer C, Duncan J. (2025). Preliminary investigation of equine veterinary hospital staff attitudes towards pain assessment in a single centre. Vet Rec. https://doi.org/10.1002/vetr.6122

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English

Researcher Affiliations

Curry, Olivia
  • The University of Edinburgh Royal Dick School of Veterinary Studies, Edinburgh, UK.
Everett, Alice
  • The University of Edinburgh Royal Dick School of Veterinary Studies, Edinburgh, UK.
Pearson, Gemma
  • The University of Edinburgh Royal Dick School of Veterinary Studies, Edinburgh, UK.
  • The Horse Trust, Princes Risborough, UK.
Dwyer, Cathy
  • SRUC, School of Veterinary Medicine and Biosciences, Edinburgh, UK.
Duncan, Juliet
  • The University of Edinburgh Royal Dick School of Veterinary Studies, Edinburgh, UK.

Grant Funding

  • BB/T00875X/1 / Biotechnology and Biological Sciences Research Council

References

This article includes 73 references
  1. Hawkins P. Recognizing and assessing pain, suffering and distress in laboratory animals: a survey of current practice in the UK with recommendations. Lab Anim 2002;36:378–395.
  2. Viñuela‐Fernández I, Weary D, Flecknell P. Pain. Animal welfare 2018. p. 76–91.
  3. de Grauw JC, van Loon J. Systematic pain assessment in horses. Vet J 2016;209:14–22.
  4. van Loon J, Van Dierendonck MC. Objective pain assessment in horses (2014–2018). Vet J 2018;242:1–7.
  5. Kongara K, Squance He, Topham Ia, Bridges JP. Attitudes and perceptions of veterinary paraprofessionals in New Zealand to postoperative pain in dogs and cats. N Z Vet J 2016;64:112–116.
  6. Benato L, Murrell J, Blackwell E, Saunders R, Rooney N. Pain and analgesia in pet rabbits: a survey of the attitude of veterinary nurses. J Small Anim Pract 2020;61:576–581.
  7. Marco‐Martorell M, Duffy N, Martinez M, Maddox T, Robson K. Agreement of pain assessment using the short form of the canine Glasgow composite measure pain scale between veterinary students, veterinary nurses, veterinary surgeons, and ECVAA‐diplomates. Animals 2024;14(16):2310.
  8. 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;37:358–368.
  9. Menéndez S, Cabezas MA, Gomez de Segura IA. Attitudes to acute pain and the use of pain assessment scales among Spanish small animal veterinarians. Front Vet Sci 2023;10:1302528.
  10. Spahija N, Lutvikadić I, Ćoso A. Current attitudes and self‐rated abilities toward pain assessment of horse owners in Bosnia and Herzegovina. Online J Anim Feed Res 2022;12:261–265.
  11. Raekallio M, Heinonen KM, Kuussaari J, Vainio O. Pain alleviation in animals: attitudes and practices of Finnish veterinarians. Vet J 2003;165:131–135.
  12. Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022 WSAVA guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2023;64:177–254.
  13. Epstein ME, Rodanm I, Griffenhagen G, Kadrlik J, Petty MC, Robertson SA. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg 2015;17:251–272.
  14. Guedes A. Pain management in horses. Vet Clin North Am Equine Pract 2017;33:181–211.
  15. Bowen IM, Redpath A, Dugdale A, Burford JH, Lloyd D, Watson T. Beva primary care clinical guidelines: analgesia. Equine Vet J 2020;52:13–27.
  16. Beswick A, Dewey CE, Johnson R, Dowsett‐Cooper J, Niel L. Survey of ontario veterinarians' knowledge and attitudes on pain in dogs and cats in 2012. Can Vet J. 2016;57:1274–1280.
  17. Roberts C, Blackwell EJ, Roe E, Murrell JC, Mullan S. Awareness and use of canine quality of life assessment tools in UK veterinary practice. Animals. 2023;13:1105.
  18. Hunt JR, Knowles TG, Lascelles BDX, Murrell JC. Prescription of perioperative analgesics by uk small animal veterinary surgeons in 2013. Vet Rec. 2015;176:493–493.
  19. Coleman DL, Slingsby LS. Attitudes of veterinary nurses to the assessment of pain and the use of pain scales. Vet Rec. 2007;160:541–544.
  20. Hernandez‐Avalos I, Mota‐Rojas D, Mora‐Medina P, Martínez‐Burnes J, Casas Alvarado A, Verduzco‐Mendoza A, et al. Review of different methods used for clinical recognition and assessment of pain in dogs and cats. Int J Vet Sci Med. 2019;7:43–54.
  21. Bloor C, Allan L. Pain scoring systems in the canine and feline patient. Vet Nurs. 2017;8:252–258.
  22. Costa RS, Hassur RL, Jones T, Stein A. The use of pain scales in small animal veterinary practices in the USA. J Small Anim Pract. 2023;64:265–269.
  23. Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006;27:237–246.
  24. DeJonckheere M, Vaughn LM. Semistructured interviewing in primary care research: a balance of relationship and rigour. Fam Med Community Health. 2019;7:e000057.
  25. Safdar B, Heins A, Homel P, Miner J, Neighbor M, DeSandre P, et al. Impact of physician and patient gender on pain management in the emergency department—a multicenter study. Pain Med. 2009;10:364–372.
  26. Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth. 2013;111:52–58.
  27. Otter.ai. Otter: AI meeting notes and transcription app. Mountain View, CA: Otter.ai; 2022.
  28. Tashakkori A, Teddlie C. Sage handbook of mixed methods in social & behavioral research. 2nd ed. Thousand Oaks, CA: SAGE Publications; 2010.
  29. Lumivero. Nvivo 14. Denver: Lumivero; 2023.
  30. 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;212:61–66.
  31. Tschoner T, Mueller KR, Zablotski Y, Feist M. Pain assessment in cattle by use of numerical rating and visual analogue scales—a systematic review and meta‐analysis. Animals. 2024;14:351.
  32. Holton L, Pawson P, Nolan A, Reid J, Scott EM. Development of a behaviour‐based scale to measure acute pain in dogs. Vet Rec. 2001;148:525–531.
  33. Pritchett LC, Ulibarri C, Roberts MC, Schneider RK, Sellon DC. Identification of potential physiological and behavioral indicators of postoperative pain in horses after exploratory celiotomy for colic. Appl Anim Behav Sci. 2003;80:31–43.
  34. Graubner C, Gerber V, Doherr M, Spadavecchia C. Clinical application and reliability of a post abdominal surgery pain assessment scale (PASPAS) in horses. Vet J. 2011;188:178–183.
  35. Gleerup KB, Forkman B, Lindegaard C, Andersen PH. An equine pain face. Vet Anaesth Analg. 2015;42:103–114.
  36. Lawson AL, Opie RR, Stevens KB, Knowles EJ, Mair TS. Application of an equine composite pain scale and its association with plasma adrenocorticotropic hormone concentrations and serum cortisol concentrations in horses with colic. Equine Vet Educ. 2020;32:20–27.
  37. van Loon J, Macri L. Objective assessment of chronic pain in horses using the horse chronic pain scale (HCPS): a scale‐construction study. Animals. 2021;11:1826.
  38. Auer U, Kelemen Z, Vogl C, von Ritgen S, Haddad R, Torres Borda L, et al. Development, refinement, and validation of an equine musculoskeletal pain scale. Front Pain Res. 2023;4:1292299.
  39. Nannarone S, Ortolani F, Scilimati N, Gialletti R, Menchetti L. Refinement and revalidation of the equine ophthalmic pain scale: R‐eops a new scale for ocular pain assessment in horses. Vet J. 2024;304:106079.
  40. Taffarel MO, Luna SPL, de Oliveira FA, Cardoso GS, Alonso JDeM, Pantoja JC, et al. Refinement and partial validation of the UNESP‐Botucatu multidimensional composite pain scale for assessing postoperative pain in horses. BMC Vet Res. 2015;11:83.
  41. Bussières G, Jacques C, Lainay O, Beauchamp G, Leblond A, Cadoré J‐L, et al. Development of a composite orthopaedic pain scale in horses. Res Vet Sci. 2008;85:294–306.
  42. van Loon J, 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;206:356–364.
  43. Agne GF, May BE, Lovett A, Steel C, Santos L, Guedes do Carmo L, et al. Horse grimace scale does not detect pain in horses with equine gastric ulcer syndrome. Animals. 2023;13:12.
  44. Ask K, Andersen PH, Tamminen L‐M, Rhodin M, Hernlund E. Performance of four equine pain scales and their association to movement asymmetry in horses with induced orthopedic pain. Front Vet Sci. 2022;9:14.
  45. 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;9:10.
  46. Dalla Costa E, Stucke D, Dai F, Minero M, Leach M, Lebelt D. Using the horse grimace scale (HGS) to assess pain associated with acute laminitis in horses (Equus caballus). Animals. 2016;6:9.
  47. Chiavaccini L, Gupta A, Chiavaccini G. From facial expressions to algorithms: a narrative review of animal pain recognition technologies. Front Vet Sci. 2024;11:2024.
  48. Rose L, Smith O, Gelinas C, Haslam L, Dale C, Luk E, et al. Critical care nurses’ pain assessment and management practices: a survey in Canada. Am J Crit Care. 2012;21:251–259.
  49. Wikström L, Eriksson K, Årestedt K, Fridlund B, Broström A. Healthcare professionals' perceptions of the use of pain scales in postoperative pain assessments. Appl Nurs Res. 2014;27:53–58.
  50. Dujardin CL, van Loon JP. Pain recognition and treatment in the horse: a survey of equine veterinarians in the Netherlands and Belgium. Tijdschr Diergeneeskd. 2011;136:715–724.
  51. Whay HR, Huxley J. Pain relief in cattle: a practitioner's perspective. Cattle Pract. 2005;13:81–85.
  52. Huxley JN, Whay HR. Current attitudes of cattle practitioners to pain and the use of analgesics in cattle. Vet Rec. 2006;159:662–668.
  53. Morales‐Vallecilla C, Ramírez N, Villar D, Díaz MC, Bustamante S, Ferguson D. Survey of pain knowledge and analgesia in dogs and cats by Colombian veterinarians. Vet Sci. 2019;6:6.
  54. Layman Young J, Horton FM, Davidhizar R. Nursing attitudes and beliefs in pain assessment and management. J Adv Nurs. 2006;53:412–421.
  55. Ijichi C, Collins LM, Elwood RW. Pain expression is linked to personality in horses. Appl Anim Behav Sci. 2014;152:38–43.
  56. Driessen B, Zarucco L. Pain: from diagnosis to effective treatment. Clin Tech Equine Pract. 2007;6:126–134.
  57. Taylor PM, Pascoe PJ, Mama KR. Diagnosing and treating pain in the horse. Where are we today? Vet Clin North Am Equine Pract. 2002;18:1–19.
  58. Torcivia C, McDonnell S. In‐person caretaker visits disrupt ongoing discomfort behavior in hospitalized equine orthopedic surgical patients. Animals. 2020;10:210.
  59. Hötzel MJ, Vieira MC, Leme DP. Exploring horse owners’ and caretakers’ perceptions of emotions and associated behaviors in horses. J Vet Behav. 2019;29:18–24.
  60. Fiedler JM, Ayre ML, Rosanowski S, Slater JD. Horse sector participants’ attitudes towards anthropomorphism and animal welfare and wellbeing. Animals. 2024;14:2482.
  61. Demirtas A, Atilgan D, Saral B, Isparta S, Ozturk H, Ozvardar T, et al. Dog owners' recognition of pain‐related behavioral changes in their dogs. J Vet Behav. 2023;62:39–46.
  62. Sellon DC, Sanz M, Kopper JJ, Mattei D. Pain severity scores for common equine disorders as provided by horse owners and equine veterinarians. Equine Vet J. 2022;54:1094–1102.
  63. Gleichgerrcht E, Decety J. The relationship between different facets of empathy, pain perception and compassion fatigue among physicians. Front Behav Neurosci. 2014;8:243.
  64. Grégoire M, Coll MP, Tremblay MPB, Prkachin KM, Jackson PL. Repeated exposure to others’ pain reduces vicarious pain intensity estimation. Eur J Pain. 2016;20:1644–1652.
  65. Ramakrishnan S, Yiannakou JY, Ellis WR, Bain I. Assessment of patient pain at colonoscopy: are nurses better than endoscopists? J R Soc Med. 2004;97:432–433.
  66. Mäki‐Asiala M, Kaakinen P, Pölkki T. Interprofessional collaboration in the context of pain management in neonatal intensive care: a cross‐sectional survey. Pain Manag Nurs. 2022;23:759–766.
  67. Lövsund A, Stålnacke B‐M, Stenberg G. Multiprofessional assessment of patients with chronic pain in primary healthcare. Scand J Pain. 2020;20:319–327.
  68. van Ransbeeck A, Budilivski A, Spahn DR, Macrea L, Giuliani F, Maurer K. Pain assessment discrepancies: a cross‐sectional study highlights the amount of underrated pain. Pain Pract. 2018;18:360–367.
  69. Vasileiou K, Barnett J, Thorpe S, Young T. Characterising and justifying sample size sufficiency in interview‐based studies: systematic analysis of qualitative health research over a 15‐year period. BMC Med Res Methodol. 2018;18:148.
  70. Young DS, Casey EA. An examination of the sufficiency of small qualitative samples. Soc Work Res. 2018;43:53–58.
  71. Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med. 2022;292:114523.
  72. Truter P, Edgar D, Mountain D, Bulsara C. An emergency department optimized protocol for qualitative research to investigate care seeking by patients with non‐urgent conditions. Nurs Open. 2021;8:628–635.
  73. Karatsareas P. Semi‐structured interviews. In: Kircher R, Zipp L, editors. Research methods in language attitudes. Cambridge: Cambridge University Press; 2022. p. 99–113.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,001 horse owners like you who receive our email updates on horse health and nutrition.