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Ferlini Agne G, May BE, Lovett A, Simon O, Steel C, Santos L, Guedes do Carmo L, Barbosa B, Werner LC, Daros RR, Somogyi AA, Sykes B, Franklin S. Horse Grimace Scale Does Not Detect Pain in Horses with Equine Gastric Ulcer Syndrome. Animals (Basel) 2023; 13:1623. [PMID: 37238054 PMCID: PMC10215503 DOI: 10.3390/ani13101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/05/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Equine gastric ulcer syndrome (EGUS) is a highly prevalent and presumptively painful condition, although the amount of pain horses might experience is currently unknown. The aims of this study were to determine if the Horse Grimace Scale (HGS) could identify pain behaviours in horses with and without EGUS and if severity would be positively associated with the HGS score. Horse grimace scale scores were assessed blindly using facial photographs by seven observers and involved evaluation of 6 facial action units as 0 (not present), 1 (moderately present) and 2 (obviously present). Lameness examination, serum amyloid A (SAA) measurement and gastroscopy evaluation were performed on all horses. Horses (n = 61) were divided into two and three groups based on the presence (yes, no) and severity (none, mild, moderate-severe) of EGUS, respectively. Presence of lameness and elevated SAA (≥50 µg/mL) were used as exclusion criteria. Inter-observer reliability was analyzed by intra-class correlation coefficients (ICC). HGS scores between groups were compared using Welch's and Brown Forsythe tests (p < 0.05). Overall, HGS ICC was "excellent" (0.75). No significant differences (p = 0.566) were observed in HGS scores between horses with and without gastric lesions (mean, 95% CI; 3.36, 2.76-3.95 and 3, 1.79-4.20, respectively). HGS was not influenced by the presence or severity of EGUS in this current study. Further studies investigating the use of different pain scales in horses with EGUS are needed.
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Affiliation(s)
- Gustavo Ferlini Agne
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
| | - Bridget Eileen May
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
| | - Amy Lovett
- School of Veterinary Medicine, Massey University, Palmerston North 4474, New Zealand
| | - Olivier Simon
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
| | - Catherine Steel
- Department of Veterinary Clinical Services, Hong Kong Jockey Club, Sha Tin Racecourse, New Territories, Hong Kong
| | - Luiz Santos
- School of Biodiversity, One Health and Veterinary Sciences, The University of Glasgow, Bearsden, Glasgow G12 8QQ, UK
| | - Laize Guedes do Carmo
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Bianca Barbosa
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Laís Cristine Werner
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Ruan R. Daros
- Graduate Program in Animal Science, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Andrew A. Somogyi
- Discipline of Pharmacology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - Benjamin Sykes
- School of Veterinary Medicine, Massey University, Palmerston North 4474, New Zealand
| | - Samantha Franklin
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, Adelaide, SA 5371, Australia
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Barton C, Hassel DM. Critical Care of the Colic Patient: Monitoring, Fluid Therapy, and More. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00023-8. [PMID: 37169620 DOI: 10.1016/j.cveq.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
A successful outcome to management of the critical colic patient is highly dependent on how the patient is monitored and treated, particularly, in the perioperative period. In this article, we will provide an update on monitoring techniques, advances in fluid therapy, nutrition management and pharmacotherapeutic agents, inclusive of pain monitoring and management, prokinetics, and management of systemic inflammatory response syndrome and the hypercoagulable state.
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Affiliation(s)
- Charlie Barton
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine & Biological Sciences, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - Diana M Hassel
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine & Biological Sciences, 300 West Drake Road, Fort Collins, CO 80523, USA.
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Bauck AG. Basic Postoperative Care of the Equine Colic Patient. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00022-6. [PMID: 37120332 DOI: 10.1016/j.cveq.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
The 3 time periods around colic surgery (preoperative, operative, and postoperative) are all critical to successful outcomes. Although much focus is often paid to the first 2 time periods, the importance of sound clinical judgment and rational decision-making in the postoperative period cannot be overstated. This article will outline the basic principles of monitoring, fluid therapy, antimicrobial therapy, analgesia, nutrition, and other therapeutics routinely used in patients following colic surgery. Discussions of the economics of colic surgery and expectations for normal return to function will also be included.
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Affiliation(s)
- Anje G Bauck
- Large Animal Surgery, Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA.
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Jacobsen S. Use of serum amyloid A in equine medicine and surgery. Vet Clin Pathol 2023; 52 Suppl 1:8-18. [PMID: 36336845 DOI: 10.1111/vcp.13195] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/10/2022] [Accepted: 09/06/2022] [Indexed: 11/09/2022]
Abstract
Serum amyloid A (SAA) has become an indispensable part of the management of equine patients in general practice and specialized hospital settings. Although several proteins possess acute phase properties in horses, the usefulness of SAA exceeds that of other acute phase proteins. This is due to the highly desirable kinetics of the equine SAA response. SAA concentrations exhibit a rapid and pronounced increase in response to inflammation and a rapid decline after the resolution of inflammation. This facilitates the detection of inflammatory disease and real-time monitoring of inflammatory activity. SAA may be used in all stages of patient management: (1) before diagnosis (to rule in/rule out inflammatory disease), (2) at the time of diagnosis (to assess the severity of inflammation and assist in prognostication), and (3) after diagnosis (to monitor changes in inflammatory activity in response to therapy, with relapse of disease, or with infectious/inflammatory complications). By assessing other acute phase reactants in addition to SAA, clinicians can succinctly stage inflammation. White blood cell counts and serum iron concentration change within hours of an inflammatory insult, SAA within a day, and fibrinogen within 2-3 days; the interrelationship of these markers thus indicates the duration and activity of the inflammatory condition. Much research on the equine SAA response and clinical use has been conducted in the last decade. This is the prerequisite for the evidence-based use of this analyte. However, still today, most published studies involve a fairly low number of horses. To obtain solid evidence for use of SAA, future studies should be designed with larger sample sizes.
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Affiliation(s)
- Stine Jacobsen
- Department of Veterinary Clinical Sciences, Section Medicine & Surgery, University of Copenhagen, Copenhagen, Denmark
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