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Auer U, Kelemen Z, Vogl C, von Ritgen S, Haddad R, Torres Borda L, Gabmaier C, Breteler J, Jenner F. Development, refinement, and validation of an equine musculoskeletal pain scale. FRONTIERS IN PAIN RESEARCH 2024; 4:1292299. [PMID: 38312997 PMCID: PMC10837853 DOI: 10.3389/fpain.2023.1292299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/08/2023] [Indexed: 02/06/2024] Open
Abstract
Musculoskeletal disease is a common cause of chronic pain that is often overlooked and inadequately treated, impacting the quality of life of humans and horses alike. Lameness due to musculoskeletal pain is prevalent in horses, but the perception of pain by owners is low compared with veterinary diagnosis. Therefore, this study aims to establish and validate a pain scale for chronic equine orthopaedic pain that is user-friendly for horse owners and veterinarians to facilitate the identification and monitoring of pain in horses. The newly developed musculoskeletal pain scale (MPS) was applied to 154 horses (mean age 20 ± 6.4 years SD) housed at an equine sanctuary, of which 128 (83%) suffered from chronic orthopaedic disease. To complete the MPS, the horses were observed and videotaped from a distance while at rest in their box or enclosure. In addition, they received a complete clinical and orthopaedic exam. The need for veterinary intervention to address pain (assessed and executed by the sanctuary independent from this study) was used as a longitudinal health outcome to determine the MPS's predictive validity. To determine the interrater agreement, the MPS was scored for a randomly selected subset of 30 horses by six additional blinded raters, three equine veterinary practitioners, and three experienced equestrians. An iterative process was used to refine the tool based on improvements in the MPS's correlation with lameness evaluated at the walk and trot, predictive validity for longitudinal health outcomes, and interrater agreement. The intraclass correlation improved from 0.77 of the original MPS to 0.88 of the refined version (95% confidence interval: 0.8-0.94). The refined MPS correlated significantly with lameness at the walk (r = 0.44, p = 0.001) and trot (r = 0.5, p < 0.0001). The refined MPS significantly differed between horses that needed veterinary intervention (mean MPS = 8.6) and those that did not (mean MPS = 5.0, p = 0.0007). In summary, the MPS showed good interrater repeatability between expert and lay scorers, significant correlation with lameness at the walk and trot, and good predictive validity for longitudinal health outcomes, confirming its ability to identify horses with orthopaedic health problems.
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Affiliation(s)
- Ulrike Auer
- Anaesthesiology and Perioperative Intensive Care Medicine Unit, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Zsofia Kelemen
- Equine Surgery Unit, Department of Companion Animals and Horses, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Claus Vogl
- Department of Biomedical Sciences, Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Stephanie von Ritgen
- Anaesthesiology and Perioperative Intensive Care Medicine Unit, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Rabea Haddad
- Equine Surgery Unit, Department of Companion Animals and Horses, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Laura Torres Borda
- Equine Surgery Unit, Department of Companion Animals and Horses, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Christopher Gabmaier
- Anaesthesiology and Perioperative Intensive Care Medicine Unit, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - John Breteler
- Equine Surgery Unit, Department of Companion Animals and Horses, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Florien Jenner
- Equine Surgery Unit, Department of Companion Animals and Horses, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna, Austria
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Ask K, Rhodin M, Rashid-Engström M, Hernlund E, Andersen PH. Changes in the equine facial repertoire during different orthopedic pain intensities. Sci Rep 2024; 14:129. [PMID: 38167926 PMCID: PMC10762010 DOI: 10.1038/s41598-023-50383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
A number of facial expressions are associated with pain in horses, however, the entire display of facial activities during orthopedic pain have yet to be described. The aim of the present study was to exhaustively map changes in facial activities in eight resting horses during a progression from sound to mild and moderate degree of orthopedic pain, induced by lipopolysaccharides (LPS) administered in the tarsocrural joint. Lameness progression and regression was measured by objective gait analysis during movement, and facial activities were described by EquiFACS in video sequences (n = 348, total length 892.5 min) of the horses obtained when resting in their box stalls. Predictive modeling identified 16 action units and action descriptors, related to ears, eyes, and lower face. Lower lip depressor (AU16), lips part (AU25), half blink (AU47), single ear forward (SEAD101) and single ear rotator (SEAD104) were selected as co-occurring significantly more in horses with pain than in horses without pain. The major change in co-occurring facial activities occurred in the transition from no pain to mild pain. In conclusion, resting horses with induced orthopedic pain showed a dynamic upper and lower facial repertoire and the relationship between level of pain intensity and facial activity appears complex.
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Affiliation(s)
- Katrina Ask
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Marie Rhodin
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Elin Hernlund
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Pia Haubro Andersen
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Soiluva J, Häyrinen L, Gangini G, Öistämö R, Gracia-Calvo LA, Raekallio MR. Comparison of Asymmetry During Trot In-Hand With Evaluations of Discomfort and Pain in Horses While Exercised. J Equine Vet Sci 2023; 126:104282. [PMID: 36914101 DOI: 10.1016/j.jevs.2023.104282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/23/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023]
Abstract
Traditional visual lameness assessment is subjective. Ethograms have been developed for evaluating pain and objective sensors to detect lameness. Heart rate (HR) and heart rate variability (HRV) have been used to evaluate stress and pain. The aim of our study was to compare subjective and behavioral lameness scores, a sensor system measuring movement asymmetry, HR, and HRV. We hypothesized that these measures would show related trends. In 30 horses, an inertial sensor system was used to measure movement asymmetries during trot in-hand. A horse was categorized as sound if each asymmetry was less than 10 mm. We recorded riding to observe lameness and evaluate behavior. Heart rate and RR intervals were measured. Root mean squares of successive RR intervals (RMSSD) were calculated. Five horses were categorized as sound and 25 horses as lame by the inertial sensor system. No significant differences were detected between sound and lame horses in the ethogram, subjective lameness score, HR, and RMSSD. Overall asymmetry, ethogram, and lameness score had no significant correlation with each other, whereas overall asymmetry and ethogram correlated significantly with HR and RMSSD during certain phases of the ridden exercise. The main limitation of our study was the small number of sound horses detected by the inertial sensor system. The association between gait asymmetry and HRV suggests that the more gait asymmetry a horse shows during trot in-hand, the more pain or discomfort it probably experiences when ridden with a higher intensity. The threshold for lameness used by the inertial sensor system may require further evaluation.
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Affiliation(s)
- Johanna Soiluva
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
| | | | | | - Ruut Öistämö
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Luis Alfonso Gracia-Calvo
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Marja Riitta Raekallio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Anderson KA, Morrice-West AV, Wong ASM, Walmsley EA, Fisher AD, Whitton RC, Hitchens PL. Poor Association between Facial Expression and Mild Lameness in Thoroughbred Trot-Up Examinations. Animals (Basel) 2023; 13:1727. [PMID: 37889660 PMCID: PMC10251806 DOI: 10.3390/ani13111727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 10/29/2023] Open
Abstract
Musculoskeletal injuries in racehorses are difficult to detect prior to catastrophic breakdown. Lameness is commonly attributed to orthopaedic pain in horses, therefore, subtle lameness may be a pre-clinical sign of injury and, if identified early, could allow for preventative intervention. Our objective was to determine if facial expressions could be used to detect mild lameness as an indicator of orthopaedic pain in 'fit to race' horses. The Horse Grimace Scale (HGS) and the facial expressions in ridden horses (FEReq), were used to score images (n = 380) of mildly lame (n = 21) and non-lame (n = 17) Thoroughbred horses by two independent observers. Using an Equinosis Lameness Locator®, the lameness status of each horse was determined according to published thresholds [forelimb lameness (>|14.5 mm|) and hindlimb lameness (>|7.5 mm|)]. Inter and intraobserver reliability were assessed using two-way random-effects models. Univariable associations between lameness and facial expression parameters were identified using logistic and linear regression. Interobserver reliability was moderate (κ 0.45; 95% CI 0.36, 0.55). Horses with moderate mouth strain (HGS) and tense and extended upper lip (FEReq) were less likely to be lame (p = 0.042 and p = 0.027, respectively). Exposed sclera was associated with lameness (p = 0.045). Higher orbital tightening (HGS) scores were associated with a lower degree of maximum head amplitude (HDmax) lameness (p = 0.044). Tension and moderate tension above the eye, for the HGS and FEReq scores, were associated with increasing amplitude of HDmax (p = 0.048 and p = 0.034, respectively). Inconsistent associations between lameness status and HGS and FEReq scores may limit the potential use of the facial expression for the prediction of mild orthopaedic pain during pre-race lameness examinations. More objective parameters associated with mild orthopaedic pain should be explored.
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Affiliation(s)
- Katrina A. Anderson
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, VIC 3030, Australia
| | - Ashleigh V. Morrice-West
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, VIC 3030, Australia
| | - Adelene S. M. Wong
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, VIC 3030, Australia
| | - Elizabeth A. Walmsley
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, VIC 3030, Australia
- Avenel Equine Hospital, 34 Ferguson Lane, Avenel, VIC 3664, Australia
| | - Andrew D. Fisher
- Animal Welfare Science Centre, Faculty of Science, University of Melbourne, Parkville, VIC 3052, Australia
| | - R. Chris Whitton
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, VIC 3030, Australia
| | - Peta L. Hitchens
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, VIC 3030, Australia
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Golzari K, Kong Y, Reed SA, Posada-Quintero HF. Sympathetic Arousal Detection in Horses Using Electrodermal Activity. Animals (Basel) 2023; 13:ani13020229. [PMID: 36670768 PMCID: PMC9855141 DOI: 10.3390/ani13020229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/10/2023] Open
Abstract
The continuous monitoring of stress, pain, and discomfort is key to providing a good quality of life for horses. The available tools based on observation are subjective and do not allow continuous monitoring. Given the link between emotions and sympathetic autonomic arousal, heart rate and heart rate variability are widely used for the non-invasive assessment of stress and pain in humans and horses. However, recent advances in pain and stress monitoring are increasingly using electrodermal activity (EDA), as it is a more sensitive and specific measure of sympathetic arousal than heart rate variability. In this study, for the first time, we have collected EDA signals from horses and tested the feasibility of the technique for the assessment of sympathetic arousal. Fifteen horses (six geldings, nine mares, aged 13.11 ± 5.4 years) underwent a long-lasting stimulus (Feeding test) and a short-lasting stimulus (umbrella Startle test) to elicit sympathetic arousal. The protocol was approved by the University of Connecticut. We found that EDA was sensitive to both stimuli. Our results show that EDA can capture sympathetic activation in horses and is a promising tool for non-invasive continuous monitoring of stress, pain, and discomfort in horses.
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Affiliation(s)
- Kia Golzari
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Youngsun Kong
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Sarah A. Reed
- Department of Animal Science, University of Connecticut, Storrs, CT 06269, USA
| | - Hugo F. Posada-Quintero
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Correspondence: ; Tel.: +1-(860)-486-1556
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