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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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Anderson K, Morrice-West AV, Walmsley EA, Fisher AD, Whitton RC, Hitchens PL. Validation of inertial measurement units to detect and predict horse behaviour while stabled. Equine Vet J 2023; 55:1128-1138. [PMID: 36537838 DOI: 10.1111/evj.13909] [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: 01/25/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Musculoskeletal injuries are observed in Thoroughbred racehorses and may become catastrophic. Currently, there are limited methods for early detection of such injuries. Most injuries develop gradually due to accumulated damage, providing the opportunity for early detection. Horses experiencing pain or lameness may exhibit changes in behaviour so the development of an objective, real-time system monitoring horse behaviour may enable detection of bone injuries before catastrophic failure. OBJECTIVES To determine whether intensive observational methods of assessing horse behaviour can be replaced by use of inertial measurement units (IMUs). STUDY DESIGN Validation study assessing IMU use against video observation. METHODS Six hospitalised Thoroughbreds (algorithm training data) and 19 Thoroughbred racehorses in-training (algorithm testing data) were equipped with an IMU placed on the lateral side of both forelimbs (left fore, LF; right fore, RF) and monitored in a stable for 4 h. An algorithm was developed to classify behaviour and then validated against video recordings. RESULTS Standing was the most prevalent behaviour (LF 88.8%, 95% confidence interval [CI] 88.7-89.0; RF 88.5%, 95% CI 88.4-88.7). IMU classification of recumbent and standing activities showed excellent agreement (sensitivity) with video observation (>98%). This was followed by stepping (LF 89.4%, RF 85.5%) then weight-shifting (LF 54.3%, RF 61.5%). Predictions from the algorithm showed misclassification of 2.5% (LF 5500/225 352, RF 5218/210 170). Excluding standing, misclassification was 6.8% (1705/25 158) and 7.5% (1812/24 077) for the left and right forelimbs, respectively, with pawing and weight-shifting most frequently misclassified. MAIN LIMITATIONS Increasing the number of horses and types of behaviours observed may improve predictions. CONCLUSIONS IMUs displayed a high sensitivity to movement on a small number of horses, and with further validation they have the potential to effectively monitor behaviour of racehorses in training. However, more sensitive methods may be needed to validate the classification of weight-shifting behaviour. Future studies should evaluate the association between each behaviour and musculoskeletal injury.
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Affiliation(s)
- Katrina Anderson
- Equine Lameness and Imaging Centre, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | - Ashleigh V Morrice-West
- Equine Lameness and Imaging Centre, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | - Elizabeth A Walmsley
- Equine Lameness and Imaging Centre, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | - Andrew D Fisher
- Animal Welfare Science Centre, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - R Chris Whitton
- Equine Lameness and Imaging Centre, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | - Peta L Hitchens
- Equine Lameness and Imaging Centre, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
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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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Mercer MA, Davis JL, McKenzie HC. The Clinical Pharmacology and Therapeutic Evaluation of Non-Steroidal Anti-Inflammatory Drugs in Adult Horses. Animals (Basel) 2023; 13:ani13101597. [PMID: 37238029 DOI: 10.3390/ani13101597] [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: 12/21/2022] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
This review firstly examines the underlying pathophysiology of pain and inflammation associated with orthopedic disease and endotoxemia. Then, it reviews the clinical pharmacology (pharmacokinetics and pharmacodynamics) of both conventional and non-conventional NSAIDs in the adult horse, and finally provides an overview of different modalities to evaluate the therapeutic efficacy of NSAIDs in research.
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Affiliation(s)
- Melissa A Mercer
- Department of Biological Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - Jennifer L Davis
- Department of Biological Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - Harold C McKenzie
- Department of Large Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
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Going Deeper than Tracking: A Survey of Computer-Vision Based Recognition of Animal Pain and Emotions. Int J Comput Vis 2022. [DOI: 10.1007/s11263-022-01716-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AbstractAdvances in animal motion tracking and pose recognition have been a game changer in the study of animal behavior. Recently, an increasing number of works go ‘deeper’ than tracking, and address automated recognition of animals’ internal states such as emotions and pain with the aim of improving animal welfare, making this a timely moment for a systematization of the field. This paper provides a comprehensive survey of computer vision-based research on recognition of pain and emotional states in animals, addressing both facial and bodily behavior analysis. We summarize the efforts that have been presented so far within this topic—classifying them across different dimensions, highlight challenges and research gaps, and provide best practice recommendations for advancing the field, and some future directions for research.
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Carvalho JRG, Trindade PHE, Conde G, Antonioli ML, Funnicelli MIG, Dias PP, Canola PA, Chinelatto MA, Ferraz GC. Facial Expressions of Horses Using Weighted Multivariate Statistics for Assessment of Subtle Local Pain Induced by Polylactide-Based Polymers Implanted Subcutaneously. Animals (Basel) 2022; 12:ani12182400. [PMID: 36139260 PMCID: PMC9495041 DOI: 10.3390/ani12182400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Facial expression (FE) has been used for pain diagnosis in horses. The current study aimed to identify pain in horses undergoing under-skin polylactide-based polymer implantation. Five statistical methods for analyzing FE were used, including conventional and new approaches. First, we scored the seven FEs separately. Subsequently, the scores of the seven FEs were added (SUM). Subsequently, principal component analysis (PCoA) was performed using the scores of the seven FEs obtained using the first method. Afterwards, weights were created for each FE based on each variable’s contribution variability obtained from the PCoA (SUM.W). Finally, we applied a general score to the animal’s face (GFS). The horses were filmed before and 24 and 48 h after implantation. The tissue sensitivity to mechanical stimulation and skin temperature of the horses were assessed at the same time points. The results show no changes in the FEs analyzed separately or jointly. The horses with incision and suture but no polymer implant displayed a higher pain-related FE 48 h after implantation, while the horses implanted with polymers displayed more apparent alterations in the mechanical skin sensitivity and temperature. Our findings show that the five statistical methods used to analyze the faces of the horses were not able to detect low-grade inflammatory pain. Abstract Facial-expression-based analysis has been widely applied as a pain coding system in horses. Herein, we aimed to identify pain in horses undergoing subcutaneously polylactide-based polymer implantation. The sham group was submitted only to surgical incision. The horses were filmed before and 24 and 48 h after implantation. Five statistical methods for evaluating their facial expressions (FEs) were tested. Primarily, three levels of scores (0, 1, and 2) were applied to the seven FEs (ear movements, eyebrow tension, orbicularis tension, dilated nostrils, eye opening, muzzle tension, and masticatory muscles tension). Subsequently, the scores of the seven FEs were added (SUM). Afterwards, principal component analysis (PCoA) was performed using the scores of the seven FEs obtained using the first method. Subsequently, weights were created for each FE, based on each variable’s contribution variability obtained from the PCoA (SUM.W). Lastly, we applied a general score (GFS) to the animal’s face (0 = without pain; 1 = moderate pain; 2 = severe pain). The mechanical nociceptive threshold (MNT) and cutaneous temperature (CT) values were collected at the same moments. The results show no intra- or intergroup differences, when evaluating each FE separately or in the GFS. In the intragroup comparison and 48 h after implantation, the control group showed higher values for SUM, PCoA, and SUM.W, although the horses implanted with polymers displayed more obvious alterations in the CT and MNT. Our findings show that the five statistical strategies used to analyze the faces of the horses were not able to detect low-grade inflammatory pain.
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Affiliation(s)
- Júlia R. G. Carvalho
- Department of Animal Morphology and Physiology, School of Agricultural and Veterinarian Sciences, São Paulo State University, FCAV/UNESP, Jaboticabal 14884-900, SP, Brazil
| | - Pedro H. E. Trindade
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University, FMVZ/UNESP, Botucatu 18618-681, SP, Brazil
| | - Gabriel Conde
- Department of Animal Morphology and Physiology, School of Agricultural and Veterinarian Sciences, São Paulo State University, FCAV/UNESP, Jaboticabal 14884-900, SP, Brazil
| | - Marina L. Antonioli
- Department of Veterinary Clinical and Surgery, School of Agricultural and Veterinary Sciences, São Paulo State University, FCAV/UNESP, Jaboticabal 14884-900, SP, Brazil
| | - Michelli I. G. Funnicelli
- Department of Technology, School of Agricultural and Veterinary Sciences, São Paulo State University, FCAV/UNESP, Jaboticabal 14884-900, SP, Brazil
| | - Paula P. Dias
- Department of Materials Engineering, São Carlos School of Engineering, University of São Paulo, EESC/USP, São Carlos 13563-120, SP, Brazil
| | - Paulo A. Canola
- Department of Veterinary Clinical and Surgery, School of Agricultural and Veterinary Sciences, São Paulo State University, FCAV/UNESP, Jaboticabal 14884-900, SP, Brazil
| | - Marcelo A. Chinelatto
- Department of Materials Engineering, São Carlos School of Engineering, University of São Paulo, EESC/USP, São Carlos 13563-120, SP, Brazil
| | - Guilherme C. Ferraz
- Department of Animal Morphology and Physiology, School of Agricultural and Veterinarian Sciences, São Paulo State University, FCAV/UNESP, Jaboticabal 14884-900, SP, Brazil
- Correspondence:
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Ask K, Andersen PH, Tamminen LM, 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; 9:938022. [PMID: 36032285 PMCID: PMC9411665 DOI: 10.3389/fvets.2022.938022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study investigated the relationship between orthopedic pain experienced at rest, and degree of movement asymmetry during trot in horses with induced reversible acute arthritis. Orthopedic pain was assessed with the Horse Grimace Scale (HGS), the Equine Utrecht University Scale of Facial Assessment of Pain (EQUUS-FAP), the Equine Pain Scale (EPS), and the Composite Orthopedic Pain Scale (CPS). Reliability and diagnostic accuracy were evaluated with intraclass correlation coefficients (ICC) and area under the curve (AUC). Study design and animals Eight healthy horses were included in this experimental study, with each horse acting as its own control. Methods Orthopedic pain was induced by intra-articular lipopolysaccharide (LPS) administration. Serial pain assessments were performed before induction and during pain progression and regression, where three observers independently and simultaneously assessed pain at rest with the four scales. Movement asymmetry was measured once before induction and a minimum of four times after induction, using objective gait analysis. Results On average 6.6 (standard deviation 1.2) objective gait analyses and 12.1 (2.4) pain assessments were performed per horse. The ICC for each scale was 0.75 (CPS), 0.65 (EPS), 0.52 (HGS), and 0.43 (EQUUS-FAP). Total pain scores of all scales were significantly associated with an increase in movement asymmetry (R2 values ranging from −0.0649 to 0.493); with CPS pain scores being most closely associated with movement asymmetry. AUC varied between scales and observers, and CPS was the only scale where all observers had a good diagnostic accuracy (AUC > 0.72). Conclusions and clinical relevance This study identified significant associations between pain experienced at rest and degree of movement asymmetry for all scales. Pain scores obtained using CPS were most closely associated with movement asymmetry. CPS was also the most accurate and reliable pain scale. All scales had varying linear and non-linear relations between total pain scores and movement asymmetry, illustrating challenges with orthopedic pain assessment during rest in subtly lame horses since movement asymmetry needs to be rather high before total pain score increase.
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Affiliation(s)
- Katrina Ask
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
- *Correspondence: Katrina Ask
| | - Pia Haubro Andersen
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Lena-Mari Tamminen
- Department of Clinical Sciences, 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
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Evaluation of the practical clinical use of the Horse Grimace Scale translated into French. Vet Anaesth Analg 2022; 49:615-623. [DOI: 10.1016/j.vaa.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/11/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022]
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Sharing pain: Using pain domain transfer for video recognition of low grade orthopedic pain in horses. PLoS One 2022; 17:e0263854. [PMID: 35245288 PMCID: PMC8896717 DOI: 10.1371/journal.pone.0263854] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/26/2022] [Indexed: 12/16/2022] Open
Abstract
Orthopedic disorders are common among horses, often leading to euthanasia, which often could have been avoided with earlier detection. These conditions often create varying degrees of subtle long-term pain. It is challenging to train a visual pain recognition method with video data depicting such pain, since the resulting pain behavior also is subtle, sparsely appearing, and varying, making it challenging for even an expert human labeller to provide accurate ground-truth for the data. We show that a model trained solely on a dataset of horses with acute experimental pain (where labeling is less ambiguous) can aid recognition of the more subtle displays of orthopedic pain. Moreover, we present a human expert baseline for the problem, as well as an extensive empirical study of various domain transfer methods and of what is detected by the pain recognition method trained on clean experimental pain in the orthopedic dataset. Finally, this is accompanied with a discussion around the challenges posed by real-world animal behavior datasets and how best practices can be established for similar fine-grained action recognition tasks. Our code is available at https://github.com/sofiabroome/painface-recognition.
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A Systematic Review of Musculoskeletal Mobilization and Manipulation Techniques Used in Veterinary Medicine. Animals (Basel) 2021; 11:ani11102787. [PMID: 34679808 PMCID: PMC8532674 DOI: 10.3390/ani11102787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Neck and back pain are common ailments in animals. While there are medical and surgical treatment options available for select patients, conservative care is the most common form of management of pain, stiffness and muscle spasms. Physical therapists, osteopaths and chiropractors use mobilization and manipulation techniques to evaluate and treat muscle and joint problems in both humans and animals, but there seems to be little scientific evidence available to support their use in veterinary medicine. This study reviews the scientific literature with the goal of identifying the clinical indications, dosages, outcome parameters, and efficacy of mobilization and manipulation techniques in dogs and horses. Fourteen articles were included in this review of which 13 were equine and one was a canine study. There was a large variability in the quality of evidence that supports the use of joint mobilization or manipulation in treating pain, stiffness and muscle hypertonicity in horses. Therefore, it was difficult to draw firm conclusions despite all studies reporting positive effects. Future studies need to establish standardized methods to evaluate the optimal dosages of mobilization and manipulation for use in animals. Abstract Mobilization and manipulation techniques are often used in small animal and equine practice; however, questions remain concerning indications, dosing and efficacy. A bibliographic search was performed to identify peer-reviewed publications from 1980 to 2020 that evaluated the clinical effects of musculoskeletal mobilization and manipulation techniques in dogs, cats and horses. The search strategy identified 883 papers for review. Inclusion and exclusion criteria were applied. The clinical indications, dosages, outcome parameters, and reported efficacy within each publication were recorded and categorized for comparison with scientific quality assessed according to a standardized grading system. Fourteen articles were included in this systematic review of which 13 were equine and one was a canine study. Seven of these were cohort studies and seven were randomized controlled clinical trials. The canine study involved carpal immobilization-remobilization and all equine studies focused on the effects of passive mobilization (n = 5) or manipulation (n = 8) of the axial skeleton. Study quality was low (n = 4), moderate (n = 7), and high (n = 3) and included a wide array of outcome parameters with varying levels of efficacy and duration of therapeutic effects, which prevented further meta-analysis. Therefore, it was difficult to draw firm conclusions despite all studies reporting positive effects. Optimal technique indications and dosages need to be determined to improve the standardization of these treatment options.
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Andersen PH, Broomé S, Rashid M, Lundblad J, Ask K, Li Z, Hernlund E, Rhodin M, Kjellström H. Towards Machine Recognition of Facial Expressions of Pain in Horses. Animals (Basel) 2021; 11:1643. [PMID: 34206077 PMCID: PMC8229776 DOI: 10.3390/ani11061643] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 01/30/2023] Open
Abstract
Automated recognition of human facial expressions of pain and emotions is to a certain degree a solved problem, using approaches based on computer vision and machine learning. However, the application of such methods to horses has proven difficult. Major barriers are the lack of sufficiently large, annotated databases for horses and difficulties in obtaining correct classifications of pain because horses are non-verbal. This review describes our work to overcome these barriers, using two different approaches. One involves the use of a manual, but relatively objective, classification system for facial activity (Facial Action Coding System), where data are analyzed for pain expressions after coding using machine learning principles. We have devised tools that can aid manual labeling by identifying the faces and facial keypoints of horses. This approach provides promising results in the automated recognition of facial action units from images. The second approach, recurrent neural network end-to-end learning, requires less extraction of features and representations from the video but instead depends on large volumes of video data with ground truth. Our preliminary results suggest clearly that dynamics are important for pain recognition and show that combinations of recurrent neural networks can classify experimental pain in a small number of horses better than human raters.
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Affiliation(s)
- Pia Haubro Andersen
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, SE 75007 Uppsala, Sweden; (J.L.); (K.A.); (E.H.); (M.R.)
| | - Sofia Broomé
- Division of Robotics, Perception and Learning, KTH Royal Institute of Technology, SE 100044 Stockholm, Sweden; (S.B.); (Z.L.)
| | - Maheen Rashid
- Department of Computer Science, University of California at Davis, California, CA 95616, USA;
| | - Johan Lundblad
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, SE 75007 Uppsala, Sweden; (J.L.); (K.A.); (E.H.); (M.R.)
| | - Katrina Ask
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, SE 75007 Uppsala, Sweden; (J.L.); (K.A.); (E.H.); (M.R.)
| | - Zhenghong Li
- Division of Robotics, Perception and Learning, KTH Royal Institute of Technology, SE 100044 Stockholm, Sweden; (S.B.); (Z.L.)
- Department of Computer Science, Stony Brook University, New York, NY 11794, USA
| | - Elin Hernlund
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, SE 75007 Uppsala, Sweden; (J.L.); (K.A.); (E.H.); (M.R.)
| | - Marie Rhodin
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, SE 75007 Uppsala, Sweden; (J.L.); (K.A.); (E.H.); (M.R.)
| | - Hedvig Kjellström
- Division of Robotics, Perception and Learning, KTH Royal Institute of Technology, SE 100044 Stockholm, Sweden; (S.B.); (Z.L.)
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Equine Discomfort Ethogram. Animals (Basel) 2021; 11:ani11020580. [PMID: 33672338 PMCID: PMC7931104 DOI: 10.3390/ani11020580] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/15/2021] [Accepted: 01/25/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Pain and discomfort behavior in horses tends to be especially subtle, and not readily or widely appreciated even by equine professionals, including many long-time horse keepers, trainers, and even by veterinarians, veterinary technicians, and care staff. Based on decades of evaluating the behavior of normal and physically uncomfortable horses in a referral hospital, as well as research context, we describe and illustrate a catalog of behaviors (ethogram) associated with equine physical discomfort. Our objective is to promote an unambiguous universal understanding of equine discomfort behaviors associated with various body systems and anatomic sources. Abstract In recent years, there has been a growing interest in and need for a comprehensive ethogram of discomfort behavior of horses, particularly for use in recognizing physical discomfort in domestically managed horses. A clear understanding of the physical discomfort behavior of horses among caretakers, trainers, and professional health care personnel is important to animal welfare and caretaker safety. This is particularly relevant to pain management for hospitalized equine patients. Various pain scale rubrics have been published, typically incorporating only a few classically cited pain behaviors that, in many cases, are specific to a particular body system, anatomic location, or disease condition. A consistent challenge in using these rubrics in practice, and especially in research, is difficulty interpreting behaviors listed in various rubrics. The objective of this equine discomfort ethogram is to describe a relatively comprehensive catalog of behaviors associated with discomfort of various degrees and sources, with the goal of improving understanding and clarity of communication regarding equine discomfort and pain. An inventory of discomfort-related behaviors observed in horses has been compiled over 35 years of equine behavior research and clinical consulting to medical and surgical services at the University of Pennsylvania School of Veterinary Medicine’s equine hospital. This research and clinical work included systematic evaluation of thousands of hours of video-recordings, including many hundreds of normal, healthy horses, as well as hospitalized patients with various complaints and/or known medical, neurologic, or orthopedic conditions. Each of 73 ethogram entries is named, defined, and accompanied by a line drawing illustration. Links to online video recorded examples are provided, illustrating each behavior in one or more hospitalized equine patients. This ethogram, unambiguously describing equine discomfort behaviors, should advance welfare of horses by improving recognition of physical discomfort, whether for pain management of hospitalized horses or in routine husbandry.
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Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment. Animals (Basel) 2021; 11:ani11020422. [PMID: 33562089 PMCID: PMC7915466 DOI: 10.3390/ani11020422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 01/14/2023] Open
Abstract
Simple Summary Neck pain and dysfunction in the horse is becoming an increasingly important topic among riders, trainers and veterinarians. Some horses may present for a subtle performance decline, while others may show dramatic, dangerous behavior. It is important to recognize how to carefully evaluate the horse in an effort to understand the different types of pain that may be contributing to the different behaviors. The musculoskeletal and nervous systems may both play a role in the development of clinical signs. Recognizing that there are many diagnostic options as well as several treatments choices is important. This synopsis covers the disease processes that may contribute to the development of neck pain and dysfunction in the horse, as well as several possible diagnostic and treatment options. Abstract Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous structures, soft tissues and the central and the peripheral nervous system may all play a role in these various clinical presentations. After completing the clinical evaluation, several imaging modalities may be implemented to help determine the underlying pathologic processes. There are multiple treatment options available and each must be carefully chosen for an individual horse. Provided is a synopsis of the current knowledge as to different disease processes that can result in cervical pain and dysfunction, diagnostic approaches and treatment strategies. Improving the knowledge in these areas will ideally help to return horses to a state of well-being that can be maintained over time and through the rigors of their job or athletic endeavors.
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