Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma.
Authors: van Loon J P A M, Van Dierendonck M C
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Accurate pain assessment is fundamental to optimising post-operative and post-traumatic care in equine orthopaedics, yet inconsistent evaluation between practitioners can compromise treatment decisions. Van Loon and Van Dierendonck evaluated two validated pain scales—the Composite Pain Scale (CPS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP)—in 77 adult horses across orthopaedic trauma cases (n=43) and controls, with assessments conducted at arrival and on days one and two. Both instruments demonstrated excellent inter-observer reliability (Cronbach's alpha 0.97 for CPS and 0.93 for EQUUS-FAP) with narrow limits of agreement (±1.9 points), and significantly differentiated between control and affected horses; notably, traumatic cases presented with higher pain scores than post-operative horses, and both scales showed meaningful reduction following NSAID administration. These findings provide equine professionals with evidence-based tools for consistent, objective pain quantification in the orthopaedic setting, enabling more targeted analgesia protocols and facilitating meaningful comparisons of pain responses across time and between cases in clinical practice. Systematic adoption of either scale could substantially improve the welfare assessment and management of horses recovering from orthopaedic injury or surgery.
Read the full abstract on PubMed
Practical Takeaways
- •Use either CPS or EQUUS-FAP as reliable, objective tools to quantify pain in orthopaedic cases—these scales are consistent between different observers and sensitive enough to detect NSAID response
- •Trauma cases show higher pain levels than post-surgical cases, so adjust analgesia protocols accordingly and monitor closely in the first 48 hours
- •Implement these validated pain scales in your practice to guide treatment decisions, track response to therapy, and improve overall welfare outcomes
Key Findings
- •Both CPS and EQUUS-FAP scales demonstrated high inter-observer reliability (Cronbach's alpha 0.97 and 0.93 respectively, P<0.001) with low bias and narrow limits of agreement (-1.9 to 1.9)
- •Both pain scales showed significant differences between control horses and orthopaedic cases (P<0.001), with trauma cases having significantly higher pain scores than postoperative cases
- •Pain scores from both CPS and EQUUS-FAP significantly decreased following NSAID administration, validating their use as objective pain assessment tools