Monitoring equine head-related pain with the Equine Utrecht University scale for facial assessment of pain (EQUUS-FAP).
Authors: van Loon Johannes P A M, Van Dierendonck Machteld C
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: EQUUS-FAP for Equine Head Pain Assessment Facial expression provides a valuable but underutilised window into equine pain, particularly when injury or pathology affects the head region. Van Loon and Van Dierendonck's 2017 validation study examined the Equine Utrecht University scale for facial assessment of pain (EQUUS-FAP) across 23 horses presenting with acute or postoperative head-related pain—including dental disease, ocular trauma, and skull injuries—alongside 23 healthy controls, using a cohort design to establish the scale's clinical reliability. The EQUUS-FAP demonstrated robust discriminatory ability between painful and non-painful states, with significantly higher scores in affected horses (P<0.001), and scores declined meaningfully over the postoperative recovery period (P<0.001), whilst inter-observer reliability proved excellent at 0.92. With sensitivity and specificity both at 80%, coupled with positive and negative predictive values of 80% and 78% respectively, the scale offers practitioners a standardised, objective tool for identifying and monitoring head pain—particularly useful when assessing dental cases, post-operative recovery, or ocular conditions where behavioural signs may be subtle or ambiguous. For farriers and veterinarians managing equine dentistry or trauma, integrating EQUUS-FAP assessment into routine clinical evaluation could enhance pain recognition and guide treatment efficacy without reliance on more invasive monitoring methods.
Read the full abstract on PubMed
Practical Takeaways
- •EQUUS-FAP is a reliable tool for detecting and monitoring head-related pain in equine patients, particularly useful in dental, ocular, and trauma cases
- •The scale's high inter-observer reliability (ICC=0.92) makes it practical for consistent pain assessment across different handlers or veterinarians
- •Use EQUUS-FAP to track pain resolution post-surgery, providing objective evidence of treatment efficacy over time
Key Findings
- •EQUUS-FAP scores showed significant differences between control horses and horses with head-related pain (P<0.001)
- •Pain scores decreased significantly over time following surgery (P<0.001)
- •The scale demonstrated good inter-observer reliability (ICC=0.92) with 80% sensitivity and 78% specificity
- •Positive and negative predictive values were both 80% and 78% respectively, supporting clinical utility