title: Using the Horse Grimace Scale (HGS) to Assess Pain Associated with Acute Laminitis in Horses (Equus caballus).
abstract: Acute laminitis is a common equine disease characterized by intense foot pain, both acutely and chronically. The Obel grading system is the most widely accepted method for describing the severity of laminitis by equine practitioners, however this method requires movement (walk and trot) of the horse, causing further intense pain. The recently developed Horse Grimace Scale (HGS), a facial-expression-based pain coding system, may offer a more effective means of assessing the pain associated with acute laminitis. The aims of this study were: to investigate whether HGS can be usefully applied to assess pain associated with acute laminitis in horses at rest, and to examine if scoring HGS using videos produced similar results as those obtained from still images. Ten horses, referred as acute laminitis cases with no prior treatment, were included in the study. Each horse was assessed using the Obel and HGS (from images and videos) scales: at the admission (before any treatment) and at seven days after the initial evaluation and treatment. The results of this study suggest that HGS is a potentially effective method to assess pain associated with acute laminitis in horses at rest, as horses showing high HGS scores also exhibited higher Obel scores and veterinarians classified them in a more severe painful state. Furthermore, the inter-observer reliability of the HGS total score was good for both still images and video evaluation. There was no significant difference in HGS total scores between the still images and videos, suggesting that there is a possibility of applying the HGS in clinical practice, by observing the horse for a short time. However, further validation studies are needed prior to applying the HGS in a clinical setting.
authors.affiliation: Department of Veterinary Medicine, University of Milan, Milan 20122, Italy. emanuela.dallacosta@unimi.it.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Dalla Costa
authors.affiliation: Havelland Equine Clinic, Beetzsee 14778, Germany. diana.stucke@pferdeklinik-havelland.de.
authors.forename: Diana
authors.initials: D
authors.lastname: Stucke
authors.affiliation: Department of Veterinary Medicine, University of Milan, Milan 20122, Italy. francesca.dai@unimi.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Dai
authors.affiliation: Department of Veterinary Medicine, University of Milan, Milan 20122, Italy. michela.minero@unimi.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Minero
authors.affiliation: School of Agriculture, Food & Rural Development, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK. Matthew.Leach@newcastle.ac.uk.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Leach
authors.affiliation: Havelland Equine Clinic, Beetzsee 14778, Germany. lebelt@pferdeklinik-havelland.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Lebelt
keywords: Horse Grimace Scale; Obel; acute laminitis; horse; pain assessment