Pain questionnaire adapted to identify osteoarthritis in horses

A team of researchers has developed a questionnaire to help horse owners identify and monitor signs of osteoarthritis (OA) pain to facilitate earlier and more effective treatment for horses. The tool also may help owners monitor treatment effectiveness and pain progression over time, and guide owners and veterinarians in making quality-of-life decisions.

The Equine Brief Pain Inventory (EBPI) was developed by Dr. Janny de Grauw, a senior lecturer from Utrecht University Faculty of Veterinary Medicine in the Netherlands, and Diane Howard, MSc, an equine science graduate from the University of Edinburgh in the United Kingdom.

Dr. de Grauw and Howard modeled the questionnaire after the Brief Pain Inventory used to evaluate pain severity in humans and its impact on functioning. The questions in the EBPI cover equine posture, facial expressions, movement, and changes in behavior, based on input from owners of horses diagnosed with osteoarthritis.

Teenage equestrian girl checking for injury of chestnut horse leg
Osteoarthritis (OA) is a major cause of chronic pain in horses but remains an underrecognized and condition. To best treat pain, caregivers and clinicians need a way of monitoring and quantifying the amount of discomfort felt.

The investigators received a Morris Animal Foundation Donor-Inspired Study grant for their work. A preliminary trial of the questionnaire involved 25 owners or caretakers of horses with osteoarthritis. More than 84% of the pilot group found the questionnaire easy to complete and useful and a similar percentage (88%) found the questionnaire beneficial. The EBPI took less than five minutes to finish.

Osteoarthritis (OA) is the leading cause of horse lameness. It is found around in more than half of horses older than 15 years, increasing to 80%-90% and in horses over 30. However, many owners overlook signs of the degenerative disease, not realizing that it can affect horses of any age.

Howard found that many horse owners blame themselves for their horse’s arthritis or believe it to be a natural occurrence beyond treatment. Using this tool can help horse owners recognize when their animals are in pain and contact a veterinarian for appropriate treatment. By giving owners an effective tool for detection, monitoring, and decision making, the EBPI could have a significant impact on animal welfare.

Existing pain assessment methods for horses often rely on behavioral observation. These tools include the Horse Chronic Pain Scale, published in the June 2021 issue of Animals, and a March 2014 study in the journal PLoS One that assessed pain in horses based on a standardized scale of facial expressions called the Horse Grimace Scale.

The EBPI is undergoing further reliability testing in a larger population of owners and caretakers of arthritic and healthy horses before it can be introduced in practice.

“As veterinarians, we want to treat horses with painful and debilitating conditions like OA as effectively as possible,” said Dr. de Grauw in a press release. “How well we can manage their condition critically relies on recognition of subtle signs of (worsening) pain by owners and caregivers, who can then seek help.”