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The Equine Pain Face

November 2014 by Cristina Wilkins, Editor, Horses and People Magazine

Horses may not be able to say how much it hurts in words, but recent research is demonstrating their face tells all. Learn to recognise the signs of the equine 'pain face' with Karina Bech Gleerup in this illustrated article.

Recognising pain and pain intensity in horses has been a challenge for veterinarians and anaesthetists, making it difficult to assess if horses are receiving appropriate pain relief. New research, however, shows that, as happens in humans and other animals, certain facial expressions can indicate a horse is in pain, and that learning to recognise the signs is relatively easy and feasible for veterinarians, nurses and horse owners alike.

The findings follow the publication this year of two important studies. A team of researchers from Italy, Germany and the United Kingdom were first to publish a standardised pain scale based on facial expressions in horses. Similar to the Body Condition Scoring system, the HGS recommends scoring of different facial expressions to add up to a final pain intensity score.

Now, a team of researchers from Denmark and Sweden have followed up with another study that not only agrees that facial expressions of pain can be appreciated in horses, but suggest that a pain face scale may not need to score all pain features separately.

The study shows that it is possible to score a ‘pain face’ as a simple yes/no, and that the intensity of the expression may be sufficient and more applicable.

Karina Bech Gleerup, a veterinarian and lecturer from the University of Copenhagen, presented a poster of the findings at the 10th International Equitation Science Conference, Denmark.

The group of researchers have identified five key areas to watch out for (ears, eyes, nostrils, muzzle and facial muscles) and showed that learning to recognise facial expressions of pain is feasible. After a 20 minute lesson, participants were able to successfully score a pain face (yes/no) and the pain intensity as ‘low’, ‘medium’ and ‘high’ with, on average, 82% accuracy.

Gleerup says: “We think it is really important that more people learn to recognise pain in their horses.” Although horses usually become less social when in pain, Gleerup has noticed her own horses displaying contact seeking behaviour while in pain. “This may be important for owners,” says Gleerup. “Because contact seeking behaviour towards the people the horse trusts may be the first sign of pain. All my own research horses displayed this behaviour in a more or less obvious manner and I have seen it in patients too.” Gleerup added that learning to recognise the equine pain face in their horses may help owners identify chronic or low grade pain at an earlier stage.

The study titled: An Equine Pain Face by Karina B Gleerup, Björn Forkman, Casper Lindegaard and Pia Andersen is open access and available here.

Download a FREE poster of The Equine Pain Face!

And watch this fantastic interview by VetTALK.TV