| dc.description.abstract | Pain assessment methods for adult horses have been constructed in the past decade. Foals were never included in these studies, even though they are treated for painful conditions in veterinary clinics. This study describes the construction of a facial expression-based pain scale for foals with acute pain in the age of 14 days to 6 months. The aim of the study was to develop a clinically applicable, reliable and repeatable pain scale. The ‘Equine Utrecht University Scale for Facial Assessment of Pain’ (EQUUS-FAP) for foals and the ‘Horse Pain Face’ (HPF) for foals were used to assess the facial pain expression in 32 foals in the age of 14 days to 6 months (10 patients with acute pain, 22 healthy, pain free control foals). 30 seconds long video clips were collected of foals together with the mare in the box. The video clips were randomized and blinded before the observation. Three observers scored the video clips and two of the observers scored all video clips twice. The EQUUS-FAP for foals had a good inter-observer reliability (Cronbach’s Alpha (C.A.) 0,90, p<0,001), the HPF for foals had a moderate inter-observer reliability (C.A. 0,71, p<0,001). The intra-observer reliability was good to excellent for both pain scales (EQUUS-FAP for foals C.A. 0,96, p<0,001 and HPF for foals C.A. 0,86, p<0,001). The EQUUS-FAP for foals was able to differentiate between the patient and control group (p<0,01), the HPF for foals was not able to differentiate between the two groups (p=0,063). Both pain scales were not able to differentiate between a limited number of foals from the patient group before and after administration of NSAIDs (EQUUS-FAP for foals p=0,416 and HPF for foals p=0,480). The cut-off value for differentiation between healthy and sick foals were determined at >2 for the EQUUS-FAP for foals and >1 for the HPF for foals. The sensitivity and specificity of the EQUUS-FAP for foals were good (90% and 86,36% respectively). The sensitivity of the HPF for foals was acceptable (70%), however the specificity of the HPF for foals was moderate (63,63%). The EQUUS-FAP for foals seems to be a promising tool for assessment of acute pain in foals aged from 14 days to 6 months. It is a repeatable and reliable facial expression-based pain scale and therefore this pain scale can be used for foals in acute pain. However, more research is necessary to further validate this pain scale | |
