New Tool Recognizes Pain in Horses with Osteoarthritis

Acknowledging the importance of treating chronic pain caused by osteoarthritis in horses, a team of veterinary scientists recently developed a novel tool called the “Equine Brief Pain Inventory” or EBPI.^* With this tool, horse owners monitor chronic pain in their horses so they can identify discomfort caused by osteoarthritis, gauge response to treatment, and recognize when treatment modifications may be indicated.

“Chronic pain from cartilage damage, heat, and joint swelling due to osteoarthritis result in lameness, decreased mobility, and loss of normal function. Further, uncontrolled pain negatively affects the quality of life and welfare of a horse,” explained Kathleen Crandell, Ph.D., a nutritionist for Kentucky Equine Research. “When the amount of discomfort an animal appears to be feeling goes unrecognized by the caretaker, chances are it will be left untreated by a veterinarian.”

Currently, veterinarians manage arthritis using a multimodal treatment approach typically involving nonsteroidal anti-inflammatory drugs (NSAIDs) including phenylbutazone or bute, regenerative therapies such as IRAP (interleukin-1 receptor agonist protein) and PRP (platelet-rich plasma), and oral joint health supplements. Kentucky Equine Research offers several research-based supplements to prevent or manage horses with osteoarthritis, such as Synovate HA.

“Horse owners consistently see their own horses and are best able to detect changes in behavior, movement, and facial expressions that indicate pain. However, as prey animals, horses tend to hide signs of discomfort to avoid attracting the attention of predators. As a result, signs of chronic pain may be overlooked by owners. This is particularly true for a condition such as osteoarthritis that may have wax-wane pain presentation,” Crandell said.

Using established strategies, researchers developed an EBPI specific to horses with osteoarthritis, mirroring closely ones that are used in human and canine patients. This tool involved a 15-question survey that polled owners about their horses’ posture, movement, facial expressions, and behavior. Owners circled a number from 0 to 10 based on the score that best describes their horses.

After extensive development, 25 owners or caretakers of horses with osteoarthritis tested the EBPI. Most of this pilot group (over 84%) found the questionnaire easy to complete and useful. The EBPI took less than five minutes to finish and had a readability suitable for 11- and 12-year-olds.

“Using this tool, owners can play a more proactive role in identifying pain so that a management plan can be created with the veterinarian. It will also allow caretakers to continuously monitor horses to address when their pain management strategy needs tweaking or updating.”

^*Howard, D.L., B. Lancaster, and J. de Grauw. 2024. Development and preliminary validation of an equine brief pain inventory for owner assessment of chronic pain due to osteoarthritis in horses. Animals (Basel) 14(2):181.