EQUINE VETERINARY EDUCATION / AE / FEBRUARY 2022


105


TABLE 2: Behavioural features that can reflect musculoskeletal pain in ridden horses (adapted from Dyson et al. 2018a) Area


Behavioural features


Face Ears Eyes


Mouth Body Head Tail Gait Changes


abnormalities Obedience


or


A rushed gait, irregular rhythm, repeated changes in speed, gait too slow, moves on three tracks, canter repeated leg changes, repeated strike off wrong leg, spontaneous changes in gait, stumbling, toe dragging


Sudden changes in direction against rider direction, reluctant to move forward, rearing, bucking or kicking backwards (one or both hindlimbs)


Repeated changes in head position (up/down), head tilting, head in front or behind of vertical for >10 s, regular changes in head position (tossed or twisted from side to side) Tail clamped tightly to middle or held to one side, tail swishing


Ears rotated back or flat >5s Eyelids closed or half-closed for 2–5 s, sclera exposed, intense stare for >5s


Mouth opening and shutting repeatedly for >10 s, tongue exposed and/or moving in and out, bit pulled through the mouth on one side


TABLE 3: Pain-related aetiologies to consider in the differential diagnosis of nonspecific performance and rideability issues in horses Pain type


Differential diagnosis


Musculoskeletal pain Lameness


Back pain


Bilateral foot, fetlock, carpal or distal hock joint pain Bilateral proximal suspensory desmitis


Impinging dorsal spinous processes Osteoarthritis of the thoracic and/or lumbar facet articulations Sacroiliac joint region pain


Muscle pain


Muscle cramps Muscle strains Muscle trauma Sporadic exertional rhabdomyolysis Chronic exertional rhabdomyolysis Chronic exertional myopathies Aorta-iliac thrombosis (TAI)


Miscellaneous Temporomandibular joint disease


Oral pain Bit and tack- related pain


Dental disorders


Oral ulcerations Aggravation of existing dental disorders


Soft tissue injuries caused by sharp enamel points Presence of the first premolar teeth Abscessed teeth Periapical infection Dental fractures Periodontal disease Abnormalities of eruption Malocclusions


Visceral pain Gastrointestinal pain


Equine gastric ulcer syndrome (EGUS) Inflammatory disorders Parasite infestation Intestinal ulceration Intestinal spasms Mesenteric tension Neoplasia Partial obstruction of the intestinal lumen (i.e. sand impaction, adhesions, stricture, intussusception, enterolithiasis or intra-abdominal abscesses)


Urogenital pain Referred pain syndrome Ovarian pain associated with impending ovulation Postcastration complications in geldings (i.e. neuroma formation or spermatic cord adhesions)


References Dyson (2002), Dyson (2009), Dyson (2010a)


Jeffcott (1980), Walmsley et al. (2002), Dyson and Murray (2003), Girodroux et al. (2009), Barstow and Dyson (2015)


Brama et al. (1996), Rijkenhuizen et al. (2009), Valberg (2018), Rijkenhuizen and Pokar (2019)


Jørgensen et al. (2015) Tell et al. (2008), Bj€


ornsd


ottir et al. (2014), Cook and


Kibler (2019), Pehkonen et al. (2019), Uldahl and Clayton (2019), Thomas (2020)


Griffin (2009), Anthony et al. (2010), Bryant (2014), Pehkonen et al. (2019), Thomas (2020)


Vatistas et al. (1999), Jonsson and Egenvall (2006), Archer (2008), Franklin et al. (2008), Sykes et al. (2015), Cot


e (2019)


Cox and DeBowes (1987), Echte et al. (2006), Christoffersen et al. (2007), Chenier (2008), Lindegaard et al. (2009), Dyson (2010b), Weaver (2011)


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