Scoring Disease Severity in Horses with Trigeminal-Mediated Headshaking

A study aimed to develop and validate a History, Rest and Exercise Score (HRE-S) to assess disease severity for trigeminal-mediated headshaking in horses.
A grey horse demonstrating headshaking.
A study aimed to develop and validate a scoring system for trigeminal-mediated headshaking in horses. | Getty Images

In horses with trigeminal-mediated headshaking, clinical signs are likely to be an expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as a measure of compromise of the animal’s welfare. The aims of this retrospective observational study were to develop and validate a precise scoring system for trigeminal-mediated headshaking: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three sub scores: history score (H-S), resting score (R-S) and exercise score (E-S).

Seven masked observers with different experience used HRE-S to score 40 video recordings taken during rest and lunging, including five duplicates. Video recordings were taken from nine horses with trigeminal-mediated headshaking and three controls. Inter- and intra-observer reliability and practicability of HRE-S were assessed. For every video recording, severity of clinical signs was graded by every observer using an intuitive global-type-scale, and interobserver reliability was calculated.

Reliability for HRE-S was excellent, irrespective of observers’ experience: Spearman’s Rho = 0.946, p < 0.001 (intraobserver reliability) and intraclass correlation coefficient = 0.98, p < 0.001 (interobserver reliability). 

Interobserver reliability for intuitive global-type-scale was fair to substantial: Fleiss’ Kappa = 0.48 (R-S) −0.63 (E-S). Groups created by intuitive global-type-scale had significantly different R-S and E-S (p < 0.05), demonstrating discriminant validity. 

Convergent validity was proven as horses with grade 3/3 had significantly higher average E-S and total scores compared with an existing score than those with grade 0/3 or 1/3 (p < 0.001).

Bottom Line 

HRE-S is a valid and reliable score evaluating disease severity in trigeminal-mediated headshaking, independent of observers’ experience.

https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13986

categories
tags
Trending Articles
Horses in the stable
Multi-State EIA Outbreak in Quarter Horse Racehorses
Equine Ultrasound Exam
Using Ultrasound to Diagnose Muscle Injuries in Horses 
Tablets Pills Horse
Using the Right Medications to Manage Chronic Pain in Horses
syringe horse background
Injectable Omeprazole for Horses
Newsletter
Get the best from EquiManagement delivered straight to your inbox once a week! Topics include horse care, disease alerts, and vet practitioner updates.

"*" indicates required fields

Name*
Country*

Additional Offers

Untitled
This field is for validation purposes and should be left unchanged.