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Animals were assessed at the time of stunning and immediately after for signs of effective\/ineffective stunning and shot positioning, with macroscopic gross brain pathology conducted to determine brain trauma. Twenty-five percent (25\/100) received more than one shot and 28% (28\/100) displayed behavioural signs of ineffective stunning. Of these 28 animals, all had deviations of more than 10 mm from the suggested shot position outlined by the Humane Slaughter Association with rostral-caudal deviation associated with an absence of damage to the thalamus, midbrain, and pons. Forty-four percent (44\/100) of animals displayed no damage to critical brain structures (thalamus, midbrain, pons and medulla), with this associated with ineffective stunning. Overall, 16% of shots missed the brain (16\/100), with a higher proportion of poll shots (30%) missing the brain compared to frontal shots (12%). There is the potential, when animals are shot into the poll, for paralysis from damage to the spinal cord and caudal brainstem structures. Appropriate position, angle and performance of PCB is therefore vital to achieving an effective stun, by targeting critical brain structures responsible for maintaining consciousness and ensuring proper PCB maintenance. Animals should be routinely checked between stunning and exsanguination, with minimal time between these stages, to minimise recovery of consciousness and alleviate suffering for horses at slaughter.<\/jats:p>","DOI":"10.1017\/awf.2025.10025","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T07:37:06Z","timestamp":1753429026000},"source":"Crossref","is-referenced-by-count":3,"title":["Pathophysiology of penetrating captive-bolt stunning of horses"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-5528","authenticated-orcid":false,"given":"Katharine A","family":"Fletcher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-3103","authenticated-orcid":false,"given":"Beatrice","family":"Benedetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6230-2475","authenticated-orcid":false,"given":"Georgina","family":"Limon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-8262","authenticated-orcid":false,"given":"Andrew","family":"Grist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7630-8285","authenticated-orcid":false,"given":"Barbara","family":"Padalino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7180-9702","authenticated-orcid":false,"given":"Mariano","family":"Hern\u00e1ndez-Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1242-2695","authenticated-orcid":false,"given":"Troy J","family":"Gibson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"S0962728625100250_r35","unstructured":"Leary, S , Regenstein, J , Shearer, J , Smith, SA and Golab, GC 2016 AVMA Guidelines for the Humane Slaughter of Animals: 2016 Edition Members of the Panel on Humane Slaughter AVMA Staff Consultants. chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/https:\/\/www.cnr-bea.fr\/wp-content\/uploads\/2019\/10\/AVMA-Humane-Slaughter-Guidelines.pdf (accessed 8 July 2025)."},{"key":"S0962728625100250_r3","volume-title":"Assessment of Cattle and Pig Welfare at Stunning in Commercial Abattoirs","author":"Atkinson","year":"2015"},{"key":"S0962728625100250_r5","doi-asserted-by":"publisher","DOI":"10.1079\/9781789240573.0145"},{"key":"S0962728625100250_r58","doi-asserted-by":"publisher","DOI":"10.2527\/asasann.2017.020"},{"key":"S0962728625100250_r37","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30197-7"},{"key":"S0962728625100250_r14","first-page":"135","article-title":"Recovery from disorders of consciousness: mechanisms, prognosis and emerging therapies","volume":"17","author":"Edlow","year":"2021","journal-title":"Nature Reviews: Neurology"},{"key":"S0962728625100250_r46","doi-asserted-by":"publisher","DOI":"10.1016\/j.meatsci.2015.11.010"},{"key":"S0962728625100250_r27","doi-asserted-by":"publisher","DOI":"10.3390\/ani9080552"},{"key":"S0962728625100250_r29","unstructured":"Humane Slaughter Association 2016 Captive-Bolt Stunning of Livestock. www.hsa.org.uk"},{"key":"S0962728625100250_r18","unstructured":"Food and Agricultural Organisation Statistical Database: Live Animals 2023 FAOSTAT. https:\/\/www.fao.org\/faostat\/en\/#data (accessed 23 August 2024)."},{"key":"S0962728625100250_r36","doi-asserted-by":"publisher","DOI":"10.3390\/ani14071112"},{"key":"S0962728625100250_r43","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-0277(00)00127-X"},{"key":"S0962728625100250_r50","first-page":"202","article-title":"The physiology of the brain and determining insensibility and unconsciousness","author":"Terlouw","year":"2020","journal-title":"The Slaughter of Farmed Animals: Practical Ways of Enhancing Animal Welfare"},{"key":"S0962728625100250_r52","unstructured":"Terlouw, C , Ducreux, B and Bourguet, C 2021 Specificities of consciousness and unconsciousness indicators according to slaughter methods. 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