{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:31:28Z","timestamp":1790703088256,"version":"4.1.0"},"reference-count":16,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Animals"],"abstract":"<jats:p>Pain assessment is very important for monitoring welfare and quality of life in horses. To date, no studies have described pain scales for objective assessment of pain in foals. Studies in other species have shown that facial expression can be used in neonatal animals for objective assessment of acute pain. The aim of the current study was to adapt a facial expression-based pain scale for assessment of acute pain in mature horses for valid pain assessment in foals. The scale was applied to fifty-nine foals (20 patients and 39 healthy controls); animals were assessed from video recordings (30\u201360 s) by 3 observers, who were blinded for the condition of the animals. Patients were diagnosed with acute health problems by means of clinical examination and additional diagnostic procedures. EQUUS-FAP FOAL (Equine Utrecht University Scale for Facial Assessment of Pain in Foals) showed good inter- and intra-observer reliability (Cronbach\u2019s alpha = 0.95 and 0.98, p &lt; 0.001). Patients had significantly higher pain scores compared to controls (p &lt; 0.001) and the pain scores decreased after treatment with NSAIDs (meloxicam or flunixin meglumine IV) (p &lt; 0.05). Our results indicate that a facial expression-based pain scale could be useful for the assessment of acute pain in foals. Further studies are needed to validate this pain scale.<\/jats:p>","DOI":"10.3390\/ani10091610","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T22:58:01Z","timestamp":1599778681000},"page":"1610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Objective Assessment of Acute Pain in Foals Using a Facial Expression-Based Pain Scale"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7828-191X","authenticated-orcid":false,"given":"Johannes","family":"van Loon","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8744-7635","authenticated-orcid":false,"given":"Nicole","family":"Verhaar","sequence":"additional","affiliation":[{"name":"Clinic for Horses, University of Veterinary Medicine Hannover, 30559 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Els","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Dierenhospitaal Visdonk, 4707PE Roosendaal, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0502-7785","authenticated-orcid":false,"given":"Sarah","family":"Ross","sequence":"additional","affiliation":[{"name":"Anglesey Lodge Hospital, The Curragh, Kildare R56 YX98, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janny","family":"de Grauw","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2746\/042516405775314826","article-title":"Behavioural Assessment of Pain in Horses and Donkeys. Application to Clinical Practice and Future Studies","volume":"37","author":"Ashley","year":"2005","journal-title":"Equine Vet. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tvjl.2018.10.001","article-title":"Objective pain assessment in horses (2014\u20132018)","volume":"242","year":"2018","journal-title":"Vet. J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Dalla Costa, E., Minero, M., Lebelt, D., Stucke, D., Canali, E., and Leach, M.C. (2014). Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0092281"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/vaa.12212","article-title":"An equine pain face","volume":"42","author":"Gleerup","year":"2015","journal-title":"Vet. Anaes. Analg."},{"key":"ref_5","first-page":"23677219881655","article-title":"Improvement of the Mouse Grimace Scale set-up for implementing a semi-automated Mouse Grimace Scale scoring (Part 1)","volume":"24","author":"Ernst","year":"2019","journal-title":"Lab. Anim."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"19128","DOI":"10.1038\/s41598-019-55693-8","article-title":"Facial expressions of pain in cats: The development and validation of a Feline Grimace Scale","volume":"13","author":"Evangelista","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.tvjl.2015.08.023","article-title":"Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): S scale-construction study","volume":"206","year":"2015","journal-title":"Vet. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.tvjl.2017.01.006","article-title":"Monitoring equine head-related pain with the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP)","volume":"220","year":"2017","journal-title":"Vet. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.tvjl.2019.02.001","article-title":"Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma","volume":"246","year":"2019","journal-title":"Vet. J."},{"key":"ref_10","first-page":"E1","article-title":"Analgesia in foals","volume":"34","author":"Robertson","year":"2012","journal-title":"Vet. Learn"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1002\/ejp.1436","article-title":"Age-related differences in the acute pain facial expression during infancy","volume":"23","author":"Oster","year":"2019","journal-title":"Eur. J. Pain"},{"key":"ref_12","first-page":"51","article-title":"Development of a Piglet Grimace Scale to Evaluate Piglet Pain Using Facial Expressions Following Castration and Tail Docking: A Pilot Study","volume":"18","author":"Viscardi","year":"2017","journal-title":"Front. Vet. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.beproc.2016.09.010","article-title":"Coding and quantification of a facial expression for pain in lambs","volume":"132","author":"Guesgen","year":"2016","journal-title":"Behav. Process."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Vullo, C., Barbieri, S., Catone, G., Gra\u00efc, J.M., Magaletti, M., Di Rosa, A., Motta, A., Tremolada, C., Canali, E., and Dalla Costa, E. (2020). Is the Piglet Grimace Scale (PGS) a Useful Welfare Indicator to Assess Pain after Cryptorchidectomy in Growing Pigs?. Animals (Basel), 10.","DOI":"10.3390\/ani10030412"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/S0003-3472(85)80005-1","article-title":"The ontogeny of flehmen in horses","volume":"33","author":"Houpt","year":"1985","journal-title":"Anim. Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/S0168-1591(02)00110-7","article-title":"Preliminary study of the development of the Flehmen response in Equus Caballus","volume":"78","author":"Weeks","year":"2002","journal-title":"Appl. Anim. Behav. Sci."}],"container-title":["Animals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2615\/10\/9\/1610\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:08:30Z","timestamp":1760177310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2615\/10\/9\/1610"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,10]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["ani10091610"],"URL":"https:\/\/doi.org\/10.3390\/ani10091610","relation":{},"ISSN":["2076-2615"],"issn-type":[{"value":"2076-2615","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,10]]}}}