Introducing an innovative pain scale for assessing postpartum pain in mares: Preliminary clinical evaluation (2025)

Bolesławska-Szubartowska, J., Kucharczuk, M., Skrabska, A. et al.

Abstract

Background: Pain after giving birth is commonly observed in horses, yet there has not been a specific tool developed for assessing this pain in postpartum mares. The goal was to adapt existing equine pain scales and to preliminarily validate a practical pain scale for use by veterinarians and caregivers after foaling. Methods: The pain scale was developed by adapting items from other pain scales, including established orthopedic and colic equine pain scales, and incorporating caregiver feedback. The final scale includes eight areas for assessing pain: behavior, facial expressions, vital signs, udder examination, gastrointestinal function, hoof temperature, response to food, and movement. Observations were conducted on ten heavy draft mares that experienced dystocia, with pain scores recorded twice daily for 1 to 4 days postpartum. Simultaneous saliva samples were collected to measure cortisol levels. Results: The pain scale proved feasible for use at the stall and allowed for partial scoring when certain assessments were deemed risky. Pain scores were highest on the first day after foaling and decreased as the mares recovered. In a case of clinical deterioration, a substantial increase in pain score was noted. Increased pain scores were associated with elevated cortisol levels, supporting the biological relevance of the scale. In clinical practice, if a pain score exceeded 40% of the maximum score, the mare was identified as a patient requiring analgesic treatment. Conclusions: This postpartum-specific pain scale provides a standardized method for assessing pain in mares after foaling and may assist in guiding appropriate pain management. Although the proposed pain scale shows promise as a clinical tool, the present results are preliminary and require confirmation in larger studies.