Dr. Alice Rodrigues de Oliveira and other scientists at São Paulo State University in Brazil noted that there was only one objective measure of sedation in horses that didn't require interpretation: head height above the ground. Other methods being used to assess depth and quality of sedation were subjective and based on the observer's experience with sedated horses.

Though there are typical facial responses to sedation, no studies have measured their validity and reliability. The research team sought to create a scale that measured equine sedation based on facial expression. They adapted three of the facial measures used in the Horse Grimace Scale: ear position, eye opening, and relaxation of the lower and upper lips.

To test their pain scale, the scientists sedated seven horses both lightly and heavily, and photographed the horse's face before sedation, at the height of sedation, in the middle, and at the end of sedation. Images were sent to four vets who were trained on the FaceSed scale.

There was agreement and consistency between all four vets. The scientists determined that the FaceSed scale is a reliable tool to assess and determine sedation in horses. They recommend further studies be completed in clinical settings and using inexperienced observers.

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Drs. Yamit Maskato, Alexandra Dugdale, Ellen Singer, Gal Kelmer and Gila Sutton created the Equine Acute Abdominal Pain Scale (EAAPS) in 2013. The scientists report that the scale requires no training, can be used easily in hospital settings and can improve equine welfare.

They suggest that the EAAPS now be tested in the field by veterinarians, as well as by horse owners and farm caretakers who lack medical training. Colic is the most common cause of equine deaths in the United States. Severity of pain is an important parameter for decision making regarding a horse that is colicking; it can also assist in evaluating pain-relieving measures, patient status and surgical or euthanasia decisions.

The EAAP gives typical colic behaviors a one-digit score to grade the severity of pain, with 1 being the most mild (flank watching or lip curling) to 5 being the most severe (rolling).  Participants at the two clinics where the EAAP was trialed reported that the EAAP was quick and easy to use, even with no training on the scale.

The creators determined that the EAAPS is feasible to use in an equine clinical setting to determine the severity of colic cases.

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