The Modern Equine Vet
November 2023
Vol 13 Issue 11 2023
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News Notes

Assessing Severity in Horses With Trigeminal-Mediated Headshaking

The History, Rest and Exercise Score (HRE-S) is a reliable method for evaluating disease severity in horses with trigeminal-mediated headshaking.

The HRE-S score is a combination of 3 subscores: the history score, resting score and exercise score.

Clinical signs of trigeminal-mediated headshaking include neuropathic facial pain, but the assessment tends to be subjective, and an incorrect assessment could mean the horse is suffering severe pain, according to the researchers, who wanted to develop and validate a precise scoring system for trigeminal-mediated headshaking.

Seven blinded observers with different experience used HRE-S to score 40 video recordings taken during rest and lunging in 9 horses with trigeminal-mediated headshaking and 3 without, who acted as controls. The videos included 5 duplicates. For every video recording, the observer graded the severity of clinical signs using an intuitive global-type-scale and interobserver reliability was calculated.

Reliability for HRE-S was excellent, irrespective of observers’ experience, according to the researchers. 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).

Interobserver reliability for intuitive global-type-scale was fair to substantial with wide variability. MeV

For more information:
Kloock T, Pickles KJ, Roberts V, et al. History, rest and exercise score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking. Equine Vet J. 2023 Aug. 22. Published online.