Osteoarthritis (OA) in horses is often assessed through clinical signs such as lameness or gait changes. But these measures may not capture the full impact of chronic pain — especially as it evolves over time and across different contexts.

‍

In a recent study published in Frontiers in Veterinary Science, Claudia Spadavecchia and colleagues at the University of Bern explored whether a tool commonly used in small animals—a client-specific outcome measure (CSOM)—could help capture a broader and more individualised picture of pain in horses. The approach brings horse owners into the assessment process, recognising their unique insight into daily behaviour and subtle changes over time.

We asked Claudia Spadavecchia to explain what this research means in practice.

‍

What were you trying to understand with this study?

Pain assessment in horses is challenging, as they cannot communicate verbally, and traditional methods—such as lameness scoring or gait analysis—only capture part of the picture.

We wanted to understand whether a client-specific outcome measure (CSOM)—a tool already used in small animals—could be applied effectively to assess chronic osteoarthritis (OA) pain in horses. Our key question was: Can individualised, caretaker-based observations provide a reliable and meaningful way to monitor chronic pain in horses, and how do these compare with existing clinical and objective measures?

‍

What did you find that might change how people think about osteoarthritis in horses?

One important takeaway is that osteoarthritis pain is not just about lameness or movement impairment. We found that:

• Caretaker-based CSOM scores correlated significantly with both subjective and objective measures (lameness scores, gait asymmetry)
• Owners often identified issues beyond locomotion, including motivation, activity, and behavior, highlighting a broader impact of pain
• Caretakers and veterinarians showed good overall agreement in pain scoring, despite some variability

This suggests that OA pain has multiple dimensions—physical, behavioural, and affective—and that relying only on gait or clinical exams may underestimate its true impact.

‍

What does this mean in practice for vets and horse owners?

In practical terms, this study supports a more integrated and collaborative approach to pain assessment:

• Caretakers can play an active role in monitoring chronic pain, especially over time and in real-life conditions
• CSOM provides a simple, individualised tool that can be adapted to each horse
• Combining CSOM with clinical and objective measures can give a more complete picture of the horse’s condition
• This is particularly useful in the field, where frequent veterinary evaluations may not be feasible

Overall, it encourages vets to listen more systematically to owners’ observations and to incorporate them into clinical decision-making.

‍

What still isn’t clear or needs more research?

The study included a relatively small number of horses, so validation in larger populations is needed. Several other aspects still require further investigation:

• Standardisation and training: caretakers were not formally trained, which may influence how CSOM items are selected and scored
• Comparison with validated equine pain scales: unlike in small animals, there is still a lack of widely accepted reference tools for chronic pain in horses (even if recently new tools have been proposed and will hopefully be adopted more and more)
• Long-term monitoring: OA is a fluctuating disease, and longer studies would help understand how CSOM performs over time
• Diagnostic performance: future studies would need to assess sensitivity, specificity, and clinical thresholds

‍

Final thought

This research highlights the value of combining clinical expertise with lived observation. By bringing together veterinary assessment and owner insight, we may be able to better understand — and ultimately manage — chronic osteoarthritis pain in horses.

‍