Recognising Signs of Pain in Horses: A Checklist for Horse Owners and Caregivers

Written by Sarah Johnson

Peer reviewed

Introduction

The recent publication of comprehensive equine pain and discomfort ethograms, such as the Equine Discomfort Ethogram,¹ have the potential to be used as a management tool to improve the rate of diagnosis of mild acute and chronic conditions by enabling horse owners to better recognise indicators of pain in their animals.

Ensuring that horses are not experiencing pain or discomfort is an important welfare consideration.² In a study by World Horse Welfare (Horseman, et al., 2022), unresolved stress and pain behaviour was identified as one of the highest-priority welfare concerns for domestic horses in the U.K. due to poor recognition of pain indicators amongst the equestrian population.³

A template for an observation-based record can equip a horse owner or caregiver with the tools to monitor their horse during standard non-ridden activities and could help to identify behavioural changes which may be driven by underlying pain or discomfort which is not yet diagnosed. The resulting portfolio of credible evidence of possible pain indicators can be presented to a vet or other professional and may help to better direct where investigations might begin with the overall aim of producing a more effective, targeted and therefore positive outcome for both horse and owner.

Description

The template is designed specifically for the observation of horses during day-to-day husbandry (i.e., non-ridden activities) and is based on the Equine Discomfort Ethogram by Catherine Torcivia and Sue McDonnell. This particular ethogram was chosen because it is the most comprehensive catalogue of behaviours affecting the whole body rather than just those seen in the face or while ridden.

The template document comprises a covering page which provides simple instructions on using the template. There follows a description of each pain indicator, which the user can refer to. The data recording template is presented in blank form and with a fictitious example of how it should be filled out.

Objectives

The template was designed to achieve the following objectives:

The template should be quick and easy to use.
It should be in a format which is easily reproducible either on a household printer or photocopier – this means that it is in black and white / greyscale, and has minimal graphics.
It should be applicable to multiple situations reflecting the different living environments of leisure horses, while having non-ridden equines specifically in mind.
The descriptions of the behavioural indicators should be unambiguous and easily understandable by someone with no background in horse behaviour or anatomy to increase the accuracy of the data collected.

Designing the template

The Equine Discomfort Ethogram records 64 specific behaviours and was based on observations of horses with acute pain. To make the template usable, it was necessary to reduce the number of behavioural indicators without losing any important information. Each indicator was assessed to determine (a) its implied importance in terms of directing a possible diagnosis and (b) its degree of similarity or ambiguity compared to a related indicator. Some indicators could be grouped together under one heading, for example: Table 1, h. Dangling a Limb and Table 2, b. Lifting/Holding Limb Up. While there is a nuanced difference in the two indicators, which might be relevant in a clinical setting, a leisure horse owner would probably struggle to decide which of the two descriptions best applied during observation while the overall information that a horse was holding or dangling a limb for a period of time is what is actually relevant. Some indicators were omitted altogether on the grounds that it could be too difficult for a horse owner to assess an abnormal expression of what is a normal behaviour, for example 2h. Rolling.

In rewriting the indicators and their descriptions the wording was changed from the original in some cases to use terms that may be more familiar to horse owners, with the aim of making the indicators as clear and understandable as possible.

The template itself has spaces to record the prevailing weather conditions at the time of observation, the date and duration of the observation period, and the activities or location of the horse during the observation. This information is easily recorded and may help to increase the validity of the data collected and to highlight trends relating to specific conditions, time of day, or activities.

Guidelines for and limitations of use

The template is designed to be a guide that could be used to assess and monitor horses either on a regular basis as a management tool, or in cases when the owner has some mild concerns about their horse’s physical comfort but is unable to pinpoint anything specific. It is explicitly not designed for the diagnosis of any particular condition, and it contains the caveat that a horse who has obvious pain, discomfort or distress would require immediate veterinary intervention.

A Template for a Daily Record of Observations of Potential Pain Indicators for Leisure Horse Owners

When to use this template

This template can be used to record your observations of possible indicators of pain or discomfort in your horse during routine non-ridden day-to-day activities such as bringing in or turning out, grooming and picking out feet or simply from observation of the horse in the field. It can be used where you suspect that there may be a problem but you cannot identify a specific cause*, or on a regular basis as a management tool to check if your horse appears to be healthy and comfortable.

*This template is not designed to diagnose acute conditions such as laminitis or colic, where there is an obvious injury, or where your horse is in distress and/or they are unable to continue their normal day-to-day activities such as eating or moving around. In all these cases, you should seek immediate veterinary intervention.

The indicators in this template are based on those identified by Catherine Torcivia and Sue McDonnell in their Equine Discomfort Ethogram^[1].

Instructions for use:

Read through the descriptions of the different pain indicators to familiarise yourself with them.
Fill out an observation record during every visit to your horse. There is an example of a completed record sheet at the back of this template. Use the back of the template to record any additional freehand observations or notes, for example: “was more difficult than normal to catch.”
Try to vary the times of day that you visit your horse to carry out the observation as much as you reasonably can, and include observation during routine healthcare visits, for example by your farrier. Different times of day and conditions may highlight indicators or trends that would not otherwise be apparent.
If you regularly use surveillance cameras at your yard or barn, it can be especially useful to record your observations from watching footage recorded over a 24-hour period.
Taking photographs or video to record specific behaviours or interactions with your horse can also be helpful.
The number of observations that might be needed to produce enough meaningful information will vary from one situation to another. The observation period could be as little as one week but may need to extend over at least one month or more if symptoms seem to come and go.
Assess the information you are collecting at regular intervals. Look for patterns such as:
1. Clusters of the same or similar indicators which occur regularly
2. Single indicators which occur regularly and are out of context, for example a horse that repeatedly kicks out even though there isn’t another horse or a person behind them.

Some of the indicators in this template can be seen in normal behaviour, for example a horse will swish theirtail in response to irritation from flies. A horse with pain or discomfort will typically display several different indicators in a short space of time and the observer may see one or more physical indicators combined with some behavioural indicators. It is also important not to ignore certain indicators just because the horse has always done something, for example where a horse has always tended to stand with his hind legs crossed. It is better to observe with an open mind and record everything that you see regardless of what you might consider to be normal for your horse.

8. If pain indicators are present, discuss your findings with your vet or another appropriate professional such as an osteopath. A certified behaviour consultant can help you to interpret your observations and support you in obtaining a diagnosis.

Detailed description of the pain indicators in the template

INDICATOR		DETAILED DESCRIPTION
Movement- related indicators	Movement	Horse’s movement is atypical, for example: uneven stride, limping, frequent tripping or stumbling, dragging a toe. May be accompanied by an unusual or exaggerated head movement.
	Walking backwards	Horse walks backwards, often with small tentative steps and where there is no apparent reason to do so.
	Rearing and bucking	Short bouts of rearing and bucking, particularly when seen in an unusual context such as in a stable.
Standing position indicators	Atypical standing position	Horse stands with front or hind or all legs positioned outside of a normal square halt position. Forelegs may be positioned too far forward from the body or too far back under the body. Hind legs may be positioned forward under the body or angled too far back behind the body.
	Holding limb up	The horse holds one limb up as if reluctant to put weight on it. The foot may hover just above the ground with a toe just touching the ground or the horse may hold it up completely for several seconds at a time. Can be seen with a trembling limb from the effort of balancing on three legs for a long period of time.
	Changing resting leg	While standing, the horse frequently changes the resting leg.
	Pointing / resting foreleg	Horse stands with one foreleg pointed forward or with the toe of that foot resting on the ground.
	Prolonged resting – hind	While standing, the horse rests one leg for an unusually long time. This may occur during an activity such as grazing suggesting that the horse is reluctant to place the hoof flat on the ground.
	Crossing hind legs	While standing, the horse crosses one hind leg behind the other.
	Trembling limb	One leg visibly trembles as if the muscles are tired. Often seen where the horse is not supporting weight through one leg.
	Flinching	Horse flinches or starts suddenly as if surprised by something.
	Leaning against something	While standing the horse leans against a solid object such as a wall or fence for support.
	Stepping feet	Picking up a foot and holding it up briefly before lightly placing it back down again. May involve only one leg or both forelegs / hind legs and can be repeated to give the impression that the horse is marching on the spot.
	Stamping feet	Picking up a foot and bringing it down again sharply. Can be seen in a comfortable horse that is irritated by flies.
	Kicking up towards abdomen	Kicking up with a hind leg towards the abdomen. Can be seen in a comfortable horse that is irritated by flies.
	Kicking out or back	Kicking out or back with one or both hind legs, particularly where not provoked.
Head and neck	Tilting head	Horse stands with his head tilted to one side.
	Tossing nose	Horse repeatedly nods their nose up and down as if in annoyance.
	Looking or swatting	Horse looks towards an area of their body and / or bites at the area as if to swat a fly.
	Shaking head or body	Horse shakes either just the head or the whole body from one side to another. Can be seen as a normal behaviour in situations such as returning to standing from rolling or lying down.
	Tossing / swaying head	Horse tosses their head up and down or sways it from side to side.
	Ears back	Horse’s ears are held back. Often with visible tension in the face. Unlike pinned ears in response to the presence of another horse, this may be seen when there is no obvious cause.
Tail	Lifting or slapping tail	Horse lifts and holds tail up or to one side, or repeatedly lifts and slaps the tail down again.
Tail	Swishing tail	Horse swishes tail from side to side as can be seen in response to flies or other similar irritation.
Self-care	Sipping water	Instead of drinking normally, the horse sips hesitantly at water.
	Atypical jaw motion	While eating or yawning, the horse moves his jaw in an unusual way or as if reluctant to open it fully.
	Quidding	During eating, the horse drops partially chewed morsels of food from his mouth.
	Straining to pass urine	Adopting a position as if to pass urine but failing to do so. May be accompanied by other signs of discomfort such as kicking a leg up towards the abdomen or swishing the tail.
	Straining to pass droppings	Adopting a position to pass droppings but straining to do so. May be accompanied by other signs of discomfort such as focussing ears back, swishing tail, and groaning.
	Lying down	Spending longer than normal lying down.
	Difficulty getting up	When getting up from lying down, the horse appears to struggle to get up or seems to require more effort to do so. They may require more than one attempt before theyare able to rise.
	Stretching – head and neck	The poll and the neck are extended upwards so that the neck becomes vertical. Alternatively, the neck is flexed with the chin curled in towards the chest.
	Stretching – forelegs	The forelegs are extended forward, the shoulders are lowered towards the ground and the horse’s weight is shifted back onto the hind legs in a deep abdominal stretch.
	Stretching – hind legs	Horse extends one hind leg out behind them, toe pointed away. Can be accompanied by a neck curl stretch.
Behavioural indicators	Dull, depressed	Horse stands with head and neck low, eyes may appear to be glazed or staring at nothing in particular and general attitude appears depressed / disinterested in theirsurroundings. They may also look worried or tense.
	Biting / aggressive	Horse is unusually aggressive towards other horses or humans, threatening to bite or kick and pinning ears.
	Defensive / guarding	Horse stands in corner of stable or field in a defensive position, and is reluctant to approach or to be approached by another horse or a person.
	Increased spookiness	Horse is more reactive than normal to noises or movement.
	Restless / fidgeting	Horse is restless and / or fidgets, going from one activity to another without purpose. They may nibble at food or bedding, bite or lick at nearby objects, pace back and forth,or circle their box.
	Licking / chewing	Horse licks, extends tongue out, and chews although they are not eating. This is a common stress-relieving response.
	Frequent yawning	Yawning several times in succession, sometimes alternated with licking and chewing. A common stress-relieving response.
	Flehmen response	Horse lifts nose and extends upper lip. Normally used to detect odours but can indicate stress.
	Self-grooming / rubbing	Horse rubs themself against other objects or other parts of his body, or nibbles at various parts of their body. Can be a normal behaviour but often signifies stress.
	Vocalisation	Horse makes sounds which are either unusual, e.g., grinding teeth, groaning, or grunting, or makes normal sounds such as whinnying, squealing, snorting or sighing but more frequently than normal or out of a normal context.

A Blank Observation Record

Pain Indicators Blank Observation Record Downloadable PDF

OBSERVATION RECORD		Date
Horse		Start	End
Observer		LOCATION / ACTIVITY
Weather
INDICATORS
Movement related	Atypical movement
	Walking backwards
	Rearing and bucking
Standing position	Atypical standing position
	Holding limb up
	Changing resting leg
	Pointing / resting foreleg
	Prolonged resting – hind
	Crossing hind legs
	Trembling limb
	Flinching
	Leaning against something
	Stepping feet
	Stomping feet
	Kicking up towards abdomen
	Kicking out or back
Head and Neck	Tilting head
	Tossing nose
	Looking or swatting
	Shaking head or body
	Tossing / swaying head
	Ears back
Tail	Lifting or slapping tail
Tail	Swishing tail
Self care	Sipping water
	Atypical jaw motion
	Quidding
	Straining to pass urine
	Straining to pass droppings
	Lying down
	Difficulty getting up
	Stretching – head and neck
	Stretching – forelegs
	Stretching – hind legs
Behavioural indicators	Dull, depressed
	Biting / aggressive
	Defensive / guarding
	Increased spookiness
	Restless / fidgeting
	Licking / chewing
	Frequent yawning
	Flehmen response
	Self-grooming / rubbing
	Vocalisation

Example of a filled-out Observation Record

Pain Indicators Example Observation Record Downloadable PDF

OBSERVATION RECORD		Date 15 May 2022
Horse Jester		Start 1pm		End 2.30pm
Observer Annabel		LOCATION / ACTIVITY
Weather Clear blue sky, sunshine, light south-westerly wind Temperature 14 degrees		Grazing – field	Standing tied – barn	Farrier visit
INDICATORS		Grazing – field	Standing tied – barn	Farrier visit
Movement related	Atypical movement
	Walking backwards
	Rearing and bucking
Standing position	Atypical standing position
	Holding limb up
	Changing resting leg	✔	✔
	Pointing / resting foreleg
	Prolonged resting – hind
	Crossing hind legs
	Trembling limb
	Flinching
	Leaning against something		✔
	Stepping feet
	Stomping feet
	Kicking up towards abdomen
	Kicking out or back			✔
Head and Neck	Tilting head
	Tossing nose
	Looking or swatting
	Shaking head or body
	Tossing / swaying head
	Ears back		✔	✔
Tail	Lifting or slapping tail
Tail	Swishing tail		✔	✔
Self care	Sipping water
	Atypical jaw motion
	Quidding
	Straining to pass urine
	Straining to pass droppings
	Lying down
	Difficulty getting up
	Stretching – head and neck
	Stretching – forelegs
	Stretching – hind legs
Behavioural indicators	Dull, depressed
	Biting / aggressive
	Defensive / guarding
	Increased spookiness			✔
	Restless / fidgeting			✔
	Licking / chewing		✔	✔
	Frequent yawning			✔
	Flehmen response
	Self-grooming / rubbing
	Vocalisation

Notes:

While I was brushing his body, Jester moved away from me several times. I don’t recall this happening before.

Did not stand still for farrier and farrier had difficulty maintaining hold of left hind leg. Farrier did not remark on anything unusual with condition or wear pattern on hooves.

References

Sarah Johnson is a horse owner and trainer with a particular interest in ethology and equine behavioral science. She is passionate about improving leisure horse owners’ awareness and understanding of equine behavior and how it impacts on welfare and quality of life.

TO CITE: Johnson, S. (2023) Recognising Signs of Pain in Horses: A Checklist for Horse Owners and Caregivers. The IAABC Foundation Journal 27, doi: 10.55736/iaabcfj27.4