Tuesdays with Tony

Recognizing Pain in Horses: The Telltale Signs

If I’ve heard it once, I’ve heard it a thousand times: “Gee doc, your job must be so hard, because you can’t tell when your patient is hurting.” But the truth is, our docs use non-verbal signs to tell when a horse is in pain, and after years of practice they have become quite proficient at recognizing when something is wrong. So, how do horses “tell us” when they are in pain?


It may seem obvious, but limping is a sign of pain. The source of that pain can be anywhere from the tip of the toe to the shoulder/hip. The docs have a wide array of tools to determine where exactly the pain is coming from, but that’s a topic for another day.

Horses don’t “fake” lameness to get out of work. They are prey animals, so if anything, they will try to hide a limp when their adrenaline kicks in. Horses that are “sometimes a little off” or horses that “work out of it” are also in pain. I will add here that Bute is a powerful pain-killer. If your horse is “sound on Bute” but lame when off of Bute, he has an underlying source of pain somewhere.

Vets go through rigorous training during school in order to be able to see a subtle lameness. Both of my docs also happen to be experienced horsewomen, so they also understand what lameness feels like under saddle. However, during a lameness evaluation, they are looking for signs such as a head bob, hip hike, fetlock drop, or shortening of stride to tell them where a horse is hurting.

Heart Rate

One reliable indicator of pain that vets use on a daily basis is heart rate. In human medicine, a doctor may ask you to rate your pain on a scale of 1-10. Well, vets can’t do that in horses. But they can measure their heart rate and monitor whether it goes down with various treatments.

You can easily learn how to take your horse’s heart rate at home. Get yourself a stethoscope (it doesn’t have to be fancy). Locate the horse’s heartbeat just behind the left elbow. Look at your watch and count the number of beats in 15 seconds, then multiply by 4. This gives you the horse’s heart rate in beats per minute. The normal resting heart rate in a horse is about 30-40 beats per minute.

Some horses are very stoic. They may not show any overt signs of pain until they are near death. Certain breeds such as Walking horses, Draft breeds, Mules, Standardbreds, and some Quarter horses can be very stoic when it comes to pain. In these horses, it is very useful to get a quick heart rate measurement to assess their current comfort level.

Pain in horse expressionFacial Expression

Have you heard the phrase “I can see it in his eyes” when referring to a horse in pain? Well there is actually some truth to this theory, and it has even been empirically studied. Horses have a characteristic grimace that they often exhibit when they are in severe pain. You may have seen it if you have ever had a horse suffering from colic, laminitis, or a major injury.

When horses are in pain, their ears tilt back, their nostrils scrunch up at the corners, and they elevate their eyebrow muscles. There is a subtle distinction between a pain expression and an angry or worried expression. Our docs are all too familiar with the pain face, and can recognize it quickly, then get busy looking for the source of the pain.

If you think your horse looks like he is in pain, give him a good once-over. Is he “pointing” one forelimb in front of the other- a common sign of foot pain? Is he “flank-watching” or looking at his sides- a common sign of colic? Is he squinting one eye more than the other? If you’re not sure where the pain is coming from, give me a call at the clinic and I will get my experts involved!

The Silent Treatment

Animals certainly do feel pain. Just because they aren’t screaming and kicking like a human doesn’t mean they are not hurting. Even dogs and cats like me are rarely vocal when they are in pain. We use meows, hisses, barks, and growls to communicate other emotions, but not pain. I am more likely to slink off into a corner if I’m hurt than to come crying to a human.

Horses will almost always suffer in silence. For this reason, it is important to have a vet who can recognize and interpret their silent cries for help. It is also important to listen to your veterinarian’s recommendations regarding pain management. Sometimes the best option for easing your horse’s suffering may be humane euthanasia. But rest assured, our docs always have the best interests of your horse in mind.

Hopefully after writing this I’ll begin to hear a different comment from horse owners: “Gee doc, your job isn’t hard because you can’t tell when your patient is hurting. Your job is hard because you have to convince me that my horse is hurting.” Hey, a cat can hope, right?

Until next week,

~ Tony


Tuesdays with Tony is the official blog of Tony the Office Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

[jetpack_subscription_form title="Subscribe to Whinny's Wisdoms"]