How to Recognise Signs of Pain in Horses

If your horse is in pain, he will do everything he can to hide it. Horses are prey animals, and in the wild a visibly weak animal is the one that gets picked off. That instinct has not gone away. By the time a horse looks obviously uncomfortable, the problem is usually well established.

That means the responsibility sits with you. Not to diagnose, but to notice. Below are eight signs of pain in horses, from the earliest and most subtle to the ones that need a vet on the yard the same day.

Why horses hide pain

Pain suppression is a survival reflex, not stoicism. A horse in a herd that shows weakness invites attention from predators and pressure from other horses, so the instinct is to carry on as normal for as long as possible.

The practical consequence for you is simple. The signals you get are quiet, and they are usually changes rather than events. Something your horse always does, he now does slightly differently. That is the signal.

1. Changes in behaviour

A shift in behaviour is often the very first thing owners notice, and the easiest to explain away. Your horse may be less active than usual, less interested in his feed, or drinking less.

He may also become irritable. Pinning ears when you approach, moving away from grooming, snapping when you do up the girth, or refusing contact he normally accepts without a thought. A horse who is suddenly grumpy is very often a horse who hurts somewhere.

Equally telling is the opposite: a normally forward, opinionated horse who goes quiet and withdrawn.

2. Lameness and uneven movement

Lameness is the classic sign, and it can come from joints, muscles, tendons, ligaments or the hoof. It is not always a dramatic head nod. Watch for a shortened stride, reluctance to turn on a small circle, uneven wear on the shoes, or difficulty picking up one canter lead.

A useful habit is to walk and trot your horse on a hard, level surface once a week, in a straight line and on both reins. You will spot small asymmetries far sooner than you will in the school.

Any lameness that lasts more than a day or two deserves a call to your vet.

3. Changes in posture and stance

Pain changes how a horse stands. He may park his hind legs further under his body, shift weight forward onto the front feet, or stand with one hind leg constantly rested when that is not his habit.

A horse standing rocked back on his heels with his front feet pushed out in front of him is a red flag for laminitis and needs a vet urgently.

Also watch the whole outline. A tucked-up belly, a roached back, or a horse who stands with his neck low and still for long periods are all worth noting.

4. Changes in breathing

Breathing gives away discomfort that a horse is otherwise masking. A resting horse should take roughly 8 to 16 breaths per minute, quietly and evenly.

Faster, shallower breathing at rest, flared nostrils, or visible effort in the flanks can point to pain in the chest or abdomen, to fever, or to a respiratory problem.

Count the breaths before you panic. Rising respiratory rate combined with any other sign on this list is a reason to call.

5. Sweating without work

A horse who breaks out in patchy sweat while standing in a stable on a mild day is telling you something. Pain and stress both trigger a sympathetic nervous system response, and sweating is part of it.

Patchy sweat behind the elbows, along the flanks or on the neck, with no exercise and no heat to explain it, is one of the more reliable distress signals you will get. In combination with pawing, flank watching or rolling, treat it as suspected colic and call the vet immediately.

6. Facial expression

Horses have a consistent pain face, and it has been formally described. The Horse Grimace Scale identifies six facial features that change when a horse is in pain:

• Ears held stiffly backwards
• Tightening around the eye, giving a half-closed look
• Tension in the muscles above the eye
• Strained, prominent chewing muscles
• A tense mouth with a pronounced chin
• Strained nostrils and a flattened profile

None of these on its own proves much. Several of them together, in a horse who does not usually look that way, is meaningful. Take neutral photos of your horse's face when he is well, so you have something to compare against.

7. Changes under saddle

Behaviour that gets labelled as naughtiness is frequently pain. Research into the Ridden Horse Pain Ethogram found that a cluster of eight or more specific ridden behaviours strongly suggests underlying musculoskeletal pain.

Signs worth taking seriously include repeated head tossing, tail swishing, teeth grinding, an open mouth, bucking, napping, reluctance to go forward, difficulty on one rein, and a sudden loss of quality in work the horse previously found easy.

Before you book more training, rule out pain. Check saddle fit, teeth and feet, and involve your vet if the pattern persists.

8. Changes in eating, drinking and droppings

Chewing slowly, dropping half-chewed balls of food, tilting the head while eating or quidding usually points to dental pain. A drop in water intake, fewer droppings than normal, or a change in their consistency can point to abdominal pain long before colic becomes obvious.

Most healthy adult horses pass droppings roughly 8 to 12 times a day. If you know your horse's normal, a change is easy to spot.

Know your horse's normal

You cannot recognise abnormal without knowing normal. Take these readings a few times when your horse is healthy and relaxed, and write them down where you can find them.

A strong, bounding digital pulse in one or more feet is a warning sign for laminitis or a foot abscess.

When to call the vet immediately

Some signs do not wait until morning. Contact your vet straight away if you see:

• Rolling, pawing, repeatedly looking at the flank, or sweating with no gut sounds, which suggest colic
• Sudden severe lameness or refusal to bear weight on a leg
• A laminitic stance, rocked back on the heels
• Temperature above 39 °C, or a resting heart rate consistently above 60
• A closed, weeping or squinting eye
• Coughing, distress and food or saliva at the nostrils, which suggest choke

The habit that matters most

Recognising pain is not about knowing every syndrome. It is about knowing your own horse well enough that a small change stands out. Handle him daily, use the same routine, and pay attention to the moments when something feels slightly off.

Trust that instinct. If you think your horse is in pain, ring your vet and let them find the cause. Getting a horse comfortable quickly is better for his recovery, and better for the relationship you have with him.

This article is for general information and does not replace veterinary advice. If you are worried about your horse, contact your vet.