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Is your horse in pain? Recognizing the behavioral signs of discomfort

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photo canva pro (1)

Have you ever wondered why your horse was challenging to ride on the bit, why he took an uneven contact on the rein or was reluctant to canter? Have you ever considered that this may be related to pain? These problems are often attributed to training problems, but could they be pain-induced?

READ ALSO: What should you have in your stable's first aid kit?

According to Sue Dyson, there seems to be a culture in the horse industry that believes that it is normal for the horse to be grumpy or not performing well, rather than considering that it may reflect that the horse is in pain. She is a renowned veterinarian and researcher and an internationally acknowledged equine orthopedic expert. 

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“Let him ride through it,” “He is just a difficult horse,” or “This is how my horse has always gone” are just some of the excuses that riders come up with. In this way, they accept the behavior as normal, rather than considering that the horse through his behavior is trying to communicate an underlying muscular-skeletal pain. 

Sue Dyson has dedicated her working life to horses and throughout her many years of clinical work, she has spoken extensively to riders, vets and coaches, and she has seen countless horses both lunged and ridden. She has done meticulous research into the behaviors that she found were presented by these horses.  

Sue Dyson saw a significant difference between the facial expressions and behavior of the ridden horse in lame versus sound horses. She experienced that many of the behaviors she observed were seen repeatedly, but they disappeared after removing the pain using nerve blocks. This proved a strong relationship between ridden horse behavior and muscular-skeletal pain. Sue Dyson believes that we need to listen to what our horses are trying to communicate to us, and we must learn to understand its relevance. 

According to Sue Dyson, even experienced riders and trainers are often unable to spot low-grade lameness. The horse may seem reluctant to work, and lameness may manifest pain as a change of performance rather than overt lameness. Sue Dyson believes it is necessary to acknowledge that behavior can be a sign that the horse is in pain. 

24 distinct behaviors that indicate pain

Sue Dyson found a need for a tool that any trained observer could apply to show the presence or absence of pain. If it was possible to scientifically demonstrate that behavior was related to pain, it could help owners recognize pain in their horses. 

After reviewing many videos of non-lame and lame horses, Sue Dyson and her team of experts created a checklist or “ethogram”, a catalogue of each behaviorist definition. 

Sue Dyson

  • Sue Dyson VetMB Ph.D. DEO DipECVSMR FRCVS is an RCVS Specialist in Equine Orthopedics and a European Specialist in Sports Medicine and Rehabilitation.
  • Sue qualified from the University of Cambridge in 1980. After an internship at the University of Pennsylvania and a year in practice in USA, she spent 37 years at the Animal Health Trust, specializing in lameness and poor performance.
  • Sue Dyson now works as a private consultant. She has also ridden to advanced level eventing, Grade A showjumping, and advanced medium level dressage.
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Photo: Canva Pro

The team started by defining 117 behaviors that were present in lame horses and finally reached a list of 24 behaviors. The Ridden Horse pain Ethogram, in short RHpE, is a catalogue of 24 distinct behaviors in ridden horses that are likely to occur at least ten times more frequently in lame horses versus sound horses.

These behaviors included eyes closed for two to five seconds, or the horse blinking frequently, opening the mouth with exposure of the teeth for at least 10 seconds, an intense stare for at least five seconds, repeated tail swishing, repeated head movements, spooking, and spontaneous gait changes bucking, rearing and others.

Most non-lame horses may show two or three behaviors. However, the display of eight or more of these behaviors is highly likely to reflect underlying musculoskeletal pain.

Sue Dyson and colleagues assessed several horses in walk, trot, and canter and looked at the behaviors indicative of pain. For example, lame horses are more likely than sound horses to put their ears back behind the vertical position for 5 seconds, or they may hold their tail clamped down the middle or held to one side. 

You might experience repeated exposure of the sclera, the white of the eye, the mouth being opened with separation of the teeth for 10 seconds or more, or the tongue being out or moving in and out repeatedly. All behaviors were scored as present or absent. According to Sue Dyson, is it essential to recognize that some lame horses score below 8, such as stoic horses or those with low-grade lameness. Also, some horses may appear comfortable in trot and score fewer than eight, while the same horse can be uncomfortable in canter with scores greater than eight.

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Other behaviors not included in the ethogram are likely to reflect underlying pain. These include grinding the teeth, sweating disproportionally or an elevated breathing rate during exercise relative to the horse's fitness, the amount of work, and the environmental conditions.

According to Sue Dyson pain in the horse is a controversial subject, but defining the ethogram's behaviors objectively helps avoid bias and thus to improve the welfare of the horses.

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If you think that your horse may have pain-related problems, please don’t ignore it.

Malgre Tout - Pain related signs
Malgre Tout - Pain related signs
Malgre Tout - Pain related signs
Malgre Tout - Pain related signs

The RHpE applied in riding schools and events

60 sports horses and riding school horses in regular work, all of whom were assumed by their owners to be working comfortably, were evaluated by the researchers using the RHpE. They performed an eight-point dressage type test, and it showed that in rising trot, 73% of the riding school horses were lame or had a low-grade lameness. In canter, 47 % of the horses had gait abnormalities. 

The horses were a part of a study done by Sue Dyson and her colleagues. The RHpE scores ranged from 3 - 16 points out of 24, and the most common score was nine. The higher the RHpE score, the more likely the horse was lame or had gait abnormalities.

The researchers have also done extensive studies at 5 Star events and national competitions to see if there was a relationship between the scores and performances in dressage, show jumping and cross-country events. The lower the RHpE score, the less likelihood of pain and discomfort. Sue Dyson found that horses placed first to third had a lower RHpE score than other finishers, and horses with RHpE of more than eight were overrepresented in the group of horses that did not complete or were placed lower. 

In the showjumping phase of the event, riders often rode more positively forward than in dressage. Just because a horse can jump well doesn't mean it's necessarily clinically normal. According to Sue Dyson, the release of endorphins and adrenaline when jumping could enhance the horse's performance by masking muscular-skeletal discomfort, states Sue Dyson. 

Essential to educate riders and professionals

Overall, there was a low average RHpE score observed in the studies and most horses were sound. However, 9 % of the starters had an RHpE score higher than eight out of 24 behaviors, and this merits attention, says Sue Dyson. She noted that several dressage judges had considered that some horses looked uncomfortable before the start, but they felt reluctant to advise competitors to withdraw because of previous adverse experiences. Some competitors had sought advice from the vet, but the horse was only evaluated in hand, and no lameness had been observed. 

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Nerve blockage 

A nerve blockage is a medical blockage of one or more nerves. It is a local anesthetic that works for a few hours, and it prevents impulses from the pain area from reaching the brain. This means that the horse does not experience the pain when it moves. According to Sue Dyson, one can use RHpE to evaluate lameness in the horse by looking at the horse's reaction to a nerve blockage and find the cause of the horse's pain.

Sue Dyson believes it is of utmost importance to educate riders and coaches to recognize gait abnormalities that reflect discomfort and to observe the ridden horse behaviors.

According to her, it is essential to understand the potential consequences of incorrect training on long-term muscular-skeletal health. 

The RHpE is a tool that can help owners detect the presence or the absence of a problem and identify that their horse may have a pain-related problem. Even low-grade lameness or pain can still contribute to poor performance. By early recognition of muscular-skeletal pain and investigation of the problem, she believes that we can improve the welfare and performance of some of these horses.

The RHpE can confirm if pain is absent

The RHpE can also show if horses, in general, are comfortable and pain is absent. A Grand Prix dressage horse photograph from a worried spectator, spurred Sue Dyson's interest in using the RHpE on several high-level dressage horses. Someone sent her a photograph of a specific horse and asked ‘Is this horse suffering?’ Her response was that she couldn’t make a judgment call without seeing the video recording of the entire test. 

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Sue Dyson and her fellow researchers observed videos of 147 horses competing at nine FEI World Cup dressage competitions in 2018 and 2019 and noted the horses’ behaviors during their entire dressage tests. The RHpE score can help to explain the “picture in time” phenomenon—photos of high-level competition horses looking as if they’re in pain, even if they’re not.

According to Sue Dyson, you can’t just look at snapshots to know how a horse is feeling. Instead, you have to look at the whole picture and evaluate the entire test.

Horses can show short moments of discomfort during a demanding dressage program, but that may be just one or two seconds in a six-and-a-half-minute test, so how is that representative of the overall comfort level of the horse? Sue Dyson doesn’t think it necessarily is.

Different responses to pain

Horses react differently to pain, and no two horses are the same. According to Sue Dyson, you can have two horses with the same source of pain, but they can exhibit a completely different spectrum of behaviors. She describes that while one horse may have its ears flat back and not want to go forward and swish its tail repeatedly, another horse may gallop off uncontrollably, ears forward but hurried movements and spontaneously changing legs.

Uneven rein tension

Many lame horses ride with significantly higher rein tension in one rein over the other rein.  

If the rider doesn’t have even contact in both hands, or if you are pulled in one side of your arm, it could be a sign of the horse being in pain. From her experience, Sue Dyson has often seen that the horse will suddenly make even contact when the pain is taken away by a nerve block. This shows that the horse induces rein tension. Horses have adapted their way of moving, so they lean more on one side, and somehow, they are inflicting discomfort on themselves, states Sue Dyson. There is no obvious answer to why horses do so, she says, but it is essential to check if there is an underlying cause of the pain. 

Lameness during high-intensity work

Some horses cannot cope with the ridden work they are asked to do. They may exhibit signs of lameness during higher intensity work, while there are no signs during low-intensity work, like hacking out. This is because hacking is much less demanding, and the horse may be comfortable under those circumstances. 

Schooling, however, places high biomechanics demands on the horse, like going in circles and continuously asking for increased time, engagement and impulse, says Sue Dyson. This can be the cause of pain and lameness. If this is the case, you will have to evaluate the problem, and you can investigate further, identify the underlying cause and treat it. If you can’t afford this, you can decide to hack the horse because he is comfortable under these circumstances. Sue Dyson is not saying that we should not ride horses, but we have a responsibility to figure out under which circumstances the horse is lame.

Spooking can be a sign of pain

If your horse is spooking, it could be a sign of pain, says Sue Dyson. She had observed several horses that stopped spooking when the pain was taken away. Spooking is a manifestation that something is not quite right. It is natural for a horse to spook if it sees a paper bag floating about in the bushes, she says, but if the horse spooks at imaginary ghosts in the arena, when there is nothing obvious to spook about, there has to be an underlying reason why it is doing so.

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My message to owners and riders is that if we can find the cause of the horse's higher RHpE - score, then we can help the horse, improve its comfort and also its performance and the welfare of the horse

Can professional riders mask the pain?

Based on a study of 40 horses ridden by a regular rider and an experienced professional rider, Sue Dyson demonstrated that while a more skilled rider could improve how the horses worked, and the gait quality scores went up, they could not hide behavioral aspects reflecting discomfort. Some of the behaviors changed with an experienced rider, but the behavioral scores remained similar. In her observations, Sue Dyson noticed that horses ridden by an average rider would keep the front of the head in a vertical position of more than 30 degrees and for more than 10 seconds. However, ridden by a skilled rider, the horse would keep the front of the head behind the vertical position for more than 10 seconds and more than 10 degrees. The horse's behavior will change, but according to Sue Dyson, you cannot mask pain, even as a professional rider. 

Using RHpE at pre-purchase examinations

When buying a new horse, using the RHpE at pre-purchase examinations can help to determine whether or not a horse is suitable for purchase for the purposes for which it is required, and if the saddle is suitable for your new horse, Sue Dyson says.

An ill-fitting saddle can contribute to pain, and according to Sue Dyson, it is highly critical to have the saddle checked regularly. The RHpE is also useful when assessing saddle fit because horses often change shape. Sue Dyson did a long-term study for one year where she looked at 120 horses every two months during the course of the year. She could see measurable changes, and while some of the changes were seasonal, others were related to time off because the horse was lame, and the muscle dimension tended to decrease. 

Sue Dyson noted that if the rider changed from an ill-fitting saddle to a better saddle, within two months, she could see a measurable increase in the back muscles. Saddle fitting is hugely important to avoid pain in the horses, and it would be ideal to have the saddle checked every three months, especially when you work with young horses, says Sue Dyson.

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Photo: Canva Pro

Take home message

The take home message from Sue Dyson is that if you think your horse may have pain-related problems, please don’t ignore it. Once you are aware of a problem with your horse, you must first seek your vet's advice. It should be a general appraisal of your horse, saddle, and the rider. It’s about looking at the bigger picture.

When the problem has been identified, the owner can bring in other professionals such as their farrier, physiotherapist and nutritionist to cover all bases of their horse’s management, states Sue Dyson.

What can you do as an owner?

Even if a horse appears non-lame in hand, it may be lame when ridden. This may manifest in its behavior as an indicator that something is not right. If it's not performing satisfactorily on the flat, that generally reflects the presence of a problem. 

The relationship between the RHpE scores and performance highlights the importance of recognition and management of pain for optimizing the potential of the horse. The results are fascinating, because we have a tool that any trained observer can accurately apply. Riders and their coaches/trainers also need to consider why a horse performed poorly rather than attribute blame to rider errors, ground conditions, or the horse's training.

Sue Dyson strongly believes that education of all involved in the equine industry is needed to recognize that these behaviors are not normal behaviors of horses. They reflect underlying muscular-skeletal pain. 

According to Sue Dyson, we can learn so much from riding and watching horses and think of what we see and feel. She concludes that if we recognize this and look at our horses, their performance would be improved, and the horses would be a pleasure to ride. 

In short, we have a duty of care for the horses we ride and, more importantly, a moral obligation to improve equine welfare by limiting pain and suffering. Horsemanship is a continuous process that never stops. It is all about looking at the horses’ behavior, asking: Are they happy?

READ ALSO: No hoof no horse: Nutritional support for the horse's hooves

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