Veterinarians at Rood and Riddle Equine Hospital answer your questions about sales and healthcare of Thoroughbred auction yearlings, weanlings, 2-year-olds and breeding stock.

Question: Some horses can be really “stoic” when they’re experiencing pain or illness. How can an owner pick up on subtle signs of pain in a stoic horse?

Dr. Jordan Kiviniemi-Moore, Rood and Riddle Equine Hospital: Stoicism has an evolutionary advantage for horses, as it helps them avoid being singled out by predators. As such, horses may conceal substantial levels of pain and carry on without dramatic symptoms, making it easy to miss subtle signs that reflect underlying discomfort. It is also important to recognize that certain common signs such as stiff movement or a squinty eye are in fact a reflection of pain, even if the horse is bright, eating, and otherwise behaving normally.


A grimacing horse.

Knowing what is “normal” for a particular horse will help owners pick up on small cues that may indicate an issue. Horse owners may notice subtle changes in behavior such as decreased enthusiasm for feed, slower or reluctant movement, or uncharacteristic separation from the rest of the herd or group of horses. The horse may become “girthy” or fussy when being bridled, or very reactive under saddle. Such behavior alterations can also occur in the absence of physical discomfort, but ruling out underlying pain and physical causes should be among the first steps in investigating behavior changes or training issues.

Additional signs of generalized underlying pain include lethargy, low head carriage or abnormal posture, shifting weight, and bruxism or teeth grinding. The “horse grimace scale” was developed by researchers who correlated pain levels with changes in equine facial expressions such as squinting, stiffly backward ears, and strained mouth and nostrils. This is particularly helpful to assess discomfort following medical procedures or for horses suffering from ongoing issues such as chronic lameness.

Learn more about the horse grimace scale here.

Subtle signs of pain often correlate with the underlying issue and affected body system. In my practice I most commonly see horses dealing with musculoskeletal and hoof pain, gastrointestinal pain, and ocular pain. Dental pain is also quite common and can be difficult to recognize. Musculoskeletal pain often manifests as an altered gait (i.e., stiffness or limping), failure to keep up with the group of horses, and lying down excessively. Horses suffering from ocular pain may squint one or both eyes or have increased redness or discharge. Of course, the more severe manifestation of gastrointestinal pain is overt colic signs such rolling, pawing, sweating, and flank-watching, but more subtle signs include decreased appetite, lethargy, and grinding teeth. Horses suffering from dental pain may become fussy with the bit, drop feed, act reluctant to accept treats, or seem to chew predominately on one side of their mouth.

Horses have evolved to eat, watch for predators, run when needed, and keep up with their social group, and most will attempt to maintain and preserve these activities even in the face of discomfort. If you notice uncharacteristic behaviors or changes with your horse your veterinarian can help you assess comfort level and also examine for underlying painful conditions. Together you can construct a plan to evaluate problems and optimize performance and quality of life for your horse.


Dr. Jordan Kiviniemi-Moore

Dr. Kiviniemi-Moore grew up in Lexington, Ky., pleasure riding and dreaming of becoming a veterinarian. Living in central Kentucky presented Dr. Kiviniemi-Moore with wonderful opportunities from local veterinarians who fostered her desire to become one herself.

In 2010 she graduated from Transylvania University with a BA in Biology and earned her DVM from Auburn University College of Veterinary Medicine in 2014. She completed a rotating equine internship which included internal medicine, surgery, and ambulatory rotations at the University Of Missouri College Of Veterinary Medicine in 2015. Her areas of interest include theriogenology and primary care.

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