How can I tell if my horse is in pain?

Horses have lots of ways of telling us they are in pain.  The most common way, and the most variable way, is that your horse will “act weird” or “behave differently”.  Not so scientific, right? I will run down a list of things to keep your eyes peeled for, and then also go over one very easy way to measure in most instances.  Hint:  you only need a stethoscope.  


There is a school of thought out there about how horses show pain and why so many tend to be stoic until the pain becomes too much.  Horses are herd animals that are eaten by predators.  So, horses need to appear healthy and not lame so that the lions and tigers and bears (oh my) won’t eat them for dinner.  This can explain a lot of things - like your seemingly sound horse that all of a sudden is super lame.  He just reached his threshold!  




Speaking of lamenesses, horses don’t always go around head bobbing lame to show their pain.  Often, the rider will notice they are not as forward, their endurance has decreased, and they are snarky when you put your leg on.  You may even be so astute to notice they sound differently as they clip clop along the road at your barn.  Or you walk him by the mirrors and you notice that his step on the right hind is not as long as the left hind.  You may also want to document your horse’s hooves at every farrier visit.  Your farrier can help you track wear patterns on shoes and hooves that are valuable feedback.  


For colic cases, another instance when pain is present, your horse’s behavior will usually tell you what’s up.  Weird postures, different appetite, pawing, frequently laying down and getting up, staring at the flanks, belly kicking, not eating, and even distance from the herd. 


For laminitis, you will see posture changes, like rocking back onto his hind legs and sticking his front feet out, and your horse will look like he’s walking on eggshells trying not to break them.  Often, the early stages of laminitis only appear as your horse walks on hard surfaces, or you feel the heat from the hooves on your daily leg and hoof inspection.  He may also resist picking up his feet for a cleaning.  By the time your horse has rocked his weight back to relieve the pressure on his front hooves he’s in severe pain.  



Use a stethoscope to check your horse's pulse.  An increased pulse can indicate pain. 


You can also take your horse’s TPR to check for signs of pain before he decides to “tell” you with his actions.  Your horse’s heart rate (Pulse in TPR) will typically elevate from his normal when he’s having pain.  Again, know the normal and then you can be alerted.  His respiratory rate can increase, too, and you may even see sweating.  One reason that I check TPR every single day when I groom is that your horse’s TPR will tell you long before his outward signs will be.  I have caught laminitis, viruses, and colics with TPR monitoring alone.  If you don’t have a stethoscope, you can pick one up inexpensively.  It’s also fun to walk around with and pretend you are Doogie Howser.  




Your horse may also sweat when he's in pain.  This is sometimes hard to determine if the weather is horriblly hot already, but knowing what's normal for your horse is a great place to start. 





The flehmen response is also another signal of pain.  Horses curl their lips to take in smells, but they will also wiggle their lips, flare their nostrils, and show the flehmen response when in pain.  For more on the flehmen response, read this article. 


How does your horse tell you he’s in pain?