Pain Recognition and Management in Horses

Recognising signs of pain in horses is extremely important in terms of animal welfare and also preventing further complications and prolonged recovery due to pain.

How I do recognise whether my horse is in pain? 

Horses are prey animals and have evolved to hide obvious signs of pain to avoid being an easy target for predators! Sometimes pain is easy to detect but often the signs are quite subtle and we must look closely to notice them. Some examples of conditions causing pain and how to recognise them are as follows: 


Signs of abdominal pain (colic) 

  • Depression/quiet demeanour
  • Lack of appetite
  • Droppings may be reduced or absent
  • Pawing the ground
  • Flank-watching (turning round to look at the abdomen)
  • Teeth grinding
  • Repeatedly displaying the Flehmen response (curling up the top lip)
  • Lying down more than normal, or lying down and getting up repeatedly
  • Rolling

If you notice these signs, call your veterinary surgery immediately. Any suspected case of colic should be examined by a veterinary surgeon. If veterinary attention is not sought right away, the horse's condition may deteriorate, and treatment may be less successful. Do not leave it too late! 


Signs of laminitis: 

  • Spending long periods standing in one spot
  • Reluctance or complete refusal to move
  • Walking slowly with a short stride or 'pottery' gait
  • Rocking back on the hindlimbs to take weight off forelimbs
  • Reluctance to walk on hard surfaces/preference for grass & other soft surfaces
  • Lying down more than normal
  • Pain in both front feet, both front & hind feet or sometimes only in one foot

Laminitis is often under-estimated by horse owners as a cause of pain but laminitic pain can be severe and unlike many other conditions may last for weeks or months, resulting in major welfare issues. If you suspect your horse or pony has laminitis, remove him/her off pasture into a stable if possible and call your veterinary surgeon. 


Signs of limb pain/lameness: 

  • Reluctance to bear weight on one limb
  • Resting one limb constantly
  • Shortening of the stride in affected limb
  • Rider noticing changes in movement during ridden exercise
  • Poor performance
  • Heat or swelling in affected region


In severe lameness, horses may be non weight-bearing on the affected limb. This should be viewed as an emergency and veterinary attention sought immediately. 

Please note: Only a veterinary surgeon is legally allowed to diagnose and treat lameness. This will usually involve examination at rest and at exercise, often including lunging or assessment on different surfaces. Nerve or joint blocks using local anaesthesic, or imaging such as radiographs (x-rays) and scans may be necessary to accurately locate the exact source of the lameness. Vets will liase with farriers and qualified paraprofessionals such as physiotherapists when appropriate to create a plan for long-term pain management or prevention of future lameness. 


What is 'acute' and 'chronic' pain? 

These terms relate to the duration of pain -not the severity. Acute pain refers to pain within a short time frame e.g. hours or 1-3 days. Chronic pain refers to pain which is more long-term e.g. days, weeks or months. 


How is pain treated in horses? 

Pain needs to be managed pharmacologically i.e. using drugs and by other means where necessary. 

Pain and inflammation often go hand-in-hand. Therefore anti-inflammatories often form the backbone of a pain treatment plan. Phenylbutazone ('Bute') is a commonly used anti-inflammatory drug in horses. It is useful in both short-term and long-term painful conditions including orthopaedic disease e.g. arthritis, laminitis, wounds and soft tissue injuries. Other types of drugs will be prescribed by your vet as necessary. Please do not give Phenylbutazone unless advised by your vet, you may be removing vital clinical signs which the vet uses to make a diagnosis. 

Additional methods of managing pain that your vet may recommend may include physiotherapy, cryotherapy e.g. cold-hosing and immobilisation (box rest). 

For more useful information on pain management, have a look at: www.equinepainmatters.com 

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Abbey Equine Clinic

Llansabbath Barns, Llanellen, Abergavenny, Gwent NP7 9BY
T: 01873 840 069
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Ride and Stride, St Arvans, Chepstow. NP16 6DN
T: 01291 444877
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