Analyze Diet
Animals : an open access journal from MDPI2020; 10(2); doi: 10.3390/ani10020210

In-Person Caretaker Visits Disrupt Ongoing Discomfort Behavior in Hospitalized Equine Orthopedic Surgical Patients.

Abstract: Horses have evolved to show little indication of discomfort or disability when in the presence of potential predators, including humans. This natural characteristic complicates the recognition of pain in equine patients. It has been our clinical impression that, whenever a person is present, horses tend to "perk up" and ongoing discomfort behavior (DB) more or less ceases. The objective of this study was to quantitatively evaluate and describe this effect. For each of 20 orthopedic surgical patients, continuous 24-h video was reviewed to record all occurrences of DB during a caretaker visit (3.23 to 7.75 min), for comparison to the hour preceding as well as the hour following when undisturbed. The mean ± S.E. DB observed per minute during the preceding and following hours, respectively, were 1.65 ± 0.17 and 1.49 ± 0.22. The difference was not significant (p > 0.05). In contrast, mean DB per minute during the visit was 0.40 ± 0.11. This was significantly lower than during both the preceding and following hours (p < 0.0001). All 20 patients expressed fewer observable DB per minute during the visit, with a mean reduction of 77.4% ± 0.17%. For 30% of these patients, ongoing DB ceased altogether during the visit. These findings confirm our clinical impression that caretaker visits interrupt DB, resulting in under-appreciation of discomfort.
Publication Date: 2020-01-27 PubMed ID: 32012670PubMed Central: PMC7070845DOI: 10.3390/ani10020210Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study explores the impact of human presence on the behavior of horses, particularly those under post-operation orthopedic care. The study found that horses tend to exhibit fewer signs of discomfort during human visits, making it more challenging for caregivers to accurately assess their pain levels.

Study Objective

  • The study aimed to quantify and describe the observed phenomenon where horses, as a survival instinct, reduce behaviors indicating discomfort when humans are present.

Methodology

  • The study examined 20 orthopedic surgical patients – horses that have undergone a surgical procedure.
  • For each horse, continuous 24-hour video footage was reviewed. The researchers documented any signs of Discomfort Behavior (DB) during a caretaker visit, which lasted about 3 to 8 minutes.
  • The team compared these findings to the behavior of the horse an hour before and an hour after the visit, during which they were undisturbed.

Results

  • The study found that the mean DB per minute during the visits was 0.40 ± 0.11, significantly lower than the preceding and following hours, with DB at 1.65 ± 0.17 and 1.49 ± 0.22 per minute respectively.
  • All 20 patients presented fewer observable DB per minute during human visitation, with the mean reduction in DB at 77.4% ± 0.17%.
  • Additionally, for 30% of these patients, DB ceased completely during the visit.

Conclusion

  • The study confirmed the researchers’ initial hypothesis that caretaker visits have a subduing effect on horse discomfort behavior.
  • This pattern could lead to an underestimation of discomfort in horses, as they instinctively mask signs of pain in front of humans, similar to potential predators.

Cite This Article

APA
Torcivia C, McDonnell S. (2020). In-Person Caretaker Visits Disrupt Ongoing Discomfort Behavior in Hospitalized Equine Orthopedic Surgical Patients. Animals (Basel), 10(2). https://doi.org/10.3390/ani10020210

Publication

ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 10
Issue: 2

Researcher Affiliations

Torcivia, Catherine
  • Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, New Bolton Center, 382 W Street Road, Kennett Square, PA 19348, USA.
McDonnell, Sue
  • Havemeyer Equine Behavior Lab and Clinic, Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, New Bolton Center, 382 W Street Road, Kennett Square, PA 19348, USA.

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 8 references
  1. McDonnell S. Is it Psychological, Physical or Both?. Proceedings of the 51st AAEP Annual Convention; Seattle, WA, USA. 3–7 December 2005; pp. 231–238.
  2. Gleerup KB, Lindegaard C. Recognition and quantification of pain in horses: A tutorial review. Equine Vet. Educ. 2016;28:47–57.
    doi: 10.1111/eve.12383google scholar: lookup
  3. Bussières G, Jacques C, Lainay O, Beauchamp G, Leblond A, Cadoré JL, Desmaizières LM, Cuvelliez SG, Troncy E. Development of a composite orthopaedic pain scale in horses. Res. Vet. Sci. 2008;85:294–306.
    doi: 10.1016/j.rvsc.2007.10.011pubmed: 18061637google scholar: lookup
  4. Price J, Catriona S, Welsh EM, Waran NK. Preliminary evaluation of a behaviour-based system for assessment of post-operative pain in horses following arthroscopic surgery. Vet. Anaesth. Analg. 2003;30:124–137.
  5. de Graw JC, van Loon JPAM. Systematic pain assessment in horses. Vet. J. 2016;209:14–22.
    doi: 10.1016/j.tvjl.2015.07.030pubmed: 26831169google scholar: lookup
  6. van Loon JPAM, van Dierendonck MC. Objective pain assessment in horses (2014-2018). Vet. J. 2018;242:1–7.
    doi: 10.1016/j.tvjl.2018.10.001pubmed: 30503538google scholar: lookup
  7. Dalla Costa E, Minero M, Lebelt D, Stucke D, Canali E, Leach MC. Development of the horse grimace scale (HGS) as a pain assessment tool in horses undergoing routine castration. PLoS ONE 2014;9:e92281.
  8. van Loon JPAM, van Dierendonck MC. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht Scale for Facial Assessment of Pain (EQUUS-FAP): A scale-construction study. Vet. J. 2015;206:356–364.
    doi: 10.1016/j.tvjl.2015.08.023pubmed: 26526526google scholar: lookup

Citations

This article has been cited 27 times.
  1. Bolesławska-Szubartowska J, Kucharczuk M, Skrabska A, Zbysław A, Adamowicz J, Alszko A, Domagalska-Stomska K, Durska M, Dziekcierów A, Janiszewska Z, Korzeniowska R, Kraujutowicz K, Kulesza K, Marciniak P, Pacyna Z, Przeborowska J, Siwek Z, Leonard M, Rapacz-Leonard A. Introducing an Innovative Pain Scale for Assessing Postpartum Pain in Mares: Preliminary Clinical Evaluation. Animals (Basel) 2025 Nov 30;15(23).
    doi: 10.3390/ani15233454pubmed: 41375512google scholar: lookup
  2. Klinck M, Lovett A, Sykes B. Incorporating a Behavioral Medicine Approach in the Multi-Modal Management of Chronic Equine Gastric Ulcer Syndrome (EGUS): A Clinical Commentary. Animals (Basel) 2025 Oct 17;15(20).
    doi: 10.3390/ani15203019pubmed: 41153946google scholar: lookup
  3. Musial F, Weiss T. What if Horses Were Humans? Comparing Rein Tension and Bit Pressures to Human Pressure Pain Thresholds. Animals (Basel) 2025 Oct 15;15(20).
    doi: 10.3390/ani15202989pubmed: 41153916google scholar: lookup
  4. Rega V, Brause S, Kästner SB, Schütter AF. Comparison of the feline Glasgow Composite Measured Pain Scale in a feline population without painful disease at home and in a veterinary hospital: a prospective clinical study. J Feline Med Surg 2025 Nov;27(11):1098612X251385847.
    doi: 10.1177/1098612X251385847pubmed: 40999572google scholar: lookup
  5. Lascelles BDX, Barratt D, Basran PS, Brown DC, Coetzee JF, Gill M, Hutchinson MR, Johnson C, Luna SPL, Mohapatra DP, Oshinsky ML, Robertson S, Ruberman CF, Smith ER, Zhang Q. Advancing outcome measure development and analytical approaches: Pain in Animals Workshop 2023. Front Pain Res (Lausanne) 2025;6:1615862.
    doi: 10.3389/fpain.2025.1615862pubmed: 40919438google scholar: lookup
  6. Lundblad J, Rhodin M, Hernlund E, Bjarnestig H, Hidén Rudander S, Haubro Andersen P. Facial expressions during compound interventions of nociception, conspecific isolation, and sedation in horses. Sci Rep 2025 Feb 13;15(1):5373.
    doi: 10.1038/s41598-025-89329-xpubmed: 39948238google scholar: lookup
  7. van Loon JPAM, Trindade PHE, da Silva GV, Keus J, Huberts C, de Grauw JC, Lanci A. Objective assessment of acute pain in foals using a facial expression-based pain scale. Equine Vet J 2025 Nov;57(6):1520-1530.
    doi: 10.1111/evj.14481pubmed: 39888021google scholar: lookup
  8. Torcivia C, McDonnell SM. Behavioral Signature of Equine Gastric Discomfort? Preliminary Retrospective Clinical Observations. Animals (Basel) 2025 Jan 3;15(1).
    doi: 10.3390/ani15010088pubmed: 39795031google scholar: lookup
  9. Sidwell AE, Duz M, Hill B, Freeman S, Hole SL. Application of the horse grimace scale in horses with dental disease: Preliminary findings. Vet Rec 2025 Feb 1;196(3):e4800.
    doi: 10.1002/vetr.4800pubmed: 39520383google scholar: lookup
  10. Nowak M, Martin-Cirera A, Jenner F, Auer U. Time budgets and weight shifting as indicators of pain in hospitalized horses. Front Pain Res (Lausanne) 2024;5:1410302.
    doi: 10.3389/fpain.2024.1410302pubmed: 39109240google scholar: lookup
  11. Auer U, Kelemen Z, Vogl C, von Ritgen S, Haddad R, Torres Borda L, Gabmaier C, Breteler J, Jenner F. Development, refinement, and validation of an equine musculoskeletal pain scale. Front Pain Res (Lausanne) 2023;4:1292299.
    doi: 10.3389/fpain.2023.1292299pubmed: 38312997google scholar: lookup
  12. Howard DL, Lancaster B, de Grauw J. Development and Preliminary Validation of an Equine Brief Pain Inventory for Owner Assessment of Chronic Pain Due to Osteoarthritis in Horses. Animals (Basel) 2024 Jan 5;14(2).
    doi: 10.3390/ani14020181pubmed: 38254349google scholar: lookup
  13. Ask K, Rhodin M, Rashid-Engström M, Hernlund E, Andersen PH. Changes in the equine facial repertoire during different orthopedic pain intensities. Sci Rep 2024 Jan 2;14(1):129.
    doi: 10.1038/s41598-023-50383-ypubmed: 38167926google scholar: lookup
  14. Anderson KA, Morrice-West AV, Wong ASM, Walmsley EA, Fisher AD, Whitton RC, Hitchens PL. Poor Association between Facial Expression and Mild Lameness in Thoroughbred Trot-Up Examinations. Animals (Basel) 2023 May 23;13(11).
    doi: 10.3390/ani13111727pubmed: 37889660google scholar: lookup
  15. Fonseca MW, Trindade PHE, Pinho RH, Justo AA, Tomacheuski RM, Silva NEOFD, Gonçalves HC, Luna SPL. Development and Validation of the Unesp-Botucatu Goat Acute Pain Scale. Animals (Basel) 2023 Jun 28;13(13).
    doi: 10.3390/ani13132136pubmed: 37443934google scholar: lookup
  16. Kim SM, Cho GJ. Analysis of Various Facial Expressions of Horses as a Welfare Indicator Using Deep Learning. Vet Sci 2023 Apr 10;10(4).
    doi: 10.3390/vetsci10040283pubmed: 37104439google scholar: lookup
  17. Robles I, Luna SPL, Trindade PHE, Lopez-Soriano M, Merenda VR, Viscardi AV, Tamminga E, Lou ME, Pairis-Garcia MD. Validation of the Unesp-Botucatu pig composite acute pain scale (UPAPS) in piglets undergoing castration. PLoS One 2023;18(4):e0284218.
    doi: 10.1371/journal.pone.0284218pubmed: 37053294google scholar: lookup
  18. Ask K, Andersen PH, Tamminen LM, Rhodin M, Hernlund E. Performance of four equine pain scales and their association to movement asymmetry in horses with induced orthopedic pain. Front Vet Sci 2022;9:938022.
    doi: 10.3389/fvets.2022.938022pubmed: 36032285google scholar: lookup
  19. Broomé S, Ask K, Rashid-Engström M, Haubro Andersen P, Kjellström H. Sharing pain: Using pain domain transfer for video recognition of low grade orthopedic pain in horses. PLoS One 2022;17(3):e0263854.
    doi: 10.1371/journal.pone.0263854pubmed: 35245288google scholar: lookup
  20. Barreto da Rocha P, Driessen B, McDonnell SM, Hopster K, Zarucco L, Gozalo-Marcilla M, Hopster-Iversen C, Esteves Trindade PH, Gonzaga da Rocha TK, Taffarel MO, Alonso BB, Schauvliege S, Luna SPL. A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses. PLoS One 2021;16(8):e0255618.
    doi: 10.1371/journal.pone.0255618pubmed: 34352001google scholar: lookup
  21. van Loon JPAM, Macri L. Objective Assessment of Chronic Pain in Horses Using the Horse Chronic Pain Scale (HCPS): A Scale-Construction Study. Animals (Basel) 2021 Jun 18;11(6).
    doi: 10.3390/ani11061826pubmed: 34207290google scholar: lookup
  22. Andersen PH, Broomé S, Rashid M, Lundblad J, Ask K, Li Z, Hernlund E, Rhodin M, Kjellström H. Towards Machine Recognition of Facial Expressions of Pain in Horses. Animals (Basel) 2021 Jun 1;11(6).
    doi: 10.3390/ani11061643pubmed: 34206077google scholar: lookup
  23. Trindade PHE, Taffarel MO, Luna SPL. Spontaneous Behaviors of Post-Orchiectomy Pain in Horses Regardless of the Effects of Time of Day, Anesthesia, and Analgesia. Animals (Basel) 2021 May 31;11(6).
    doi: 10.3390/ani11061629pubmed: 34072875google scholar: lookup
  24. Torcivia C, McDonnell S. Equine Discomfort Ethogram. Animals (Basel) 2021 Feb 23;11(2).
    doi: 10.3390/ani11020580pubmed: 33672338google scholar: lookup
  25. Ask K, Rhodin M, Tamminen LM, Hernlund E, Haubro Andersen P. Identification of Body Behaviors and Facial Expressions Associated with Induced Orthopedic Pain in Four Equine Pain Scales. Animals (Basel) 2020 Nov 19;10(11).
    doi: 10.3390/ani10112155pubmed: 33228117google scholar: lookup
  26. Luna SPL, de Araújo AL, da Nóbrega Neto PI, Brondani JT, de Oliveira FA, Azerêdo LMDS, Telles FG, Trindade PHE. Validation of the UNESP-Botucatu pig composite acute pain scale (UPAPS). PLoS One 2020;15(6):e0233552.
    doi: 10.1371/journal.pone.0233552pubmed: 32480399google scholar: lookup
  27. Mellor DJ. Mouth Pain in Horses: Physiological Foundations, Behavioural Indices, Welfare Implications, and a Suggested Solution. Animals (Basel) 2020 Mar 29;10(4).
    doi: 10.3390/ani10040572pubmed: 32235343google scholar: lookup