Blog Post One: How to tell if your horse is in pain using RHpE
As an owner, we do not want our horses to be in pain, so
how do you know if your horse is exhibiting signs of pain?
is there a quantitative way of measuring pain?
how often should you asses your horse?
if you notice certain signs of pain or a certain level of pain, when do you contact your vet or bodyworker?
It is easier to prevent an injury than to have to deal with the aftermath of an injury (and its rehab), so catching a problem early is paramount.
What is RHpE? It stands for Ridden Horse Pain Ethogram and was designed by Drs. Sue Dyson and Danica Pollard and described in their scientific article titled “Application of the Ridden Horse Pain Ethogram to Elite Dressage Horses Competing in World Cup Grand Prix Competitions” (2001).
The following are excerpts from the article:
“A Ridden Horse Pain Ethogram (RHpE) was developed comprising 24 behaviors; a score of ≥8/24 is likely to reflect the presence of musculoskeletal pain. The aim of the study was to apply the RHpE to elite dressage horses, competing at World Cup Grand Prix qualifying competitions or finals. It was hypothesised that this should be a group of horses with a low incidence of musculoskeletal pain; thus, RHpE scores would be consistently <8.
The RHpE was applied by a trained assessor to video recordings of 147 competitors at nine venues.
The median RHpE score for all competitors was 3/24 (range 0, 7).
There was a high frequency of occurrence of head behind vertical ≥10 degrees ≥10 seconds, mouth open with separation of the teeth ≥10 seconds, and repeated tail swishing, behaviors that should be penalized according to FEI rules.
It was nonetheless concluded that most horses appeared to work comfortably for the majority of the test.
In contrast, in a study of a convenience sample of 148 sports and leisure horses in the UK, believed by their owners (both amateur and professional riders) to be working comfortably, 62% were lame when ridden, and 60% of horses showed gait abnormalities in canter, specifically (Dyson S., Bondi A., Routh J., Pollard D. “Gait abnormalities and ridden horse behavior in a convenience sample of the United Kingdom ridden sports horse and leisure horse population”. Equine Vet. Educ. 2020). The median RHpE score for this group of horses was 8/24. There was a positive association between lameness and the RHpE score. This study highlighted the need to educate owners and trainers about lameness recognition and the RHpE.
Table 1. Summary of the 24 behaviors of the Ridden Horse Pain Ethogram (adapted from Dyson et al. 2001,).
Definitions of Each of the Behaviors
1. Repeated changes of head position (up/down), not in rhythm with the trot
2. Head tilted or tilting repeatedly
3. Head in front of vertical (≥30◦ ) for ≥10 s
4. Head behind vertical (≥10◦ ) for ≥10 s
5. Head position changes regularly, tossed or twisted from side to side, corrected constantly
6. Ears rotated back behind vertical (both or one only) for ≥5 s; repeatedly lay flat
7. Eye lids closed or half closed for 2–5 s; frequent blinking
8. Sclera exposed repeatedly
9. Intense stare (glazed expression, “zoned out”) for ≥5 s
10. Mouth opening ± shutting repeatedly with separation of teeth, for ≥10 s
11. Tongue exposed, protruding or hanging out, and/or moving in and out repeatedly
12. Bit pulled through the mouth on one side (left or right), repeatedly
13. Tail clamped tightly to middle or held to one side
14. Tail swishing large movements: repeatedly up and down/side to side/circular; repeatedly during transitions
15. A rushed gait (frequency of trot steps >40/15 s); irregular rhythm in trot or canter; repeated changes of speed in trot or canter
16. Gait too slow (frequency of trot steps <35/15 s); passage-like trot
17. Hindlimbs do not follow tracks of forelimbs but repeatedly deviated to left or right; on 3 tracks in trot or canter
18. Canter repeated leg changes, change of leg in front, and/or behind; repeated strike off wrong leg; disunited
19. Spontaneous changes of gait (e.g., breaks from canter to trot or trot to canter)
20. Stumbles or trips more than once; repeated bilateral hindlimb toe drag
21. Sudden change of direction, against rider direction; spooking
22. Reluctance to move forwards (has to be kicked ± verbal encouragement), stops spontaneously
23. Rearing (both forelimbs off the ground)
24. Bucking or kicking backwards (one or both hindlimbs)”
(The following is from Understanding and Using the Ridden Horse Pain Ethogram)
“You can assess your horse.”
“To become more familiar with the 24 behaviors to check for pain while being ridden, watch the video How To Use The Ridden Horse Pain Ethogram To Monitor Your Horse's Physical Wellness
This is how you can use the RHpE with your horse. After warming up, ask someone to video you riding him for 5 to 10 minutes. Include walk, trot and canter large on both reins, transitions within and between the paces, 10m circles in rising trot in a figure of eight, and any more advanced movements you and your horse can perform as a partnership. Video the horse moving in a straight line towards and away from you from two corners of the arena. Watch the video as many times as necessary to work through the list of 24 behaviours, marking them as ‘yes’ or ‘no’. A ‘yes’ scores 1, and a ‘no’ scores 0. You may want to use a stopwatch for some of them and a protractor to measure angles to get a more accurate score.
How about doing this exercise with a friend once a month to monitor your horse’s well-being? You can video your friend; they can video you, and you can go through the videos together. Like any skill, it will take practice and get easier with time. Keep a record of your horse’s score, and contact your vet for further investigation if he scores 8 or more out of 24.”
You can get an idea of the impact of the performance checklist through the award-winning film, ‘The 24 Behaviors of the Ridden Horse in Pain: Shifting the Paradigm of How We See Lameness’. The 24 Behaviors of the Ridden Horse in Pain: Shifting the Paradigm of How We See Lameness
Here is a very helpful website that gives you tools to asses your horse, including free downloadable mobile field guide and observational worksheet: Resources — 24 Behaviors of the Ridden Horse in Pain”
Ideally, horse owners would do the RHpE worksheet on their horse once a month and therefore be able to monitor any changes over time. This would also be helpful information to share with the horse’s veterinarian and body worker.
I hope these excerpts have been helpful, as well as the videos, to start assessing your own horse and if they have any pain. If you have any questions, please contact your veterinarian.
* this is not a substitution for veterinary care and does not constitute a diagnosis
