Animals: Equine Discomfort Ethogram

animals
Commentary
Equine Discomfort Ethogram
Catherine Torcivia 1, * and Sue McDonnell 2
1 Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, 382 W Street Road,
Kennett Square, PA 19382, USA
2 Havemeyer Equine Behavior Lab and Clinic, University of Pennsylvania School of Veterinary Medicine,
382 W Street Road, Kennett Square, PA 19382, USA; suemcd@vet.upenn.edu
* Correspondence: torcivia@upenn.edu
Simple Summary: Pain and discomfort behavior in horses tends to be especially subtle, and not
readily or widely appreciated even by equine professionals, including many long-time horse keepers,
trainers, and even by veterinarians, veterinary technicians, and care staff. Based on decades of
evaluating the behavior of normal and physically uncomfortable horses in a referral hospital, as well
as research context, we describe and illustrate a catalog of behaviors (ethogram) associated with
equine physical discomfort. Our objective is to promote an unambiguous universal understanding of
equine discomfort behaviors associated with various body systems and anatomic sources.
Abstract: In recent years, there has been a growing interest in and need for a comprehensive
ethogram of discomfort behavior of horses, particularly for use in recognizing physical discomfort in
domestically managed horses. A clear understanding of the physical discomfort behavior of horses
among caretakers, trainers, and professional health care personnel is important to animal welfare and
caretaker safety. This is particularly relevant to pain management for hospitalized equine patients.

Various pain scale rubrics have been published, typically incorporating only a few classically cited
Citation: Torcivia, C.; McDonnell, S.
pain behaviors that, in many cases, are specific to a particular body system, anatomic location, or
Equine Discomfort Ethogram.
disease condition. A consistent challenge in using these rubrics in practice, and especially in research,
Animals 2021, 11, 580.
is difficulty interpreting behaviors listed in various rubrics. The objective of this equine discomfort
https://doi.org/10.3390/
ani11020580
ethogram is to describe a relatively comprehensive catalog of behaviors associated with discomfort of
various degrees and sources, with the goal of improving understanding and clarity of communication
Academic Editors: Emanuela regarding equine discomfort and pain. An inventory of discomfort-related behaviors observed
Dalla Costa, Thijs van Loon and in horses has been compiled over 35 years of equine behavior research and clinical consulting to
Mandy Paterson medical and surgical services at the University of Pennsylvania School of Veterinary Medicine’s
equine hospital. This research and clinical work included systematic evaluation of thousands of hours
Received: 6 August 2020 of video-recordings, including many hundreds of normal, healthy horses, as well as hospitalized
Accepted: 25 January 2021 patients with various complaints and/or known medical, neurologic, or orthopedic conditions.
Published: 23 February 2021
Each of 73 ethogram entries is named, defined, and accompanied by a line drawing illustration.
Links to online video recorded examples are provided, illustrating each behavior in one or more
Publisher’s Note: MDPI stays neutral
hospitalized equine patients. This ethogram, unambiguously describing equine discomfort behaviors,
with regard to jurisdictional claims in
should advance welfare of horses by improving recognition of physical discomfort, whether for pain
published maps and institutional affil-
management of hospitalized horses or in routine husbandry.
iations.
Keywords: behavior; horse; welfare; pain
Copyright: © 2021 by the authors.

Licensee MDPI, Basel, Switzerland.
1. Introduction
This article is an open access article
distributed under the terms and The recognition of physical discomfort in horses is important to ensuring adequate
conditions of the Creative Commons welfare, both for general husbandry and for veterinary care procedures. Traditional veteri-
Attribution (CC BY) license (https:// nary evaluation of pain in equine patients has relied heavily on objective physical measures
creativecommons.org/licenses/by/ (e.g., heart rate, respiratory rate), and to a lesser extent, endocrine measures (e.g., circu-
4.0/). lating levels of cortisol, ß-endorphins, catecholamines, or pro-inflammatory mediators),
Animals 2021, 11, 580. https://doi.org/10.3390/ani11020580 https://www.mdpi.com/journal/animals

Animals 2021, 11, 580 2 of 21
mostly in research applications [1,2]. None of these, alone or in combination, have been
found to be definitive indicators of pain, due to multiple complicating factors, resulting in
an inability to distinguish pain from other physiological or psychological stress [1,2]. In an
effort to more accurately evaluate pain in horses, in recent decades, multiple composite
pain scales have been designed to take into account both objective physical measures
and classically cited, observable behaviors associated with discomfort [3–5]. Despite this
progress, a recent review of these equine pain scoring systems emphasizes that there are
still important shortcomings with the existing equine pain scales, specifically recognizing
mild pain states [1]. One factor contributing to this may be the lack of detailed descrip-
tions, images, or video examples of behaviors included in the scoring systems. In our
experience, in practice, this ambiguity leads to considerable confusion resulting in poor
recognition of discomfort. One exception is the Horse Grimace Scale (HGS) designed by
Dalla Costa et al. [6], which includes detailed descriptions and photographs to illustrate
various components of facial expressions associated with discomfort. To our knowledge, a
comprehensive equine discomfort ethogram has not been published. Certain reports do
describe some specific discomfort behaviors in post-operative equine patients following
particular surgical procedures, for example, orthopedic surgery [7,8] or celiotomy [9]. An
earlier review also grouped behavioral indicators of pain into categories based on body
system affected [10]. However, there is still a need for a relatively comprehensive and well-
illustrated equine discomfort ethogram that would be easily understood across various
languages and horse care cultures.
The validity of any pain scoring system that includes behavioral indicators requires
that (1) the developers clearly understand the various behaviors that may indicate discom-
fort in horses and (2) that users universally understand and are able to recognize those
behaviors. The objectives of this report were to (1) unambiguously describe a relatively
comprehensive list of behaviors that in decades of clinical experience we have observed
to be associated with the physical discomfort of various degrees and sources in horses,
providing both line drawing illustrations and video examples, and (2) for various clinical
conditions, describe clusters of those behaviors we have commonly observed.
2. Background Details
2.1. Original Observations
The information presented in this ethogram was primarily collected by the senior
author (SM) over 35 years of equine behavior research and clinical consulting at the
University of Pennsylvania School of Veterinary Medicine New Bolton Center. This work
included systematic evaluation of thousands of individual horses, each with a minimum
of 24 h of continuous video recording. These included normal, healthy horses in research
studies or in breeding programs, as well as hospitalized patients with various presenting
complaints and/or known medical, neurologic, or orthopedic conditions. Patient behavior
evaluations were performed primarily to assist hospital clinicians or referring veterinarians
with their diagnostic process. Typically, this involved advising whether a change in
behavior or performance appeared to more likely to reflect a psychological/behavioral
problem and/or current physical discomfort [11]. In most cases, a source of physical
discomfort was eventually diagnosed, providing feedback that enhanced the evaluator’s
body of knowledge. During this work, an inventory of discomfort-related behaviors
associated with various body systems and anatomic sources in horses was compiled. This
work also often included evaluation of behavior before and after administration of analgesia.
In these cases, if a behavior was suspected to reflect pain, and if it diminished with the
administration of analgesia, the behavior could more confidently be judged to reflect pain.
At times, clinicians also requested the author’s (SM) professional opinion concerning the
level of discomfort or quality of life in patients with known painful conditions. These
consults provided further information concerning types of discomfort behavior associated
with various body systems and anatomic sources.
Animals 2021, 11, 580 3 of 21
The standard behavior consultation performed for these services involves an analysis
of a 24-h (or occasionally longer) continuous video-recorded sample of a horse in its
stall. This method includes observation during periods without caretaker presence, which
provides more detailed and complete information regarding discomfort behavior than
direct observation [11]. Caretaker presence has been shown to disrupt ongoing discomfort
behavior in horses [7]. Additionally, the ability to scan video in fast forward enhances the
recognition of repetitive behaviors and postures that are typically more difficult to identify
in shorter periods of direct observation.
Before 2017, the majority of these evaluations did not involve patients with orthopedic
conditions requiring surgery. To ensure a comprehensive inventory of discomfort behaviors
associated with a variety of orthopedic conditions, in 2017, the authors together evaluated
a set of 60 hospitalized patients undergoing elective or emergency orthopedic surgical
procedures (e.g., arthroscopy, fracture repairs, arthrodesis). For each horse, a minimum
of 48 h of continuous video footage was obtained, including samples before and after
surgery. Specific discomfort behaviors associated with various orthopedic conditions were
cataloged in a manner similar to that of observations from the previous 35 years. All animal
procedures for obtaining video recordings during the 2017 pain assessment study were
approved by the University of Pennsylvania Institutional Animal Care and Use Committee
(protocol #806321).
2.2. Behavior Inventory from the Literature

A search of veterinary, animal science, and equine behavior science literature (English
language, from mid 20th century to the present) was undertaken to identify research re-
ports and review articles or book chapters describing behaviors associated with physical
discomfort in horses. Forty-five such sources [1–45] were reviewed to confirm agreement
with our identified behaviors, as well as to identify any behavioral elements or sequences
reported to reflect physical discomfort in horses that had not been identified in our clini-
cal observations.
3. Ethogram
The resulting list of equine discomfort behaviors in this ethogram includes a total
of 64 specific discomfort behaviors grouped into eight categories: posture and weight-
bearing; limb and body movements; head, neck, mouth, and lip movements; attention
to area; ear and tail movements; overall demeanor; altered eating or drinking; and vocal-
izations/audible sounds. Some behaviors have slight variations in form (e.g., stretching),
resulting in a total of 73 entries (see Tables 1–8). Each entry includes a name we believe to
be commonly used in English, a word definition, a line drawing depiction, and (with one
exception, sipping water) a link to a supplemental video file depicting one or more examples
of equine patients displaying the behavior. Many, but not all, of these behaviors, have been
mentioned in the literature that we reviewed. There were no additional behaviors described
in the literature that we did not record in our clinical observations. In addition, Table S1
summarizes behaviors commonly associated with various anatomic sources of discomfort.
4. Comments
We propose that this ethogram provides a relatively complete catalog of behaviors that
can be used as a reference to recognize discomfort in horses, both for general husbandry
and for clinical veterinary assessments. Hopefully, it will also prove useful for research
and for future pain scale development or refinement.
Recognition of discomfort in a prey species is particularly challenging. Horses have
evolved to show little evidence of discomfort or disability in the presence of predators,
including humans. This obviously can confound discomfort assessment [36]. In our clinical
review of 24-h continuous video, the effect of this phenomenon has been conspicuous (11).
In their pain assessments of horses following arthroscopic surgery, Price et al. [30] com-
mented that patients in their study showed a reduced incidence of certain pain behaviors
Animals 2021, 11, 580 4 of 21
(e.g., restlessness, weight shifting) when observed directly, even when caretakers viewed
from a distance, compared to remotely by video. Recently, we quantitatively evaluated
this important effect in 20 hospitalized equine orthopedic patients [7]. In those patients,
ongoing discomfort behaviors diminished or stopped altogether during caretaker visits for
pain assessment, and resumed once the caretakers had departed. Those patients displayed
a mean reduction of over 75% in the number of discomfort behaviors per minute when
caretakers were present, and 30% of those patients stopped performing discomfort behav-
iors altogether during the caretaker visit. Due to this effect, composite pain scoring systems
that require a period of direct observation likely underestimate discomfort behaviors. We,
therefore, posit that, when assessing discomfort in horses, it is important to observe re-
motely. Regardless of how well-trained a caretaker may be in behavior observation, if
discomfort behavior is interrupted by their presence, information regarding the horse’s
condition is lost.
Brief periods of direct observation may also lead to misinterpretations of comfort. For
example, stalled horses typically go through cycles of foraging and resting, often always
standing in one particular area of the stall when resting. If not observing longer periods
of continuous video, it may appear that a horse rarely moves from one area, when they
are actually going through normal resting/foraging cycles, but always returning to the
same area for standing rest. Similarly, if a caretaker happened to repeatedly visit during
rest periods, they may erroneously conclude that the horse has a decreased appetite. For
this reason, observing for longer periods of time via video recording, which can be viewed
in fast forward, is invaluable in understanding the overall behavior pattern of a horse.
Behaviors that suddenly interrupt ongoing goal-directed behavior, such as foraging
or resting, when the horse is otherwise calm, more clearly appear to represent acute
discomfort. In our experience, deviation from, or apparent inability to perform, normal
sequences of foraging and resting behavior, has been associated with increased levels
of discomfort.
Our experience with video observation of such a large number of clinical cases, many
with similar sources and types of diagnosed physical discomfort, has allowed us to appre-
ciate that there appear to be individual differences among horses in the expression and the
particular combination of various discomfort behaviors for any particular diagnosed condi-
tion. Ijichi et al. [46] recently explored the association of pain expression and corresponding
severity of musculoskeletal lesion in horses with owner-assessed personality factors. An
important finding in that work was that the degree of clinical lameness was not a reliable
indicator of the severity of tissue damage as diagnosed on ultrasound or radiographic
imaging. The conclusion of their preliminary study was that individual variation in the
expression of pain may be associated with certain personality factors.
Many of the discomfort behaviors included in this ethogram can be expressed with
slight variation in form. For example, as described in Table 2e, kicking out or back can
be performed in several distinct forms, varying in height and degree of extension of the
limb or limbs. In this ethogram, our illustration depicts just one common form. We
expect that variations will be easily recognizable as that behavior. Experience observing
horses over time will likely increase the observer’s knowledge of the possible variations of
particular behaviors.
We would not consider a single occurrence of any one behavior to be conclusive
evidence of discomfort. When viewing video of a horse to assess comfort level, in most
instances, we consider the first occurrence of a potential discomfort behavior as an indicator
to continue watching for repetitions of that particular behavior. Before making a judgment
about the causes of a behavior, or what a specific behavior might indicate regarding
discomfort, it is important to be sure that it was not an isolated event with an alternate
explanation. Repetitive clusters of behaviors, including one or more non-specific discomfort
behaviors (e.g., moving/focusing ears caudally, swishing/flicking tail, rotational shaking head or
whole body, restlessness/ill-at-ease), are also helpful in confidently judging that a behavior
reflects physical discomfort. For example, if one or more episodes of stomping are observed
Animals 2021, 11, x FOR PEER REVIEW 5 of 22
als 2021, 11, x FOR PEER REVIEW 5 of 22
Animals 2021, 11, 580 whole body, restlessness/ill-at-ease), are alsoinhelpful in confidently judging that a behavior 5 of 21
whole body, restlessness/ill-at-ease), are also helpful confidently judging that a behavior
reflects physical
reflects physical discomfort. discomfort.
For example, For example,
if one or ifmore one episodes
or more episodesof stomping of stomping
are ob- are ob-
served without any other indicators of discomfort, one might be more suspicious of su- of su-
served without any other indicators of discomfort, one might be more suspicious
perficial
perficial irritation,
without irritation,
such a such
anyasotherbiting asinsect.
a biting
indicators ofinsect.
In our In our one
experience,
discomfort, experience,
additional
might be additional
specific specific indicators
indicators
more suspicious of superficial
of limb pain
of limb pain irritation, (e.g., non-physiologic
(e.g., non-physiologic
such as a bitinglocomotion, locomotion,
insect.shifting shifting
In ourweight/resting weight/resting
limb, pointing)
experience, additional limb, pointing)
or multi-
specific or multi-
indicators of limb
ple
ple non-specific non-specific
painindicators indicators
of discomfort,
(e.g., non-physiologic of discomfort,
typically
locomotion, typically
increase
shifting increase
confidencelimb,
weight/resting confidence
that pointing)that
these behav- these behav-non-
or multiple
iors
iors reflect reflect
pain.
specific pain.
Similarly, Similarly,
particular
indicators particular
combinations
of discomfort, combinations of temporally-associated
of temporally-associated
typically increase confidence that behaviors behaviors
of-
these behaviors of-
reflect
ten provide insight
pain. Similarly,
ten provide insight as to
as to the particular the anatomic
anatomic source combinations source of discomfort.
of temporally-associated
of discomfort. (see
(see supplementary supplementary
behaviors Table
Table S1:often provideS1:
Discomfort
Discomfort insightBehaviors Behaviors
as to the Commonly
anatomic source
Commonly Associated Associated
of discomfort.
with Various with Various
(see supplementary
Anatomic TableAnatomic
Sources Sources
S1: Discomfort
https://doi.org/10.5281/zenodo.4537909
Behaviors Commonly Associated
https://doi.org/10.5281/zenodo.4537909 (accessed (accessed
withonVarious on
18 February 18
AnatomicFebruary
2021)). 2021)).
Sources https://doi.org/10.528
This ethogram
1/zenodo.4537909
This ethogram is based on is (accessed
based on on
observations observations stalledofhorses
18ofFebruary stalled
2021)). at horses
rest. Itatdoes rest.not
It does
neces-not neces-
sarily address
sarily address discomfort discomfort
This ethogrambehaviors behaviors
is based
thaton may that may
observations
be observed be observed
of stalled
in horses in
horses horses
at rest.
during during
work. Forwork.
It does not For a
a necessarily
recently
address
recently published published pain
discomfort
pain ethogram ethogram
behaviors
for horses for
that horses
may
while while
be observed
being being
ridden, see ridden,
in horses see
Dysonduring Dyson et
work.
et al. 2018 al. 2018 [47].
[47].For a recently
Further,
Further, and publishedand importantly,
importantly, pain ethogram
our ethogramourforethogram
ishorses
not meant is not
while meant
tobeing to be see
ridden,
be independently independently
Dyson et al.diagnostic,
diagnostic, 2018 but
but[47]. Further,
rather
and to provide
importantly, additional
our detailed
ethogram isinformation
not meant to
to
rather to provide additional detailed information to veterinary professionals. Should rou- veterinary
be independently professionals. Should
diagnostic, but rou-
rather
tine
tine caretakers caretakers
to orprovide or health
healthadditional care professionals
detailed observe
care professionals information observe behavior
to veterinary
behavior suggesting suggesting
professionals. discomfort,
discomfort, fur- fur-
Should routine
thercaretakers
ther veterinary veterinary
diagnostics ordiagnostics
health careare
are indicated. indicated. observe behavior suggesting discomfort, further
professionals
Finally,
Finally, veterinary
within within
the theofcontext
diagnostics
context ofhorse
are indicated.
various various horse behavior
behavior courses and courses
summer and research
summer research
student training,
Finally, we
within havethe had the
context opportunity
of various
student training, we have had the opportunity to introduce approximately 50 graduate to
horse introduce
behavior approximately
courses and 50 graduate
summer research
students,
student veterinary
training, students,
we have veterinarians,
had the horse
opportunity
students, veterinary students, veterinarians, horse owners, and trainers to this method of owners,
to and
introduce trainers to
approximately this method
50 of
graduate
evaluating
students, discomfort
veterinary in horses
students, using video
veterinarians, recorded
evaluating discomfort in horses using video recorded behavior of horses in stalls. Our horse behavior
owners, of
and horses
trainers intostalls.
this Our
method
informal informal measures
of evaluating
measures of time
training
discomfort
of training intime
suggesthorses suggest
the rapidthe
using videorapid acquisition
recorded
acquisition of the behaviorof Following
skill. theofskill.
horses Following
ain stalls. aOur
review ofreview informal
earlierofversions measures
earlier versions of training
of this ethogram, time
of this ethogram, suggest the
reliable recognition
reliable recognition rapid acquisition
of these behaviorsof the skill.
has Following
of these behaviors has a
been almostbeen review
almost
immediate. ofimmediate.
earlier versions
The typical of
Thetime this
for ethogram,
typical atime
newfor areliable to recognition
new observer
observer reach an of these
to acceptable
reach behaviors
an acceptable
inter- has been
inter-
almost
observer immediate.
agreement The
with typical
highly time for
experienced a new observer
observers
observer agreement with highly experienced observers has been less than 3 h of experi- to
has reach
been an acceptable
less than 3 h inter-observer
of experi-
ence withencetheagreement with highly
with the technique
technique (unpublished experienced observations).
(unpublished
observations). observers has been less than 3 h of experience with the
technique (unpublished observations).
5. Conclusions
5. Conclusions
5. Conclusions
This ethogram,
This ethogram, unambiguously
unambiguously describing describing
equine equine discomfort
discomfort behaviors, behaviors,
promises promises
to promises to
This
advanceofwelfare ethogram,
of unambiguously describing equine discomfort behaviors, whether for to
advance welfare advance horses
welfarebyhorses
improving
of horses
by improving
by recognition
improving
recognition
of physical
recognition
of discomfort,
physical discomfort,
of physical whether
discomfort, for whether for
pain management
pain management of hospitalized
of hospitalized horses orhorses or in everyday
in everyday husbandry. husbandry.
pain management of hospitalized horses or in everyday husbandry.
Table 1.
e 1. Posture Posture
and and weight-bearing.
weight-bearing. Table 1. Posture and weight-bearing.
a. Non-physiologic
on-physiologic LocomotionLocomotion
a. Non-physiologic Locomotion
Lameness,Lameness,
includingincluding alteredimpact,
altered stride, stride, impact, and weight-bearing.
Lameness, including alteredand weight-bearing.
stride, impact, and weight-bearing.
May include
May include altered limbaltered limb
placement,
May include
placement,
alteredhead,
head, and
and neck head,
limb placement,
neck
movements movements
and neck
thatoff-loading,
that suggest suggest movements
off-loading, and/or
that
and/or limitedsuggestlimited
range range and/or
off-loading,
of motion ofofmotion of arange
limited
a limb. limb.of
Video S2 motion of a limb.
https://doi.org/10.5281/zenodo.4537915 (accessed on 18
Video S2 https://doi.org/10.5281/zenodo.4537915 (accessed on 18(accessed
Video S2 https://doi.org/10.5281/zenodo.4537915 on
February
February 2021) 2021)
18 February 2021)
hiftingb.Weight/Resting
Shifting Weight/Resting
b. Shifting Limb
Weight/Resting
Limb Limb
Frequent Frequent
shifting ofshifting of the weight-bearing
the primary primary weight-bearing
limb or limbs.limb orThelimbs. The
Frequent shifting of the primary weight-bearing limb or limbs.
frequencyfrequency of abnormal
of abnormal Theweight
frequency
weight isshifting
shifting
of abnormaltypicallyis typicallyduring
weightgreater
greater during
shifting is typically greater
the transition
the transition to standingto standing
during as ifrest,
the transition
rest, as
the to if the
standing
horse horse
rest, asisdifficulty
is having ifhaving
the horsedifficulty
is having
finding a comfortable resting
difficulty finding
finding a comfortable resting position. a position.
comfortable resting position.
Video S3 https://doi.org/10.5281/zenodo.4537972 (accessed on
Video S3Video S3 https://doi.org/10.5281/zenodo.4537972
18 February 2021) (accessed(accessed
on 18 on 18
FebruaryFebruary
2021) 2021)
nimals 2021, 11, x 2021,
Animals FOR PEER REVIEW
11, x FOR PEER REVIEW 6 of 22 6 of 22
1, 11, x FOR PEER REVIEW 6 of 22
imals 2021, 11, x FOR PEER REVIEW 6 of 22
Animals 2021, 11, 580 6 of 21
Consistent extension
Consistent of one forelimb,
extension of reducingreducing
one forelimb, weight-bearing on
weight-bearing on
Consistent
thatextension
limb. of oneis
Pointing forelimb,
often most reducing
apparent weight-bearing
during periods onof stand-
Consistent
Consistent extension
that limb.
extension of one
Pointing
of oneforelimb,
is often
forelimb, reducing
most weight-bearing
apparent
reducing during
weight-bearing on
periods on of stand-
Pointing that limb. Pointing iscan
often most
Cont. apparent during periods ofone
stand-
g c. Pointing thating
limb. butTable
rest,Pointing
ing rest, is1.
also
often
but occur
canmost
alsoduring
apparent
occur foraging,
during
during when
periods
foraging, offorelimb
when stand- is
one forelimb is
inting that
ing rest, but limb.
can Pointing
also occur is often
during most apparent
foraging, when during
one periods
forelimb of
is stand-
Pointing c. Pointing consistently
inging
rest, but can placed
also
consistently cranially,
occur during while the
foraging, otherwhenis placed
one caudally
forelimb and
is
consistently rest, but
placed can also placed
cranially, occur
while cranially,
during
the other iswhile
foraging,
placed the
whenotherone
caudally is forelimb
placed caudally
and is and
under
consistently the body
placed
under (healthy
cranially,
the body comfortable
while
(healthy
Consistent the horses
other
comfortable
extension of is
one typically
placed
horses
forelimb, either
caudally
typically
reducing andstand
either stand
weight-bearing
consistently
under the placedcomfortable
body (healthy cranially, whilehorsesthetypically
other is placed
either caudally
stand and
squarely
under thethe on forelimbs
body
squarely(healthy
on or alternate
comfortable
onforelimbs
that limb. or forelimb
horses
Pointing
alternate placement
typically
is often as they
either
most apparent
forelimb placement standmove
during periods
as they moveof
under
squarelywhile
on forelimbs body (healthy
or alternate
standing
comfortable
forelimb horses
placement
rest,forelimb
but can also
typically
occuras during either
they move stand
foraging, when one
squarely foraging).
on forelimbs
while or
foraging). alternate placement as they move
squarely on
while foraging). forelimbs or alternate
forelimb forelimb
is consistently placement
placed as while
cranially, they move
the other is
Video
while S4Video
foraging).https://doi.org/10.5281/zenodo.4537978
S4 https://doi.org/10.5281/zenodo.4537978
placed caudally and under the body (accessed
(healthy on 18 on 18
(accessed
comfortable
Video while
S4
February
foraging).
2021) 2021) (accessed on 18
Video S4 https://doi.org/10.5281/zenodo.4537978
horses typically either stand squarely (accessed onon1818
on forelimbs or alternate
February 2021)S4February
Video https://doi.org/10.5281/zenodo.4537978
forelimb placement as they move while (accessed
foraging).
February 2021)
February 2021) Video S4 https://doi.org/10.5281/zenodo.4537978 (accessed on
18 February 2021)
. Prolonged Resting of Limb
d. Prolonged
ged Resting of Limb Resting of Limb
olonged Resting
Prolonged d. of of
Limb
Prolonged
Resting Resting of Limb
Limb Flexing aFlexing
fore orahindlimb,
fore resting the
or hindlimb, toe ofthethetoehoof on the sub-
Flexing strate.
a fore or hindlimb,
Hindlimb resting
resting is athe toe ofresting
normal the hoof
behavior, on of the
the sub-hoof
particularly
on the sub-
during
Flexing a fore
Flexing astrate.
foreor hindlimb,
orHindlimb
hindlimb, resting
resting the
oris
a resting
toe of
a normal
the toe ofthe hoof
behavior,
the hoof on the sub-
onparticularly
ofthe hoof onduring
the sub-
strate. Hindlimb
standing resting is Flexing
rest. resting a normal
Prolonged
fore hindlimb,
behavior,
resting of
resting
a particularly
particular
theduring
toe
limb, especially
the
strate. Hindlimb
strate. standing rest. is a
substrate.normal
Prolonged behavior,
Hindlimb resting
resting ofparticularly
is a normal during
behavior,
particular limb,particularly
especially
standing rest.Hindlimb
when Prolonged
standing
resting
resting
alertduring
is aofnormal
standing
or foraging,
behavior,
a particular
rest.
may limb,
Prolonged
indicate
particularly
especially
resting
discomfort.
during
of a particular limb,
standing
standing rest.
when Prolonged
rest. standing
Prolonged resting
alert or
resting of a aparticular
foraging,
of may
particular limb,
indicate
limb, especially
discomfort.
especially
when standing
Video alert
S5 or foraging, maywhen
especially indicate discomfort.
standing
https://doi.org/10.5281/zenodo.4538011 alert or foraging, may indicate
(accessed(accessed
on 18 on 18
when standing
Video alert
S5orhttps://doi.org/10.5281/zenodo.4538011
foraging, may indicate discomfort.
Video when
S5 standing
February 2021)
alert or foraging,
discomfort.
https://doi.org/10.5281/zenodo.4538011 may indicate discomfort.
(accessed on 18
Video S5 https://doi.org/10.5281/zenodo.4538011 (accessed
(accessedonon1818
Video 2021)
18 February 2021)
February 2021)
February 2021)
Cross-legged Resting of Limb of Limb
e. Cross-legged
gged Resting
e. of Limb Resting
Cross-legged Resting of Limb
oss-legged Resting
Cross-legged Resting of of
Limb
Limb
Resting aResting
limb (usually hind) crossed
a limbcrossed
(usually hind) slightly
crossed behind
slightly or in front
behind or of
in front of
Resting the
a limb (usually
opposite hind)
limb. Resting slightly behind or in front of
Resting
Restinga limb (usually hind) crossed slightly behind or in front of
a limb (usually hind) crossed slightly behind or in front of or in front
the opposite limb. a limb (usually hind) crossed slightly behind
the opposite
Videolimb.
S6Video of the opposite limb.
https://doi.org/10.5281/zenodo.4538028 (accessed on 18 on 18
thethe
opposite limb. S6 Video
Video S6 opposite limb.
February 2021) (accessed on 18(accessed
S6 https://doi.org/10.5281/zenodo.4538028 (accessed on
(accessedonon1818
Video 2021)
18 February 2021)
February
February 2021)
2021)
Camping Under Under

g Underf. Camping
f. Camping Under StandingStanding
with forewithand/or
mping Under
Camping Under Standingneath
withthefore and/or Standing forehindlimbs
hindlimbs and/or
bilaterally
bilaterally
hindlimbspositioned
positioned
bilaterally
under-
under- under-
positioned
Standing withabdomen,
fore sometimes with fore and/or
associated hindlimbs
with a bilaterally
hunched back positioned
pos-back pos-
Standing
neath the abdomen, neath
with theand/or
fore abdomen,
and/or
sometimes
hindlimbs
sometimes
hindlimbs
associated
underneath
bilaterally
with
the abdomen,bilaterally
a hunched
positioned
associated
sometimes
with
positioned
back pos-
under-
a hunched
under-
associated with a hunched
ture.
neath theWeight-bearing
abdomen,
ture. is greater
sometimes
Weight-bearing
back posture. on the camped
associated
isassociated
greater with
onwith
Weight-bearing the under
a hunched
camped limbs
back
underor, in theor,under
pos-
limbs in the
neath the
ture. Weight-bearingabdomen,
is sometimes
greater on the camped under ais hunched
limbs greater onback
or,may
in the
the camped
pos-
case
ture. of camping
Weight-bearing
case of under
is
camping on
greater
limbs or,both
on
in
under the fore
thecase
on and
camped
of
both hindlimbs,
under
camping
fore and limbs
under onor,
hindlimbs, be
in
both associ-
the
fore
may and
be associ-
ture. Weight-bearing
case of camping under on bothis greater
fore and
hindlimbs, on the camped
mayhindlimbs,
beof
associated under
may
withmaybelimbs or, in the
associ-weight-bearing of
relieving
ated
case withated
of of
camping relieving
under
with weight-bearing
onon both
relieving fore and
weight-bearing the back.
hindlimbs,
of the back. bebeassoci-
case
ated with camping
relieving under
the both
back.
weight-bearing of the back. fore and hindlimbs, may associ-
Video
ated with S7Video
relieving S7weight-bearing
Video S7 of the back. (accessed
https://doi.org/10.5281/zenodo.4538039 on (accessed
18 on 18
(accessed on
ated
Video S7 with relieving weight-bearing
https://doi.org/10.5281/zenodo.4538039 of the back.
(accessed on 18
February
Video S7 2021) 18 February 2021)
Video 2021)
February 2021)
February 2021)
. Dragging g.a Dragging
Limb a Limb
g. Dragging a Limb
ng a Limb
ragging a Limb
Dragging a Limb
PartiallyPartially
flexing aflexing
limb such thatsuch
the that
toe scrapes along oralong
slightly
Partiallyabove
flexingthe asubstrate
limb such thatamoving.
Partially
when
limb
flexing
the toe ascrapes
limb suchthe toethe
that
along orscrapes or or
toe scrapes along
slightly slightly
Partially
Partiallyflexing
above a
flexing limb
the such
slightly
substrate
a limb that
above the
whenthe toe scrapes
substrate
moving. along
when or
moving. slightly
such that the toe scrapes along or slightly
above the substrate
Video S8 when moving.
https://doi.org/10.5281/zenodo.4539062 on (accessed
(accessed(accessed
18 on 18 on
above
abovethethesubstrate
Video S8
substratewhen moving.
when moving.
February 18 February
2021) 2021) 2021) (accessed on 18
(accessedonon1818
February
February 2021)
2021)
Animals 2021, 11, 580 7 of 21
Flexing and
Flexing and hanging
hanging aa limb limb above
above the
the substrate
substrate for
for several
several seconds
seconds
Flexing and hanging
Flexing and hanging
Table 1.
a limb
Cont.
above
a limb the substrate
above for several
the substrate seconds
for several seconds
Dangling aa Limb
Dangling Limb or longer,
or longer,
Flexing andoften in aa series,
hanging
often in series,
a limb momentarily
above the
momentarily restingfor
substrate
resting theseveral
the tow lightly
tow lightly on
seconds
on
Dangling a Limb
h. Dangling a Limb or longer, often in a series, momentarily resting the tow
or longer, often in a series, momentarily resting the tow lightly lightly on on
Dangling a h.
Limb thelonger,
or
the substrate between
often lifts. momentarily resting the tow lightly on
in a series,
Dangling a Limb thesubstrate
substrate between
between lifts.
lifts.
the substrate between lifts.
Video
the
substrate
S9 between lifts. (accessed on
(accessed on 1818
Video S9 https://doi.org/10.5281/zenodo.4538101 (accessed on 18
(accessed on 18
February
Video
February 2021)
S92021)
February 2021)
February 2021) Flexing and hanging a limb above the substrate for several
February 2021) seconds or longer, often in a series, momentarily resting the tow
lightly on the substrate between lifts.
18 February 2021)
ase Narrow
ase Narrow or
or Wide
Wide
Base
i. Narrow or Wide
Base Narrow or Wide
ase Narrowi. or Wide
Base Narrow or Wide
Standing or
Standing or moving
moving with
with fore
fore and/or
and/or hindlimbs
hindlimbs placed
placed either
either more
more
Standing or moving
Standing or movingwith with
fore and/or
fore hindlimbs
and/or placed
hindlimbs eithereither
placed moremore
medially
Standing
medially or
or laterally
moving
laterally Standing
than
with
than is
fore
is or moving
normal
and/or
normal for
for with
the fore
hindlimbs
the and/or
horse’s
placed
horse’s hindlimbs
conformation.
either
conformation. placed either
more
medially or laterally
medially thanmedially
or laterally
more is normal
than or for
is normal the
forhorse’s
laterally conformation.
the horse’s
than is normalconformation.
for the horse’s
Video S10
S10orhttps://doi.org/10.5281/zenodo.4538117
medially
laterally conformation. (accessed on
than is normal for the horse’s conformation.
(accessed on 18
18
Video S10 https://doi.org/10.5281/zenodo.4538117 (accessed on 18on 18
(accessed
February
Video S10
February 2021)
2021) Video S10 (accessed
https://doi.org/10.5281/zenodo.4538117 on 18 (accessed
February 2021)2021)
February
February 2021) on 18 February 2021)
ow Head
ow Head Carriage
Carriage
Lowj. Head Carriage
Low Head
j. LowCarriage
Head Carriage
ow Head Carriage Moving or
Moving or standing
standing with with the
the neck
neck below
below horizontal.
horizontal. In In deep
deep stand-
stand-
Moving
Movingor standing
or standingwith with
the neck below
the neck horizontal.
below In deep
horizontal. stand-
In deep stand-
ing
ing rest,
Moving
rest, it
or
it is
is normal
standing
normal for
with
for the
the
Moving head
the neck
head
or and
and
standing neck
below
neck to
to
with drop
horizontal.
drop
the below
below
neck In
belowhorizontal.
deep stand-
horizontal.
horizontal. In deep
ing rest, it is normal
ing rest, it is normal for the head
for the and
head neck to
and neck drop below
to drop horizontal.
below horizontal.
Lowrest,
ing
Low headitcarriage
head carriage
is normalis often
is often
for theassociated
standing rest,and
head
associated with
it is neck
with dull
normal
to
dull overall
for
drop
overall demeanor
thebelow
head and or ex-
neck ex-drop below
to
horizontal.
demeanor or
Low head
Low carriage is often
head carriage associated
is often with with
associated
Low head dull overall
dull demeanor
overall or ex-ordull
demeanor ex-overall
haustion.
Low head carriage is often
haustion.
haustion.
horizontal.
associated
demeanor or
withcarriage
exhaustion.
is often
dull overall associated
demeanor orwith
ex-
haustion.
Video S11
haustion.
https://doi.org/10.5281/zenodo.4538125 (accessed on
(accessed on 18
18 (accessed
Video S11 https://doi.org/10.5281/zenodo.4538125 (accessed on 18on
(accessed 18
February
Video S11 2021) on 18 February 2021)
February
February 2021)
2021)2021)
February
February 2021)
Tucked Up Abdomen
ucked Up Abdomen
Tucked Upk.Abdomen
k. Tucked Tucked
Up Up Abdomen
Abdomen
Tucked Up Abdomen Tensing of
Tensing of the
the abdominal
abdominal muscles,
muscles, hollowing
hollowing out out the
the flank,
flank, some-
some-
Tensing of theof
Tensing abdominal muscles,
the abdominal hollowing
muscles, hollowingout theoutflank, some-
the flank, some-
times with
Tensing
times with
of aathe
hunched Tensing
abdominal
hunched back. of the
back.muscles,
Reduced
Reduced abdominal
hollowing
ingesta muscles,
ingesta and
and
out thehollowing
dehydration
flank,
dehydration out
may
some-
maythe flank,
timestimes
with with
a hunched back.
a hunched
sometimes Reduced
back. Reduced
with a ingesta
hunched and
ingesta
back. dehydration
and dehydration
Reduced may
ingesta andmay
contribute
times withto
contribute to the hollow
hollow
atohunched
the appearance
back. Reduced(also
appearance (also known
ingesta and as
known as “drawn
“drawn up”
dehydration up”
mayor
or
contribute
contribute thetohollow
the appearance
dehydration
hollow (also
may contribute
appearance known
(also ashollow
toknown
the “drawn up” or
appearance
as “drawn up”(also
or
“sucked
contribute
“sucked up”).
to
up”). the hollow appearance
known as “drawn (also
up” known
or “sucked as “drawn
up”). up” or
“sucked up”).up”).
“sucked
Video S12
“sucked
Video S12
up”). Video S12 https://doi.org/10.5281/zenodo.4538135
(accessed 18 (accessed
on 18
Video S12
on 18 February 2021) (accessed on 18on 18
(accessed
February
Video
February 2021)
S122021)
February 2021)
February 2021)
February 2021)
eaning Against
eaning Against Objects
Objects
l. Leaning Against Objects
Leaning Against
l. Leaning Objects
Against Objects
eaning Against Objects
Supporting weight
Supporting weight and/or
and/or stabilizing
stabilizing balance
balance against
against aa wall
wall or
or
Supporting
Supportingweight and/or
Supporting
weight stabilizing
and/orweight balance
and/or
stabilizing against
stabilizing
balance a wall
balance
against or aor
against
a wall wall or
fence,
fence, usually
Supporting
usually during
weight
during standing
and/or
standing
fence, rest.
stabilizing
rest.
usually during balance
standing against
rest. a wall or
fence,fence,
usually during
usually standing
during rest. rest.
standing
Video usually
fence,
Video
Video S13
S13 duringVideo S13
standing https://doi.org/10.5281/zenodo.4539088
rest.
(accessed on
(accessed
(accessed
18 (accessed
on 18
on 18on 18
on 18 February 2021) (accessed
February
Video
February 2021)
S132021)
February 2021)
February 2021)
February 2021)
Animals 2021, 11, 580 8 of 21
Prolonged or frequent interrupted recumbent rests and/or in-
Prolonged
Prolonged or
or frequent
frequent interrupted
interrupted recumbent
recumbent rests
rests and/or
and/or in-
creased recumbent resting time budget. Atypical recumbency mayin- oc-
Prolonged
creased or frequent
recumbent resting interrupted
time budget. recumbent
Atypical rests and/or
recumbency may oc- in-
creased recumbent
cur during resting time
circumstances when budget.
the horseAtypical recumbency
would may oc-
not normally lie
m. Atypical Recumbency curcreased
during recumbent
circumstances resting
whentimethebudget.horse Atypical
would recumbency
not may oc-
Atypical
Atypical Recumbency
Recumbency cur during
down, Table 1. Cont.
andcircumstances
the horse maywhenlie inthefull horse would
lateral not normally
recumbencynormally lie
lie
without
cur
down, during
and thecircumstances when the horse would not normally
withoutlie
m. Atypical Recumbency
m. Atypical Recumbency
down,
sleeping. the horse
andAtypical horse may
may lie
recumbency
in
in full
lie may full lateral recumbency
lateralsighing
include recumbency
and/or without
groaning,
down,
sleeping. and the
Atypical horse
recumbencymay lie
may in full lateral recumbency without
sleeping. Atypical
tense facial recumbency
muscles, may include
gaping mouth, include sighing
sighing and/or groaning,
and/orteeth
lip quivering/wincing, groaning,
grind-
sleeping.
tense facial Atypical gaping
muscles, recumbency
mouth, may lipinclude sighing and/or
quivering/wincing, teethgroaning,
grind-
tense facial muscles, gaping mouth, lip quivering/wincing,
ing, and/or atypical limb placement. For healthy horses, typical in- teeth grind-
tense
ing, facial
and/or muscles,
atypical gaping
limb mouth,
placement. lipinterrupted
For quivering/wincing,
healthy horses, teeth
typical grind-
in-
ing,
dividual atypical Prolonged
and/orrecumbency limb
durations or
placement.frequent
range For healthy
from recumbent
15 tohorses,
40 rests
min.typical
Prolonged and/or
in-
ing,
dividualand/or atypical
recumbency limb
increased placement.
durationsrecumbent
range For
resting
from healthy
15time
to horses,
budget.
40 min. typical
Atypical
Prolonged in-
recumbency
dividual
recumbencyrecumbency
may be maydurations
related
occur to range
difficulty
during from 15 todiscomfort
rising,
circumstances 40 min.
when Prolonged
the standing,
horse
dividual recumbency
recumbency may durations rangerising,
from 15 Prolonged not
to 40 min.standing, would
recumbency
or exhaustion. may be related
related to
benormally lie difficulty
to difficulty
down, and rising, discomfort
discomfort
the horse may lie instanding,
full lateral
or recumbency
exhaustion. may recumbency
be related to difficulty
without rising,Atypical
sleeping. discomfort standing,
recumbency may include
orVideos
exhaustion.
S14 andsighing S15and/or
or exhaustion.
Videos S14 and S15 groaning, tense facial muscles,
https://doi.org/10.5281/zenodo.4539094 gaping mouth, lip
Videos
(accessedS14 on 18and S15 2021)
February https://doi.org/10.5281/zenodo.4539094
quivering/wincing, teeth grinding, and/or atypical limb placement.
Videos S14
(accessed and S15 https://doi.org/10.5281/zenodo.4539094
(accessed onon 1818 February
February 2021)
2021)horses, typical individual recumbency durations
For healthy
(accessed on 18 February
range from 2021)
15 to 40 min. Prolonged recumbency may be related
to difficulty rising, discomfort standing, or exhaustion.
Videos S14 and S15 https://doi.org/10.5281/zenodo.4539094
(accessed on 18 February 2021)
. Difficulty Rising
Difficulty Rising
Difficulty n.
Rising
Difficulty Rising
n. Difficulty Rising
Failing to rise gracefully, requiring increased effort and/or attempts
Failing
Failing to rise gracefully, requiring
requiring increased
increased effort
effort and/or
and/or attempts
to rise.to rise gracefully, attempts
to Failing
rise. to rise gracefully,
Failing torequiring increased
rise gracefully, effort
requiring and/oreffort
increased attempts
and/or
toVideo
rise. S16 https://doi.org/10.5281/zenodo.4539120
attempts to rise. (accessed on 18
to rise.
Video S16 https://doi.org/10.5281/zenodo.4539120 on 18
18(accessed
Video
FebruaryS16 2021) (accessed
Video S16
February 2021)https://doi.org/10.5281/zenodo.4539120
on 18 February 2021) (accessed on 18
February 2021)
February 2021)
. Urination Posture and Effort Without Stream

Urination
Urination Posture
Posture and Effort
Effort Without
andPosture
o. Urination and EffortStream
Without Stream
Without Stream
o. Urination Posture and Effort Without Stream Posturing to urinate, often repeatedly for extended durations, with
Posturing to
Posturing urinate, often
often repeatedly for extended durations, with
apparent to urinate,
effort, butPosturing
without repeatedly
urinate,for
a normal extended
stream durations,
of urine. Often with
accom-
Posturing
apparent to urinate,
effort, but oftenato
without repeatedly
normal
often
for repeatedly
stream extended
of urine.
for
Often
extended
durations,
accom-
durations,
with
apparent
panied by effort, but without
groaning,with a normal
apparent
swishing, effort, stream
or slapping but of urine.
without
tail, a Often caudally,
normal
ears focused accom-
stream of urine.
apparent effort, but without a normal bystream
groaning, ofswishing,
urine. Often accom-
panied
panied by groaning,
looking by groaning,
caudally,
Often accompanied
swishing,
swishing,
and/or kicking
or
orupslapping
slapping tail,
tail,
towardcaudally,
ears
ears
abdomen. focusedorcaudally,
focused slapping
caudally, tail, ears
panied by focused
groaning, caudally,
swishing, orlooking
slapping tail, and/or
ears kickingcaudally,
focused up toward
looking caudally,
looking caudally, and/or
and/or kicking up
kicking up toward
toward abdomen.
abdomen.
abdomen. (accessed on 18
looking
Video S17caudally, and/or kicking up toward abdomen.
Video https://doi.org/10.5281/zenodo.4539122 (accessed
S17 2021)
February Video S17 (accessed on
https://doi.org/10.5281/zenodo.4539122 on 18
18(accessed
Video S17
February 2021)
2021) https://doi.org/10.5281/zenodo.4539122
February
February 2021)
. Parking Out
Parking
Parking Out
Outp. Parking Out
p. Parking Out
Standing with forelimbsStanding positioned
with forelimbs forward and forward
positioned hindlimbs andposi-
hindlimbs
Standing
Standing with
with forelimbs
forelimbs positioned
positioned
positioned behind aforward
forward
normal and
and hindlimbs
hindlimbs posi-
posi-
tioned behind a normal “squared up” stance.“squared up” stance.
Standing
tioned behind with forelimbs
a normal S18positioned
Video“squared up” forward and hindlimbs posi-
mals 2021, 11, x FOR PEER REVIEW tioned
Videobehind
S18 anda Photo
normal S19“squared up” stance.
and Photo S19
stance.
https://doi.org/10.5281/zenodo.4539206 9 of 22 on 18
tioned behind a https://doi.org/10.5281/zenodo.4539206
normal “squared up” stance. (accessed
Video
Video S18
S18 and
and Photo
Photo S19
(accessed on 18 February
February 2021)
2021)
Video S18 18
(accessed and Photo S19 https://doi.org/10.5281/zenodo.4539206
(accessed onon 18 February
February 2021)
2021)
Straining to Defecate
q. Straining to Defecate
Exerting greater than the normal abdominal effort to pass feces. Of-
ten accompanied byExerting greater
groaning, than the normal tail,
swishing/flicking abdominal effort
slapping to pass feces.
tail
Often accompanied by groaning, swishing/flicking tail, slapping tail
against perineum, earsagainst
focusedperineum,
caudally,ears
looking caudally,
focused caudally,and/or kicking and/or
looking caudally,
up toward abdomen. kicking up toward abdomen.
on 18 February 2021)
(accessed on 18
February 2021)
ble 2. Limb and body movements.
tepping in Place
Repeated flexing of a limb, briefly relieving weight-bearing on that limb.

The toe may touch or be held slightly above the substrate for up to several
seconds, before the hoof is lightly placed down again. Stepping often occurs
up toward abdomen.
againstup
perineum,
toward ears focused caudally, looking caudally, and/or kicking
Video
Video S20 S20 abdomen.
https://doi.org/10.5281/zenodo.4539216 (accessed(accessed
on 18 on 18
up toward abdomen.
FebruaryFebruary
2021) 2021)
Video February
2021) (accessed on 18
February 2021)
Animals 2021, 11, 580 9 of 21
Tableand
le 2. Limb 2. Limb
bodyand body movements.
movements.
Table 2. Limb and body movements.
epping
able a. Stepping
2. in Placeand
Limb inbody
Place movements.
a. Stepping in Place Table 2. Limb and body movements.
Stepping in Place RepeatedRepeated
flexing offlexing
a limb,ofbriefly
a limb,relieving
briefly relieving weight-bearing
weight-bearing on that limb.
on that limb.
a. Stepping in Place Repeated
The toe mayflexing
touch of
or a limb,
be held briefly
slightlyrelieving
above weight-bearing
the substrate
The toe may touch or be held slightly above the substrate for up to several for on to
up that limb.
several
RepeatedThe flexing
seconds,toe mayof touch
before aRepeated
limb,
the or
hoofbriefly
beisheld relieving
flexing of a
slightly
lightly placed weight-bearing
limb, briefly
above
down the on that
relieving
substrate
again. for
Stepping limb.
weight-bearing
up to
often several
occurs on
seconds, before the hoof is lightly placed down again. Stepping often occurs
The toe may
seconds,
in a touch
series or
before
of that
be
the
several limb.
held
hoof The
slightly
is
rhythmic toe
lightly may
above
placed
steps at touch
the or
down
about 1 sbe
substrateheld
again. slightly
forStepping
up with
intervals, above
to several
often
a pause thebe-
occurs
in a series of several rhythmic steps at about 1 s intervals, with a pause be-
seconds,inbefore
a seriesthe substrate
ofhoof is lightly
several forplaced
rhythmic up steps
to several
down seconds,
again.
at about beforeoften
1Stepping
s intervals,the hoof
withoccursis lightly
a pause be-
tween
tween series. series.
in a series
tween of several
series. rhythmic steps at about 1 s intervals, with a pause be-of several
placed down again. Stepping often occurs in a series
Video S21 Video S21 https://doi.org/10.5281/zenodo.4540099
rhythmic steps at about 1 s intervals, (accessed
with(accessed
aon
pause on 18
18between
tween series.
February
February 2021) 2021) series.
Video February
b. Lifting/Holding
ting/Holding Limb Up Limb Up
b. Lifting/Holding Limb Up
b. Lifting/Holding
Lifting/Holding Limb Up Limb Up
Flexing aFlexing
forelimb, a forelimb,
lifting thelifting thethe
hoof off hoof off the substrate
substrate (usually
(usually 20 20 cm or more),
cm or more),
and then andFlexing
thenitaplacing
placing forelimb,
back down,
Flexing lifting
it back the to
adown,
similar hoof
forelimb, thatoff
similar the
seen
lifting substrate
to the
that
in in(usually
seenoff
response
hoof response 20to
cm
to cutaneous
the substrate or more),20
cutaneous
(usually
Flexingirritation,
a forelimb,
and then lifting
placing it
e.g., insects.the
backhoof off
down, the substrate
similar to that(usually
seen in 20 cm or
response more),
to
cm or more), and then placing it back down, similar to that seen cutaneous
irritation, e.g., insects.
and then placing e.g.,
irritation, it back down, similar
insects.
in response to that seen
to cutaneous in response
irritation, to cutaneous
e.g., (accessed
insects.
(accessed
February
Video February on 18 February
2021) 2021) (accessed on 18
February 2021)
wingc. Pawing
c. Pawing
c. Pawing
Pawing ReachingReaching
a forelimb a forelimb
cranially cranially
Reaching and dragging
and dragging
a forelimb the the
hoof along
cranially hoof
and or along or
above
dragging theabove
the hoofthe
sub- sub-or
along
Reaching
strate
strate while sweeping a forelimb
while sweeping cranially
above the
caudally, caudally,and
substrate
often dragging
often
while
in rhythmic the
in sweepinghoof
rhythmic along
series.
caudally,
series. This or above
This
behavior the
behavior
often sub-
is
is in rhythmic
Reaching a
strateforelimb
while cranially
sweeping
series. and
This dragging
caudally,
behavior the
often
is hoof
in along
rhythmic
similar to that or above
series.
which the
This
often sub-
behavior
occurs is
within
similar tosimilar to that
that which which
often often
occurs occurs
within thewithin
contexttheofcontext
foragingof foraging
or drinkingor drinking
strate while
similar sweeping
to
(particularly that caudally,
which
the often
context
when thwarted, often
occurs
of in
foragingrhythmic
within
or the series.
context
drinking
or in anticipation). This
of behavior
foraging
(particularly or
when is
drinking
thwarted,
(particularly when thwarted, or in anticipation).
similar (particularly
to that whichwhen often occurs
or in thwarted,within
or inthe
anticipation). context of foraging or drinking
anticipation).
on 18 on 18
(particularly
Video when
S23 Video S23
thwarted, or https://doi.org/10.5281/zenodo.4540104
in anticipation).
on 18
February
February 2021) 2021) on 18 February 2021)
February 2021) (accessed on 18
February 2021)
d. Stomping
omping d. Stomping
d. Stomping
Stomping SuddenlySuddenly
flexing andflexing
then and then extending
extending
Suddenly flexinga and
limb, a limb, striking
sharply
then
sharply the
extending a limb,
striking
hoof the
sharply
hoof
striking
imals 2021, 11, x FOR PEER REVIEW Suddenly
against flexing
the substrate, and then
similar extending
to that seen a response
in limb, sharply
to 10 of irritation,
striking
cutaneous 22the hoof
against the substrate, similar to that seen in response to cutaneous irritation,
the hoof against the substrate, similar to that seen in response to
Suddenly flexing
against the and then
substrate, extending
similar to a
that limb,
seen
e.g., insects. cutaneous irritation, e.g., insects. sharply
in responsestriking
to the
cutaneous hoof
irritation,
e.g., insects.
againste.g.,
the substrate,
insects. similar to that seen in response to cutaneous irritation,
on 18 on 18
(accessed
e.g., insects.
nimals 2021, 11, x FOR PEER REVIEW February
February 2021) 2021) 10 of 22
Video February
February 2021)
e. Kicking Out or Back Lifting
Lifting and and extending
extending onehindlimbs
one or both or both hindlimbs
caudally,caudally, either back
either straight straight back
Lifting
or and
sometimes extending
arcing
or sometimes arcing laterally. one or
laterally. both hindlimbs caudally, either straight back
ckinge.Out
Kicking Out or Back
or Back Lifting or
and extendingarcing
sometimes one orlaterally.
both hindlimbs caudally, either straight back
(accessed
e. Kicking Out or Back Video S25 Video S25 https://doi.org/10.5281/zenodo.4540109
or sometimes
Video arcing laterally. (accessed
Kicking Out or Back FebruaryFebruary
2021) 2021) Lifting and extending one or both hindlimbs caudally,on 18
either
Video February
2021) (accessed
straight back or sometimes arcing laterally. on 18
February 2021) Video S25 https://doi.org/10.5281/zenodo.4540109 (accessed
Kicking Up Toward Abdomen

f. Kicking Up Toward Abdomen Flexing a hindlimb, directing the hoof or stifle toward the abdomen, often
arcing laterally as the hoof returns toward the substrate, often similar to that
Flexing airritation,
seen in response to cutaneous hindlimb, directing
e.g., insects.the hoof or stifle toward the
abdomen, often arcing laterally as the hoof returns toward the
Kicking Up Toward Abdomen substrate,
Flexing a hindlimb, directing theoften
hoofsimilar to toward
or stifle that seen inabdomen,
the response to cutaneous
often
February 2021) irritation, e.g., insects.
arcing laterally as the hoof returns toward the substrate, often similar to that
seen in response to cutaneous irritation, e.g., insects.
February 2021)
Romping/Bucking
Alternate rearing and kicking out, often repeatedly in rapid succession.

Romping and bucking may indicate an acutely painful event that appears
Romping/Bucking to startle the horse; or alternatively, an outburst reflecting frustration with
an inability to get relief from discomfort.
icking Upf.Up
. Kicking Toward Abdomen
Toward
Kicking UpAbdomen
Toward Abdomen Flexing a hindlimb,
Flexing aFlexing
hindlimb,adirecting
directing
hindlimb, thedirecting
hoof
the or the
hoof stifle toward
or stifle
hoof towardthethe
or stifle abdomen,theoften
abdomen,
toward often
abdomen, often
arcing laterally as
arcing laterally the
arcing as hoof returns
the hoof
laterally toward
as returns
the hooftoward the
returnsthesubstrate, often
substrate,
toward similar to
often similar
the substrate, that
oftentosimilar
that to that
seen in response
seen in responseto response
seen in cutaneous toirritation,
to cutaneous e.g.,
irritation,
cutaneous insects.
e.g., insects.
Video
VideoS26S26 https://doi.org/10.5281/zenodo.4540113
Videohttps://doi.org/10.5281/zenodo.4540113
S26 https://doi.org/10.5281/zenodo.4540113 (accessed
(accessed onon18 18 on 18
(accessed
Animals 2021, 11, 580 10 of 21
February 2021)
February
Table 2. Cont.
Romping/Bucking
g. Romping/Bucking
g. Romping/Bucking
g. Romping/Bucking
Alternate
Alternaterearing
rearing
Alternate Alternate
andandkicking
kicking
rearing andrearing
out, often
out, and
often
kicking kicking
oftenout,
repeatedly
repeatedly
out, in often
rapid
in repeatedly
rapid
repeatedly rapidinsuccession.
succession.
succession.
in rapid
Romping
Romping and bucking
and
Rompingbuckingsuccession.
may
and indicate
may Romping
indicate
bucking mayan an andpainful
acutely
acutely
indicate bucking
an painful
acutelymay
event
eventindicate
that
painfulthat an that
appears acutely
appears
event appears
to startle theto
to startle horse;
the horse;
startle painful
orthe
or event
alternatively,
alternatively,
horse; that
an anappears
outburst
outburst
or alternatively, antooutburst
startle frustration
reflecting the
reflecting horse; or alternatively,
with
frustration
reflecting with
frustration with
an an
inability to get
inability
an to relief
get an
relief
inability to outburst
fromfrom
get reflecting
discomfort.
discomfort.
relief frustration with an inability to get relief
from discomfort.
from discomfort.
Video
VideoS27S27 https://doi.org/10.5281/zenodo.4540115
S27Video (accessed
https://doi.org/10.5281/zenodo.4540115 (accessed
onon18 18
(accessed on 18
(accessed
February 2021)
February on 18 February 2021)
Rolling
h. Rollingh. Rolling
h. Rolling
Lying down
Lying downto sternal Lying
to sternal
Lying down downrecumbency
recumbency
torecumbency
sternal to sternal
and then
and thenrecumbency
rotating from
rotating
and then and
from then
sternal torotating
sternal
rotating fromlateral
tosternalfrom
lateral to lateral
andand
then dorsal
then dorsal
and sternal
recumbency,
recumbency,
then to lateral
sometimes and
sometimes
dorsal recumbency, overthen
overfrom
sometimes dorsal
one
from recumbency,
side
one
over to the
side
from to
onethe sometimes
other.
other.
side over
to the other.
from one side to the other.
Video
VideoS28S28https://doi.org/10.5281/zenodo.4540117
Videohttps://doi.org/10.5281/zenodo.4540117
S28 https://doi.org/10.5281/zenodo.4540117(accessed
(accessed onon18 18 on 18
(accessed
February 2021)
FebruaryFebruary
2021) 2021)
acking
. Backingi. Backing
i. Backing
Walking backwards
Walking backwards
Walking Walking
tentatively, backwards
as
tentatively,
backwards if tentatively,
asattempting
as if to
if attempting
tentatively, as iffrom
retreat
to retreat
attempting attempting
to to retreat
discomfort.
from discomfort.
retreat from from
discomfort.
discomfort.
Video
VideoS29S29
Video (accessed
S29 https://doi.org/10.5281/zenodo.4540123 (accessed onon18 18 on 18
(accessed
February
February2021)
2021) 2021)
nimals
als 2021,
2021, 11, x11,
FORx FOR PEER
PEER REVIEW
REVIEW 11 22
11 of of 22
j. Limb Trembling Rhythmic

Rhythmicmuscle tremors.
muscle
Rhythmic tremors.
muscle Limb
Limbtrembling
tremors. Limbmay,
trembling in some
may, in some
trembling may,instances,
somereflect
instances,
in reflect reflect
instances,
muscle exhaustion
muscle or or
exhaustion effort to or
effort
muscle exhaustion relieve
to effort weight-bearing
relievetoweight-bearingof aoflimb. With
a limb.
relieve weight-bearing a re-
ofWith re- With re-
limb.
.mb Trembling
Limb Trembling
j. Limb Trembling duced weight-bearing,
duced Rhythmic
thethe
weight-bearing, entire muscle
limb
entire
duced weight-bearing, limb
the tremors.
may quiver
may
entire Limb
with
quiver
limb may trembling
thethe
with
quiver may,
theintrembling.
trembling.
trembling.
with some
instances, reflect muscle exhaustion or effort to relieve
Video
VideoS30S30
Video (accessed
S30 https://doi.org/10.5281/zenodo.4540125 (accessed onon18 18 on 18
(accessed
weight-bearing of a limb. With reduced weight-bearing, the
February
February2021)
2021) 2021)
February entire limb may quiver with the trembling.
Flinching k. Flinching
nching
Sudden
Sudden reflexive
reflexive contraction
contraction of muscles. Flinching
of muscles. may indicate an acutely
Sudden reflexive Flinching may
contraction of indicate
muscles.an acutely
Flinching may indicate
painful
painful event
event thatthat startles
startles the the horse,
horse,
an acutely causing
causing
painful sudden
eventsudden
that escape
escape
startles movement
themovement
horse, causing sudden
and/or
and/or lossloss of balance.
of balance. escape movement and/or loss of balance.
Video
Video S31S31 https://doi.org/10.5281/zenodo.4540528
(accessed on on
Video S31 https://doi.org/10.5281/zenodo.4540528 18 18
(accessed
February
February 2021)
2021) on 18 February 2021)
i. Head
i. Head HighHigh
Stretching
etching Raising
Raising andand pulling
pulling headhead caudally,
caudally, withwith
the the back
back curved
curved ventrally.
ventrally. Head
Head
maymay be held
be held in different
in different positions
positions ranging
ranging fromfrom horizontal
horizontal to curled
to curled ven-ven-
trally
trally with
with muzzle
muzzle drawn
drawn toward
toward the the chest.
chest.
Video S32 https://doi.org/10.5281/zenodo.4540532 (accessed (accessed on on18 18
February
February 2021)
2021)
and/or
and/or loss
loss
Video of
ofS31balance.
balance.
Video
Video S31https://doi.org/10.5281/zenodo.4540528
S31
February https://doi.org/10.5281/zenodo.4540528
2021) (accessedonon1818
(accessed
February
February 2021)
2021)
Animals 2021, 11, 580 11 of 21
i. Head HighTable 2. Cont.

l. Stretching i. Head
i. Head Highand pulling head caudally, with the back curved ventrally. Head
Raising
High
tretching
tching l. Stretching Raising and pulling head caudally, with
Raisingmay bepulling
and held in head
different positions
caudally, with thethe
ranging back
from
back curved ventrally.
horizontal
curved Head
to curled
ventrally. Head ven-
maymay be be
trallyheld
held in in
with different
muzzle
differentdrawnpositions
toward
positions ranging from
the chest.
ranging from horizontal
horizontal to to curled
curled ven-
ven-
trally with muzzle i. Head
drawn Highthe chest.
toward
trally with muzzle
S32 drawn toward the chest. (accessed
Raising and pulling head caudally, with the backon 18
curved
Video
VideoFebruaryS32 https://doi.org/10.5281/zenodo.4540532
2021) ventrally. Head may be held in(accessed
S32 https://doi.org/10.5281/zenodo.4540532 (accessedonon1818
different positions ranging from
February
February 2021)
2021) horizontal to curled ventrally with muzzle drawn toward the
chest.
ii. Deep Abdominal

ii. ii.
DeepDeep Abdominal
Extending
Abdominal forelimbs Deep Abdominal
ii. cranially, shifting weight onto hindlimbs with the
Extending forelimbs Extending
cranially, forelimbs
shifting cranially,
weight onto shifting weight
hindlimbs onto
with hindlimbs
shoulders
Extending lowered
forelimbs toward shifting
cranially, ground, and
weightthe onto
back curved
hindlimbsventrally.
with thethe
shoulders lowered with
toward the shoulders
ground, and lowered toward ground, and the back
shoulders
Videolowered toward ground, and thethe back
back
S33 https://doi.org/10.5281/zenodo.4540538 curved
curved ventrally.
ventrally.
(accessed on 18
curved ventrally.
Video
S33
February https://doi.org/10.5281/zenodo.4540538 (accessedonon1818 (accessed
(accessed
2021) Video S33 https://doi.org/10.5281/zenodo.4540538
February
February 2021)
2021) on 18 February 2021)
iii. Hindlimb Extension

iii. Hindlimb Extension
iii.iii. Hindlimb
Extending
Hindlimb Extension
a hindlimb
Extension caudally,
Extending occasionally
a hindlimb with occasionally
caudally, a neck curl stretch, and curl
with a neck
Extending
Extendingsometimesa hindlimb
with the
a hindlimb caudally,
stretch, and
back curved
caudally, occasionally
sometimes
ventrally.
occasionally with
with
with a neck
athe back
neck curl
curl stretch,
curved
stretch, and
ventrally.
and
sometimes
sometimesVideowithwith
S34thethe
back Video
back S34
curved
curved https://doi.org/10.5281/zenodo.4540542
ventrally.
ventrally.
https://doi.org/10.5281/zenodo.4540542 (accessed on (accessed
18
Video
Video S34
S34 on 18 February 2021)
(accessed on on 1818
February 2021)
February
February 2021)
2021)
nimals 2021, 11, x FOR PEER REVIEW 12 of 22
iv. Neck Curl iv. Neck Curl

Arching the neck, with Arching
muzzlethe
to neck,
chest, with
backmuzzle
arched to chest, back
dorsally, arched
usually withdorsally,
usually with a hindlimb extension stretch.
a hindlimb extension stretch.
Video S35 https://doi.org/10.5281/zenodo.4540548 (accessed on 18(accessed
February 2021)
able 3. Head, neck, mouth, and lip movements.
. Rotational Head or Whole Body Shaking Rapid, rhythmic rotation of the whole body or just the head and
neck along the long axis. This is similar to shaking in response to
cutaneous irritation around the head, neck, or body, e.g., insects.
Rotational head or whole body shaking is often associated with bearing
weight on an affected limb or another behavior, such as lifting or
kicking a limb. May occur during prolonged periods of unrelieved
Animals 2021, 11, 580 12 of 21
. Head, neck, mouth, and lip movements.

Table 3. Head, neck, mouth, and lip movements.
e 3. Head, neck, mouth, and lip movements. Table 3. Head, neck, mouth, and lip movements.
ational Head or Whole Body Shaking Rapid, rhythmic rotation of the whole body or just the head and
a. Rotational Head or Whole Body Shaking Rapid,
otational Head or Whole Body Shaking
a. Rotational Head or Whole Body Shaking neck along
Rapid, therhythmic
rhythmic axis.rotation
longrotation This
of is
of the whole
thesimilar
wholetobody
body in
shaking or just the head
or just response
the head to and
and
neckirritation
along thearound Rapid,
long axis. rhythmic rotation of the whole body response tohead and
or just the
cutaneous
neck along the long axis.neck the This
This
along head,
isthe
isneck,
similar
long
similar
to or
axis.
to
shaking
This
shaking
body,is e.g.,
in
in
insects.
response
similar to to in response
shaking
cutaneous
Rotational head or irritation
whole body around
shaking the
is head,
often neck, orwith
associated body, e.g.,
bearing insects.
cutaneous irritation around the head,
to cutaneous neck,
irritation or body,
around e.g.,neck,
the head, insects.
or body, e.g.,
weight Rotational
on an head orlimb
affected wholeorbody
insects. shaking
another
Rotational is often
behavior,
head or wholeassociated
suchbodyas with
lifting
shaking bearing
isor
often associated
Rotational head or whole body shaking is often associated with bearing
kicking weight
a limb. on an affected
with limb
bearing or another
weight on anbehavior,
affected such
limb oras lifting
another or
behavior,
weight on anMay occurlimb
affected during prolonged
or another periodssuch
behavior, of unrelieved
as lifting or
kicking a limb. Maysuch as lifting
occur or kicking
during a limb.periods
prolonged May occur of during prolonged
unrelieved
discomfort, oftenMay
kicking a limb. during
occur episodes
during of fidgeting. periods of unrelieved
prolonged
discomfort, often periods
during ofepisodes
unrelieved of discomfort,
fidgeting. often during episodes of
discomfort, often during episodes of fidgeting. (accessed on 18
fidgeting.
FebruaryVideo
2021) S36 https://doi.org/10.5281/zenodo.4540550 (accessed on 18
https://doi.org/10.5281/zenodo.4540550 (accessed on 18 (accessed
February 2021)
stration Head Tossing
b. Frustration Head Tossing
b. Frustration
rustration Head TossingHead Tossing
Quick rotational toss of the head, similar to a head threat.
Quick rotational Quick
toss of the head, similar
of the to a head threat.
Video S37
Quick toss of the rotational toss
rotational head, similar head,
to a head similar
(accessed
threat. to a18
on head threat.
on 18
February 2021)
February 2021)
d Bobbing c. Head Bobbing

c. Head Bobbing
ead Bobbing
Repetitive nodding of head and neck. Not usually as rhythmic as
a Repetitive nodding of headnodding
and neck. Notandusually
neck. as
Notrhythmic
persis-as as
Repetitive of head usually as rhythmic
with stereotypy.
Repetitive noddingOften appears
ofashead toneck.
reflect frustration with
with a stereotypy. with and
Often aappears
stereotypy.Not
to
usually
Often
reflect
as
appears rhythmic
to reflect
frustration with frustration
persis- with
tent discomfort,
with particularly
a stereotypy. Often when
appears
persistent the horseparticularly
to reflect
discomfort, seems unable
frustration with
when to find
persis-
the horse seems unable
tent discomfort,
a comfortable posture. particularly when the horse seems unable to find
tent discomfort, particularly
to find awhen the horse
comfortable seems unable to find
posture.
Video a comfortable
S38 posture.
https://doi.org/10.5281/zenodo.4540559 (accessed on 18 (accessed
a comfortable posture.
Video
February S38
s021, 11,11,
2021, x FOR PEER
x FOR REVIEW
PEER REVIEW February 2021) 13 13
of of
22 22
February 2021)
d. Nose Tossing/Flipping Flicking upward extension of the head and neck. Not usually
Flicking
rhythmic, upward extension of the head and neck. Not usually
Flicking as with
upward a stereotypy.
extension Often
Flicking of the appears
upward head to of
and
extension reflect
neck. frustration
Notand
the head usually
neck. Not usually
with rhythmic,
persistent as with
discomfort,a stereotypy.
particularlyOften
when appears
the to reflect frustration
rhythmic, as with a stereotypy.
rhythmic, Often
as with appears tohorse
a stereotypy. reflect
Oftenseems un-to reflect
frustration
appears
e Tossing/Flipping
d. Nose Tossing/Flipping able to with
with find apersistent
comfortable
persistent
discomfort,
frustration
discomfort,posture. particularly
with persistent
particularly
when the horse
when discomfort,
seems un-
particularly
the horse seems un- when the
ose Tossing/Flipping able to find a comfortable
horse posture.
seems unable to find a comfortable posture.
able to find a comfortable posture. (accessed on 18
Video Video S39 https://doi.org/10.5281/zenodo.4540563
S39 https://doi.org/10.5281/zenodo.4540563 (accessed on 18 (accessed
February
Video S39 2021)
February 2021)
February 2021)
eviated Weaving
breviated Weaving
e. Abbreviated Weaving
Rhythmic
Rhythmicside-to-side
side-to-sideswaying
swayingofofthe thehead
headand
andneck.
neck.Typically
Typically
does
doesnotnotinclude
includeanimated Rhythmic
animated weight side-to-side
weight shifting swaying
shiftingand of the flexing,
andalternate
alternate head and neck. Typically
flexing,
does not include animated weight shifting and alternate flexing,
lifting, and/or
lifting, lateral
and/or movement
lateral movement ofof
forelimbs,
forelimbs,asasis is
common
common with
with
lifting, and/or lateral movement of forelimbs, as is common
thethestereotypy
stereotypy form
form ofof
weaving.
weaving.
with the stereotypy form of weaving.
Video
S40 (accessed onon
https://doi.org/10.5281/zenodo.4540565 (accessed 1818 (accessed
February 2021)
February 2021)
athetic Surge
mpathetic Resolution
Surge Signs:
Resolution Extending
Signs: Extending Cluster
Clusterofofautonomic
autonomicresponses
responsesfollowing
followingananacute
acutesympathetic
sympathetic
, Licking,
ue, Chewing,
Licking, Chewing,Itching
Itching surge, including
surge, includingsalivation (leading
salivation (leadingtoto
chewing
chewingmovements,
movements, swal-
swal-
lowing,
lowing,tongue
tongueextensions) and/or
extensions) autogrooming
and/or (typically
autogrooming rubbing
(typically rubbing
face against
face againstforelimb).
forelimb).
February 2021)
Animals 2021, 11, 580 13 of 21
ympathetic Cluster of autonomic responses following an acute sympathetic

athetic SurgeSurge Resolution
Resolution Signs:
Signs: Extending Cluster
Extending of autonomic
Tableresponses
3. Cont. following an acute sympathetic
ngue, f.Licking, Chewing,
Sympathetic SurgeItching
Resolution Signs: Extending surge, including salivation
autonomic (leading to
responses chewing movements,
surge, including salivation (leading to chewing movements,acute
Cluster of following an swal-swal-
sympathetic
Licking, Chewing, Itching
Tongue,f. Sympathetic Surge Resolution
Licking, Chewing, lowing,
Itching Signs: Extending tongue
surge,
lowing, Tongue,
tongue extensions)
includingand/or
Licking,
extensions) and/or
salivation autogrooming
autogrooming (typically
(leading (typically
to chewing rubbing
movements, swal-
rubbing
Chewing, Itching face against forelimb).
lowing,
face against forelimb).tongue extensions) and/or autogrooming (typically rubbing
Cluster of autonomic responses
face against forelimb).
Video S41 https://doi.org/10.5281/zenodo.4541367 (accessed on an
following
(accessed acute
18on 18 sympathetic
February surge, including salivation (leading to chewing
2021)S41 https://doi.org/10.5281/zenodo.4541367 (accessed movements,
February Video
2021) on 18
swallowing, tongue extensions) and/or autogrooming (typically
February 2021) rubbing face against forelimb).
requent
ent Yawning
Yawning BoutsBouts
g. Frequent Yawning Bouts Frequent
Frequent boutsbouts of yawning,
of yawning, oftenoften
withwith a greater
a greater number numberof yawns of yawns
g. Frequent Yawning Bouts
per bout than
Frequent is boutsFrequent
characteristic
of bouts
yawning, of
(greater yawning,
often than
with 3 often
ato with
5).
greaterOften a greater number
associ-
number of yawns of
per bout than is characteristic (greater than 3 to 5). Often associ-
ated with changes yawns
in per bout than
sympathetic tone, is characteristic
so may occur (greater than 3 to 5). Often
intermit-
per boutinthan
ated with changes is characteristic
sympathetic tone, so(greater
may than 3intermit-
occur to 5). Often associ-
associated with changes in sympathetic tone, so may occur
tently with
ated lip
withlicking,
changes
tently with lip licking, chewing, chewing,
in tongue
sympathetic
tongue
intermittently with
extensions
extensions tone, so characteristic
may
lip licking, characteristic
chewing, tongue occur extensions
intermit-
of sympathetic
tently surge
with
of sympathetic surge resolution resolution
lip licking, signs.
chewing, tongue extensions
signs. of sympathetic surge resolution signs.
characteristic characteristic
VideoVideo S42 https://doi.org/10.5281/zenodo.4541373
of sympathetic Video
surgeS42 (accessed
resolution
S42 https://doi.org/10.5281/zenodo.4541373 signs. (accessed on 18on 18 (accessed
2021)S42 https://doi.org/10.5281/zenodo.4541373 (accessed on 18
Video
February 2021)
February 2021)
pontaneous
aneous h.Flehmen
Flehmen Response
Response
Spontaneous Flehmen Response Lifting
Lifting of theof head
the headwithwithcurlingcurling
of the of upper
the upper lip, drawing
lip, drawing nasalnasal
Lifting of the head with curling of the upper lip, drawing nasal
h. Spontaneous Flehmen Response fluids into
fluids into the the
Lifting vomeronasal
of thefluids
vomeronasal head organ.
withFlehmen
organ. Flehmen
curling is
isofa the a
normal normal
upper lip,response
response drawing nasal
into the vomeronasal organ. Flehmen is a normal response
within
within the
the contextcontext
fluids into ofwithin
the sniffing
of sniffing the pungent
vomeronasal
pungentcontext of fluids,
organ.
fluids, typically
Flehmen
typically
sniffing pungent in a social
inis aafluids,
normal
social response
typically in a social
olfactory context,
within the but with
context
olfactory ofdiscomfort,
sniffing
context, flehmen
pungent
but
olfactory context, but with discomfort, flehmen may occur out of with may
fluids,
discomfort, occur
typically out
flehmen of
in
may a social
occur out of
that context. that context.
021,
that context.olfactory context, but with discomfort, flehmen may occur out of
1, 11,11, x FOR PEER REVIEW Video S43 https://doi.org/10.5281/zenodo.4541379 1414of of2222
x FOR PEER REVIEW
VideoVideo S43
thathttps://doi.org/10.5281/zenodo.4541379
context.
(accessed on 18on 18 (accessed
February
February 2021)S43 https://doi.org/10.5281/zenodo.4541379 (accessed on 18
Video
2021)
i. Lip Quivering/Wincing Involuntary
Involuntary Februarymovements
movements 2021) (twitching)
(twitching) of the of lips
the lips
and and nares, nares,oftenoften
ip Quivering/Wincing
uivering/Wincing Video S44 https://doi.org/10.5281/zenodo.4541385 (accessed on1818nares, often
Video S44
with https://doi.org/10.5281/zenodo.4541385
relaxation
with relaxationInvoluntary (drooping)
(drooping) movements of the
of the lower lower
(twitching)
lip. lip. (accessed
of the lips and on
i. Lip Quivering/Wincing February2021)
February 2021)
with relaxation (drooping) of the lower lip.
Involuntary movements (twitching) of the lips and nares, often
with relaxation (drooping) of the lower lip.
gHead
Head j. Tilting Head
Holdingororcocking
Holding cockingthe
thehead
headtotoone
Holding
oneside,
side,such
or cocking
suchthat
the head
that theside,
to the
sagittal
one sagittal
such that the sagittal
plane is off vertical.
plane is off vertical. plane is off vertical.
VideoS45
https://doi.org/10.5281/zenodo.4541387 (accessedonon1818
(accessed (accessed
February2021)
2021, 11, xAnimals
Animals FOR
2021,PEER x REVIEW
2021,
11, 11, 580
FOR PEER REVIEW 15 of 22 15 of 2214 of 21
Table 4. Attention to an area.

4. Attention to an area.to an area.
Table 4. Attention Table 4. Attention to an area.
a. Looking
kinga. Looking
a. Looking
Glancing or gazing at a particular area of the body.
Glancing Glancing
or gazing atgazing
a particular area of the body.
Video S46orhttps://doi.org/10.5281/zenodo.4541390
at aorparticular
Glancing gazing at aarea of thearea
particular body.
of(accessed
the body. on 18
Video S46Video
S46 Video S46
(accessed
(accessed
(accessed
February 2021)
February February
2021) on 18 February 2021)
2021)
b. Swatting
atting
b. Swatting
b. Swatting
Swinging the head and neck, batting at a particular area of the
SwingingSwinging
the head the
andhead
neck, batting atbatting
a particular area of the
body, similar to thatand
Swinging theneck,
seen in response
head atbatting
to
and neck, a particular
cutaneous area of
irritation,
at a particular the
e.g.,
area of the
body, similar
body,to that seen in
similar body,
to that response
seen to
similar to
in thatcutaneous
response
seen into irritation,
cutaneous
response e.g.,
irritation,
to cutaneous e.g.,
irritation,
insects.
insects. insects. e.g., insects.
Video S47Video
S47 https://doi.org/10.5281/zenodo.4541394(accessed(accessed
on 18
on 18
February February
2021) 2021)
c. Autogrooming
togrooming c. Autogrooming
c. Autogrooming
Nibbling, nuzzling, and/or

Nibbling, biting
nuzzling, at an area
and/or bitingofatthe
an body,
area ofortherubbing
body, or
Nibbling,Nibbling,
nuzzling, and/or biting atpart
an area ofbody
thearea
body, or rubbing
one part ofnuzzling,
bodyand/or
therubbing one
to biting
another of orat
the an
against to anofobject,
the
another body, or rubbing
or similar
against an
to object,
that
one part of
onethepart
body
of to similar
theanother
body to
to or against
that seen
another inan
or object,an
response
against similar
to tosimilar
cutaneous
object, that
irritation,
to e.g.,
that
seen in response to cutaneous irritation, e.g., insects.
seen in response
seen in to cutaneous
insects.
response to irritation,irritation,
cutaneous e.g., insects.
e.g., insects.
(accessed on 18
(accessed
Video S48Video
S48 https://doi.org/10.5281/zenodo.4541398 (accessed(accessed
on 18 on 18
February February
2021) 2021)
Animals
s 2021, x2021,
11, 11, 11,
x FOR xPEER
FOR PEER REVIEW 22 16
22 of 2216 of1522
021, FOR PEER
Animals
Animals 11,REVIEW
REVIEW
2021,
2021, 11, 580 PEER REVIEW
x FOR 16 16
of of of 21
ble 5. Ear and tail movements.

Table
5. Ear5.and
Ear and
tailtail tail movements.
Ear andTable 5. movements.
movements.
Ear and tail movements. Table 5. Ear and tail movements.
Moving/Focusing Ears Caudally
a. Moving/Focusing
oving/Focusing
ng/Focusing Ears
Ears Ears Caudally
Caudally
Caudally
a. Moving/Focusing Ears Caudally
a. Moving/Focusing Ears Caudally
Rotating ears to focus caudally, or laying ears back against neck.

Rotating
Rotating
Rotating ears
ears ears
to to tocaudally,
focus
focus focus caudally,
caudally,
or or orears
laying
laying laying
ears ears
back
back back against
against
against neck.
neck. neck.
Video Rotating
S49 ears to focus caudally, or
https://doi.org/10.5281/zenodo.4541402laying ears back
(accessed
Rotating ears to focus caudally, or laying
against
on 18
ears back
neck.neck.
Video
Video Video
S49S49 S49 https://doi.org/10.5281/zenodo.4541402
(accessed
(accessed onon
18 18onagainst
18
FebruaryVideo
2021)S49 https://doi.org/10.5281/zenodo.4541402 (accessed
Video S49 https://doi.org/10.5281/zenodo.4541402 on 18
(accessed
February
February
February 2021)
2021) 2021) on 18 February 2021)
February 2021)
Swishing/Flicking Tail
b. Swishing/Flicking
wishing/Flicking
hing/Flicking Tail Tail
Tail
b. Swishing/Flicking
b. Swishing/FlickingTail
Tail
Moving tail suddenly from side to side, similar to that seen in re-
Moving Moving
Movingtailtail tail suddenly
suddenly
suddenly from
from from
sideside side
to to to
side,
side, side, similar
similar
similar to to seen
that that
intoseen
in re-inseen
re-
sponse Moving
to cutaneoustail suddenly
irritation,
Moving from
e.g.,
tail suddenly side toto
insects.
from
that
side,
side to
seen
similar re-
that
side, similar in re-
to that seen in
sponse sponse
sponse
to to to
cutaneous cutaneous
cutaneous irritation,
irritation,
irritation, e.g.,
e.g., e.g.,
insects.
insects. insects.
sponse to cutaneous irritation,
Video S50 https://doi.org/10.5281/zenodo.4541408 e.g., insects.
response to cutaneous irritation, e.g., (accessed
insects. on 18
Video
Video Video
(accessed
Video S50 https://doi.org/10.5281/zenodo.4541408 onon 18 18on 18(accessed
February Video
February
February
February 2021)
2021) 2021) on 18 February 2021)
February 2021)
Slapping Tail Against Perineum

c. Slapping
pping
ing Tail
Tail Tail Against
c.Against Perineum
Perineum
c.Against
Slapping Perineum
Slapping Tail
Tail Against
Against Perineum
Perineum
Sudden lifting and smacking of the tail against the perineum.
Sudden Sudden
Sudden lifting
lifting lifting
andand and
smacking smacking
smacking of of
Sudden thetheoftail
tail
lifting the tail against
against
against
and the
thetail
smacking thetail
perineum.
perineum.
perineum.
of against
the against the18perineum.
Video Sudden
S51 lifting and smacking of the
https://doi.org/10.5281/zenodo.4541736 the perineum.
(accessed on
VideoVideo
S51
VideoFebruary S51 https://doi.org/10.5281/zenodo.4541736
Video S51
(accessed
(accessed on 18 on 18 on 18(accessed
Video
February
February 2021)
2021)February 2021)
Lifting/Holding Tail Off Perineum

d. Lifting/Holding
ting/Holding
ng/Holding d.
TailTail Tail
OffOff Off Tail
Lifting/Holding Perineum
Perineum
Perineum Off Perineum
d. Lifting/Holding Tail Off Perineum
Raising the tail dorsally off the perineum for a few seconds or
Raising
Raising
Raising thethe the
tail
tail tail dorsally
Raising
dorsally
dorsally off off
the
the the
tail perineum
dorsally
perineum foroff a for
a the
for a seconds
few for
perineum
few seconds
aor or
few seconds or
more. Raising the off
tail the perineum
dorsally off the few
perineum seconds
for a or
few seconds or
more. more.
more.
more.Video S52more.https://doi.org/10.5281/zenodo.4541740 (accessed on 18 (accessed
Video
Video Video
(accessed
(accessed onon
18 18on 18 on 18
FebruaryVideo
2021)S52 https://doi.org/10.5281/zenodo.4541740
on 18 February 2021) (accessed
February
February
February 2021)
2021) 2021)
February 2021)
ble 6. Overall demeanor.

Table 6. demeanor.
Overall
6. Overall
Overall demeanor.
demeanor.
Table 6. Overall demeanor. Table 6. Overall demeanor.
Dull Expression/Depressed Demeanor
a. Expression/Depressed
ull Dull Expression/Depressed
Expression/Depressed Demeanor
Demeanor
Demeanor
a. Dull Expression/Depressed
a. Dull Expression/Depressed Demeanor
Demeanor
Less responsive to the environment, often with “zoned out,” wor-

Less
Less Less responsive
responsive
responsive to
thethetoenvironment,
to responsivethe environment,
environment, often
often often
with
with with
“zoned
“zoned “zoned
out,” out,”
wor- wor-
ried, Less
or glassy-eyed to the
staring
Less environment,
facial
responsive expression. oftenout,”
to the environment, with wor-
often“zoned out,” out,”
with “zoned wor-
ried,
ried, or ried,
or or glassy-eyed
glassy-eyed
glassy-eyed staring
staring facialfacial expression.
expression.
Video ried,
S53 orstaring facial
glassy-eyed expression.
staring facialstaring
worried, or glassy-eyed expression.(accessed
facial on 18
expression.
Video
Video Video
(accessed onon
Video S53 https://doi.org/10.5281/zenodo.4541763 18 18on 18
(accessed
February Video
February
February
February 2021)
2021) 2021) on 18 February 2021)
February 2021)
Animals 2021,Animals 2021,
11, x FOR 11, xREVIEW
PEER FOR PEER REVIEW 17 of 22 17 of 22
Animals 2021, 11, 580 16 of 21
uarding
b. Guardingb. Guarding Especially cautious movement
Table 6.
EspeciallyEspecially
Cont.
cautious
cautious movement
and retreat from potential
movement
and retreatand fromretreat disturb-
from
potential potential disturb-
disturb-
Guarding b. Guarding ance or “cowering”
ance submissive
or “cowering” appearance
submissive as if threatened
appearance as by
if hu-
threatened by hu-
ance or “cowering”
Especially cautious submissive
movement appearance
and retreat fromas ifpotential
threatened by hu-
disturb-
mans or othermanshorses.
or The horse
other mayThe
horses. stand in the
horse may back
standof in
thethestall
back of the stall
mansor or other horses. The horse may stand asinif the back of by thehu-
stall
or ance “cowering”
uncharacteristically submissive
not
or uncharacteristically
appearance
approach a
not person
approach whothreatened
enters.
a retreat
person They
who enters. They
mans or other horses. Thenot
Especially approach
cautious
horse may a person
movement
stand and
in the who
back enters.
of from
the They
potential
stall
may stand with
maymuscles
stand tensed
with
disturbance and
muscles
or seem unwilling
tensed
“cowering” and to move
seem
submissive even
unwilling
appearance to
asmove
if even
ormay
when
stand with muscles
uncharacteristically
encouraged. nottensed
approachand seem unwilling
a person to move
who enters. even
They
when threatened by humans or other horses. The horse may stand in
encouraged.
when
may encouraged.
stand with muscles tensed
Video S54 the back of theand
stallseem
https://doi.org/10.5281/zenodo.4541765 unwilling to move
(accessed on even
not approach
18 a
Video
when S54Video
encouraged.
person who enters. They may stand (accessed
with muscles
(accessed
on 18 and
tensed
on 18
February 2021)February 2021)
February
Video 2021) seem unwilling to move even when(accessed
S54 https://doi.org/10.5281/zenodo.4541765 encouraged. on 18
February 2021)
onservativec.Movement
Conservative Movement
c. Conservative Movement
c. Conservative Movement
Conservative Movement
Less than typical Lessmovement
than typicalabout the stall,about
movement with the
apparentwith hesita-
Less than typical movement about the stall, with stall, apparent hesita-
apparent hesita-
tion to walk (e.g.,
tion reaching
to Less
walk with
than
(e.g., head
typical and
movement
reaching neck
with rather
about
head the
and than
stall,
neck step-
with apparent
rather
tionthan
Less to walk (e.g.,
typical reaching about
movement with head
the andwith
stall, neckapparent
rather than step-than step-
hesita-
ping forward).ping forward).hesitation to walk (e.g., reaching with head and neck rather than
ping
tion to forward).
walk (e.g., reaching with
stepping forward).head and neck rather than step-
Video
ping S55Video
forward).
Video (accessed on
S55 https://doi.org/10.5281/zenodo.4541767 (accessed on 18
18(accessed
February 2021)February on 2021)
18 February 2021)
February
Video 2021)
February 2021)
ncharacteristic Aggression Aggression

d. Uncharacteristic
Uncharacteristic
d.
d. Uncharacteristic AggressionAggression Increased irritability/aggression
Increased Increased
(biting, kicking,
irritability/aggression
barging)
(biting,
(biting, kicking,
toward
kicking,
barging) barging) toward
toward
people or other animals.
people Similar
Increased to hyper-responsiveness,
or otherSimilar
animals. a horse
(biting, un-
kicking,
Similar to hyper-responsiveness, barging)
Uncharacteristic Aggression people orirritability/aggression
Increased other animals. to hyper-responsiveness, a horse un-a horse un-
der increased derstress toward
from people (biting,
discomfort or other
may kicking,
animals.
display barging)
Similar
changes toward
hyper-responsiveness,
to in de-
der increased increased
stress from stress from
discomfort discomfort
may displaymay display
changes inchanges
de- in de-
people
meanor or other
that animals.
manifest a horseSimilar
under
as increased to hyper-responsiveness,
increased stress
aggression. a horse
from discomfort
These horses may un-
may display
meanor meanor
that stress that
manifest manifest
as discomfort
changes increased as
in demeanor increased
aggression. aggression.
that manifestThese These
horses
as increased may horses may
beder increased
generally sour or from
unexpectedly lash may
out atdisplay
people changes
or other in aggression.
ani-de-
be generallybe sour
generally
These sour
horsesormay
or unexpectedly unexpectedly
be out atlash
generally
lash sour out
people at other
peopleani-
or unexpectedly
or orlash
other
outani-
at
meanor
mals. that manifest as increased aggression. These horses may
mals. people or other animals.
bemals.
Videogenerally sour orVideo
unexpectedly lash out at people or other
S56 https://doi.org/10.5281/zenodo.4541773 (accessed on 18ani- (accessed
Video S56Video
mals.
on 18 February 2021) (accessed on (accessed
18 on 18
February
Video 2021)
yper-Responsive/Startle Prone
e.e. Hyper-Responsive/Startle
Hyper-Responsive/Startle Prone February 2021)
e. Hyper-Responsive/Startle Prone Prone
Hyper-Responsive/Startle Prone Lower threshold andthreshold
more animated reaction to environmental
Lower
Lower threshold and more and more
animated animated
reaction toreaction to environmental
environmental
Lower threshold and more animated reaction to environmental
stimuli. Hyper-responsiveness
stimuli. may indicate amay
Hyper-responsiveness lowindicate
tolerance a for
low stim-
tolerance forfor
stim-
stimuli. Hyper-responsiveness
stimuli. may indicate
Hyper-responsiveness a low
maytotolerance
indicate for stim-
a low tolerance
uli,Lower
due to threshold
anuli, and
increased more
stress animated
level reaction
associated with environmental
discomfort.
uli, due
stimuli. to an due to an due
stimuli,
increased
Hyper-responsiveness
increased
to an
stress
may levelstress
increased
indicate
level
stressassociated
associated level
withassociated
a low tolerance
withwith
discomfort.
for stim-
discomfort.
Palpation of the painful
Palpation area
of themay
discomfort. also
painful illicit
Palpation
area an
theuncharacteristically
ofmay painful
also areaan
illicit may also illicit an
uncharacteristically
Palpation
uli, due to of
anthe painful area
increased stressmay also
level illicit an uncharacteristically
associated with discomfort.
strong reaction. uncharacteristically strong reaction.
strong strong reaction.
reaction.
Palpation of the painful
Video area
S57 may also illicit an uncharacteristically
Video S57 https://doi.org/10.5281/zenodo.4543427 (accessed on 18 (accessed
strong S57Video
Videoreaction. S57 https://doi.org/10.5281/zenodo.4543427
on 18 February 2021) (accessed on (accessed
18 on 18
February
Video 2021)
February 2021)
estlessness/Ill-at-ease
f. Restlessness/Ill-at-ease i. Changing Activities Frequently
f. Restlessness/Ill-at-ease i. Changingi.Activities
Changing Activities Frequently
Frequently
Changing major activitymajor
Changing (foraging, standing
activity rest,standing
(foraging, standingrest,
alert)standing alert)
Restlessness/Ill-at-ease i. Changing
more Changing
frequently
major activity
Activities
than expected,
(foraging,
Frequently as often
standing rest,
as from
standing alert)
minute-to-minute,
more frequently
more frequently than expected,than as
expected,
often asas often
from as from minute-to-minute,
minute-to-minute,
Changing
with major
other signs activity
of other
discomfort. (foraging, standing rest, standing alert)
with
withfrequently
other signs signs
of discomfort.of discomfort.
more
Video S58 (in 4x than
time) expected, as often as from minute-to-minute,
Video S58 Video
(in 4x S58
time)(inhttps://doi.org/10.5281/zenodo.4543432
4x time) https://doi.org/10.5281/zenodo.4543432
with other
(accessed signs
on 18 of discomfort.
February 2021)
(accessed (accessed
on 18time) on 18 2021)
February February 2021)
Video S58 (in 4x https://doi.org/10.5281/zenodo.4543432
Animals 2021, 11, 580 17 of 21
Table 6. Cont.
mals 2021, 11, x FOR PEER REVIEW i. Changing Activities Frequently 18 of 22

Animals 2021, 11, x FOR PEER REVIEW Changing major activity (foraging, standing rest,18standing
of 22 alert)
nimals 2021,
Animals 2021,11,
11,xxFOR
FORPEER
PEERREVIEW
REVIEW
ii. Circling/Pacing 18
18 ofof 22
22
more frequently than expected, as often as from
f. Restlessness/Ill-at-ease Walking in circles or minute-to-minute,
back and forth along a perimeter. In cases of
with other signs of discomfort.
mild to moderate discomfort, circling/pacing
Video S58 (in may interrupt ongo-
4x time) https://doi.org/10.5281/zenodo.4543432
ii. Circling/Pacing
ing (accessed
behaviors in a manner on 18
that February
suggests 2021)
the horse cannot find a
Walkingii. Circling/Pacing
in circles or position.
back and forth along a perimeter. In cases of
comfortable standing
ii. Circling/Pacing
mild Walking
to moderatein circles or back and
discomfort, forth along a perimeter.
circling/pacing Inongo-
cases of
Video ii.
WalkingCircling/Pacing
in circles or back and
ii. Circling/Pacing forth along amay interrupt
(accessed
perimeter. In oncases 18 of
ing mild
Walking to in
behaviors moderate
in a
circles manner
ordiscomfort,
back that
and circling/pacing
suggests
forth along the a horsemay
perimeter. interrupt
cannot In find
casesongo-
a of In cases
February 2021) Walking in circles
mild to moderate discomfort, circling/pacing may interrupt ongo-or back and forth along a perimeter.
ing
mild behaviors
to moderate in a manner
discomfort, that suggests the horse cannot find a
comfortable
ing behaviors standing
in a of position. thatcircling/pacing
mild to moderate
manner discomfort,
suggests the may horse interrupt
circling/pacing
cannot find ongo-
may
ainterrupt
Video comfortable
ing behaviors standing
in aongoing
manner position.
behaviors
S59 https://doi.org/10.5281/zenodo.4543444 in a manner
that suggests that
the horse suggests
(accessedcannoton the
find
18horsea cannot
iii.comfortable
Abandoning standing Recumbencyfindposition.or Elimination
a comfortable Attempt
standing position. (accessed on 18
Video
comfortable
February S59
standing position.
Video
Repeated S59 https://doi.org/10.5281/zenodo.4543444
posturing as
Video if intending to lie down, urinate,
S59 https://doi.org/10.5281/zenodo.4543444 (accessed or defe- on 18(accessed
February
Video S59 2021)
February
cate, that appears on 18 February
2021) interrupted by 2021)
discomfort (accompanied by, for
iii.February
Abandoning 2021) Recumbency or Elimination Attempt
example,
Repeated swishing/flicking
iii. Abandoning
posturing as if tail,
Recumbency intendingfocusing toears
or Eliminationlie caudally,
down,Attempt rotational
urinate, or shak-
defe-
ing iii. Abandoning
head or whole Recumbency
body). For or Elimination
example, attempts Attempt
at recumbency dur-
cate, Repeated
that appearsposturing iii. Abandoning
interrupted as if intending
by Recumbency
discomfort or Elimination
to lie(accompanied
down, urinate, Attempt
by, orfor defe-
Repeated
iii. Abandoning posturingRecumbencyas if intending
Repeated or to
as lie
Elimination
posturing iflyingdown,
Attempt
intending urinate,
to(circle,
lie down, orpaw defe-
urinate,
ing which
cate,
example, the
that horse
appears appears
swishing/flicking interrupted to commence
tail, focusing by discomfort
ears caudally, down,
(accompanied
rotational by, by,
shak- for or
the cate, that
Repeated
substrate, appears
posturing
with interrupted
as
defecate,
headFor downif that by
intending discomfort
appears
andfocusing
bucklingto lie
interrupted
at the (accompanied
down, byurinate,
knees), discomfort or
but then for
defe-
(accompanied
ing example,
head or whole swishing/flicking
body).by,
tail,
example,
for example, attempts ears
swishing/flicking
caudally,
at recumbency rotational
tail, rotational
focusing ears dur- shak-
caudally,
example,
cate, to
returns that swishing/flicking
appearsas
standing, interrupted
if tail, focusing
reluctant byor ears caudally,
discomfort
uncomfortable (accompanied
lying down. shak-
by, for
ing ing headthe
which or horse
whole appears
body).
rotational For to example,
commence
shaking head attempts
or lying
whole at recumbency
down,
body). For (circle,
example, paw dur-
attempts at
ing
Video head
example,
S60 or whole body).
swishing/flicking For example,
tail,
https://doi.org/10.5281/zenodo.4543446 focusing attempts
ears at
caudally,recumbency
(accessedrotational on dur-
shak-
18paw lying
the ing which
substrate, the
with horse
head appears
recumbency
downto to commence
during
and which the
buckling atlying
horse
the down,
appears
knees), (circle,
but tothen
commence
ing
ingwhich
February head orthe
2021) horse
whole appears
body).
down, For
(circle, commence
example,
paw theattempts lying
substrate, down,
at recumbency
with (circle,
head down paw
dur-
and buckling
returnsthe substrate,
to standing, with as head down and
if reluctant buckling at thelying
orbuckling
uncomfortable knees), down.but then
the substrate,
ing which the horse with head
at appears down
the knees), and
tobut
commence
then returns at
lying the knees),
down, (circle,
to standing, but then
paw or
as if reluctant
Video returns to standing, as if reluctant or uncomfortable
S60tohttps://doi.org/10.5281/zenodo.4543446 (accessed lyingon down.
18
returns
the substrate, standing, as if reluctant
withuncomfortable
head down and orbuckling
lying uncomfortable
down. at the lying down.
knees), but then
Video
February S60
Video
returns S60 to https://doi.org/10.5281/zenodo.4543446
standing, as if reluctant or uncomfortable (accessed
lying down. on 18(accessed
February
Video S60 2021)
FebruaryRepositioning
iv. Frequent 2021) During Recumbency
During recumbent rest, frequent alternating between sternal and
iv. Frequent
lateral position, Repositioning During Recumbency
and/or repositioning of limbs or head and neck as
During iv. Frequent
recumbent Repositioning
rest, frequentDuring Recumbency
alternating between sternal and
iv. Frequent Repositioning
if trying to find a comfortable position.
iv. During
Frequent Recumbency
Repositioning During Recumbency
lateralDuring recumbent
position, and/or Duringrest, frequent
repositioning
recumbent alternating
of limbs
rest, frequent or between
head and
alternating sternal
neck
between asandsternal
During
Video S61 recumbent rest, frequent
https://doi.org/10.5281/zenodo.4543448 alternating between
(accessed sternal
on 18and
lateral
if lateral
trying
iv. to
Frequentposition, and/or
and lateral
findRepositioning
a comfortable repositioning
Duringposition,
position.
Recumbencyof limbs
and/or or head and
repositioning neckorashead and
of limbs
February position,
2021) and/or repositioning of limbs or head and neck as
Video if trying
S61 to find a neck as if trying
comfortable
https://doi.org/10.5281/zenodo.4543448 to find a comfortable
position. position.
ifDuring
trying to recumbent rest, frequent
find a comfortable alternating between sternal18
position. (accessed on and
https://doi.org/10.5281/zenodo.4543448 (accessed onas (accessed
18
February
lateral 2021)
position, and/or repositioning
on 18 February 2021) of limbs or head and
(accessed on 18 neck
ifFebruary
trying to
February
2021)
find a comfortable position.
2021)
FebruaryAimlessly
v. Nibbling 2021)
v. Nibbling
Reduced Aimlessly
interest in hay or feed, but continued nominal foraging
Reducedv. Nibbling
gestures, interest
often Aimlessly
in v.
directed hay Nibbling
atornon-food
feed, Aimlessly
butobjects.
continued The nominal
horse may foraging
have
v. Nibbling Aimlessly Reduced interest inbut
haycontinued
or feed, butnominal continuedforaging nominal foraging
access Reduced
gestures, to hayoften interest
directed
or feed, in
but hay
at or
non-food
instead feed,
picks objects.
around The horse
in bedding may have
or only
Reduced interest ingestures,
hay or feed,
often but
directed continued
at non-food nominal
objects. foraging
The horse may have
access gestures,
to hay often
or feed,directed
but instead atwith non-food objects.inThe horse may have
nibbles
gestures,small bites
often alternately
access
directed to hay
at orpicks
non-food other around
activities.
feed,objects.
but instead Thebedding
The
picks
horse horse
aroundor
may only
mayin
havebedding or
nibblev.
nibbles Nibbling
access
orsmallto
lick Aimlessly
hay
bites
at or
walls,feed,
alternately
onlyfeed butor
nibbles instead
with
water
small picks
other
containers,
bites around
activities.
alternatelyor in
The
other bedding
with horse
non-food
other or
may only The
activities.
access to hay or feed, but instead picks around in bedding or only
Reduced
nibble nibbles
or small interest
small
lick atbitesbites
walls, in
horse hay mayor
alternately
feed or water feed,
nibble but
withor continued
other
lick
containers,at activities.
walls, nominal
feed
or other The
or waterforaging
horse may
containers, or
objects.
nibbles alternately
other non-food
with other activities.
objects.
The non-food
horse may
gestures,
nibble
objects.
Video often directed at non-food
or lick at walls, feed or water containers,
S62orhttps://doi.org/10.5281/zenodo.4543452 objects. The horse
or other on
(accessed may have
non-food
18
nibble lick at walls, Video feed
S62 or water containers, or
https://doi.org/10.5281/zenodo.4543452 other non-food
Videoaccess
Februaryobjects.
S62 to hay or feed, but instead
2021) picks around in bedding
(accessed on 18 or only(accessed
objects. on 18 February 2021)
nibbles
Video 2021)
February small
S62 bites alternately with other activities. The
https://doi.org/10.5281/zenodo.4543452 horse on
(accessed may 18
vi. Fidgeting
nibble
February or lick2021)at walls, feed or water containers, or other non-food
vi.February
Fidgeting2021) vi. Fidgeting
Biting, mouthing, and/or
objects. rubbing against objects (e.g., stall walls,
Biting,vi. Fidgeting
mouthing, Biting,rubbing
and/or mouthing, and/orobjects
against rubbing against
(e.g., stallobjects
walls,(e.g., stall
vi.
feed/waterFidgeting
Video S62 containers). These responses
https://doi.org/10.5281/zenodo.4543452 often reflect frustration
(accessed on 18reflect
Biting,
feed/water mouthing,
containers). walls,
and/or feed/water
These rubbing
responsescontainers).
against often These
objects
reflect responses
(e.g., stall
frustration often
walls,
withBiting,
the
February mouthing,
inability
2021) to and/or
find a
frustration rubbing
comfortable against
withresponses posture
the inabilityoftenobjects
or (e.g.,
relief
to findreflect stall
from
a comfortable walls,
pro- posture or
with feed/water
the inability containers).
to relief
find afrom These
comfortable posture frustration
feed/water
longed discomfort. containers). These responses
prolonged oftenorreflect
discomfort.
relief from pro-
frustration
longed withdiscomfort.
the inabilityVideo to find ahttps://doi.org/10.5281/zenodo.4543456
comfortable posture or relief from pro-
Video vi. Fidgeting
with S63 inability to findS63
thehttps://doi.org/10.5281/zenodo.4543456
a comfortable posture or relief from
(accessed on 18 pro-(accessed
Video longed
S63 discomfort.
Biting,2021)
longed
February mouthing, and/or rubbing against objects (e.g., stall walls,
discomfort.
Video 2021)
February S63 https://doi.org/10.5281/zenodo.4543456 (accessed on 18
feed/water
Video containers). These responses often reflect
S63 https://doi.org/10.5281/zenodo.4543456 (accessed frustration
on 18
February 2021)
with the 2021)
February inability to find a comfortable posture or relief from pro-
longed discomfort.
Animals 2021, 11, 580 18 of 21
2021,
2021,
2021, 11,
s 2021,
11,
11, xxxFOR
11, xFOR
FOR PEER
FOR PEER
PEER
PEER REVIEW
REVIEW
REVIEW
REVIEW 19 of
1919
19 22
ofof
of 2222
22
Table 6. Cont.
vii.
vii.
vii. Intense
vii. Intense
Intense
Intense Distantly-Focused
Distantly-Focused
Distantly-Focused
Distantly-Focused Staring
Staring
Staring
Staring
vii. Intense Distantly-Focused Staring
Distant
Distant gazing
gazing
Distant gazing
Distant in
gazing in a
in fixed
a
in aa fixed
fixed direction
fixed direction
direction
direction
Distant for
gazing for
for
for
in aaa prolonged
afixed
prolonged
prolonged
prolonged period,
period,
period,
period,
direction often
often period, often
often
often
for a prolonged
with a glassy-eyed,
withaa aglassy-eyed,
with
with tense,
glassy-eyed,tense,
glassy-eyed, worried
with a
tense,worried
tense, expression.
glassy-eyed,
worriedexpression.
worried tense,
expression.
expression. worried expression.
Video Video S64 https://doi.org/10.5281/zenodo.4545919 (accessed
Video
Video S64
S64
(accessed
(accessed onon
on
on 18
1818
18
February
February
February
February 2021)
2021)
2021)
2021)
Altered
7..7.
Altered
Altered eating
Alteredeating
eating or
eatingor drinking.
oror drinking.
drinking.
drinking. Table 7. Altered eating or drinking.
ing
ing Water
pping
ping Water
Water
Water a. Sipping Water
Drinking
Drinking
Drinking
Drinking smaller
smaller
smaller than
smallerthan
than the
thanthe
the typical
thetypical
typical volume
typical volume
volume
volume ofof
of water,
water,
water, often with
often
often with
with aaa a
Drinking smaller thanof
thewater,
typical often
volumewith
of water, often with a
tentative
tentative
tentative approach
tentativeapproach
approach and
approachand
andexpression
andexpression
expression
expression
tentative of
of hesitation
ofofhesitation
approach hesitation
hesitation or discomfort
orordiscomfort
or discomfort
discomfort
and expression of hesitation or discomfort
dding
uidding
dding
dding b. Quidding
Dropping
Dropping
Dropping
Dropping strands
strands
strands
strands or
or partially
oror
partially
partially chewed
partially chewed
chewed
chewed clumps
clumps
clumps
clumps of
of forage
ofofforage
forage or
forage grain
oror
or grain
grain
grain
Dropping strands or partially chewed clumps of forage or grain
from
from
from the
fromthe
the mouth
the mouth
mouth
mouth while
while
while
while eating.
eating.
eating.
eating.
from the mouth while eating.
Video
Video
Video
Video S65
S65
S65
(accessed
(accessed
(accessed on
on
on 18
on1818
18
February 2021)
February2021)
February
February 2021)
2021) on 18 February 2021)
ical Jaw
ypical
pical
pical Jaw
Jaw Motion
Jaw Motion
Motion
Motion
c. Atypical Jaw Motion
Conservative
Conservative
Conservative
Conservative or
or atypical
oror atypical
atypical
atypical jaw
jaw
jaw movements,
jaw movements,
movements,
movements, for
for
for example,
for example,
example,
example, when
when
when
when for-
for-
for-
for-
Conservative or atypical jaw movements, for example, when
aging,
aging,
aging, chewing,
aging, chewing,
chewing,
chewing, or
or yawning.
oror yawning.
yawning.
yawning.
foraging, chewing, or yawning.
Video
Video
Video
Video S66
S66
S66
(accessed
(accessed on
(accessedon
on 18
on1818
18 (accessed
February 2021)
February2021)
2021) on 18 February 2021)
February
February 2021)
d. Disinterest in Food or Water
Reduced
Reduced
Reduced
Reduced or
or no
oror
no
no interest
nointerest
interest in
interestin palatable
inin
palatable
palatable forage,
palatableforage,
forage, grain,
forage,grain,
grain, or
grain, water.
oror
or water.
water.
water.
nterest Reduced or no interest in palatable forage, on
grain, or water.
nterestin
sinterest
nterest in Food
ininFood
Food or
Foodor Water
oror Water
Water
Water Video
Video S67
Video S67
(accessedon
https://doi.org/10.5281/zenodo.4545947 (accessed(accessedon18
on 1818
18
February
February
February 2021)
February 2021)
2021)
2021) on 18 February 2021)
Animals 2021, 11, 580 19 of 21
Table 8. Vocalizations/audible sounds.
a. Sighing Emitting an audible long exhalation following a deep inhalation.

Emitting an audible sudden forced exhalation through the
b. Snorting
nares.
c. Whining Emitting a long, high-pitched vocalization.
d. Groaning Emitting a long, low-pitched, sometimes raspy, vocalization.
e. Grunting Emitting a short, sharp, low-pitched vocalization.
f. Squealing Emitting a short, sharp, high-pitched vocalization.
Emitting a long loud whinny vocalization, typical of calling to
g. Screaming/Calling
locate distant herd mates.
Moving tightly clenched jaws back and forth and grating the
h. Teeth Grinding upper and lower molars, resulting in a crunching, scraping
sound.
Videos S68–S75 https://doi.org/10.5281/zenodo.4545955 (accessed on 18 February 2021)
Supplementary Materials: In addition to links to individual files which appear in each Tables 1–
8 entry, supplementary Table S1 and all video files for Tables 1–8 are available together in one zip
folder for download at: https://zenodo.org/badge/DOI/10.5281/zenodo.4477080.svg (accessed on
18 February 2021).
Author Contributions: Conceptualization and resources S.M.; methodology, investigation, writing
and editing S.M., C.T.; illustration C.T.; video acquisition C.T., S.M.; project administration C.T. and
S.M. All authors have read and agreed to the published version of the manuscript.
Funding: This is a Dorothy Russell Havemeyer Foundation project conducted by the Havemeyer
Equine Behavior Lab at the University of Pennsylvania. CT was funded as a Havemeyer Veterinary
Research Fellow.
Institutional Review Board Statement: Procedures for obtaining video recordings of client-owned
hospitalized equine patients during the 2017 pain assessment study were approved by the University
of Pennsylvania Institutional Animal Care and Use Committee according to all applicable guidelines
for humane care and use of animals in research (protocol #806321). Owners of these horses also
provided informed consent for this clinical research.
Acknowledgments: Bernd Driessen and Klaus Hopster facilitated videotaping of hospitalized ortho-
pedic surgery patients participating in other clinical research projects. Numerous colleagues at the
University of Pennsylvania’s New Bolton Center hospital assisted with identification of patients of
interest for obtaining video recorded examples.
Conflicts of Interest: The authors declare no conflict of interest.
References
1. De Grauw, J.C.; Van Loon, J.P.A.M. Systematic pain assessment in horses. Vet. J. 2016, 209, 14–22. [CrossRef] [PubMed]
2. Gleerup, K.B.; Lindegaard, C. Recognition and quantification of pain in horses: A tutorial review. Equine Vet. Educ. 2016, 28,
47–57. [CrossRef]
3. Bussières, G.; Jacques, C.; Lainay, O.; Beauchamp, G.; Leblond, A.; Cadoré, J.L.; Desmaizières, L.M.; Cuvelliez, S.G.; Troncy, E.
Development of a composite orthopaedic pain scale in horses. Res. Vet. Sci. 2008, 85, 294–306.
4. Van Loon, J.P.A.M.; Back, W.; Hellebrekers, L.J.; Van Weeren, P.R. Application of a composite pain scale to objectively monitor
horses with somatic and visceral pain under hospital conditions. J. Equine Vet. Sci. 2010, 30, 641–649. [CrossRef]
5. Graubner, C.; Gerber, V.; Doherr, M.; Spadavecchia, C. Clinical application and reliability of a post abdominal surgery pain
assessment scale (PASCAS) in horses. Vet. J. 2011, 188, 178–183. [CrossRef] [PubMed]
6. Dalla Costa, E.; Minero, M.; Stucke, D.; Canali, E.; Leach, M.C. Development of the horse grimace scale (HGS) as a pain assessment
tool in horses undergoing routine castration. PLoS ONE 2014, 9, e92281. [CrossRef]
7. Torcivia, C.; McDonnell, S. In-person caretaker visits disrupt ongoing discomfort behavior in hospitalized equine orthopedic
surgical patients. Animals 2020, 10, 210. [CrossRef]
Animals 2021, 11, 580 20 of 21
8. Raekallio, M.; Taylor, P.M.; Bennett, R.C. Preliminary investigations of pain and analgesia assessment in horses administered
phenylbutazone or placebo after arthroscopic surgery. Vet. Surg. 1997, 26, 150–155. [CrossRef] [PubMed]
9. Pritchett, L.C.; Ulibarri, C.; Roberts, M.C.; Schneider, R.K.; Sellon, D.C. Identification of potential physiological and behavioral
indicators of postoperative pain in horses after exploratory celiotomy for colic. Appl. Anim. Behav. Sci. 2003, 80, 31–43. [CrossRef]
10. Ashley, F.H.; Waterman-Pearson, A.E.; Whay, H.R. Behavioural assessment of pain in horses and donkeys: Application to clinical
practice and future studies. Equine Vet. J. 2005, 37, 565–575. [CrossRef]
11. McDonnell, S.M. Is It Psychological, Physical, or Both? In Proceedings of the 51st AAEP Annual Convention, Seattle, WA, USA,
3–7 December 2005; pp. 231–238.
12. Ask, K.; Rhodin, M.; Tamminen, L.M.; Hernlund, E.; Andersen, P.H. Identification of body behaviors and facial expressions
associated with induced orthopedic pain in four equine pain scales. Animals 2020, 10, 2155. [CrossRef]
13. Casey, R.A. Clinical problems associated with the intensive management of performance horses. In The Welfare of Horses; Waran,
N., Ed.; Springer: Dordrecht, The Netherlands, 2007; pp. 19–44.
14. Contino, E.K.; Mama, K.R. Recognition of Pain. In Current Therapy in Equine Medicine; Sprayberry, K.A., Robinson, N.E., Eds.;
Elsevier Saunders: St. Louis, MO, USA, 2015; pp. 49–54.
15. Daglish, J.; Mama, K.R. Pain: Its diagnosis and management in the rehabilitation of horses. Vet. Clin. Equine 2016, 32, 13–29.
[CrossRef] [PubMed]
16. Dalla Costa, E.; Stucke, D.; Minero, M.; Leach, M.C.; Lebelt, D. Using the horse grimace scale (HGS) to assess pain associated with
acute laminitis in horses (Equus caballus). Animals 2016, 6, 47. [CrossRef] [PubMed]
17. Driessen, B.; Zarucco, L. Pain: From diagnosis to effective treatment. Clin. Tech. Equine Pract. 2007, 6, 126–134. [CrossRef]
18. Dutton, D.W.; Lashnits, K.J.; Wegner, K. Managing severe hoof pain in a horse using multimodal analgesia and a modified
composite pain score. Equine Vet. Educ. 2009, 21, 37–43. [CrossRef]
19. Fureix, C.; Menguy, H.; Hausberger, M. Partners with bad temper: Reject or cure? A study of chronic pain and aggression in
horses. PLoS ONE 2010, 5, e12434. [CrossRef] [PubMed]
20. Gleerup, K.B.; Forkman, B.; Lindegaard, C.; Anderson, P.H. An equine pain face. Vet. Anaesth. Analg. 2016, 28, 47–57. [CrossRef]
[PubMed]
21. Grint, N.J.; Beths, T.; Yvorchuk-St Jean, K.; What, H.R.; Murrell, J.C. Analysis of behaviors observed during mechanical nociceptive
threshold testing in donkeys and horses. J. Equine Vet. Sci. 2017, 50, 102–109. [CrossRef]
22. Hausberger, M.; Fureix, C.; Lesimple, C. Detecting horses’ sickness: In search of visible signs. Appl. Anim. Behav. Sci. 2016, 75,
41–49. [CrossRef]
23. Jochle, W.; Moore, J.N.; Brown, J.; Baker, G.J.; Lowe, J.E.; Fubini, S.; Reeves, M.J.; Watkins, J.P.; White, N.A. Comparison of
detomidine, butorphanol, flunixin meglumine and xylazine in clinical cases of equine colic. Equine Vet. J. Suppl. 1989, 7, 111–116.
[CrossRef]
24. Johnson, C.B.; Taylor, P.M.; Young, S.S.; Brearly, J.C. Postoperative analgesia using phenylbutazone, flunixin or carprofen in
horses. Vet. Rec. 1993, 133, 336–338. [CrossRef] [PubMed]
25. Lindegaard, C.; Thomsen, M.J.; Larsen, S.; Andersen, P.H. Analgesic efficacy of intra-articular morphine in experimentally
induced radiocarpal synovitis in horses. Vet. Anaesth. Analg. 2010, 37, 171–185. [CrossRef]
26. McDonnell, S. The Equid Ethogram: A Practical Field Guide to Horse Behavior; The Blood Horse Inc.: Lanham, MD, USA, 2003.
27. Molony, V.; Kent, K.E. Assessment of acute pain in farm animals using behavioral and physiological measurements. J. Anim. Sci.
1997, 75, 266–272. [CrossRef]
28. Obel, N. Studies on the Histopathology of Acute Laminitis; Almquisst & Wiksells Botryckeri: Upsalla, Sweden, 1948.
29. Pehkonen, J.; Karma, L.; Raekallio, M. Behavioral signs associated with equine periapical infection in cheek teeth. J. Equine Vet.
Sci. 2019, 77, 144–150. [CrossRef] [PubMed]
30. Price, J.; Catriona, S.; Welsh, E.M.; Waran, N.K. Preliminary evaluation of a behavior-based system for assessment of post-operative
pain in horses following arthroscopic surgery. Vet. Anaesth. Analg. 2003, 30, 124–137. [CrossRef]
31. Reitmann, T.R.; Stauffacher, M.; Bernasconi, P.; Auer, J.A.; Weishaupt, M.A. The association between heart rate variability,
endocrine and behavioural pain measures in horses suffering from laminitis. J. Vet. Med. 2004, 51, 218–225. [CrossRef] [PubMed]
32. Rochais, C.; Fureix, C.; Lesimple, C.; Hausberger, M. Lower attention to daily environment: A novel cue for detecting chronic
horses’ back pain? Sci. Rep. 2016, 6, e20117. [CrossRef] [PubMed]
33. Sutton, G.A.; Dahan, R.; Turner, D.; Paltiel, O. A behavior-based pain scales for horses with acute colic: Scale construction. Vet. J.
2013, 196, 394–401. [CrossRef]
34. Sutton, G.A.; Paltiel, O.; Soffer, M.; Turner, D. Validation of two behavior-based pain scales for horses with acute colic. Vet. J. 2013,
197, 646–650. [CrossRef]
35. Taffarel, M.O.; Luna, S.P.L.; De Olveira, F.A.; Cardoso, G.S.; De Moura Alonso, J.; Pantoja, J.C.; Brondani, J.T.; Love, E.; Taylor, P.;
White, K.; et al. Refinement and partial validation of the UNESP-Botucatu multidimensional composite pain scale for assessing
postoperative pain in horses. BMS Vet. Res. 2015, 11, 83. [CrossRef]
36. Taylor, P.M.; Pascoe, P.J.; Mama, K.R. Diagnosing and treating pain in the horse where are we today? Vet. Clin. Equine 2002, 18,
1–19. [CrossRef]
Animals 2021, 11, 580 21 of 21
37. Van Dierendonk, M.C.; Van Loon, J.P.A.M. Monitoring acute equine visceral pain with the equine Utrecht university scale
for composite pain assessment (EQUUS-COMPASS) and the equine Utrecht university scale for facial assessment of pain
(EQUUS-FAP): A validation study. Vet. J. 2016, 216, 175–177. [CrossRef] [PubMed]
38. Van Loon, J.P.A.M.; Jonckheer-Sheehy, V.S.M.; Back, W.; Van Weeren, P.R.; Hellebrekers, L.J. Monitoring equine visceral pain with
a composite pain scale score and correlation with survival after emergency gastrointestinal surgery. Vet. J. 2014, 200, 109–115.
[CrossRef] [PubMed]
39. Van Loon, J.P.A.M.; VanDierendonk, M.C. Monitoring acute equine visceral pain with the equine Utrecht university scale
for composite pain assessment (EQUUS-COMPASS) and the equine Utrecht university scale for facial assessment of pain
(EQUUS-FAP): A scale-construction study. Vet. J. 2015, 206, 356–364. [CrossRef]
40. Van Loon, J.P.A.M.; VanDierendonk, M.C. Monitoring equine head-related pain with the equine Utrecht university scale for facial
assessment of pain (EQUUS-FAP). Vet. J. 2017, 220, 88–90. [CrossRef] [PubMed]
41. Van Loon, J.P.A.M.; Van Dierendonck, M.C. Objective pain assessment in horse (2014–2018). Vet. J. 2018, 242, 1–7. [CrossRef]
[PubMed]
42. Van Loon, J.P.A.M.; Van Dierendonck, M.C. Pain assessment in horses after orthopedic surgery and with orthopedic trauma. Vet.
J. 2019, 246, 85–91. [CrossRef]
43. Wagner, A.E. Effects of stress on pain in horses and incorporating pain scales for equine practice. Vet. Clin. Equine 2010, 26,
481–492. [CrossRef]
44. Waring, G.H. Horse Behavior, 2nd ed.; Noyes Publications: Norwich, UK; William Andrew Publishing: Norwich, UK, 2003.
45. Wathan, J.; Burrows, A.M.; Waller, B.M.; McComb, K. EquiFACS: The equine facial action coding system. PLoS ONE 2015, 10,
e0131738.
46. Ijichi, C.; Collins, L.M.; Elwood, R.W. Pain expression is linked to personality in horses. Appl. Anim. Behav. Sci. 2014, 152, 38–43.
[CrossRef]
47. Dyson, S.; Berger, J.; Ellis, A.D.; Mullard, J. Development of an ethogram for a pain scoring system in ridden horses and its
application to determine the presence of musculoskeletal pain. J. Vet. Behav. 2018, 23, 47–57. [CrossRef]

Animals: Equine Discomfort Ethogram

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Animals: Equine Discomfort Ethogram

Uploaded by

Copyright:

Available Formats

animals

Keywords: behavior; horse; welfare; pain

Copyright: © 2021 by the authors.

Animals 2021, 11, 580. https://doi.org/10.3390/ani11020580 https://www.mdpi.com/journal/animals

2.2. Behavior Inventory from the Literature

Animals 2021, 11, 580 6 of 21

Camping Under Under

. Urination Posture and Effort Without Stream

ble 2. Limb and body movements.

Repeated flexing of a limb, briefly relieving weight-bearing on that limb.

Kicking Up Toward Abdomen

Alternate rearing and kicking out, often repeatedly in rapid succession.

j. Limb Trembling Rhythmic

Animals 2021, 11, 580 11 of 21

i. Head HighTable 2. Cont.

ii. Deep Abdominal

iii. Hindlimb Extension

iv. Neck Curl iv. Neck Curl

able 3. Head, neck, mouth, and lip movements.

. Head, neck, mouth, and lip movements.

d Bobbing c. Head Bobbing

Animals 2021, 11, 580 13 of 21

ympathetic Cluster of autonomic responses following an acute sympathetic

Table 4. Attention to an area.

Nibbling, nuzzling, and/or

ble 5. Ear and tail movements.

Rotating ears to focus caudally, or laying ears back against neck.

Slapping Tail Against Perineum

Lifting/Holding Tail Off Perineum

ble 6. Overall demeanor.

Less responsive to the environment, often with “zoned out,” wor-

imals 2021, 11, x FOR PEER REVIEW 17 of 22

Animals 2021, 11, 580 16 of 21

ncharacteristic Aggression Aggression

als 2021, 11, x FOR PEER REVIEW 18 of 22

mals 2021, 11, x FOR PEER REVIEW i. Changing Activities Frequently 18 of 22

d. Disinterest in Food or Water

Table 8. Vocalizations/audible sounds.

a. Sighing Emitting an audible long exhalation following a deep inhalation.

You might also like