Pain Scoring in Horses 
“Is Your Horse in Pain… or Just Sulking?”
“Is Your Horse in Pain… or Just Sulking?”Horses are masters of pretending everything is fine — right up until it absolutely isn’t.
So instead of guessing, we score pain, just like hospitals and athletes do.
It helps everyone speak the same language and catch problems early.
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Picture this…You’re sitting outside having a coffee. Someone walks past.
How much pain do they have to be in before you notice, as a third-party observer?
That’s the perspective we have with horses —
we only see pain when it’s big enough to shout.
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Pain scoring = a 0–10 scale• 0 = bright, eating, happy, moving freely
• 5 = stiff, guarded, grumpy, “not quite right”
• 10 = emergency — distressed, rolling, sweating, unable to move
Early intervention prevents a 5 from becoming a 10.
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What to look at when scoring painAttitude • Appetite • Posture • Movement • Heart rate • Gut sounds • Facial cues
Add them together = a clinical picture instead of guesswork.
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Pain wears costumesSometimes pain looks like:
• naughty behaviour
• ear pinning
• sensitivity to rugs or grooming
• lying down more
• isolating from the herd
• anxiety or irritability
Bad behaviour is often pain wearing mood swings.
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When pain means CALL THE VET• Not eating
• Won’t move
• Sweating, rolling, shaking
• Awkward or collapsing posture
• Pain score >5 and climbing
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Equine Grimace Scale (Quick Guide)Eyes: tension, upper eyelid triangle, squinting
Ears: pinned back or asymmetrical
Nostrils: flared or tight
Mouth/lips: pursed, teeth grinding
Overall face: rigid, strained, anxious
Facial pain cues + behaviour = early disease detection.
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Is your horse fine? Or FINE!
FINE = Frustrated, Insecure, Neurotic and Emotional. 
This blog post was provided by Dr Lauren Jones of Kentaro Veterinary Services servicing the Coffs Harbour District in NSW
