11/19/2025
So relevant to dogs too.
There is a phrase I see constantly in the horse world ESPECIALLY on social media:
“Medical issues have been cleared.”
People use it as if it means the horse has been fully assessed, fully understood and confirmed pain free. I have even seen it followed by things like
“This horse has been cleared of pain. It is just behaving like a pig.”
That kind of statement shuts down the conversation before it even starts. Once someone believes the horse is “cleared,” every behaviour afterward gets interpreted as a training issue, a character flaw or a lack of respect instead of a possible sign that something in the body still needs attention.
But pain does not work in neat, simple categories. And neither do horses.
A single appointment can absolutely rule certain things out. It can give important direction. But it cannot confirm that a horse is not experiencing discomfort. Many physical issues are not visible in a basic exam, a static scan or a straight-line trot up. Some do not even show clearly on imaging until the horse is moving or loaded in a very specific way.
We see this even in post mortem diagnostics.
A static image alone is not enough to tell the full story. Tissue changes, joint function, muscle compensation patterns and micro injuries often only come to light when the structures are examined dynamically or from multiple angles. If that is true after death, it is certainly true in a live horse whose behaviour is part of the diagnostic picture.
This is exactly why pain ethograms exist. They give us a structured, research-backed way to identify behaviour patterns that correlate with discomfort long before imaging can. Without a behavioural component, our understanding of equine pain is incomplete.
There are three major things that equine pain research keeps showing us:
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First:
Many pain related behaviours are subtle, inconsistent or suppressed when the horse is stressed or excited. Horses compensate far longer than people expect. A lack of dramatic lameness does not mean a lack of pain.
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Second:
A horse can present “normal” in a basic exam and still be uncomfortable. Low grade or multi site pain can be missed in standard checks but becomes obvious under saddle or during specific movements that recreate the problem.
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Third:
Behaviour changes are often the earliest and most reliable indicators that something is going on. Hesitation in transitions. Shortened stride. Loss of softness. Increased tension. A shift in posture. These patterns usually show up before imaging does.
This is why the phrase “the horse has been cleared” is misleading. What we actually have is a snapshot of what was ruled out on that day, under those specific conditions.
A more accurate and welfare centred approach sounds like:
“When these behaviours show up, we ask what the horse is communicating and whether the pattern aligns with known pain indicators, instead of assuming defiance.”
That mindset keeps the horse’s communication open instead of shutting it down. It keeps the door open to understanding rather than labelling. And it acknowledges that pain is far more complex than a single visit, a single scan or a single moment in time can capture.
