When it comes to tracking chronic osteoarthritic pain in senior horses, owners’ at-home observations can offer critical clues that could help veterinarians optimize pain management and welfare, new research suggests.

By keeping precise records of pain scores related to each horse’s primary, unique challenges associated with osteoarthritis, handlers could provide insight that often eludes veterinarians during their brief visits. Combined with clinical examinations, diagnostic imagery, and objective lameness and pain assessment tools, such tailored pain-score charts by the people who know the horses best could become powerful tools in senior equine pain management, says Eleonora Benetti, DVM, clinical anesthesiologist in the Department of Clinical Veterinary Medicine’s Section of Anesthesiology and Pain Therapy at Vetsuisse Faculty, part of the University of Bern, in Switzerland.

“We believe that it’s really important to involve horses’ owners not only in decision processes but also in the pain evaluation process,” she says. “They’re able to catch signs that the animal is suffering, because they know their animals and see them regularly in their home environment.”

The Challenges of Measuring OA Pain in Horses

Many older horses suffer from pain, stiffness, and lameness caused by osteoarthritis, Benetti says. It affects not only their riding ability but also their daily lives and welfare.

It can be difficult to measure that pain, however. Horses can’t rank their pain levels on a scale of 1 to 10 like humans can, she says. True, objective lameness tools—based on accelerometers or artificial intelligence, for example—can help, as can pain scoring derived from facial expressions and/or body language. But these tools remain somewhat out of reach for many owners and are generally still under development, Benetti explains. More importantly, veterinarians don’t see horses’ progression on a daily basis, and horses often mask their pain in the presence of veterinarians, especially in unfamiliar places like equine clinics.

So, Benetti decided to see if horse owners could contribute to pain assessment information the way dog and cat owners can.

Testing the Client-Specific Outcome Measure Tool

Osteoarthritis isn’t limited to horses. In human medicine, researchers have developed a home pain assessment tool called Patient-Reported Outcome Measures (PROMs), in which people regularly score their limitations and pain related to their top three physical complaints. Recently, scientists adapted PROMs for cats and dogs based on their owners’ at-home perceptions, in a tool called Client-Specific Outcome Measure (CSOM).

Benetti says her idea is for owners to observe their horses’ fluctuations in comfort and abilities related to what they consider to be the top three or four concerns—like lameness at the walk, pain reactions when touching a specific joint, difficulty walking downhill, or reluctance to move.

To test that, she and her colleagues took advantage of a study assessing the efficacy of painkillers in horses with imaging-confirmed osteoarthritis. Roughly half the horses received a newly developed drug while the others took a placebo. The results of that efficacy study have not yet been published, but the conditions were ripe for testing CSOM, Benetti says.

Veterinarians helped the owners of 17 horses—average age 17.2 years—to identify their horse’s three unique, top arthritic concerns. Every week for the next 20 weeks, owners scored those items on a scale of 0 to 4 (from no pain to extreme pain), leading to a total weekly CSOM score. The owners used clues like posture, weight bearing, motivation, activity, pain responses, and facial expressions to make their assessments, she says.

Then, the researchers compared those scores to veterinary evaluations, including objective lameness exams, gait asymmetry indexes, and visual analogue scales, during their examinations every four weeks.

The team found that the total CSOM scores aligned well with other pain and lameness measures—especially gait asymmetry, Benetti says. “This shows us that people are able to evaluate, in a critical way, the pain that their animal is feeling,” she says.

Take-Home Message

These findings suggest that CSOM might work well as a valuable complementary at-home tool for assessing and monitoring pain severity in osteoarthritic seniors, offering a better, more comprehensive overview of the horse’s condition, Benetti says.

She encourages horse owners to keep accessory records as well, such as weather conditions, presence of protective gear like blankets, and whether the horse was worked that day. Such records over time can provide useful information for veterinarians as well as researchers she says, adding that she welcomes readers’ feedback via email (eleonora.benetti@unibe.ch) as she continues to investigate the benefits of CSOM.

“Tell me your results!” she says. “We want to learn more about what you obtain and compare so we can help seniors live better.”

Reference

Benetti E, Tambella AM, Andreis SN, Witte S, Di Bella C and Spadavecchia C (2026) Client-specific outcome measure for chronic osteoarthritis pain assessment in horses. Front. Vet. Sci. 13:1771745. doi: 10.3389/fvets.2026.1771745

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  • Christa Lesté-Lasserre is a science journalist specialising in animal health and behaviour, life sciences, and evolutionary processes. Her articles and stories have appeared in major science magazines and literary reviews in multiple languages across the globe. Based in France's greater Paris area, Christa holds an MA from the University of Mississippi and a BA from Baylor University in Texas, complemented by postgraduate work in life sciences at the University of Paris René Descartes.

    A Pulitzer Center grantee for her coverage of the COVID-19 pandemic for Science magazine and recipient of American Horse Publications awards for her articles on equine behaviour, Christa focuses on shaping scientific studies into the stories they tell.

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