We argue that there is currently an under-reporting of the ways in which pain can be associated with problem behavior, which is seriously limiting the recognition of this welfare problem. A review of the caseloads of 100 recent dog cases of several authors indicates that a conservative estimate of around a third of referred cases involve some form of painful condition, and in some instances, the figure may be nearly 80%. The relationship is often complex but always logical. Musculoskeletal but also painful gastro-intestinal and dermatological conditions are commonly recognized as significant to the animal’s problem behavior. The potential importance of clinical abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed by clinicians in general practice, even when they are common within a given breed. In general, it is argued that clinicians should err on the side of caution when there is a suspicion that a patient could be in pain by carefully evaluating the patient’s response to trial analgesia, even if a specific physical lesion has not been identified.

The Equine Behaviour Assessment and Research Questionnaire (E-BARQ) is a questionnaire instrument developed to obtain quantitative data on the domestic equine triad of training, management, and behaviour of horses. The E-BARQ was developed to identify how changes in training and management impact behaviour over time, to define normal behaviour in horses, and to discover how to improve rider safety and horse welfare, leading to ethical equitation. During the development of the E-BARQ, we also investigated how best to motivate stakeholders to engage with this citizen science project. The pilot version of the E-BARQ collected qualitative data on respondents’ experience of the questionnaire. The pilot questionnaire was developed with the assistance of an international panel (with professional expertise in horse training, equitation science, veterinary science, equestrian coaching, welfare, animal behaviour, and elite-level riding), and was used to collect data on 1320 horses from approximately 1194 owner/caregiver respondents, with an option for respondents to provide free-text feedback. A Rotated Principal Component Analysis of the 218 behavioural, management, and training questionnaire items extracted a total of 65 rotated components. Thirty-six of the 65 rotated components demonstrated high internal reliability. Of the 218 questionnaire items, 43 items failed to reach the Rotated Principal Component Analysis criteria and were not included in the final version of the E-BARQ. Survey items that failed the Rotated Principal Component Analysis inclusion criteria were discarded if found to have a less than 85% response rate, or a variance of less than 1.3. Of those that survived the Rotated Principal Component Analysis, items were further assigned to horse temperament (17 rotated components), equitation (11 rotated components), and management and equipment (8 rotated components) groups. The feedback from respondents indicated the need for further items to be added to the questionnaire, resulting in a total of 214 items for the final E-BARQ survey. Many of these items were further grouped into question matrices, and the demographic items for horse and handler included, giving a final total of 97 questions on the E-BARQ questionnaire. These results provided content validity, showing that the questionnaire items were an acceptable representation of the entire horse training, management, and behavioural domain for the development of the final E-BARQ questionnaire.

Equine gastric ulcer syndrome (EGUS) refers to mucosal gastric disease in horses, including equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD), which present as two distinct disease entities differing in pathophysiology and approach to disease management. Both diseases are a source of pain in affected horses, partly explaining why EGUS continues to receive substantial attention in the equine medical, welfare and equitation research sectors. There is a complex interplay between EGUS and a variety of physical and psychological stressors. Horses with EGUS are often presented to veterinarians with a history of problem behaviors, some of which resolve following gastroprotectant therapy. However, problem behaviors persist in some cases, despite gastroscopic resolution of disease. Some of these horses have pain-related learnt, anticipatory behavior, even after the original source of pain has resolved. Such cases, as well as chronic or refractory EGUS cases, can benefit from a behavioral medicine approach. This includes the management of any underlying diseases, environmental modification, behavior modification, and, in select cases, behavior-modifying medication. This commentary, based on the authors’ clinical experiences and current literature, explores how behavioral medicine can be integrated with traditional pharmacologic, nutraceutical, and husbandry strategies for the multi-modal management of EGUS, with a focus on managing the horse’s experience to improve case outcome.