{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:42:14Z","timestamp":1789422134888,"version":"build-2803163510"},"reference-count":124,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Animals"],"abstract":"<jats:p>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\u2019 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\u2019s experience to improve case outcome.<\/jats:p>","DOI":"10.3390\/ani15203019","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:29:17Z","timestamp":1760711357000},"page":"3019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Incorporating a Behavioral Medicine Approach in the Multi-Modal Management of Chronic Equine Gastric Ulcer Syndrome (EGUS): A Clinical Commentary"],"prefix":"10.3390","volume":"15","author":[{"given":"Mary","family":"Klinck","sequence":"first","affiliation":[{"name":"Mary Klinck, Veterinary Behavioural Medicine Consultant, Vaudreuil-Dorion, QC J7V 0K5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Lovett","sequence":"additional","affiliation":[{"name":"School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-6228","authenticated-orcid":false,"given":"Ben","family":"Sykes","sequence":"additional","affiliation":[{"name":"BW Sykes Consultancy, Coffs Harbour, NSW 2450, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.2527\/1997.751266x","article-title":"Assessment of Acute Pain in Farm Animals Using Behavioral and Physiological Measurements","volume":"75","author":"Molony","year":"1997","journal-title":"J. Ani. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1155\/2009\/348184","article-title":"Behavioural Assessment of Pediatric Pain","volume":"14","author":"Blount","year":"2009","journal-title":"Pain Res. Manag."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1080\/23144599.2019.1680044","article-title":"Review of Different Methods Used for Clinical Recognition and Assessment of Pain in Dogs and Cats","volume":"7","year":"2019","journal-title":"Int. J. Vet. Sci. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1097\/j.pain.0000000000002474","article-title":"Measurement Properties of Grimace Scales for Pain Assessment in Nonhuman Mammals: A Systematic Review","volume":"163","author":"Evangelista","year":"2022","journal-title":"Pain"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mills, D.D., Demontigny-Bednard, I., Guen, M., Klinck, M.P., McPeake, K.J., Barcelos, A.M., Hewison, L., Van Haevermaet, H., Denenberg, S., and Hauser, H. (2020). Pain and Problem Behavior in Cats and Dogs. Animals, 10.","DOI":"10.3390\/ani10020318"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1093\/bja\/aen087","article-title":"Analgesia from a Veterinary Perspective","volume":"101","author":"Flecknall","year":"2008","journal-title":"B. J. Anaes."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Torcivia, C., and McDonnell, S.M. (2025). Behavioral Signature of Equine Gastric Discomfort? Preliminary Retrospective Clinical Observations. Animals, 15.","DOI":"10.3390\/ani15010088"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/eve.13468","article-title":"The Ridden Horse Pain Ethogram","volume":"34","author":"Dyson","year":"2022","journal-title":"Eq. Vet. Educ."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sykes, B., and Lovett, A. (2025). Can All Behavioral Problems Be Blamed on Equine Gastric Ulcer Syndrome?. Animals, 15.","DOI":"10.3390\/ani15030306"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"258","DOI":"10.2746\/042516402776185976","article-title":"An Investigation into the Relationship between Equine Behaviour When Tacked-up and Mounted and Epaxial Muscle Hypertonicity or Pain, Girth Region Hypersensitivity, Saddle-Fit, Rider Position and Balance, and Lameness","volume":"34","author":"Dyson","year":"2022","journal-title":"Eq. Vet. Educ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jveb.2018.05.001","article-title":"Behavioral Observations and Comparisons of Nonlame Horses and Lame Horses before and after Resolution of Lameness by Diagnostic Analgesia","volume":"26","author":"Dyson","year":"2018","journal-title":"J. Vet. Behav."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1111\/jvim.17223","article-title":"Improvement of Gastric Ulcer and Ridden Horse Pain Ethogram Scores with Diet Adaptation in Sport Horses","volume":"38","author":"Pineau","year":"2024","journal-title":"J. Vet. Int. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Torcivia, C., and McDonnell, S. (2021). Equine Discomfort Ethogram. Animals, 11.","DOI":"10.3390\/ani11020580"},{"key":"ref_14","unstructured":"Cheramie, H., Ruess, S., and Lyman, J. (2025, January 8\u201310). Prevalance, Risk Factors, Clinical Signs, and Anatomical Distribution Associated Iwth Equine Gastric Ulcer Syndrome in US Horses. Proceedings of the Equine Gastric Ulcer Syndrome (EGUS): Advances in the field, Tampa, FL, USA."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Torcivia, C., and McDonnell, S. (2020). In-Person Caretaker Visits Disrupt Ongoing Discomfort Behavior in Hospitalized Equine Orthopedic Surgical Patients. Animals, 10.","DOI":"10.3390\/ani10020210"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1111\/jvim.13578","article-title":"European College of Equine Internal Medicine\u2014Consensus Statement Equine Gastric Ulcer Syndrome (EGUS) in Adult Horses","volume":"29","author":"Sykes","year":"2015","journal-title":"J. Vet. Int. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"603","DOI":"10.2754\/avb200877040603","article-title":"Gastric Ulceration, Appetite and Feeding Practices in Standardbred Racehorses in the Czech Republic","volume":"77","author":"Jahn","year":"2008","journal-title":"Acta Vet. Brno"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.2042-3306.1999.tb05166.x","article-title":"Cross-Sectional Study of Gastric Ulcers of the Squamous Mucosa in Thoroughbred Racehorses","volume":"s31","author":"Vatistas","year":"1999","journal-title":"Equine Vet. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jevs.2019.05.025","article-title":"Girthiness: Retrospective Study of 37 Horses (2004\u20132016)","volume":"79","year":"2019","journal-title":"J. Equine Vet. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/evj.13938","article-title":"Five- versus Seven-Day Dosing Intervals of Extended-Release Injectable Omeprazole in the Treatment of Equine Squamous and Glandular Gastric Disease","volume":"56","author":"Sundra","year":"2023","journal-title":"Equine Vet. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1002\/vms3.728","article-title":"Evaluation of the Treatment of Equine Glandular Gastric Disease with Either Long-Acting-Injectable or Oral Omeprazole","volume":"8","author":"Gough","year":"2022","journal-title":"Vet. Med. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1111\/evj.14526","article-title":"Report from the 2025 Dorothy Russell Havemeyer Foundation Meeting on Equine Gastric Ulcer Syndrome (EGUS): Advances in the Field","volume":"57","author":"Sykes","year":"2025","journal-title":"Equine Vet. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Crumpton, S.M., Baiker, K., Hallowell, G.D., Habershon-Butcher, J.L., and Bowen, I.M. (2015). Diagnostic Value of Gastric Mucosal Biopsies in Horses with Glandular Disease. Equine Vet. J., 47.","DOI":"10.1111\/evj.12486_18"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1152\/physrev.00041.2006","article-title":"Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain","volume":"87","author":"McEwen","year":"2007","journal-title":"Physiol. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"9664","DOI":"10.1093\/cercor\/bhad236","article-title":"Neural Underpinnings of Preferential Pain Learning and the Modulatory Role of Fear","volume":"33","author":"Forkmann","year":"2023","journal-title":"Cereb. Cortex"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Meulders, A. (2020). Fear in the Context of Pain: Lessons Learned from 100 Years of Fear Conditioning Research. Behav. Res. Ther., 131.","DOI":"10.1016\/j.brat.2020.103635"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/evj.12951","article-title":"Prophylactic Therapy with Omeprazole for Prevention of Equine Gastric Ulcer Syndrome (EGUS) in Horses in Active Training: A Meta-Analysis","volume":"51","author":"Mason","year":"2019","journal-title":"Equine Vet. J."},{"key":"ref_28","unstructured":"Hallowell, G.D., Federica, C., Pereira, R., Rapezzano, G., Bates, C., Lane-Ley, E., and Bowen, I.M. (2025, January 8\u201310). Prevalence and Risk Factors for Refractory EGGD in a Sports and Pleasure Horse Population. Proceedings of the Equine Gastric Ulcer Syndrome (EGUS): Advances in the Field, Tampa, FL, USA."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Messay, B., Lim, A., and Marsland, A.L. (2012). Current Understanding of the Bi-Directional Relationship of Major Depression with Inflammation. Biol. Mood Anxiety Disord., 2.","DOI":"10.1186\/2045-5380-2-4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1037\/hea0001414","article-title":"A Dynamic Bidirectional System of Stress Processes: Feedback Loops Between Stressors, Psychological Distress, and Physical Symptoms","volume":"44","author":"Luo","year":"2024","journal-title":"Heal. Psychol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.3390\/ani13071261","article-title":"Equine Gastric Ulcer Syndrome: An Update on Current Knowledge","volume":"13","author":"Vokes","year":"2023","journal-title":"Animals"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.tvjl.2017.09.002","article-title":"Increased Adrenocortical Response to Adrenocorticotropic Hormone (ACTH) in Sport Horses with Equine Glandular Gastric Disease (EGGD)","volume":"228","author":"Scheidegger","year":"2017","journal-title":"Vet. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/evj.12949","article-title":"Risk Factors for Equine Glandular and Squamous Gastric Disease in Show Jumping Warmbloods","volume":"50","author":"Pederson","year":"2018","journal-title":"Equine Vet. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.tvjl.2019.05.009","article-title":"Hair Cortisol Concentration Is Inversely Related to the Severity of Equine Squamous Gastric Disease","volume":"249","author":"Prinsloo","year":"2019","journal-title":"Vet. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.sjpain.2011.01.005","article-title":"Understanding the Link between Depression and Pain","volume":"2","author":"Linton","year":"2011","journal-title":"Scand. J. Pain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.neuron.2012.01.001","article-title":"Understanding Migraine through the Lens of Maladaptive Stress Responses: A Model Disease of Allostatic Load","volume":"73","author":"Borsook","year":"2012","journal-title":"Neuron"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1037\/a0035302","article-title":"Social Signal Transduction Theory of Depression","volume":"140","author":"Slavich","year":"2014","journal-title":"Psychol. Bull."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1016\/j.pain.2010.11.010","article-title":"Pain and the Brain: Specificity and Plasticity of the Brain in Clinical Chronic Pain","volume":"152","author":"Apkarian","year":"2011","journal-title":"Pain"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Barbosa, \u00c2.P., Oliveira, T.M., Trindade, P.H.E., Seidel, S.R.T., Tokawa, P.K.A., Jaramilo, F.M., Roncati, N.V., and Baccarin, R.Y.A. (2024). Sleep Pattern Interference in the Cognitive Performance of Lusitano Horses. Animals, 14.","DOI":"10.3390\/ani14020334"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Greening, L., and McBride, S. (2022). A Review of Equine Sleep: Implications for Equine Welfare. Front. Vet. Sci., 9.","DOI":"10.3389\/fvets.2022.916737"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.cveq.2005.12.020","article-title":"Excessive Drowsiness Secondary to Recumbent Sleep Deprivation in Two Horses","volume":"22","author":"Bertone","year":"2006","journal-title":"Vet. Clin. N. Am. Eq. Pract."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Garbarino, S., Lanteri, P., Durando, P., Magnavita, N., and Sannita, W.G. (2016). Co-Morbidity, Mortality, Quality of Life and the Healthcare\/Welfare\/Social Costs of Disordered Sleep: A Rapid Review. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13080831"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.smrv.2005.08.001","article-title":"Sleep Deprivation and Pain Perception","volume":"10","author":"Lautenbacher","year":"2006","journal-title":"Sleep Med. Rev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1007\/s11916-022-01074-2","article-title":"The Influence of Sleep Disturbance on Chronic Pain","volume":"26","author":"Li","year":"2022","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/evj.14041","article-title":"Comparing Lying Behaviour of Young Riding Horses on Days in an Individual Indoor Box, on an Outdoor Paddock Alone, or in Pairs and in the Following Night","volume":"57","author":"Helmerich","year":"2024","journal-title":"Equine Vet. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.nlm.2008.07.013","article-title":"Paradoxical Sleep Deprivation Impairs Acquisition, Consolidation, and Retrieval of a Discriminative Avoidance Task in Rats","volume":"90","author":"Alvarenga","year":"2008","journal-title":"Neurobiol. Learn. Mem."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.neuropharm.2003.11.032","article-title":"Role of Hippocampal Oxidative Stress in Memory Deficits Induced by Sleep Deprivation in Mice","volume":"46","author":"Silva","year":"2004","journal-title":"Neuropharmacology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.pneurobio.2011.01.002","article-title":"The Effect of Pain on Cognitive Function: A Review of Clinical and Preclinical Research","volume":"93","author":"Moriarty","year":"2011","journal-title":"Prog. Neurobiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1037\/0735-7036.118.4.434","article-title":"Interplay Between Environmental and Genetic Factors in Temperament\/Personality Traits in Horses (Equus caballus)","volume":"118","author":"Hausberger","year":"2004","journal-title":"J. Comp. Psych."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.cub.2007.08.007","article-title":"The Human Emotional Brain without Sleep\u2014A Prefrontal Amygdala Disconnect","volume":"17","author":"Yoo","year":"2007","journal-title":"Curr. Biol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1037\/a0035747","article-title":"Cognitive-Behavioral Therapy for Individuals with Chronic Pain: Efficacy, Innovations, and Directions for Research","volume":"69","author":"Ehde","year":"2014","journal-title":"Am. Psychol."},{"key":"ref_52","first-page":"262","article-title":"Cognitive-Behavioral Therapy for Individuals with Chronic Pain: An Evidence-Based Review","volume":"62","author":"Ehde","year":"2014","journal-title":"Behav. Res. Ther."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1093\/clipsy.bpg016","article-title":"Mindfulness-Based Interventions in Context: Past, Present, and Future","volume":"10","year":"2003","journal-title":"Clin. Psych. Sci Pr."},{"key":"ref_54","first-page":"127","article-title":"Behavioral Activation for Depression: A Review","volume":"17","author":"Dimidjiian","year":"2010","journal-title":"Clin. Psych. Sci. Pr."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Wess, L., B\u00f6hm, A., Sch\u00fctzinger, M., Riemer, S., Yee, J.R., Affenzeller, N., and Arhant, C. (2022). Effect of Cooperative Care Training on Physiological Parameters and Compliance in Dogs Undergoing a Veterinary Examination\u2014A Pilot Study. Appl. Anim. Behav. Sci., 250.","DOI":"10.1016\/j.applanim.2022.105615"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Stellato, A., Jajou, S., Dewey, C.E., Widowski, T.M., and Niel, L. (2019). Effect of a Standardized Four-Week Desensitization and Counter-Conditioning Training Program on Pre-Existing Veterinary Fear in Companion Dogs. Animals, 9.","DOI":"10.3390\/ani9100767"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Raucourt, L., and Masson, S. (2025). The Effect of Gabapentin on the Efficiency of a Desensitization\u2013Counter-Conditioning Claw-Trimming Protocol for Cats with Healthcare Phobias: A Double-Blind, Placebo-Controlled Crossover Trial. Animals, 15.","DOI":"10.3390\/ani15091326"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jveb.2018.02.003","article-title":"Case Series Report: Systematic Rehabilitation of Specific Health Care Procedure Aversions in 5 Ponies","volume":"25","author":"Torcivia","year":"2018","journal-title":"J. Vet. Behav."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.jfms.2007.09.001","article-title":"AAHA\/AAFP Pain Management Guidelines for Dogs and Cats","volume":"9","author":"Hellyer","year":"2007","journal-title":"J. Feline Med. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/j.jevs.2014.09.006","article-title":"Efficacy of a Combination of Apolectol, Live Yeast (Saccharomyces Cerevisiae [CNCM I-1077]), and Magnesium Hydroxide in the Management of Equine Gastric Ulcer Syndrome in Thoroughbred Racehorses: A Blinded, Randomized, Placebo-Controlled Clinical Trial","volume":"34","author":"Sykes","year":"2014","journal-title":"J. Equine Vet. Sci."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Jacobs, R.D., Gordon, M.B.E., Vineyard, K.R., Keowen, M.L., Garza, F., and Andrews, F.M. (2020). The Effect of a Seaweed-Derived Calcium Supplement on Gastric Juice PH in the Horse. J. Equine Vet. Sci., 95.","DOI":"10.1016\/j.jevs.2020.103265"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Krueger, K., Esch, L., Farmer, K., and Marr, I. (2021). Basic Needs in Horses?\u2014A Literature Review. Animals, 11.","DOI":"10.3390\/ani11061798"},{"key":"ref_63","first-page":"323","article-title":"Optimism and the Experience of Pain: A Systematic Review","volume":"45","author":"Peters","year":"2018","journal-title":"Behav. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jveb.2015.11.005","article-title":"Pasturing in Herds after Housing in Horseboxes Induces a Positive Cognitive Bias in Horses","volume":"11","author":"Lockener","year":"2016","journal-title":"J. Vet. Behav."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Henry, S., Fureix, C., Rowberry, R., Bateson, M., and Hausberger, M. (2017). Do Horses with Poor Welfare Show \u2018Pessimistic\u2019 Cognitive Biases?. Sci. Nat., 104.","DOI":"10.1007\/s00114-016-1429-1"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Busby, D. (2025). Equine Behaviour in Practice: Understanding Horses and Treating Behaviour Problems, CRC Press.","DOI":"10.1201\/9781003581390"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jveb.2023.10.003","article-title":"Stable Design Influences Relaxation and Affiliative Behavior in Horses during Short Isolation Bouts","volume":"69\u201370","author":"Borthwick","year":"2023","journal-title":"J. Vet. Behav."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.2460\/ajvr.1996.57.11.1599","article-title":"Effects of Intermittent Feed Deprivation, Intermittent Feed Deprivation with Ranitidine Administration, and Stall Confinement with Ad Libitum Access to Hay on Gastric Ulceration in Horses","volume":"57","author":"Murray","year":"1996","journal-title":"Am. J. Vet. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Ruet, A., Lemarchand, J., Parias, C., Mach, N., Moisan, M.P., Foury, A., Briant, C., and Lansade, L. (2019). Housing Horses in Individual Boxes Is a Challenge with Regard to Welfare. Animals, 9.","DOI":"10.3390\/ani9090621"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1111\/jvim.14370","article-title":"Risk Factors for Equine Gastric Glandular Disease: A Case-Control Study in a Finnish Referral Hospital Population","volume":"30","author":"Hewetson","year":"2016","journal-title":"J. Vet. Intern. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.jevs.2015.06.006","article-title":"The Influence of a Soft Touch Therapy Flowtrition on Heart Rate, Surface Temperature, and Behavior in Horses","volume":"35","author":"Birt","year":"2015","journal-title":"J. Equine Vet. Sci."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Jastrz\u0119bska, E., G\u00f3recka-Bruzda, A., Og\u0142uszka, M., Lipka, M.S., and Paw\u0142owska, A. (2025). Effect of Massage on Stress Indicators in Recreational Horses\u2014A Pilot Study. Animals, 15.","DOI":"10.3390\/ani15060789"},{"key":"ref_73","unstructured":"(2025, October 12). How to Recognize Your Horses\u2019 FAS. Available online: https:\/\/www.fearfreehappyhomes.com\/how-to-recognize-your-horses-fas\/."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/10888705.2015.1130630","article-title":"Physiological and Behavioral Responses of Horses to Wither Scratching and Patting the Neck When Under Saddle","volume":"19","author":"Thorbergson","year":"2016","journal-title":"J. App. Anim. Welf. Sci."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2117\/psysoc.2016.91","article-title":"Failure to Find Reinforcement Effect of Neck Patting in Horses (Equus caballus)","volume":"59","author":"Takahashi","year":"2016","journal-title":"Psychologia"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Gueguen, L., Henry, S., Delbos, M., Lemasson, A., and Hausberger, M. (2023). Selected Acoustic Frequencies Have a Positive Impact on Behavioural and Physiological Welfare Indicators in Thoroughbred Racehorses. Animals, 13.","DOI":"10.3390\/ani13182970"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"259","DOI":"10.12982\/VIS.2021.023","article-title":"Effects of Playing Classical Music on Behavior of Stabled Horses","volume":"19","author":"Huo","year":"2021","journal-title":"Vet. Integr. Sci."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"146","DOI":"10.21836\/PEM20170206","article-title":"Massage or Music Meant to Be Relaxing, Result in Lowering Salivary Cortisol Concentration in Race Horses","volume":"33","author":"Janczarek","year":"2017","journal-title":"Pferdeheilkunde"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jevs.2017.02.004","article-title":"Comparison of Effects of Different Relaxing Massage Frequencies and Different Music Hours on Reducing Stress Level in Race Horses","volume":"53","author":"Janczarek","year":"2017","journal-title":"J. Equine Vet. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"de Oliveira, F.Y.U., Odakura, A.M., de Castro Burbarelli, M.F., dos Ouros, C.C., de Lima Almeida Paz, I.C., Braz, J.M., Garcia, R.G., and Caldara, F.R. (2024). Impact of Musical Rhythm on Blood, Physiological and Welfare Parameters in Stabled Horses. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-82637-8"},{"key":"ref_81","unstructured":"Greening, L. (2012, January 18\u201320). Auditory Stimulation of the Stabled Equine; the Effect of Different. Proceedings of the International Society for Equitation Science (ISES), Edinburgh, UK."},{"key":"ref_82","unstructured":"Lester, G.D., Robinson, I., and Secombe, C. (2008). Risk Factors for Gastric Ulceration in Thoroughbred Racehorses, AgriFutures Australia, the Rural Industries Research and Development Corporation (RIRDC)."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Wild, K.N., Skiba, S., R\u00e4s\u00e4nen, S., and Richter, C.P. (2023). Pupillometry to Show Stress Release during Equine Sports Massage Therapy. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-47590-y"},{"key":"ref_84","first-page":"16","article-title":"The Effects of Swedish Massage on Performance Horses in South Africa","volume":"15","author":"Badenhorst","year":"2017","journal-title":"J. New Gen. Sci."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2746\/042516407X240456","article-title":"The Effects of Chiropractic, Massage and Phenylbutazone on Spinal Mechanical Nociceptive Thresholds in Horses without Clinical Signs","volume":"40","author":"Sullivan","year":"2010","journal-title":"Equine Vet. J."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Carroll, S.L., Sykes, B.W., and Mills, P.C. (2023). Understanding and Treating Equine Behavioural Problems. Vet. J., 296\u2013297.","DOI":"10.1016\/j.tvjl.2023.105985"},{"key":"ref_87","first-page":"490","article-title":"Understanding Behavior: Serotonin Syndrome","volume":"30","author":"Poggiagliolmi","year":"2008","journal-title":"Compend. Contin. Educ. Vet."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.bbr.2013.08.045","article-title":"Animal Models of the Serotonin Syndrome: A Systematic Review","volume":"256","author":"Haberzettl","year":"2013","journal-title":"Behav. Brain Res."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/j.jevs.2020.103340","article-title":"Retrospective Evaluation of Fluoxetine Hydrochloride Use in Horses: 95 Cases (2010\u20132019)","volume":"97","author":"Fontenot","year":"2021","journal-title":"J. Equine Vet. Sci."},{"key":"ref_90","first-page":"63","article-title":"Pharmacokinetics of Fluoxetine in Horses Following Oral Administration","volume":"45","author":"Veltri","year":"2021","journal-title":"J. Vet. Pharm. Ther."},{"key":"ref_91","first-page":"50","article-title":"Antidepressant-Induced Activation in Children and Adolescents: Risk, Recognition and Management","volume":"48","author":"Luft","year":"2018","journal-title":"Curr. Prob. Ped. Adol. Heal. Care"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1111\/jvim.16821","article-title":"The Effects of Orally Administered Trazodone on Ambulation and Recumbency in Healthy Horses","volume":"37","author":"Hobbs","year":"2023","journal-title":"J. Vet. Intern. Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1111\/jvp.12477","article-title":"Pharmacokinetics, Pharmacodynamics and Clinical Use of Trazodone and Its Active Metabolite m-Chlorophenylpiperazine in the Horse","volume":"41","author":"Davis","year":"2018","journal-title":"J. Vet. Pharm. Ther."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Korpivaara, M., Laapas, K., Huhtinen, M., Sch\u00f6ning, B., and Overall, K. (2017). Dexmedetomidine Oromucosal Gel for Noise-Associated Acute Anxiety and Fear in Dogs-a Randomised, Double-Blind, Placebo-Controlled Clinical Study. Vet. Rec., 180.","DOI":"10.1136\/vr.104045"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.jveb.2010.10.004","article-title":"The Use of Clonidine in the Treatment of Fear-Based Behavior Problems in Dogs: An Open Trial","volume":"6","author":"Ogata","year":"2011","journal-title":"J. Vet. Behav. Clin. Appl. Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3389\/fvets.2020.573309","article-title":"Use of Detomidine Oromucosal Gel for Alleviation of Acute Anxiety and Fear in Horses: A Pilot Study","volume":"7","author":"Dai","year":"2020","journal-title":"Front. Vet. Sci."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1365-2885.2010.01161.x","article-title":"Pharmacokinetic Profile and Behavioral Effects of Gabapentin in the Horse","volume":"33","author":"Terry","year":"2010","journal-title":"J. Vet. Pharmacol. Ther."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Di Cesare, F., Negro, V., Ravasio, G., Cagnardi, P., Villa, R., and Draghi, S. (2023). Gabapentin: Clinical Use and Pharmacokinetics in Dogs, Cats, and Horses. Animals, 13.","DOI":"10.3390\/ani13122045"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/jvim.16386","article-title":"Pharmacokinetics and Pharmacodynamics of Repeat Dosing of Gabapentin in Adult Horses","volume":"36","author":"Gold","year":"2022","journal-title":"J. Vet. Intern. Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.2460\/ajvr.74.7.1043","article-title":"Pharmacokinetics of Single-Dose Intragastric and Intravenous Pregabalin Administration in Clinically Normal Horses","volume":"74","author":"Mullen","year":"2013","journal-title":"Am. J. Vet. Res."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/S0737-0806(00)70457-6","article-title":"A Review of Diazepam and Its Use in the Horse","volume":"20","author":"Shini","year":"2000","journal-title":"J. Equine Vet. Sci."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/jvim.12510","article-title":"Use of Alprazolam to Facilitate Mare-Foal Bonding in an Aggressive Postparturient Mare","volume":"29","author":"Wong","year":"2015","journal-title":"J. Vet. Intern. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1248\/bpb.23.1333","article-title":"Pharmacokinetics of Propranolol and Its Metabolites in Horses after Intravenous or Oral Administration","volume":"23","author":"Aramaki","year":"2000","journal-title":"Biol. Pharm. Bull."},{"key":"ref_104","unstructured":"Aleman, M., and Morales, C.J. (2025, January 18\u201321). A Case Based Approach to Equine Neuropharmacology. Proceedings of the ACVIM Forum, Louisville, KY, USA."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1038\/aps.2010.74","article-title":"The Features of Reserpine-Induced Gastric Mucosal Lesions","volume":"31","author":"Ma","year":"2010","journal-title":"Acta Pharmacol. Sin."},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Benoit, S., Chaumontet, C., Violle, N., Boulier, A., Hafeez, Z., Cakir-Kiefer, C., Tom\u00e9, D., Schwarz, J., and Miclo, L. (2022). The Anxiolytic-like Properties of a Tryptic Hydrolysate of Bovine As1 Casein Containing \u03b1-Casozepine Rely on GABAA Receptor Benzodiazepine Binding Sites but Not the Vagus Nerve. Nutrients, 14.","DOI":"10.3390\/nu14112212"},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Manna, S.S.S. (2021). Possible Influence of Neurosteroids in the Anxiolytic Effects of Alpha-Casozepine. Med. Hypo., 155.","DOI":"10.1016\/j.mehy.2021.110655"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.jevs.2014.06.003","article-title":"Modestly Improved Compliance and Apparent Comfort of Horses with Aversions to Mildly Aversive Routine Health Care Procedures Following Short-Term Alpha-Casozepine Supplementation","volume":"34","author":"McDonnell","year":"2014","journal-title":"J. Equine Vet. Sci."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.jevs.2012.05.060","article-title":"Calming Benefit of Short-Term Alpha-Casozepine Supplementation During Acclimation to Domestic Environment and Basic Ground Training of Adult Semi-Feral Ponies","volume":"33","author":"McDonnell","year":"2013","journal-title":"J. Equine Vet. Sci."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jveb.2018.12.009","article-title":"Zylk\u00e9ne to Load? The Effects of Alpha-Casozepine on Compliance and Coping in Horses during Loading","volume":"30","author":"Ijichi","year":"2019","journal-title":"J. Vet. Behav."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.applanim.2006.01.008","article-title":"Effect of a Synthetic Equine Maternal Pheromone during a Controlled Fear-Eliciting Situation","volume":"101","author":"Falewee","year":"2006","journal-title":"Appl. Anim. Behav. Sci."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jveb.2012.09.003","article-title":"Behavioral and Physiological Responses of Weaned Foalstreated with Equine Appeasing Pheromone: A Double-Blinded, Placebo-Controlled, Randomized Trial","volume":"8","author":"Berger","year":"2013","journal-title":"J. Vet. Behav. Clin. Appl. Res."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jveb.2019.01.005","article-title":"A Test of the Effects of the Equine Maternal Pheromone on the Clinical and Ethological Parameters of Equines Undergoing Hoof Trimming","volume":"31","author":"Aleixo","year":"2019","journal-title":"J. Vet. Behav."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s10311-017-0681-8","article-title":"Lavender Essential Oil Decreases Stress Response of Horses","volume":"16","author":"Poutaraud","year":"2018","journal-title":"Environ. Chem. Lett."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Papagianni, E.P., and Stevenson, C.W. (2019). Cannabinoid Regulation of Fear and Anxiety: An Update. Curr. Psychiatry Rep., 21.","DOI":"10.1007\/s11920-019-1026-z"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Di Salvo, A., Conti, M.B., and della Rocca, G. (2023). Pharmacokinetics, Efficacy, and Safety of Cannabidiol in Dogs: An Update of Current Knowledge. Front. Vet. Sci., 10.","DOI":"10.3389\/fvets.2023.1204526"},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Eichler, F., Ehrle, A., Machnik, M., Jensen, K.C., Wagner, S., Baudisch, N., Bolk, J., P\u00f6tzsch, M., Thevis, M., and B\u00e4umer, W. (2023). Behavioral Observations, Heart Rate and Cortisol Monitoring in Horses Following Multiple Oral Administrations of a Cannabidiol Containing Paste (Part 2\/2). Front. Vet. Sci., 10.","DOI":"10.3389\/fvets.2023.1305873"},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Draeger, A., Thomas, E., Jones, K., Godwin, P., Davis, A., and Porr, S. (2021, January 1\u20134). Cannabidiol in the Horse: Effects on Movement and Reactivity. Proceedings of the Virtual Equine Science Symposium, Online.","DOI":"10.1016\/j.jevs.2021.103544"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.tvjl.2004.04.017","article-title":"Calmatives for the Excitable Horse: A Review of L-Tryptophan","volume":"170","author":"Grimmett","year":"2005","journal-title":"Vet. J."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.tvjl.2016.05.003","article-title":"Randomised Clinical Trial on the Effect of a Single Oral Administration of L-Tryptophan, at Three Dose Rates, on Reaction Speed, Plasma Concentration and Haemolysis in Horses","volume":"213","author":"Noble","year":"2016","journal-title":"Vet. J."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0168-1591(94)90083-3","article-title":"Behavioral and Physiological Effect of Orally Administered Tryptophan on Horses Subjected to Acute Isolation Stress","volume":"40","author":"Bagshaw","year":"1994","journal-title":"Appl. Anim. Behav. Sci."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.applanim.2016.12.006","article-title":"Preliminary Evaluation on the Effectiveness of Varying Doses of Supplemental Tryptophan as a Calmative in Horses","volume":"188","author":"Davis","year":"2017","journal-title":"Appl. Anim. Behav. Sci."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"51","DOI":"10.2746\/042516407X238503","article-title":"Effects of a Commercial Dose of L-Tryptophan on Plasma Tryptophan Concentrations and Behaviour in Horses","volume":"40","author":"Noble","year":"2008","journal-title":"Equine Vet. J."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.applanim.2006.10.004","article-title":"A Note on the Effects of a Commercial Tryptophan Product on Horse Reactivity","volume":"107","author":"Malmkvist","year":"2007","journal-title":"Appl. Anim. Behav. Sci."}],"container-title":["Animals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2615\/15\/20\/3019\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T02:24:17Z","timestamp":1761186257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2615\/15\/20\/3019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":124,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["ani15203019"],"URL":"https:\/\/doi.org\/10.3390\/ani15203019","relation":{},"ISSN":["2076-2615"],"issn-type":[{"value":"2076-2615","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]}}}