EleFact Friday: Recognizing Pain

Lady in Male YardAs we’ve been updating you on Lady’s health issues, we’ve received some questions about how we monitor her level of pain as her osteomyelitis progresses. It’s a challenge in animal healthcare to determine pain levels in a patient who can’t describe where something hurts and how much it hurts. So for this week’s EleFact, we will be talking about how we assess pain in Lady’s – or any other elephant’s – case.

Recognizing signs of pain or discomfort in elephants is a mixture of common sense, close observation, and ongoing medical research. As caregivers, we have an intimate knowledge of what appears normal for each individual elephant here. So, if something seems “off” then we respond immediately with examinations and, if necessary, treatments. But, you have to pay close attention to the nuances of elephant behavior, because the symptoms might present as physiological, behavioral, and/or psychological changes. As wild animals, they tend to mask their pain, so knowing them for who they are, you see changes that hint toward a possibly bigger issue.

Pain scoring charts are commonly used in veterinary medicine and there are standards set for many animals – especially domesticated animals. There is no published pain scoring chart for elephants (that we have seen), so we’ve relied on our experience and the knowledge of colleagues around the world to build an evaluation tool that has proven reliable. We have found there are some basic similarities between elephants and horses and have adapted some of the criteria used to measure pain in horses to use when an elephant is demonstrating pain. (If you’d like to know what a horse pain scoring system looks like, click here:

Because each patient is different, their “normal” will be unique to them. Lady is a perfect example: her “normal” is not remotely regular for a healthy adult elephant. But we can look at any individual and determine if they’re looking particularly thin, if their face is showing pain, how they are holding their body, or if they have wounds, among many other things. We can assign a body condition score based on these observations and the scoring chart. Elephant behaviors might change as well. For instance, an elephant in distress might revert to old stereotyping patterns, show irritability or panic, be particularly tired, stop or slow their eating, stop lying down, or become tentative in their movements. When it comes to psychological changes that could indicate pain, there is no scale that can measure what’s going on in an elephant’s brain, so we must rely on our relationships with them. We’ve found that elephants are incredibly effective communicators, if you are paying attention to what they’re trying to tell you.

In cases like Lady’s, we evaluate her multiple times a day to see how she seems to be measuring pain-wise and what she’s trying to tell us. Sometimes her status changes throughout the day; she might be exhibiting a higher pain level in the morning than she does in the evening. Having a pain scoring chart helps us objectively document her status from one day to the next, or one hour to the next and be able to monitor trends. Scientific tools – like the scoring chart – and close observation are some of the keys to maintaining and sustaining elephant care.

Photo of Lady in the palms of the male Asian yard


  1. REPLY
    SHEILA says

    Aahhh I always thought and hoped Lil Lady would get better and she’d join the ladies. It breaks my heart that she suffers. I hope she gets relief from the pain meds. To get around very happily in her paradise home.

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