Well, the horses I've been around seem to know something's wrong with them before their human caretakers figure it out. I doubt he knows what it is, but I'm sure he knows something is off. Most animals seem to be better in tune with their bodies than we do -- old dogs who go off to die alone, etc. To me anyway, horses do think, but just not in a way we can comprehend.
I'm sure he also picks up on the extraordinary amount of attention and affection he's no doubt receiving, which hopefully offsets some of the physical discomfort.
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