medical practice is out of the question entirely. fluffies cannot take care of plants on their own. i personally think that water is the stopping point.
Probably nothing greater than most bird species.
So advanced culture, difference in food/water, farming and medicine.
Since they are often depicted as being similar to children in intellect.
This also means they would more so have a see and do society rather than a teaching society much alike apes and chimps.
I’d think they can do simple medical stuff like knowing that some plants can relieve pain, and to give an injured limb rest in order to heal.
For my own canon, farming on their own is something fluffies couldn’t do. But it’s all up to a person’s own headcanon, ofc.
Yeah I think similarly, except for the minor deformities e.g. reversed organs, that if it tries to evolve it comes out as a bloody deformed mess.
Also who thought alicorns being smarter was a good idea, usually adding more crap to species will incur a drawback. For example Homo Neanderthalis, an evolution of homo Sapien in portions of the world in response to the last ice age, they had bigger muscles more hair, strength, stamina and larger brains and yet were out smarted by Homo Sapien. despite having better everything they were lacking intellectually as they didn’t need to be so that went down due to evolution, so thusly an alicorn would at best be as intelligent as most fluffies.