The Top Five Horse Health Issues

Every horse owner worries about the health of their horse at some time, if not all the time.  Who was it that said, “if you go six months without a problem, then you are doing well!”?

Horses often have trivial issues – wounds from the field, knock, bangs, grazes – which owners have to manage on a regular basis.  There can also be management challenges such as irritation from dust, too much grass which can cause laminitis and hoof problems caused by poor horn quality.  But what are the top five health issues that a horse owner is likely to encounter as something big, challenging and potentially life-threatening?

 1. Colic

Put simply, colic is a gut ache.  It can be trivial and transitory or serious and lead to death.  Throughout the general equine population, anywhere between 4%-10% of horses will suffer at least one bout of colic during their lifetime.  Colic requires quick decision making and would usually be treated as a veterinary emergency.

Symptoms of Colic

These can vary depending on the type and severity of the episode but will usually include one or more of the following:

• The horse may appear listless and depressed
• He may exhibit restlessness and box walking, a general sense of agitation
• Pawing the ground
• Lying down and getting up
• Tail swishing, kicking up or out with the hind leg, swinging the head and neck around to stare at the flanks
• Rolling
• Lying on the back
• Elevated respiration
• Sweating

It is imperative to contact your vet as soon as you suspect colic.  Early interventions carry the greatest success rate and will give you time to plan other options should you want to pursue them.

Different types of colic

It may not be possible to tell what type of colic your horse is suffering from, this will need to be determined by the vet.  However, there can be some clues, for example, a reduction or total absence in the normal number of droppings could indicate a blockage or obstruction.  Gorging on spring grass will lead to a bloated appearance and the presence of too much gas in the intestine whilst the fibre is being processed.  Your vet will determine what they think is causing the colic when they arrive to examine the horse although undoubtedly, your observations will be both relevant and important.

Some different types of colic include:-

• Impaction – caused by a blockage commonly partially eaten food but it could be something else such as a lipoma which is a fatty lump that can wind its way around part of the intestine and stop the passage of digested material
• Spasmodic – muscle spasms or cramps
• Sand Colic – caused by the ingestion of sand or soil over a period of time often as a result of poor grazing. This creates a blockage but may be dealt with differently by the vet to an obstruction caused by partially digested food material
• Gas Colic – a build-up of gas caused by excess fermentation in the hind gut, can be caused by an excess of inappropriate food such as rich, spring grass or overdose on cereals
• Strangulation Colic - occurs when the blood supply to a portion of the intestine is restricted or cut off totally hence the name. Strangulation colic is fairly rare but very serious

Your response to a possible colic episode should be swift yet thoughtful.  Always contact your vet so they are aware even if the episode resolves and they don’t end up attending.

Remove all feed from the stable and walk the horse if he will walk to encourage the gut to keep moving.  Some people will lunge their horses as increased mobility can help gut motility which, depending on the type of colic, can help. 

The vet will determine the appropriate course of treatment once they have examined the horse.  This can range from drenching – the administration of liquid via a tube into the stomach to help shift a blockage – the injection of pain relief and anti-spasmodic drugs such as Buscopan, supporting the horse with fluids administered via a drip or removal to hospital for surgery.

Good management practises can considerably reduce the risk of colic occurring but it is never possible to totally eliminate the chance of a horse suffering from colic which is why it is so strongly feared by horse owners.

 2. Laminitis

Laminitis manifests as a disease of the horse’s feet, named after the sensitive and insensitive tissues within the closed capsule of the hoof, called the laminae, and which interlock to support the pedal bone.  When they become inflamed and engorged with blood, this is called laminitis.

For many years, laminitis was deemed to be a result of an excess of sweet grass.  Whilst lush grass still has a part of play in causing laminitis, science has begun to conclude that around 90% of cases are actually attributable to a hormone imbalance.  The two diseases in the frame for this are Equine Cushing’s Disease and Equine Metabolic Syndrome or EMS.

Signs and Symptoms of Laminitis

Laminitis is most common in the front feet but can occur in the hinds.  Typical signs will include:

• The horse or pony will appear uncomfortable and may be reluctant to walk. At rest, they lean backwards in a classic laminitic stance to relieve the intense pressure and pain felt in the toe
• In movement, the horse will be uncomfortable and often reluctant to move. The gait will be shortened and pottery as a result
• The feet will be warm to the touch
• There will be a clear digital pulse sometimes described as ‘bounding’ which is indicative of inflammation and which can be felt where the artery passes over the fetlock joint. An inflamed foot has restricted blood flow so the excess blood is pushed back into the artery creating a pulse which can be clearly felt
• One foot may be worse than the other – always check all four feet

Immediate First Aid

Place the horse in the stable if he is not already confined.  Make sure the bedding is deep and supportive.  Feed soaked hay and remove any hard or grain feed.

Veterinary Treatment

What your vet recommends will usually depend on how severe the attack is and the horse’s history.  Blood tests may be taken to determine whether there is an underlying cause such as Equine Cushing’s Disease or EMS.

Management measures will usually include:

• Box rest
• Pain relief and anti-inflammatories (non-steroidal) such as Phenylbutazone initially administered via injection for speed but subsequently in feed
• X Rays to determine whether the pedal bone has rotated or dropped
• Blood tests to check for any hormonal involvement
• Remedial shoeing or frog supports, this may not be the first thing the vet does, it will depend on how traumatised and painful the feet are
• A predetermined period in the box until the horse is sound without pain relief, this can be as long as six weeks to allow the inflammation in the foot to totally subside
• Very restricted turnout on poor pasture usually starting at around five or ten minutes and increasing gradually each day

Some horses and ponies are more predisposed to laminitis than others.  Good management in terms of keeping weight under control and monitoring grazing is very important in both the prevention and management of laminitis.  Horses that suffer from Equine Cushing’s Disease are more prone to it but thankfully, this can be well controlled with appropriate medication such as Prascend.

 3. Arthritis

Equine arthritis is associated with advancing years and old age and is commonly seen in high mileage sports horses and hunters.  But arthritis can present in younger horses too. 

Sometimes also referred to as DJD – Degenerative Joint Disease- arthritis, as with people, is painful and impedes movement.  Usually the progression of the disease is slow, categorised as chronic rather than acute, where the joint surface wears down over time usually resulting in lameness.

Arthritis cannot be cured but can be effectively managed for a period of time; this may include changing the horse’s job or reducing workload.  Inevitably, the disease will progress leading to retirement to the paddock and possible euthanasia on welfare grounds.

Any joint can develop arthritis but the joints of the legs are the most commonplace and significant in terms of soundness.  Popular locations for arthritis to develop are the fetlock, knee and hock.

Sign and Symptoms

• Lameness caused by pain which may be subtle initially and intermittent. It may improve with periods of rest or be less visible on a soft rather than a  hard riding surface
• General stiffness and reduced mobility without lameness can be a precursor to the development of arthritis, the horse may feel reluctant to go forward under saddle or dislike hard ground and alter his gait
• The joint may feel hot to the touch
• There could be swelling as a result of inflammation

Clinical diagnosis of arthritis

The vet will conduct a lameness work up viewing the horse on both soft and hard surfaces.  If the lameness is subtle or intermittent then nerve blocks can be used to establish the correct location.  X rays may be taken to view the level of inflammation and degeneration within the joint.

Management of arthritis

There is no cure for arthritis but there are some effective management techniques particularly in the early stages of the disease.

Corticosteroids and hyaluronic acid can be administered directly into the joint and these injections can be repeated more than once over a twelve-month period.  Anti-inflammatory medications such as Phenylbutazone can also be given orally on an occasional/need or continuous basis.  Light pain relief in this form allows the horse to retain athletic function.  If this is combined with appropriate workload in terms of amount and type (this may need to alter to reflect the progress of the disease) then the horse can continue a useful and happy ridden life.

Stem cell therapy is a new treatment which has been used for soft tissue injuries and is now being offered by some vets as a treatment for arthritis.

Correct management of the horse is essential as poor management will adversely affect any positive impact of veterinary interventions.  Horses should be turned out as much as possible; confinement to the stable will promote joint stiffness.  Work programmes should be adapted to allow plenty of warm up time.  Appropriate surfaces should be chosen for the horse to work on.

What is septic arthritis?

This is an acute joint inflammation caused by infection commonly the result of an injury to a joint.  Wounds do not have to be large and obvious; a small puncture wound can quickly introduce infection.  Any wound to a joint needs to be treated as a veterinary emergency.  The joint must be flushed out in hospital in a sterile environment and the horse kept in on maximum strength IV antibiotics to control the spread of infection.  A joint wound that is missed or has a slow response can lead ultimately to the loss of the horse.

 4. Gastric Ulcers

Also known as EGUS – Equine Gastric Ulcer Syndrome – these are similar to ulcers in people and are caused by continued exposure of the stomach lining to gastric juices.  This can cause ulceration and eventual bleeding.

The horse’s stomach is small, about the shape of a rugby ball, because most of the digestion takes place in the extensive hind gut.  The stomach is split into two sections and most lesions or ulcers are found in the upper region which is described as non-glandular, where the food enters from the oesophagus.

What causes EGUS in horses?

Poor management practises are thought to be a strong contributory factor so lack of long fibre – hay and grass – and too much grain feed with high starch content.  Stress is another predisposing factor which can be allied to this as stabled horses without adequate hay become stressed and develop stable vices through their agitation.  Saliva is a natural buffer to stomach acid but is only produced if the horse is chewing.  Stress can occur through intensive competition training, weaning and prolonged transportation.

Signs and Symptoms of EGUS

• Poor appetite or reduced eating
• Poor condition score and an inability to thrive despite good volumes of food
• Sensitivity to girthing up or irritability when being groomed
• Dull starring coat
• Miserable tucked up appearance
• Grinding teeth or crib biting
• Diarrhoea
• Reduced performance under saddle

Because some of these symptoms are rather vague and common to other conditions and diseases, your vet will need to diagnose the ulcers definitively.  Many horses do not show any outward clinical signs. 

Diagnosis is made using gastric endoscopy by which an endoscope is passed into the horse’s stomach and a camera plus light looks at the stomach lining.  With some sedation, this is a relatively simple process for the horse to undergo and usually lasts no longer than twenty minutes.

Treating ulcers

The vet can prescribe treatments such as Omeprazole which will limit the production of gastric acid and treat the ulcer.  There are drugs which completely block the production of stomach acid but these enzymes are there for a reason – to help start the digestion of food – so this is not a long-term option.

A change in management

The horse’s lifestyle and changes to it will contribute in significant part to the ability to heal existing ulcers and prevent future lesions from occurring. 

The stress levels for the horse must be minimised so this may involve a change of routine or alteration or reduction to workload.  The horse should always have access to fibre if he is stabled but the more he can be turned out into a natural environment, the better.

 5. Dental problems

Horses have evolved to continually munch on long fibre, either in the stable but preferably in the field where they can eat and roam much as they would in the wild.  Any regime which interferes with this in whole or in part runs the risk of creating dental problems for the horse. His teeth erupt continuously to cope with large portions of long fibre on a daily basis.

Routine dental checks are recommended annually and more frequently, every six months, in young and old horses or those with a specific problem.  Even with meticulous care, problems can still arise.  This list outlines some of the more common dental problems that the horse can encounter:

• Sharp edges – also called cusps, these can occur because the tooth is in a constant state of eruption. Regular dental care will smooth off these sharp edges which can cause pain and ulceration to the inside of the cheeks if left untreated
• Hooks and ramps – these deviations occur due to misalignment fo the teeth, common in horses with an overbite or underbite and in horses who have had a tooth removed so there is nothing for the opposing number to grind against
• Wolf Teeth – these are vestigial teeth, small and conical and sit usually just in front of the first cheek tooth on the upper jaw. Not all horses have them but they can interfere with the way the bit sits in the horse’s mouth and present problems under saddle.  They are frequently removed, a procedure harder in older horses as the exceptionally long roots of the teeth ossify in the socket
• Diastema – literally a gap between the teeth which can occur in the molar arcades or the incisors. Food can become trapped in these gaps and rot, causing decay and gingivitis which is inflammation of the gum leading to recession and the formation of periodontal pockets which can become repeatedly infected with decaying food matter.  Diastemas are commonplace in older horses as the gums recede naturally with age but whatever the causation, they can be managed with appropriate and regular dental care
• Tooth root infection – this usually results in the extraction of the tooth in a hospital environment. Horses cope well with missing teeth providing the diastema is wide enough to prevent food from getting stuck in it and the opposing molar is regularly monitored to prevent the formation of a ramp

These top five horse health issues all have one thing in common and that is management.  Good stable routines can have a significant impact on managing these conditions, preventing them from occurring in the first place and delay the progression of some diseases.

The more we replicate the horse’s natural mode of living and environment, the less likely he is to suffer health issues.  Unfortunately, even with the best of care, diseases and illnesses do occur but good stable management will again optimise the horse’s outlook, quality of life and promote his welfare.