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The horse in sickness and in health

(Updated October 2006)

[Signs of health versus ill-health][Common illnesses and diseases][Injuries and first aid]

Just like humans and all other animals, horses can have their off days. This might mean nothing or it can be the prelude to something serious, even life threatening. But how to tell? Some people who really know their animals well have an almost uncanny knack of picking the early warning signs of sickness, but others with less experience might have a very ill horse on their hands before they realize it.

But the beginning owner should not despair because there are some very specific, easily recognisable signs of the more common illnesses. But first of all it is important to become very familiar with the actions and behaviour of the horse in good health.

Signs of health versus ill-health

[Head][Hair coat][Sweating][Exercise][Dung][Urine][Posture]

Body condition

Irrespective of any other indicators of health or ill health that may be present, any visible sign of ribs means the horse is too thin. From there it gets progressively worse. Horses can become so thin through starvation that they lose all muscle definition and look like bones covered by skin - "walking skeletons" in other words.

Head

Expression is a good indicator of health in all animals. Horses lack the facial muscles which would allow them to show much feeling, but certainly they can look drawn with pain, anxious, worried, annoyed, relaxed or happy.

Ears are mood indicators. Laid back they are a warning sign that the horse is going to lunge and bite. Flicking backwards and forwards indicates anxiety or nervousness and may be combined with head bobbing and champing on the bit. Ears are not habitually pricked unless something attracts the horse’s attention, but they both should be held at the same angle even if lopped or lop-eared (unable to be fully pricked). One ear hanging with or without hair loss at the base from rubbing is a sure indication of mites or a foreign body like a grass seed. Not often does something get in the ear because the long hairs prevent it, which is why it is very wrong to shave or trim the hair inside the ear for show purposes. Also some horses resent their ears being handled at the best of times, so the ear trimming process can become a battle royal requiring the use of a tranquillizer, for no sensible end result.

Eyes should be clear and not runny, and capable of opening fully and evenly, although it is normal for a relaxed horse to have them half-closed. Fly irritation will cause both eyes to weep. If severe, the conjunctiva will become quite red and swollen and matter will form in the corners of the eye. A fly veil will help, there are many types on the market. Ergot, the black sticky fungus that appears on paspalum in summer, can also cause eye irritation.

If only one eye is weeping and closed, damage from a foreign body should be suspected. If this is the case, the eye will be very sore and sensitive to light. Gently prising the lids apart in a darkened stable will reveal a crater on the surface of the eye and the whole cornea may be a smoky blue colour. This is an eye ulcer and requires prompt veterinary attention to prevent the possibility of permanent scarring and vision impairment. Keeping the horse out of direct light and shielding the eye with a blinker or half-blindfold will also help the healing process.

A horse’s nostrils are not normally wet, although in very dusty conditions they may run a small amount of clear fluid. Green material in the nostrils means the horse has vomited from the oesophagus (horses cannot vomit from lower down). Bleeding from the nose can be superficial and due to external trauma, though if related to exercise especially in racehorses it may indicate exercise-induced pulmonary haemorrhage (EIPH), which is bad news because "bleeders" are banned from racing, at least for a period. A clear discharge that becomes thick and yellow with pus is a sign of a respiratory disease, plus the horse will no doubt be quite unwell and coughing.

The mucous membranes (lining of the eyes and inside the mouth) should be a healthy pink colour. Paleness can mean anaemia, usually due to worms. Blue and yellow colourations are abnormal.

A general swelling of the face below the eyes is a symptom of big head, caused by grazing oxalate-containing grasses, e.g. buffel and setaria. A swelling on one side can mean a tooth or sinus infection.

Horses do not normally dribble, although will do so if something prickly is caught in the mouth, the awns of barley hay being notorious.

Hair coat

Horses have three different types of coat throughout their lives. Much like the ugly duckling that turned into a beautiful swan story, they have a very woolly foal coat that they lose forever at about three months of age. In summer horse are sleek-coated, while in winter they grow an extra coat which makes them look quite rough and hairy, but certainly does not indicate poor health. The colder the weather the rougher the coat because muscles in the horse’s skin elevate the hairs to trap more air for added warmth. Horses will sometimes elevate their summer coat so that it looks dull for a brief period of time, but a permanently slightly dull summer coat can indicate malfunctioning of the sweat glands, or anhydrosis.

Dappling is a sign of a very healthy coat, though not all horses have the genetic ability to dapple-up.

Hair loss with or without skin damage is usually the result of external parasites, badly fitting gear or allergies. The very rapid loss of a winter coat can leave bald patches for a short while. Hair loss around the head can mean the horse has suffered a recent attack of colic and has been getting up and down and rolling violently. Around the girth it could indicate ringworm. In high summer rainfall areas, rain scald is a common cause of hair loss along the backline. Loss of mane and tail hair from rubbing is particularly associated with Queensland itch (sweet itch), while an itchy rear end is occasionally due to pinworms. Mares in season will sometimes rub hair out of their tails.

Lumps and bumps are mainly caused by external trauma, but itchy small lumps or plaques that suddenly appear all over the body (urticaria or hives) indicate an allergic reaction. Often the allergens causing urticaria cannot be pinpointed, but insect bites, feeding changes, injected or topical medications, and plants like stinging nettles have all been incriminated. Urticaria normally subsides quickly but if the horse is obviously distressed with elevated heart rate and respiratory rate, then veterinary assistance should be sought immediately. Swellings in the throat region can interfere with breathing.

Open sores on the skin surface are usually associated with tack that is rubbing. Girth galls can be prevented by ensuring leather girths are kept clean and well-oiled, or alternatively use a cord or mohair girth. Small pusy sores under the saddle known as sweat boils may develop due to sweat not being thoroughly removed after working.

A rough winter coat is normal, but any other type of dull, scurfy, scruffy or lifeless coat is a sign of ill health, because most illnesses cause interruption to the hair cycle and loss of function of the oil glands that lubricate the skin and hair.

One of the tests for dehydration is to pinch up the skin on the horse’s neck to see if it is slow to return to normal. Dehydration does exist but it is by no means as common as many horse people think. It is due basically to insufficient water intake tied up with imbalance of some minerals known as electrolytes, the principal one being salt. There is extreme misunderstanding and abuse of electrolytes by many people who own performance horses, including racehorses. Many so-called dehydration and electrolyte imbalance problems are in fact caused by improper use and/or administration of electrolyte preparations. It is difficult to get dehydration in otherwise healthy horses provided they never have their water intake restricted (except briefly, if very hot after fast work), are given access to free-choice salt, are cared for and managed in ways that minimise stress, are not overrugged and are never given diuretics except under veterinary supervision. Because of the dry appearance of the coat, dehydration is often confused with the much commoner (in warm tropical climates) anhydrosis.

Sweating

Horses in a paddock do not usually sweat, though they might do so on very hot days. The horse that sweats for no reason is the one to worry about, because it usually indicates pain and is particularly associated with colic. As also explained in the article on thermoregulation, one of the most damaging notions ever perpetrated is that fit horses do not sweat. This is absolute rubbish. Horse MUST sweat when they are hot, otherwise they will develop heat stress. The evaporation of sweat from the skin removes body heat with it. The fit-horse-not-sweating myth perhaps arose because soft or “new” horses produce a soapy sweat that lathers easily. As they get fitter, the sweat becomes more watery and evaporates more quickly. An endurance horse, for instance, will continually sweat, dry off, then sweat again - which is what they should do as they approach peak fitness.

Non-sweating in working horses is actually cause for great concern, because it means they have a condition known as anhydrosis (the puffs, puff disease, dry coat). Detailed information on anhydrosis is available under Horse welfare: thermoregulation, rugging and grooming.

Exercise

Grazing horses are not particularly energetic, preferring to walk most places, though they may run and play after rain. Occasionally they will go for a gallop for the sheer joy of it, but not often, and certainly not older horses unless something upsets them. A prime reason for paddock horses to become upset is a dog or dogs lurking in the grass somewhere. Bot flies are another. Some horses cannot cope with bot flies at all and will gallop, kicking as they go, trying to shake them.

Fence walking or running is a sign of stress - a desire to get out of the paddock and join or rejoin horses elsewhere. Calling out and walking aimlessly may indicate the onset of colic. Horses that have been confined will exercise vigorously, perhaps blindly and dangerously so, when first given some freedom. The answer is to progressively let them out into bigger areas.

Eating/grazing/drinking

In nature horses spend a greater part of their day grazing, in fact are sporadic grazers, eating little and often and slowly moving about the paddock. Confining a horse totally disrupts this behaviour pattern, so it is little wonder they develop stable vices and other stereotypic behaviours, also inadequate roughage intake associated with stabling is increasingly being implicated as the cause of gastric ulcers.

Water consumption varies enormously depending on activity of individual horses and diurnal temperatures, and should never be restricted except immediately after very hard work - allow sips only. Lapping at or playing with water rather than drinking it may indicate colic. Some horses have the habit of frequently washing out their mouths while eating their feed.

Dung

Horses pass manure ten to twelve times a day in the shape of soft balls. It is normal for stallions and some geldings to dung in the one place. Constipation is particularly associated with impaction colic, plus there are other causes. Excited and upset horses will pass manure frequently and it may be a little loose, but this should not be confused with diarrhoea or scouring, which is much more profuse and watery and is usually accompanied by a messy tail and rear end and other signs of ill health, such as depression.

Normal manure varies in colour depending on what the horse has been eating. Blood, strings of whitish tissue, worms or any quantity of undigested grain require further investigation.

Horses do not normally eat their dung but some confined horses will, perhaps looking for additional vitamin B or undigested feed, or it could be yet another displacement activity for grazing. Apart from being a very direct way of ingesting roundworm eggs, it does not seem to cause much harm. Foals enjoy a feed of their mother’s manure, no doubt as a way of inoculating their own caeca with bacteria so that they can begin digesting cellulose.

Urine

Horses urinate several times a day and will deliberately seek out grassy areas or bedding to minimise splash, though they will urinate on concrete or bare earth if they have to. Mares in season pass small amounts of urine more frequently than normal. Stallions, like dogs, use brief squirts of urine to mark territory.

Normal urine can vary from thick to thin, scant to voluminous in the course of a day, depending on what the horse had been doing, eating or drinking. It simply means the kidneys have been doing their job by regulating the concentration of desired substances in the body while eliminating others. Horses eating lucerne, for instance, will produce a cloudy urine because of the high mineral content. Thickness or thinness of the “water” is not a cardinal indicator of health, as once was thought back in the Dark Ages. The volume and consistency of urine should never be interfered with through the non-veterinary use of diuretics or by restricting water intake, or by uninformed fiddling about with electrolytes, salts, etc. Another time-honoured belief, that a horse that goes down in the back while being mounted is “crook in the kidneys”, also belongs in the Dark Ages. Such horses have some form of musculoskeletal soreness or stiffness, not sore kidneys.

There are, of course, a few specific illnesses in horses that cause a change in urine, but all are accompanied by other more obvious signs that the horse is unwell. Abnormal brown or red colouration or total absence of urination are reasons to get the vet. Unsuccessful attempts to pass urine (water gripes) is one of the signs of colic. Dribbling of urine in geldings may indicate a dirty or infected sheath, though this is rare. Washing out the sheath is not something that should be done routinely, it can cause irritation of sensitive tissues and allow bacteria to enter.

Posture

Horses are very vulnerable lying on the ground and no doubt as a protective mechanism handed down by their wild ancestors, they have the ability to doze for long periods standing up, alternately resting one back leg while locking the others, ready for instant flight if necessary. However, they do spend brief periods resting on their sternums and occasionally will lie right out on their sides, and research indicates they do need to do this for a short time each day, otherwise they develop behavioural problems. This could be yet another trigger to the development of stable vices, because some horses, especially when first introduced to a stable, will not relax sufficiently to lie right out.

A horse standing alone or lying down for long periods of time requires investigation. Holding one foreleg well forward (pointing) is a sign of acute pain in that leg or hoof. Pawing can indicate excitement, anxiety or the beginnings of colic. It is normal for horses to roll after being let go or after hosing or rain, but frequent getting up and down and rolling, or looking at or kicking the flank, are all signs of colic. Head pressing is a sign of severe abdominal pain as is dog sitting, although occasionally horses with Queensland Itch will dog-sit to scratch their tails. Very characteristic abnormal postures are associated with tetanus and laminitis.

Common illnesses and diseases

[Tetanus][Strangles][Colds/coughing][COPD/heaves][Colic][Tie-up/azoturia][Hendra virus]

Normal resting TPRs:

Temperature 38°C

Pulse 30–40 beats per minute

Respiration 10–16 breaths per minute.

Temperature is taken by inserting a moistened, shaken down thermometer into the anus and holding it against the side for one minute. Many horse establishments such as racing stables take temperatures every morning, especially during the winter months when respiratory viruses can be a problem. Special animal thermometers are available that are sturdier than the human variety. Pulse can be felt just inside the angle of the jaw. Respiration rate is best counted by watching the flanks.

Note: the following information was current in the year 2005. It is intended as a broad overview only of common illnesses and diseases in horses and their treatment. Diagnosis and treatment regimes can change in response to new information and technology.

Tetanus

As advertisements for the vaccine say, “Tetanus is a cruel and agonising death for a horse”. And indeed it must be, for the pain has been likened to repeated and violent cramping of every muscle in the body. Anyone who suffers from foot or leg cramps at night will attest to the pain of having just a few muscle fibres in spasm.

The very earliest sign of tetanus may be a suggestion of stiffness and some change in facial expression, particularly about the muzzle and ears, but generally the first sign the owner sees is the third eyelid coming across the eye and food and saliva trailing from the mouth (lockjaw). Then the stiffness becomes very apparent, the tail is elevated and held out from the body, and the horse adopts the typical “sawhorse” stance of tetanus, meaning the long muscles in the legs are so spasmed that the horse stands rigidly in a stretched out position, and then may fall over. Death occurs slowly and painfully by asphyxiation as the respiratory muscles become paralysed. Once the spasms begin, the slightest noise or even touching the horse can trigger even more severe muscle stimulation and cramping.

Treatment is prolonged, expensive and may ultimately prove futile. It involves keeping the horse in a darkened, very quiet environment and using antibiotics, muscle relaxants and other supportive therapy. Never was the cliche “prevention is better than cure” more applicable. Vaccination against tetanus is an absolute must. If a horse of unknown vaccination status is purchased, then the full vaccination program should be instigated.

The cause of tetanus is the organism Clostridium tetani, which is a common soil inhabitant particularly on land where horses and cattle have grazed or been kept intensively. It is an anaerobic bacterium, meaning it lives quite harmlessly in the environment and does not become active until it gets into a deep penetrating wound where there is no oxygen. It then multiplies and releases a powerful toxin that produces the symptoms as described. Standing on a rusty nail is the classic way to get tetanus but, of course, rust has nothing to do with it, it is just that most old nails left lying around outside, whether loose or sticking up through a discarded piece of timber, will be rusty.

Horses are particularly susceptible to tetanus but other animals including humans can get it as well, particularly those who work with horses or are exposed to animal manures, such as gardeners and horticulturists. Tetanus in humans has resulted from something as simple as a rose thorn scratch. In horses any sort of wound is a worry. Shoeing injuries such as nail prick can cause it. Even vaccinated horses should be given an antitoxin injection as an added precaution after gelding or any type of surgery or injury.

Tetanus toxoid and tetanus antitoxin are not the same thing. Tetanus antitoxin provides immediate protection in the event of an injury, lasting up to three weeks. Tetanus toxoid is the vaccine; two injections four to six weeks apart are necessary before sufficient immunity develops. Foals are born with immunity from their mother’s milk and usually are given their first vaccination at three months of age, the second at four months or so, a booster 12 months later then a booster every five years after that. Pregnant mares should be vaccinated a month before foaling to ensure adequate antibodies in their milk. There is an erroneous belief that the tetanus injection “flattens” a horse, in that the horse might not perform up to expectations the day after vaccination. If this does occur it is either coincidence or due to soreness at the injection site, which may last a day or two. Some animals and humans feel more post-vaccination discomfort than others, a fact that should be kept in mind when timetabling vaccination and performance commitments.

Strangles

Strangles is a highly contagious respiratory disease that can spread like wildfire through a group of young horses, though all age groups are susceptible. An affected horse will be off colour - obviously unwell, depressed, not eating, with a pusy discharge from the nose, swellings in the throat region and an elevated temperature.

Recovery from uncomplicated strangles is generally uneventful, the treatment being good nursing, isolation of the horse and attention to hygiene. The throat swellings are due to abscessation of the lymph nodes in the region and can become large enough to obstruct breathing (“strangles”), in which case lancing may be required. Antibiotics are sometimes necessary but are best avoided because they can lead to lodgement of the strangles organism in lymph nodes elsewhere in the body (bastard strangles), which has a far less favourable prognosis.

To prevent spread of the disease, affected horses should be isolated as soon as they start to show symptoms, along with any tack and gear used, feed and water containers etc. Personal hygiene is vitally important because all discharges carry the organism, so hand washing is a must after handling an infected horse. When strangles is prevalent, any new horse being introduced to a group should be isolated for three weeks.

Strangles vaccination does not give complete protection but it does greatly cut down the incidence. It comprises three injections a fortnight to four weeks apart, so that in foals, two of these injections can be made to coincide with the tetanus vaccination program. Annual boosters are required.

Other vaccinations

In Australia at the moment, strangles and tetanus are the only two diseases against which horses are routinely vaccinated.

Colds, coughing, “the virus”

Equine influenza as such is not in Australia at time of writing (Oct 2006), but the risk is ever present, particularly with the increasing number of horses now travelling between continents. It causes symptoms and runs a course much like human flu and a vaccine is available, though like human flu the virus keeps changing, requiring repeat vaccinations at short intervals. However, there are several milder viruses that do produce coughs and colds in horses in Australia. One, equine herpes virus, also causes abortion in mares and a vaccine is available against it.

Some sort of “virus”, as the trainers call it, frequently sweeps through racing stables and other equine establishments in winter, wrecking havoc with performance schedules. Affected horses are unwell, not eating, have an elevated temperature and clear nasal discharge that can become thick and yellow (pusy) due to secondary bacterial invaders. Treatment is rest and good nursing. Antibiotics may be necessary later to treat the secondary invaders, but of course are totally ineffective against the initiating viruses and should not be used in the early stages if at all - there is serious concern worldwide that the overuse and inappropriate use of antibiotics has led to the development of resistant strains of bacteria.

Coughing may be present from the onset of viral respiratory diseases, but certainly can remain as a legacy for some weeks after recovery, meaning affected horses should be given a decent spell rather than just a week or so off while they are getting over the worst of the illness. Persistently coughing horses do not perform well, in fact forcing them to keep working exacerbates the coughing and may lead to serious wind infirmities. There is no doubt that horses spelled until all sign of coughing has ceased return to work much better for it. A belief in the racing world is that some horses never quite regain the form they showed before an attack of “the virus”. This may be coincidence or due to other causes, but another distinct possibility is that such horses were returned to work too soon and while they were still coughing.

Chronic obstructive pulmonary disease (COPD)/heaves

Like its human counterpart, this asthma-like illness in horses is on the increase. Other names for it include inflammatory/hyperactive/chronic airway disease, broken wind and hay sickness. Affected horses have a chronic cough, difficulty expiring air and may develop thickening of the muscle along the flank known as a heave line. They may concentrate so much on trying to breathe that they do not eat sufficiently, and of course they have little exercise tolerance. The exact cause is unknown, but it appears due to airborne dusts, molds and other allergens. It is commonest in stabled horses, though it is not unknown in pastured horses. Decreasing the dust in stables by wetting bedding and feed, particularly hay, can result in immediate improvement. Removing horses from a stabled environment may totally resolve the condition in a matter of days. The treatment therefore is to change the horse’s environment if possible. Failing that, ensure dust-free feed and bedding. Medical treatments include corticosteroids and bronchodilators.

Colic

Colic is the single most common illness in horses and it can kill. The word “colic” means sharp, cramping pain in the digestive tract. Sudden feeding and management changes and even excitement can trigger it, as can migrating redworm larvae shutting off the blood supply to a section of the intestine, although this has decreased as a major cause since the introduction of the avermectin wormicides. When handling young horses it is not a good idea to do too much with them at once in case it causes an attack. But colic is by no means confined to handfed horses kept in stables or yards, or those being handled and ridden, because otherwise healthy horses spelling in a paddock can suddenly get an attack for no identifiable reason.

The signs include uneasiness, walking, calling out; standing alone and not eating; pawing, patchy sweating; lying down, mild rolling; standing stretched out as though to urinate; turning up the top lip; playing with water. Horses with mild signs often recover spontaneously before help arrives, but in case they worsen, a vet should be contacted.

More severe signs include looking at or kicking the flank; frequent getting up and down and rolling, which progresses to violent rolling resulting in abrasions to the head and hips; lying on the back; dog sitting; head pressing. Really severe colic will probably mean a twisted bowel or similar intestinal accident. The only hope these horses have is if veterinary help is extremely prompt.

Most home remedies for colic do not work – if they do, probably the horse was going to recover anyway. There is actually not a lot that can be done while waiting for the vet to arrive. Walking the horse may help distract from the pain, but never should a colic victim be flogged to keep moving. This is cruel, does nothing to halt the progress of the attack, also a horse in severe pain may fall on or otherwise injure a handler.

Only in the case of impaction colic (constipation) is home treatment worth trying. Impaction colic is classically caused by coarse hay and/or bad teeth. Either way, the hay is not broken down properly and ends up blocking the bowel. Very occasionally horses accidentally swallow foreign objects such as socks and baling twine, which can require surgical removal. Ingested sand can also cause obstruction (sand colic). But usually a horse with impaction colic is uncomfortable rather in acute pain, so exhibits the milder signs over a period of time, particularly the stretching out as though to urinate (“water gripes”). The owner can try giving some paraffin oil - two to five litres by mouth. Depending on how much ends up in the horse and how much over the person, there may be a successful outcome some hours later. But a vet with the proper equipment and drugs can save the owner and the horse much time, trouble, pain and mess.

Tie-up/azoturia

Excitable thoroughbred fillies, particularly when they are in season, are prone to this condition, although all performance horses can suffer from it, including placid-natured pleasure horses. Tie-up is a muscular stiffness and reluctance to move which appears during, or more typically, immediately after exercise. If mild, it wears off in an hour or so but may keep recurring. Its exact cause is unknown although an excitable temperament, high grain feeding, overwork and overtraining, electrolyte imbalances or insufficiencies, inability to properly use muscle glycogen, excess protein in the diet, stress, hormonal influences, even a genetic predisposition - one or all of these factors have been implicated. Some horses might tie-up once or twice and never suffer an attack again, but in horses in which it recurs, management becomes critical. Some procedures that help include cutting down the grain as much as possible and substituting with more roughage and/or a fat source, providing a well balanced electrolyte mixture daily in the feed, not overworking or overtraining, not overstabling. Some veterinary drugs appear to assist the condition, including vitamin E and selenium injections, although neither seem to work on their own or if given orally.

A much more serious form of tie-up is azoturia or Monday morning disease - so named because typically it used to occur in draught horses spelled over the weekend without sufficient reduction in grain intake. Come Monday morning and back to work again and the horse would completely seize up and be in great pain. Any horse is prone under similar circumstances and the condition is life threatening, requiring urgent veterinary treatment. Muscle damage is severe and affected horses pass brown urine.

Hendra virus (HeV)

Rare, but carried by flying foxes and can be transmitted to humans from affected horses and cause death. Care should be taken not to come in contact with the body fluids of a horse found sick or dead for unknown reasons, unless or until a vet or a Dept of Primary Industries and Fisheries officer has eliminated Hendra virus as the cause.

Injuries and first aid

[Bleeding][Wound treatment][Proud flesh][Sprains and strains][Other injuries][First-aid kit]

As already mentioned, the horse’s natural reaction to any threatening situation is to run away from it as quickly as possible. So strong is this basic survival instinct that it can override all training. If sufficiently frightened, the horse is blind to obstacles in the way, including fences, agricultural machinery and cattle grids. It is very wrong to purposefully keep horses amongst such hazards “to teach them to look after themselves”.

Bleeding

Cut wounds will bleed and a little bit of blood can look like a lot, so the first thing to do is remain calm. Bleeding that is bright red and spurting (arterial bleeding) requires urgent attention, but even so time should be taken to ring a vet - a horse can lose a fair amount of blood before shock sets in. In the meantime try to staunch the bleeding with pressure from your hand or fingers or a rolled up bandage above where the blood is spurting from. Tourniquets are not recommended because they are difficult to apply and can cause more harm than good.

In an attempt to control any type of bleeding, pressure can be applied directly over the wound with a pad of gauze or cotton wool, or even some item of your clothing in an emergency. Do not wipe, because this will prevent a clot forming. A proper pressure bandage can then be applied, a thick pad of gauze wrapped tightly with wide Elastoplast or similar. If blood does not seep through after a little while, then the bleeding is under control. Watch for swelling above the bandage, an indication that it is too tight and needs reapplying. The horse should be kept confined or tied up until the bleeding is checked.

Wound treatment

Once the bleeding has stopped a vet may decide the wound needs stitching. This should be done as soon as possible otherwise it will not be successful. Tetanus cover is a must, and depending on the type of wound, antibiotics may be considered, though as previously mentioned, they should not be used without good reason.

If the wound is not to be stitched, the treatment regime is to first remove any debris with tweezers/forceps, then spray with normal saline (teaspoon of salt in half litre of water) from a spray bottle or large syringe - use sterile water if possible. Then the wound can be swabbed with a cleansing agent such as weak iodine or chlorhexadine, nothing stronger. Apply non-stick gauze over the wound, then some padding and bandage firmly with Elastoplast or similar and leave for a day or two, but check often for tightness. Rebandage every few days until the wound has filled in, then the bandage can be left off to allow exposure to the sun and air. Fly repellent ointments/sprays can be applied around the outside of the injury. Most importantly, do not use strong disinfectants at any stage of the wound healing process, and definitely not kerosene or Stockholm tar.

The development of proud flesh is a problem in most lower leg injuries. It is an excessive growth of tissue above the surface of the healing wound which can become tumour-like. The surrounding skin cannot grow over it to complete the healing process, and it needs to be reduced or removed, even surgically sometimes. Some older topical treatments include bluestone (copper sulphate), but can also destroy new healthy cells. Your veterinary surgeon will advise. Keeping wounds free of contaminants and infection, bandaging in the early stages and even applying casts reduces the incidence of proud flesh.

Fences are the main source of injury to horses. The typical scenario is a horse lying upside down in a fence, struggling frantically. You rush to assist, and in between dodging flailing limbs and threshing hooves, you wrestle with the wire but your hands are simply not strong enough. Meanwhile the horse is becoming more entangled and the wires are biting deeper. The moral of the story? - always keep a pair of fencing pliers handy where you know you can grab them in a hurry - and be insistent about their immediate return if someone “borrows” them.

Sprains and strains

The main recognizable sprain or strain that occurs in horses is that of the tendons at the back of the fore cannons, known as bowing a tendon or bowed tendons. There will be heat, swelling and pain on palpation, these external signs not necessarily indicative of the extent of the damage, which if severe, will probably mean the end of the horse’s performance career despite the best of treatments and even after twelve months spell.

Cold is the emergency first-aid treatment for strains in the first 48 hours to help reduce the inflammation. The horse can be made to stand with the affected leg in a container of iced water, or various cold packs can be used. Cold in itself can cause pain and tissue damage, so should not be applied at too low a temperature and for too long a period. Later, heat can be applied to stimulate repair, but again, no hotter than you can stand. Ultrasound is used to diagnose the extent of the damage, also to monitor the repair process. A great many treatments have been tried for bowed tendons, including injected anti-inflammatory drugs and various surgical interventions, but with mixed results. There are always mysterious liniments popping up, secret recipes handed down from the ancients, which are claimed to affect miracle cures for bowed tendons, but unfortunately they are quackery and only appear to work if the horse was going to recover anyway or is never again subjected to the intensity of work that produced the original strain.

Other injuries

Fractures to small bones in the leg, such as the sesamoids and carpal (knee) bones, can often be repaired without too much trauma for the horse. Major leg fractures are a different matter, however. They are usually fairly obvious, because the limb will be quite displaced in relation to its normal position. Repair of such fractures is not impossible, but the size and temperament of horses adds to the difficulty. Every situation is different, but always it should be asked whether it would not be kinder in the long run to euthanase the animal.

Not much can be done to treat bruises, swellings, haematomas and contusions, they will run their own course and eventually resolve, although haematomas may require lancing and draining. If abscesses are involved, the application of external heat will help bring them to a head and they can then be lanced if necessary. Foreign bodies may need surgical removal, though they can reside under the skin or in muscle tissue for ages sometimes, without any obvious signs or ill effects; abscessation might force them out at a later date.

First-aid kit

It is not unusual for elaborate first-aid kits to end up gathering dust in the corner of a feedroom cupboard, the reason being that most of the contents are of little real use. What is always reached for first in an emergency are the normal things kept in most households - scissors, bandages, cotton wool or gauze and a bucket of water. And for most average injuries, that is about all you need. It could be improved upon by adding a few other basics, but beware of too much in the way of ointments and drugs - they have a nasty habit of expiring before they can be used. The same applies to even less likely-to-be-used items like hot and cold packs, these can always be replicated with hot water bottles, ice from the fridge, etc.

Important things to have to hand include the vet’s phone number, pliers, cotton wool and a clean bucket, gauze pads and bandages, non-stick dressings, wide Elastoplast, scissors and tweezers (rounded points), a mild cleansing solution, fly repellent ointment.

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