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Equine Emergencies

Signs to Look For and When to Call the Vet

1) Colic and Acute Diarrhea/Colitis


The “C” word can strike fear into even the most experienced horse owner. Certainly, colic signs should always be taken seriously, but more often than not, colic signs can resolve with minimal intervention.

What is “colic” and what does it look like? Colic is a generic term used to describe abdominal discomfort. Colic can be caused by a number of different things including but not limited to mild spasm of the intestines, gas distension of the large colon, an impaction, or a large colon displacement or twist that requires surgical correction. Every horse exhibits different signs, but the most common colic signs include:

  • Not eating
  • Looking at his/her belly
  • Pawing
  • Curling the upper lip
  • Laying down
  • Rolling
  • Restless behavior, getting up and down
  • Decreased manure production

What should I do if I think my horse is colicking? If you think your horse is colicking the first thing to do is to remove all feed and immediately call the office (401-766-6578) to speak with a veterinarian. Also, if possible, take your horse’s temperature and heart rate. (It’s a good idea to do these things when your horse is well so you know what “normal” is.) Make note of all of these things for the veterinarian. 

What should I do if my horse has diarrhea? Diarrhea can vary from soft, semi-formed manure to liquid feces and can be caused by a number of different things ranging from a change in diet to a potentially life-threatening infection. If you notice a change in your horse’s manure consistency, check his/her temperature, appetite, water intake and demeanor (is he/she still acting bright and normal?). If there is a fever, he/she is off feed or overtly uncomfortable, call the office immediately (401-766-6578). Be sure to note if there have been any recent feed changes, travel off the farm or exposure to other horses. If your horse is bright, eating and drinking normally, does not have a fever and the diarrhea is not continuous, then you should continue to monitor him/her closely for the next 12-24 hours. Isolation from other horses is always a good idea in case there is an infectious cause.  If the diarrhea does not resolve or if any of the above mentioned signs develop, call the office for further advice (401-766-6578)

2) Lacerations and Puncture Wounds

If you find a wound or laceration the first things to ask yourself are:

  • Is the horse in immediate distress? (i.e. non-weight bearing lame-literally will not use the limb to move, or seems to be in shock?) 
  • Is there active bleeding? (i.e. a large, actively pumping vessel or bleeding that looks like you just turned on the faucet) 
  • Is the wound near a joint or tendon sheath?

If the horse is in distress...Get the horse to a safe place if necessary and call the office immediately for further advice (401-766-6578).

If there is active bleeding…Apply a clean pressure bandage or simply hold a clean towel or dressing over the wound and apply pressure with your own hands to stop bleeding. If you do not have a clean pressure bandage just use anything available. Do not remove the dressing if it becomes saturated, simply add more layers. Removing the initial dressing may remove any clot that has developed allowing more bleeding. Have a second person call the office (401-766-6578) while you are applying the bandage. If you are alone, control the bleeding first, and then call for assistance. REMEMBER…horses can lose approximately 10% of their blood volume before showing signs of shock. Since an average 1100-lb horse has approximately 11.4 gallons of blood, then he can lose approximately 1.4 gallons before there is serious concern.

**HINT**  Dump 1-1.5 gallons of water on the floor of the barn to see what that volume looks like!

If the wound is near a joint or tendon sheath…Call the office (401-766-6578) immediately for further advice. A wound that enters a joint or tendon sheath can result in life-threatening infection. Prompt, aggressive treatment is necessary.

When you call the vet…Please be able to accurately describe the location, size and depth of the wound (i.e. “It’s approximately 5 inches long on the outside of the cannon bone and I can see the bone.”). Usually, you will be instructed to clean the wound as best as possible and apply a clean bandage until the veterinarian can arrive. Often, it is necessary to sedate the horse to adequately assess the extent of a wound. Small wounds on the body and head generally heal very well on their own, but it is always a good idea to discuss specifics with your veterinarian. If there is not serious bleeding and your horse is not in distress there will be no harm if the wound is not sutured for several hours.

3) Sudden onset, severe lameness

Any rapid onset, severe lameness (i.e. non-weight bearing lameness, “toe-touching” or overtly lame at the walk) should be taken very seriously. It could be caused by a benign hoof abscess, a potentially catastrophic fracture or a myriad of other things in between. Hoof abscesses or sole bruising are the most common cause of sudden onset lameness in one limb. Examine your horse for any wounds, heat or swelling in the affected limb. Check the foot especially well for a penetrating wound or foreign body (i.e. nail in the foot) or for any problems with a shoe. Although it seems counterintuitive, DO NOT remove a foreign body from your horse’s foot. It is extremely helpful for the vet to be able to see it in place and possibly even take an x-ray with the foreign body in place to determine exactly what structures of the foot may be involved. Your vet or the office staff can advise you how to deal with the situation by phone prior to the vet’s arrival If your horse has been shod in the past few days, it may be as easy as a “close” or “hot” nail that needs to be removed. If the horse is willing to walk, get him/her to a safe place. If the horse is resistant or appears to be in distress do not force him/her to move and call the office immediately for further advice. Check your horse’s temperature before calling or giving any medications. The presence of a fever with acute onset lameness is a more significant concern and medications like bute or Banamine can mask a fever. The veterinarian will determine the best course of action with the help of your accurate description of the situation.

4) Esophageal obstruction a.k.a. “Choke”

If the esophagus is blocked by a wad of inadequately chewed feed material you will most often see your horse coughing, stretching out his head and neck, acting very anxious and sometime it looks like he is trying to wretch or vomit (in reality, horses are unable to vomit!). The classic sign of choke is to find your horse with saliva and or food material coming out of one or both nostrils. Horses probably “choke” more often than we actually observe them to and probably resolve many of these situations on their own without our knowledge. If you find your horse “choking” please call the office immediately (401-766-6578). You may be instructed to flush his/her mouth with large volumes of water either by a large dose syringe or by using the hose. This will make the horse cough and gag more, but that is okay. The goal is to relieve the choke as soon as possible. Most often as soon as the obstruction is relieved the horse will want to continue eating almost immediately.

If the veterinarian attends the choke he/she will probably sedate your horse and pass a stomach tube to resolve the obstruction. The most common complication of a long standing “choke” is aspiration pneumonia, which can be extremely serious. Regardless of whether or not your own flushing clears the choke or if the veterinarian needs to come, it is always advisable to monitor your horse’s temperature for one week after the treatment.

A horse that experiences recurrent bouts of “choke” should have an oral exam to evaluate for potential dental problems or have an endoscopic exam to identify potential problems in the throat or esophagus.

5) Ophthalmic emergencies

Eye swelling, tearing, holding eye shut or eyelid lacerations

Eye injuries should ALWAYS be considered an emergency! Seemingly minor problems can rapidly develop into a serious problem if not dealt with properly. If you notice any of the following signs, call the office immediately:

  • Eyelid swelling
  • Excessive tearing or other drainage from the eye
  • Squinting or holding eyelids closed or partially closed
  • Cloudiness or a “blue haze”
  • Redness of any part of the eye
  • Laceration of the eyelid
  • Penetrating wound of the eye

The best way to observe your horse’s eye is with a focal light source like a pen-light or small flashlight. It is very easy to miss something in the eye without a direct light source. If your horse is uncooperative, DO NOT force the issue. Often sedation and blocking the eyelids is necessary for full evaluation and it is possible to cause further injury with aggressive restraint.

Common eye problems include blunt trauma, corneal abrasions or ulcers and uveitis (a.k.a. “moon blindness”). Accurate diagnosis is imperative to instituting proper treatment. The treatment for uveitis (i.e. topical steroid medication) is absolutely NOT appropriate in the presence of a corneal ulcer. Therefore NEVER put an ointment that contains a steroid in your horse’s eye without veterinarian’s approval. As long as you can be sure that the cornea is intact, it is OK to rinse the eye with saline or apply an antibiotic-only ointment prior to the vet’s exam. A cold compress is helpful if there is significant swelling. Often, the veterinarian will recommend a dose of bute or Banamine for anti-inflammatory and pain relieving effects prior to arriving at the farm. See Equine Recurrent Uveitis for more info.

6) Fever

If your horse seems depressed, has lost his appetite or is just not acting himself, one of the first things we recommend is to take his temperature. It is good to know your horse’s average temperature when he is feeling normal, but essentially the normal temperature for a horse should be 98.5-100.5F. If you are not comfortable taking your horse’s temperature ask your veterinarian to show you how to do so safely at your next appointment. Being able to report your horse’s temperature to the vet or other staff members over the phone is extremely helpful in many situations. These vague signs of illness can be early evidence of many different possible infectious diseases, so your veterinarian will probably ask if your horse has been travelling off the farm or out of state or if you have any other horses that have been sick recently. Fever is one of the most common signs of a viral respiratory infection such as flu or rhino. It is also fairly common to see tick-related fevers in our geographic area. If fever is accompanied by colic signs, diarrhea or neurologic signs your horse should be examined that day. If your horse is simply lethargic and not quite himself, your veterinarian may prescribe symptomatic treatment by phone and close monitoring for 24-48 hours.

7) Increased respiratory effort at rest

Flared nostrils, increased respiratory rate and excessive movement of the flanks during breathing are common signs of respiratory difficulty in horses. If your horse has been galloping around the paddock or you’ve just finished a strenuous ride, then give your horse 10 minutes or so to cool down and re-evaluate his breathing. However, if you find your horse in such as state while he or she is simply standing in the paddock or stall, then the situation is much more serious. Move your horse to a well ventilated area or put him in front of a fan (as long as it does not blow too much dust around). Check his temperature and listen for any other respiratory noises such as wheezing or gurgling in the throat. Such signs could be indicative of an allergic reaction, pneumonia, or something more chronic such as “heaves” (see “Small Airway Inflammatory Disease”. Count the number of respirations in one minute (one breath = inspiration and expiration), (and don’t forget to take his temperature!) so you can report that to the vet or office staff. Call the office (401-766-6578) immediately for further advice.

8) Laminitis

Laminitis or “founder” is an inflammatory condition of the hoof that commonly presents as lameness in both front feet or sometimes all four feet (see “laminitis” subpage for more info). Your horse may:

  • be reluctant to walk, walk very stiffly or like he/she is “on eggshells”,
  • lie down more often than usual or
  • constantly shift weight from one foot to another
  • rock back or “sit” on his/her hindquarters, or appear that his hind end is painful

These signs may be acute in onset or more slow and insidious to develop. There are many possible causes and treatments of laminitis that can only be determined by a full physical evaluation, thorough history and bloodwork. If you think your horse is exhibiting any of these signs, call the office immediately (401-766-6578). Laminitis should be treated as urgently as possible. Take the following steps until your horse is examined by a veterinarian:

  • Confine him/her to a stall with deep bedding.
  • Stop feeding grain or treats of any kind, including apples and carrots. Do not allow access to grass.
  • Feed only grass hay. If possible soak the hay for 30 minutes in warm water or 60 minutes in cold water prior to feeding.
  • Do not give any medications unless directed by the veterinarian.

Laminitis is a potentially life-threatening situation that should be taken seriously from the outset. Prompt veterinary attention and cooperation with your farrier is essential to a positive outcome.

9) Allergic Reactions

Just like people, horses can have allergic reactions to many things in their environment including but not limited to dusts and molds in the barn, feed ingredients, insect sprays or insect stings/bites. Horses can also have allergic reactions to any kind of medication or supplement. Allergic reactions can vary in severity from mild hives to full blown anaphylactic shock. It is not uncommon for geldings to develop a swollen sheath.

If you notice that your horse has hives on his body, but does not seem bothered by them (i.e. not itchy or uncomfortable) and the do not involve the head or throatlatch area, this is most likely a very mild reaction. Try to think of any new things in your horse’s environment that may have brought on the reaction. Your veterinarian may prescribe treatment over the phone. Most hives resolve on their own, but if your horse is itchy or uncomfortable, symptomatic treatment can be prescribed. If your horse has any swelling of the eyelids, muzzle or head or if there is noisy or difficulty breathing, this is much more serious and you should call the office immediately (401-766-6578).

10) Neurologic signs

Some examples of classic neurologic signs in the horse are:

  • Stumbling
  • Loss of balance
  • Incoordination
  • Unable to chew or swallow
  • Droopy lip, eyelid or ear
  • Severe depression, not responsive to normal stimulation
  • Compulsive circling, headpressing
  • Acute onset blindness
  • /- Fever

If you notice any of these signs or any other drastic changes in behavior call the office right away (401-766-6578). Most neurologic diseases are not transmissible from horses to humans. However, we must always consider Rabies, which is transmissible to humans and most often fatal, as a top differential diagnosis. When a horse exhibits neurologic signs you should minimize contact with the affected horse, always wear disposable gloves and quarantine from other horses until a definitive diagnosis is reached. Early intervention is important for collecting adequate samples for diagnosis as well as starting appropriate treatment. Neurologic horses are often a danger to themselves and their caretakers. Be extremely careful when working around a horse who is unbalance and uncoordinated. In some cases they can be managed at home, however referral to a specialty hospital for intensive supportive care is often recommended early because transportation can be difficult if not impossible as signs progress. Common causes of neurologic disease in horses are EEE/WEE, WNV, Neurologic herpesvirus (EHV-1), Equine Protozoal Myelitis, trauma to the head or spinal cord or Wobbler’s syndrome in young horses. Many of these diseases have very similar clinical signs and can only be definitively diagnosed with special tests. The neurologic form of the herpesvirus (EHV-1) is the same virus that causes the common respiratory infection known as “Rhino” but the vaccines are not protective for the neurologic variant. This is a big reason why is it so important to quarantine new horses on arrival to your farm. It is impossible to know which horses will develop respiratory illness and which infected horses will develop neurologic disease.