Draft Horse Hoof Care

Gentle Giants Draft Rescue is a 300-plus acre facility in Mt. Airy, Md., that rehabilitates and re-homes draft horses. They are currently home to more than 150 drafts. Executive Director and founder Christine Hajek says the most common problem seen in draft breeds is hoof neglect.

One misconception about drafts is that due to their size, they wear down their feet on their own. This is not true; as with other horse breeds, drafts require regular hoof trims. However, given their size, “Expect to pay more for the farrier,” she says.

Drafts can have a reputation for being stubborn about picking up and holding up their feet. This is in large part due to their background. Many drafts come from Amish and Mennonite farms, says Hajek. There, feet are trimmed in wooden restraints called stocks, so many drafts haven’t been taught to stand while having their feet held by a person.

However, this can be overcome by patient, consistent training. Staff at Gentle Giants use clicker training to accustom drafts to having their feet handled.

Skin Beneath the Feathers

Along with the beautiful feathers some draft breeds have comes extra work in keeping the skin underneath healthy. Long hair on the lower legs can create an environment that is ideal for bacteria and parasite proliferation. Many drafts that arrive at Gentle Giants have a skin condition called scratches, mite infestations, or both, says Hajek.

Scratches, also called mud fever, is a dermatitis of the pastern and heel. Overgrowth of microorganisms on the skin’s surface results in localized inflammation, causing these areas to appear greasy. The skin will be red, thickened, and scabby, and may be sensitive to touch.

Mange mites, specifically chorioptic mites (Chorioptes species), commonly take up residence along a draft horse’s lower legs. Infestations result in intense itching that can cause a horse to stomp and yank his foot away when held. Some owners may misinterpret this as a behavioral issue; however, when the underlying condition is treated, this issue resolves.

Managing these skin conditions involves a delicate balance between moisture and dryness. Yes, those beautiful feathers will likely have to be shaved off (but they grow back!) in order to expose the mites and dry out any bacteria present. Initially, regular leg bathing will help fight these infections, followed by thorough drying.

Keeping the horse’s legs clean and dry then is key in keeping these skin issues at bay. Work with your veterinarian to determine the best shampoo for your draft and any other medications needed, such as an antiparasitic or antibiotic for severe infections.

Belgians, specifically, are at risk for a different type of condition in the legs called chronic progressive lymphedema, or CPL. Belgians with this condition develop swelling in their lower legs, which can lead to thickened skin and lesions. Not much is currently understood about this disease, but it is progressive and there is no treatment. Anyone interested in a Belgian should carefully inquire about the horse’s background and lineage, if known.

Feeding Fat

Most adult draft horses in little to light work and general good health are relatively easy keepers, meaning they can maintain a good body condition on quality forage, such as hay or pasture. In fact, if fed according to the guidelines on many feed bags based on body weight, owners may accidentally over-feed their draft, leading to obesity and associated metabolic issues, such as insulin resistance and laminitis.

Inappropriate diet is a common issue in many of the draft rescues rehabilitated at Gentle Giants.

“They were fed based on light breed horse guidelines,” Hajek explains.

When a draft horse does require a higher level of nutrition than what simple forage can provide, they may need more fat as opposed to the high starch seen in grain mixes.

“A lot of people don’t realize drafts may need a higher-fat diet,” says Hajek.

If your draft horse requires a high-calorie concentrate in addition to good quality forage, work with your veterinarian or an equine nutritionist to ensure he is getting a balanced diet appropriate for his metabolic needs, age, and workload.

Possible PSSM

One serious nutrition issue common in draft horses is a metabolic disorder called equine polysaccharide storage myopathy (PSSM or EPSM). Horses with PSSM are unable to properly metabolize and store carbohydrates, which becomes an issue when a horse is fed a high-carbohydrate diet (such as grain) and then exercised.

Mild signs of PSSM include muscle weakness, twitches, and gait abnormalities, but severity of the condition varies, and can escalate to colic-like signs, refusal to move, severe muscle cramping, and kidney issues due to muscle cell death.

PSSM is diagnosed via bloodwork, muscle biopsy, and, more recently, genetic testing. While there is no cure, PSSM can be managed successfully by switching to a diet high in fat instead of carbohydrates and a consistent exercise regimen. Careful management should be overseen by a veterinarian.

Neurologic Conditions

Draft horses are also more prone to some neuromuscular disorders than can look like PSSM.

Shivers and stringhalt are two neurologic conditions that typically result in an abnormal gait, most notably in the hind legs. These conditions aren’t lethal, but they can make a horse reluctant to lift his feet for a farrier.

Some horses with shivers or stringhalt can still be ridden or driven. Severity and management of these conditions varies by horse.

Eye Health

Some breeds of drafts with wide white markings on their faces, such as Belgians, Clydesdales and Haflingers, are predisposed to a locally invasive type of cancer in the eye called squamous cell carcinoma (SCC).

SCC can range in severity. A small lesion on the third eyelid can be relatively straightforward to remove. But in extreme cases, removal of the eye may be necessary, or possibly euthanasia if the underlying bone is involved.

Owners of Belgians and any breed with excessive white on the face should regularly monitor their horse’s eyes for any unusual coloration, irregularity, or signs of irritation. If something is abnormal, have your veterinarian conduct a closer examination. The earlier SCC is diagnosed, the better the prognosis.

Heat & Humidity

Due to their larger frames and associated musculature, draft horses can struggle to dissipate heat, which can lead to heat stress. When you add to this the challenges of keeping heavily feathered legs dry in humidity, it can be difficult to keep a draft breed comfortable in the summer.

For this reason, if you live in the southeastern United States, Hajek cautions against getting a draft. At the very least, she advises, avoid getting a draft horse from a northern climate and transporting him south, where he isn’t acclimated to the heat and humidity.

Key Takeaway

At the end of the day, a draft horse is still a horse, with the same training needs, personality quirks, and general care requirements.

“They train the same way [as a lighter breed],” says Hajek. “People tend to treat them like they’re different. The worst stereotype of drafts is that they’re dull and slow. That’s not the case at all.”

With proper care and consistent training, just like their smaller counterparts, draft horses make excellent mounts and companions. There’s just a bit more of them to love.

This article about draft horse health and care appeared in the November/December 2024 issue of Horse Illustrated magazine. Click here to subscribe!

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Here’s what to watch for to catch this cancer early and what to do if your horse has it.

What is Squamous Cell Carcinoma?

The name itself—squamous cell carcinoma—can sound confusing and even intimidating, so let’s start with the basics.

What is a squamous cell, anyway? These are normal cells in the body. They are primarily found in the skin, particularly at mucocutaneous borders. These borders are where dry skin intersects with a mucous membrane, such as the line between skin and the lips, nostrils, anus, genitals, and eyelids.

Understanding the normal location of this cell type then provides context for where SCC is commonly found: in or around the eye, the genitalia and anus, and lips/nose.

The term “carcinoma” refers to a type of cancer that starts within skin cells or the lining of internal organs. In addition to SCC, there are a few other types of carcinomas, such as basal cell carcinoma, which is rare in horses but common in humans.

SCC development is related to sun and subsequent UV exposure. It’s no surprise, then, that SCC is common in horses who can spend most of their life outside, accumulating UV skin damage.

However, horses with lots of non-pigmented (pink) skin on their faces, such as horses with wide blazes or bald faces where eyes and muzzles have pink skin, have a higher rate of SCC.

Breeds that tend to have extended white on their faces such as Clydesdales, Belgians, Appaloosas, and some Paints have a higher risk of developing SCC than other breeds. Lighter-colored horses, such as palominos and cremellos, are also at higher risk for SCC.

What To Look For

So what does SCC look like in a horse? Typically, this tumor initially appears as a small, raised lump or nodule under the skin. SCC within the eye may give the cornea a flat or roughened opaque appearance.

Early SCC can be easily missed due to its small size and sometimes hidden location. As the tumor grows, it can erupt, become ulcerated, and start to impinge on neighboring tissues. SCC of the eyelid can be particularly problematic. As the tumor enlarges, it may start to pull at the lid. This can either rub the cornea or pull outward, resulting in the inability of the horse to fully close his eye.

Because it is easier to remove when it is small, the best course of action with SCC is early detection. When you groom your horse, keep an eye out for odd bumps or lesions. Owners of white-faced horses should be especially observant of their horse’s facial features on a regular basis, including a close look at the eye itself.

SCC on the eyelid typically starts off looking like a small scab, while SCC at the corner of the eye or within the third eyelid is typically a raised, pink mass. Horses with ocular SCC may also have eye discharge.

Regular checks should also include the genitals and underneath your horse’s tail. For male horses, make the most of sheath cleaning: this is the perfect time for an inspection.

SCC Treatment Options for Horses

What should you do if you find something suspicious on your horse? The first step is to have your vet out. Although you may have a very high suspicion of SCC based on the lump’s location or your horse’s history or pigment pattern, you can’t diagnose SCC based on visual examination alone.

Sometimes SCC can be confused with scar tissue, other types of tumors (such as papillomas or sarcoids), or even a skin allergy. A biopsy, or tissue sample, is the best way to definitively diagnose this tumor.

Once your vet confirms the diagnosis, it’s time to talk treatment options. As with most tumors, its location, size, and involvement of neighboring tissues heavily influence treatment options and prognosis.

Surgical removal is a common choice, but location of the tumor dictates treatment success rate. For example, SCC at the corner of the eyelid can be very challenging to reconstruct after removal of the diseased tissue. Other times, SCC may grow into deeper structures around the eye. In these circumstances, total enucleation may be the best option for the horse’s future.

Adjunct treatments along with surgical removal are the most common choices of treatment and management of SCC. These adjunct therapies occur at the time of surgery and may need to be repeated.

Cryotherapy (freezing) is a common adjunct therapy that can be done on site at your barn. Your vet will apply liquid nitrogen, which is -320° Fahrenheit, to the edges where the tumor was removed. This helps destroy any leftover cancer cells.

Some radiation and chemotherapy options are also available. Depending on the regimen, they may require a visit or two to a referral hospital for application.

Photodynamic dye therapy (PDT) is a relatively newer option for SCC treatment. This therapy involves injecting a dye containing photosensitive compounds into the affected area.

This dye is taken up selectively by the cancer cells. Next, a focused beam of light using a specific wavelength is directed at the diseased tissue. The light reacts with the dye, creating a skin reaction that kills the tissue.

Because only the cancer cells take up the dye, other nearby healthy tissue is relatively unaffected, providing a much more focused treatment compared to radiation and chemotherapy.

Prognosis after surgery and adjunct therapy for SCC depends heavily on the size and location of the tumor and how locally invasive it is. Horse owners should note, too, that once a horse has had SCC, he is at higher risk of developing it again.

Prevention Tips

Along with regular close monitoring of your horse’s skin, reducing your horse’s exposure to UV radiation is another tool for SCC prevention. Regularly applying sunblock to your horse’s non-pigmented facial features can help, as can putting a fly mask on your horse in the summer months to shade his eyes.

Interestingly, researchers at the University of California-Davis School of Veterinary Medicine have identified an equine gene variant that is a risk factor for ocular SCC in certain breeds, including Haflingers, Belgians, Rocky Mountain Horses, Connemaras, Holsteiners, and Belgian Warmbloods.

Horse owners can send plucked hairs from the mane that include the roots to the UC Davis Veterinary Genetics Laboratory to identify whether their horses are at higher genetic risk of developing ocular SCC.

Treatment options continue to develop for this equine cancer, and horse owners have more options than they did just a decade ago. While this is encouraging, the best course of action is still vigilance to catch this tumor early for a full recovery.

Key Takeaway

As with any cancer, squamous cell carcinoma is intimidating. But remember—prevention and early detection are your best weapons.

This article about squamous cell carcinoma in horses appeared in the June 2024 issue of Horse Illustrated magazine. Click here to subscribe!

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How a Hoof Abscess Starts

A hoof abscess begins when environmental bacteria access the horse’s hoof capsule.

The most common way that bacteria does this relates to fluctuating moisture in the environment. When the ground is dry, hooves become hard and somewhat brittle. This causes small fissures (cracks) to develop in the sole. When the ground becomes wet, the hoof acts like a sponge and softens, further opening these small cracks. Bacteria in the environment can take advantage of these small breaches in the otherwise impenetrable hoof wall and invade the tissue inside.

As they invade the warm, healthy inner hoof tissue, the bacteria multiply rapidly. The horse’s immune system comes to the rescue, but during the battle between good and evil (the horse’s white blood cells versus bacteria), casualties occur as white blood cells die and cause pus to accumulate.

This pus exerts pressure in the confined and inflexible hoof wall. If you’ve ever had swelling under a nail, you know the pain this causes. Now imagine the pain a horse might deal with as they stand on an abscessed hoof.

Hoof abscesses can, however, occur at any time of year, so the weather is not the only cause. Sole bruises caused by hard ground and penetrating hoof wounds also invite bacteria to invade the hoof. One type of penetrating wound is a close nail, or one that is driven too close to the sensitive laminae (internal supporting structures between the outer hoof wall and the coffin bone). This creates a convenient path for bacteria to enter on the nail, which can lead to infection.

Poor hoof conformation can also be a contributing factor to the development of a hoof abscess. Some thin-soled horses are naturally predisposed to frequent abscesses. This is likely due to their increased risk of sole bruising and the shorter distance bacteria have to travel between the outside and inside of the hoof.

What You Might See

While you might expect to see a severely lame horse, keep in mind that not all abscesses are created equal. Observable signs depend on how large the abscess is, where in the hoof it is, and how long it’s been developing. If caught early, some horses are only slightly lame. Others may have some leg swelling up to the fetlock, while others may have a bounding digital pulse and a hoof that’s hot to the touch.

Horse owners that have seen abscesses before may feel comfortable identifying one and starting treatment on their own. If this is your first time with a hoof abscess, or you feel there may be other complicating issues, it’s a good idea to call your veterinarian for help.

If lameness is accompanied by a visible injury, such as a penetrating wound, or is part of a chronic hoof disease, radiographs may be necessary to assess any internal hoof damage.

Treating Hoof Abscesses

For uncomplicated hoof abscesses, treatment starts with releasing the pressure and granting the horse instant pain relief. This is done by draining the abscess. If your horse is an extremely painful condition, sometimes a local nerve block and/or sedation may be required for safe treatment of the wound. For this, you’ll need a veterinarian.

Using a hoof knife, your veterinarian will clean and trim back the horse’s sole, which gives the ability to see any dark spots or tracts. These are usually indicative of where the abscess is. Hoof testers can also help narrow the location of the abscess.

The hoof knife is then used to carefully pare deeper until the pocket of infection is hit. Once opened, the abscess drains, although it’s usually anticlimactic. A draining abscess may only be a tiny wet spot or area of dark fluid that trickles down. However, the horse may visibly show his relief.

If left alone, an abscess will eventually rupture on its own. However, there are a few downsides to this wait-and-see approach. First, it prolongs pain for the horse. Secondly, if an abscess is not treated, it tends to move up to the coronary band or out the heel bulbs.

Manually draining the abscess with the hoof knife through the sole allows gravity to help with the process; a coronary band abscess (also called a “gravel”) may prematurely close, leaving some infection behind to cause a problem later.

Once drained, your horse now has an open wound in his sole. While it’s important to protect this wound from further infection, it’s also a handy window to allow for continual drainage. Therefore, packing the sole with a poultice and wrapping the hoof with a bandage for protection can ensure the abscess completely drains.

Depending on depth and location, sometimes an abscess can’t be located or easily drained. In such cases, repeated soaking of the hoof in an Epsom salt bath will help soften the hoof and draw the infection closer to the sole for easier drainage. A shallow feed tub makes for an ideal foot soak. Alternatively, there are special soaking boots made specifically for horses, or some owners make “soak bags” out of sturdy plastic IV bags.

Stalling a horse for 24 hours with a soak bag is usually enough time to soften the hoof so that on recheck with a hoof knife, the abscess is more easily drained. Occasionally, you might get lucky and the abscess drains itself overnight. This is often noticeable the next day since the horse is much more comfortable.

How to Prevent Abscesses

The natural expansion and contraction of a horse’s feet in response to external moisture are impossible to control, so to an extent, hoof abscesses could be considered impossible to prevent. However, a few rules of thumb can help decrease their likelihood.

Regular year-round hoof maintenance is the best place to start. Balanced hooves keep weight distributed evenly, and trimmed feet are less likely to crack and allow bacteria inside.

Providing your horse with the best of nutrition also helps keep hooves healthy, as does daily hoof cleaning and maintaining excellent stall and paddock hygiene. Removing soiled bedding and fixing chronically wet or boggy areas help hooves stay clean and dry so you’ll spend less time obsessing over abscesses and more time enjoying your horse.

Using a Poultice Supplies Needed: Iodine, soft and disposable packing material (gauze pads, diaper, etc.), ichthammol or other poultice material, Vetrap, duct tape, scissors Steps: 1. First, thoroughly clean the sole with iodine. 2. Any soft, disposable and clean material will work as packing. One common method is to use a stack of 4×4 medical gauze pads. Other options include a disposable diaper or sanitary pad. 3. Slather a glob of ichthammol or other common poultice on the packing material and place it directly over the draining abscess. 4. Use a stretchy bandage like Vetrap around the entire hoof to keep the gauze or diaper in place. Be careful not to tighten it above the hoof hairline where it could restrict circulation. 5. Next, slightly overlap strips of duct tape to make a square just larger than the bottom of the hoof. reinforce with strips laid at 90 degrees to these. Stick the square to the bottom of the hoof and wrap the edges around to adhere to the Vetrap on the hoof wall. Wind tape once or twice around the top of the square where it meets the hoof wall to hold in place. 6. Keep your horse stalled or in a small, dry paddock for a few days. 7. Change the wrap once a day, replacing the poultice and using new tape. Scissors makes cutting into the bandage for removal much easier than peeling it apart with your fingers. As a general rule, horse’s hoof abscesses tend to fully drain within three days or so, and often sooner. However, anticipate the entire healing time to take seven to 10 days, but this will depend on the depth of the abscess and the size of the drainage hole.

Key Takeaway

In this article, you’ll find common causes of hoof abscesses, methods for treating them, and tips on how to prevent abscesses, all of which are essential for hoof care and maintaining a clean environment.

This article on treating a horse’s hoof abscess appeared in the January 2020 issue of Horse Illustrated magazine. Click here to subscribe!

The post How to Manage and Treat a Hoof Abscess appeared first on Horse Illustrated Magazine.

Visualize the Triangle

Although horses are quite muscular, there are limits to the locations where we can safely give intramuscular injections. These injections should be administered deep into a large muscle to ensure that the entire contents of the syringe are adequately absorbed and metabolized.

In horses, one of the most common and preferred sites for IM injections is the side of the neck. Chances are you’ve probably seen your veterinarian use this site. But the neck of a horse is a wide, flat structure—how do you know exactly where to stick the needle?

An easy way to know for sure is to find the “triangle” formed by three structures in the neck. The nuchal ligament forms the first border; this is the thick ligament that runs from the poll to the withers and holds up the mane. The injection should be below the nuchal ligament.

The second border is made up of the cervical vertebrae (neck bones). This is a little trickier; many people actually mistake the nuchal ligament for the horse’s spine. However, the spinal column in the neck drops almost straight down from the poll and curves at the bottom to meet the thoracic vertebrae at the point of the shoulder.

Finally, the injection should be in front of the shoulder blade, which you can feel if not see. Within these three borders you’ll have a space roughly the size of your open hand. This is where you should give the injection.

The neck is the most frequently used site for IM injections due to its accessibility, but there are other locations you can consider. The pectoral muscles in the chest are another convenient location. If used, make sure to stand to the side of the horse, not directly in front, and aim for the center of one of the pecs.

The hamstrings are also an option, but serious consideration to your safety must be made: As you might imagine, injections near the hindquarters put you in danger of being kicked. Rarely are the gluteal muscles used. Although the tops of the haunches are a nice large muscle mass, if infection occurs and an abscess needs to be lanced, this area provides poor drainage.

The Technique for an Intramuscular Injection

When giving any medication to your horse, first start by confirming the following three things:

◆ Is it the correct drug?
◆ Is it the correct dose?
◆ Is it the correct delivery method?

Once you’ve confirmed all three, pick your injection location. Make sure the horse’s skin is dry and free of dirt and grime. Next, with your horse wearing a halter, have a handler hold the lead rope and stand on the same side as you.

Always use a new needle for every injection. Never share needles between horses to prevent the spread of disease and dulling of the needle.

Deliberately insert the needle perpendicular to the skin and all the way to the hub. Do this in a firm and quick movement. Some people like to desensitize the horse first with a pinch of the skin or a few taps of your hand prior to the stick. Using these tricks will depend on the horse and the location you choose.

Once the needle is fully inserted, pull back on the plunger slightly; this is a good habit to ensure you’re not in a small blood vessel. If there is blood in the hub, pull out the needle and slightly redirect. Once you confirm there is no blood, depress the plunger steadily until empty, then pull the syringe out. There should be minimal if any blood on the skin.

Once you’ve given the injection, be sure to safely dispose of the used needle. Although you can purchase a specific container for sharps disposal at a pharmacy (like those red tubs you see at hospitals), any hard plastic tub with a secure lid will do. Laundry detergent bottles or coffee canisters with fitted lids work very well. Mark the container with a label, like “Sharps,” so that everyone is aware of its contents.

Possible Complications

Troubleshooting injection site reactions and infections are the two biggest risks when giving an IM injection. Reactions tend to occur despite good aseptic technique; this is the immune system’s reaction to the drug and can range from a small lump and temporary muscle soreness to hives or anaphylactic shock.

If your horse is known to be sensitive to certain types of medications, talk with your veterinarian before giving him an IM injection on your own.

Some medications are known to be more irritating to muscle than others; for this reason, always contact your veterinarian before giving a drug IM that you don’t have experience giving.

NOTE: Not all drugs can be given in the muscle; phenylbutazone (bute) is a prime example. Injectable bute should only be given intravenously (IV) by a person experienced in giving IV injections. Bute should never be given IM, as it causes severe tissue damage.

An infection, usually evidenced by an abscess at the injection site, can be avoided by using clean, sterile needles and syringes and injecting with the correct technique through clean, dry skin.

If an infection does occur, the site will swell and become hot and painful to the touch. The horse may have a fever and go off feed. Abscess formation requires draining for complete healing and a veterinarian should be called to do this. Antibiotics and pain medications are typically prescribed.

One rare but serious complication from IM injections is the risk of Clostridial myositis. This is a deadly bacterial infection from Clostridium bacteria. These bacteria and their spores are ubiquitous in the environment and are also in the horse’s intestinal tract.

Sometimes a deep intramuscular injection can create the perfect anaerobic environment that triggers these spores to activate, resulting in a severe systemic infection in the horse that can quickly progress to septic shock. Being knowledgeable of the drug you are administering is helpful in preventing these cases. When in doubt or unsure, always check with your veterinarian first.

When To Administer an Intramuscular Injection

Although some of the risks involved with giving a horse an intramuscular injection are serious, be assured that some common medications can be safely administered in the muscle of horses. These include certain antibiotics, such as penicillin and gentamicin, as well as sedatives and tranquilizers like xylazine and acepromazine, and vaccines.

Although the non-steroidal anti-inflammatory drug (NSAID) flunixin meglumine, also known as Banamine, is approved for IM injection in horses, it has been associated with Clostridial myositis. For this reason, Banamine is safer when given IV or orally.

For any medication you have never given IM or are unsure of, always call your veterinarian prior to administration.

IM injections are a useful basic medical skill to have as a horse owner. With knowledge, practice, and someone to help hold your horse, you can confidently add this to your horsemanship toolkit.

This article about giving a horse an intramuscular injection appeared in the March 2023 issue of Horse Illustrated magazine. Click here to subscribe!

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In either instance, and in many others like them, seeking a second veterinary opinion can be a wise choice. Let’s explore what it means for you, your horse, and the relationship with your veterinarian.

What is a Second Opinion, Anyway?

A second opinion is when a second, independent veterinarian examines your horse after your primary vet has done so. This can be done at any point during a case work-up, from your horse’s initial diagnosis to chronic treatment plan, and is generally requested by the client.

A second opinion is slightly different than a referral, which is the term used when a general practitioner sends a case to a specialist clinic for further diagnostics, surgery, or management. Referrals are almost always requested by the primary veterinarian.

Horse owners seek second opinions for a wide range of reasons, but the most common include situations such as:

◆ When the prognosis for your horse is poor;
◆ When treatment is expensive and/or possibly long-term and prognosis is uncertain;
◆ When management is complicated/difficult;
◆ When end-of-life decisions are being considered;
◆ When you’re frustrated by a lengthy recovery time or a non-responsive recovery;
◆ When you’re confused or unsure of what’s going on with your horse or feel like you’re not being listened to.

Why Does It Feel Weird, Then?

For some, seeking a second opinion may feel uncomfortable, like sneaking around behind your vet’s back, especially if you’ve had a long, solid relationship with a specific individual. Keep in mind that vets, as medical professionals, acknowledge that second opinions are warranted and are part of the practice of veterinary medicine.

In fact, a second opinion could technically be considered part of a thorough work-up. We actually do it ourselves sometimes, calling colleagues or specialists when we feel the need for another point of view or a pair of fresh eyes. It’s also helpful in cases where we seek a more creative or innovative option, especially with complicated or chronic cases or when more traditional treatment regimens aren’t working.

If you’re experiencing anxiety over obtaining a second opinion, go through the exercise of asking yourself why you’re doing this in the first place. Identifying why you’re dissatisfied with your current vet’s plan can be a very valuable piece of information.

These can be hard questions to ask yourself, but be honest and try not to judge yourself on your responses. These answers may help you set expectations for the second opinion and help you clearly communicate what you’re looking for. Don’t let your angst or avoidance of a potentially awkward conversation prevent you from seeking the best care for your horse.

How Do You Get a Second Opinion on Your Horse’s Diagnosis?

As with most things in life, clear communication is the best approach when seeking a second opinion. You don’t have to justify yourself to your current vet, but letting her know your plan is the polite, direct, professional, and potentially mutually beneficial thing to do. If the second opinion unveils a novel treatment or other consideration, your current vet may be glad to know about it for the future.

If you use a multi-vet practice, a second opinion can be as simple as asking to see another vet. However, depending on where you live, sometimes finding another vet that serves your area can be a challenge.

Trailering to a vet school or larger clinic may not be an option for those with limited resources or who live in remote areas. Talking with other horse owners in the area may help you find another vet. Depending on the situation, you could also consider asking your current vet for a recommendation.

Once you’ve established contact with the vet who will give the second opinion, make sure she knows that’s what is happening. If it’s a complex or acute case and there are medical records, make sure the second vet has access to them, preferably before the visit. A complete history of the case is critical to obtaining a useful second opinion.

Some clinics have procedures regarding second opinions and may require that medical records be sent a specified number of days prior to the farm call. For this reason, when scheduling the second opinion, make sure the clinic knows about it ahead of time.

What Happens Next for Your Horse’s Diagnosis?

One of two options usually occurs after a second opinion: Either the second vet agrees and therefore confirms the first vet’s diagnosis and plan for your horse, or she offers other suggestions.

Of course, there are numerous shades of gray in between, and now it’s up to you to decide what to do. Here’s where those questions you asked yourself before come in handy: What were you looking for? Were the questions or concerns you had addressed? How do you feel about the situation now?

One scenario to beware of, however, is the one of endless opinions. If you find yourself jumping from vet to vet to vet trying to get an answer that you’re satisfied with, tap the brakes. Some further self-questioning and possible soul-searching is needed at this point.

Is your horse simply no longer ridable and you’re having trouble accepting that? Can you not afford the care offered? Is the care needed beyond your ability or comfort level? Again, try not to judge yourself. Sometimes roping in an independent third party, even a non-horse person, can help sort things out or identify a red flag where you’re unable to.

What Isn’t a Second Opinion?

Do you and your horse a favor; if you decide to seek a true second medical opinion, don’t settle for a shortcut. The main one to avoid is the internet. Social media is full of opinions, that’s for sure, but even well-intentioned individuals online haven’t physically examined your horse. This is a key component of a vet/client/patient relationship.

For this reason, also beware of online ads that read something like this: “Ask a vet online NOW! Free second opinions!”

Although some telemedicine by licensed veterinarians is legal and of high quality, its use depends on the situation and the state. Ultimately, you’ll end up saving time and maybe even money just going straight to a second veterinarian in your area.

In most instances, a vet and horse owner can amicably navigate a second opinion to yield a satisfying result that ultimately benefits the horse. And really, in most people’s opinion, acting in the horse’s best interest should always be the goal.

This article about second opinions for a horse’s diagnosis appeared in the August 2022 issue of Horse Illustrated magazine. Click here to subscribe!

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The Lymphatic System

Fluid accumulation in the lower limbs (the medical term is “dependent edema”) is a function of physics and the lymphatic system, an often-overlooked branch of the circulatory and immune systems. As blood is pumped by the heart throughout the body, it delivers oxygen and nutrients. When blood reaches the tiny capillaries, these components diffuse out into the surrounding tissues, nourishing the body.

Inevitably, some metabolic waste is created, which results in what’s called lymph fluid. This fluid is then passively collected into the surrounding lymph vessels. In a way, the lymphatic system is like a sewer system where waste materials collect from around the body.

An important difference between the circulatory and lymphatic systems is the lymphatic system isn’t directly connected to the heart; it lacks a pump. Lymph, the fluid that flows through the system, relies on the extending and flexing of ligaments and tendons when the animal walks to squeeze and push it from the delicate lymph vessels to lymph nodes to veins and ultimately back to the heart. The digital cushion in the hoof also plays an important role in moving lymph back up the leg.

When you appreciate the role of the lymphatic system, it’s now easy to understand the primary cause of stocking up in horses, which is lack of movement. Stocking up is almost always seen in horses that have been stalled. When a horse doesn’t move enough, he can’t help his lymphatic system push fluid, not only from the more distant parts of his body (relative to his heart) but also opposite gravity.

When the lymph system can’t move enough fluid back to the heart in a timely manner, it begins to accumulate. Over the course of many hours (commonly overnight), this causes the legs to “fill” and can make the typically slender lower limb get fat and feel firm. The same thing happens to humans; swollen ankles after a long flight are a typical example of human stocking up.

Confirming Everything is OK

But how can you be sure a horse’s swollen legs are due to the benign nature of a lazy lymph system, and not something more sinister? Paying close attention to your horse will provide answers.

◆ First, stocking up is a bilateral condition, meaning stocking up occurs in both hind legs, but it’s not uncommon to see it in both front legs as well—and sometimes in all four.

◆ Second, a stocked-up horse will behave normally. He should not appear lethargic, unwilling to move, lame, or otherwise seem sick or painful.

◆ Third, the legs should not be hot to the touch. They will also be uniform in size, so compare each swollen leg to the others.

◆ Fourth, consider the horse’s history: Has he had this condition before? Has he been in a stall for a lengthy period? When was the last time he was out in the field or ridden?

Once you’ve determined your horse has fat legs but is feeling good, the tried-and-true test (and cure) to confirm is movement. Tack up your horse and go for a ride, or turn him out so he can stretch and move at liberty, then re-evaluate. The swelling should dissipate, confirming the fluid accumulation was due to inactivity.

Other Reasons for Swelling

In rarer instances, swollen legs can be a clinical sign of something much more serious than a lack of movement. Heart failure and liver failure are two conditions that are thankfully uncommon in horses, but when either occurs, it is typically severe, incurable, and can lead to fluid buildup in all four legs, along with a host of other clinical signs, which should prompt a call to your veterinarian.

Alternatively, if just one leg is swollen, this is a major clue something more serious is going on. Soft tissue damage, such as an acutely bowed tendon, can result in a swollen lower limb. So can many other types of musculoskeletal trauma, such as a fracture or bruising from a kick. The most obvious difference between these clinical presentations and stocking up, however, is the fact that the horse will likely be acutely lame when trauma is the cause.

Another cause of unilateral acute limb swelling is cellulitis. This is a bacterial infection under the skin, usually due to a small cut or scrape or a more chronic condition that weakens the integrity of the skin, like mud fever or scratches. If certain types of bacteria invade the soft connective tissue under the skin, they proliferate, resulting in an acutely swollen limb and a very lame horse.

Horses with cellulitis have a leg that is hot to the touch and may be oozing serum. Depending on the extent of the infection, the horse may have a fever, be lethargic, and not want to eat. This condition can spread to the local lymph vessels. When this happens, it is called lymphangitis, and is managed the same way as cellulitis. Quick treatment with aggressive antibiotics is required, so if you suspect cellulitis, have your veterinarian out as quickly as possible.

Vasculitis is another cause for acute swelling in the limbs. The medical term for the inflammation of blood vessels, vasculitis is often viral in origin. Any horse with swollen limbs and a fever should be evaluated promptly by a veterinarian.

Horses Prone to Stocking Up

Some horses seem to be more prone to stocking up than others. Older horses in general tend to stock up frequently. This is thought to occur because their lymphatic system isn’t as effective as it used to be, leading to more fluid accumulation. This may also be a function of an animal that is reluctant to move due to osteoarthritis or other chronic conditions.

Dehydrated horses also tend to stock up more easily. This is something to keep in mind after a long, hard ride or competition or when it’s extremely hot outside. Horses that have had cellulitis/lymphangitis in the past may also stock up more frequently in the previously infected leg if there was significant damage to the lymph vessels at the time of the infection.

Prevention

At face value, the prevention of stocking up is simple: keep the horse outside as much as possible. However, many horse owners don’t have adequate pasture access or have other restrictions that preclude full turnout, and that’s OK. It’s important to note that a truly stocked-up horse is not in pain, sick, or injured. Swollen legs in this instance won’t affect his well-being or athletic pursuits.

Some prefer to use standing wraps on horses to prevent stocking up. The use of wraps should be evaluated based on an individual horse’s environment, use, health, and your ability and expertise in applying them.

One issue with standing wraps is cleanliness: sweat, dirt, and debris can easily turn these wraps into bacterial breeding grounds, setting the horse up for chronic skin conditions. Wraps that are applied too tightly may further impede circulation and the flow of lymph, and over time, they may be counterproductive in preventing swelling.

Similarly, topical products such as poultices or liniments shouldn’t be relied upon for long-term management since overuse may also negatively impact the health of the thin skin on the horse’s legs. The simplest method to reduce stocking up is to increase your horse’s time out of the stall.

Once correctly identified, stocking up in your horse can go from a worry to no big deal. With a little understanding and observation, this fluid accumulation shouldn’t be cause for alarm.

This article about stocking up in horses appeared in the April 2022 issue of Horse Illustrated magazine. Click here to subscribe!

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With all these zombie films and shows in pop culture, maybe you have thoughts of zombie horse hoards crossing your pastures during a full moon. No? Perhaps you have nightmares that all the carrots you’ve ever sacrificed to your horse’s chompers are now back for revenge. Not really? Well, even if the scariest thing about your barn is all the stalls you have to clean, here’s a spooky-themed anatomy lesson: your horse’s skeleton is way cooler than you might think. Here’s why.

1. Most horses have 205 bones in their skeleton but this can vary across some breeds. Arabians, for example, can have fewer bones in their spinal column. And while most horses have 18 ribs, because some Arabians’ thoracic spinal column is shorter, this breed may only have 17 ribs. Eight of these ribs—for all breeds—are considered “true ribs”, meaning they completely connect between the spinal column and the sternum. The remaining ribs are called “floating” because they do not reach all the way to the sternum.

2. The withers of your horse are actually the spiny vertical tops of the thoracic vertebrae. On a skeleton, they appear long and narrow and a horse’s heavily muscled back shapes them into the more comfortable saddle-sitting area we know on a live horse.

3. Most horse lovers are aware of the amazing structure of a horse’s hooves: the coffin bone, also called P3 which is short for the third phalanx, sits inside the hoof capsule, suspended by delicate, Velcro-like soft tissue called the laminae. This coffin bone is synonymous with the tip of a human’s middle finger, meaning your horse literally stands on the tip of one toe. The remaining “fingers” have long since faded away with the evolution of the horse, but the split bones along the cannon bone are vestigial remnants of the second and fourth fingers.

4. Horses don’t have a collarbone, also known as the clavicle.

5. A horse’s knee in his front legs is called the carpus and is analogous to our wrist. Understandably complex, this joint in the horse is made of two rows consisting of three primary bones each. Sometimes, a very small “extra” bone is present in the carpus. This has no purpose and causes no problems but can sometimes be confused for a chip fracture on an x-ray.

6. Talk of navicular bones sometimes breeds fear in the heart of horse owners. This pesky miniature bone buried deep in the hoof behind the coffin bone is the source of a frustrating and sometimes career-ending condition in horses called navicular syndrome. Navicular means “boat-shaped” but this term comes from the human navicular bone’s concave surface as it is wedged in the foot right in front of the ankle. In horses, the navicular bone is in a different location and is actually a sesamoid bone, analogous to the tiny bones that sit underneath our toes at the balls of our feet.

7. Lastly, it’s no joking matter. While sometimes hotly debated in barns across the country, the science just doesn’t support it: horses lack a funny bone.

This article about the horse skeleton is a web exclusive for Horse Illustrated magazine, originally published October 2016. Click here to subscribe!

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It’s finally getting cold outside and you’re bundled up, possibly with a hot cup of cocoa or coffee in hand. But how does your horse handle the chill of winter? Let’s take a look at some answers to commonly asked questions about cold weather horse care.

Also read – Senior Horse Care in Winter

1. How do horses cope with cold?

An adult horse’s “comfort zone” is lower than most people think. An acclimated healthy adult horse can remain reasonably comfortable in temperatures that dip into the 20s (Fahrenheit) and below, as long as the horse stays dry and can escape wind.

Certain physiological factors help: The most obvious is a horse’s ability to grow a thick winter coat. This natural coat works to preserve warmth by trapping warm air tightly against the horse’s body, creating a layer of insulation that is remarkably efficient at buffering cold external temperatures.

Another factor in fighting the chill is the horse’s unique digestive system. The microbial fermentation of fibrous feeds taking place in a horse’s colon creates enough internal heat that your horse’s gut acts as a type of furnace to keep him warm.

2. Do blankets flatten hair and make a horse colder?

Although a horse’s natural winter coat is meant to trap warm air against his skin, placing a blanket on top of this hair does not negate the warmth. Instead, a blanket acts as an added physical layer of insulation.

While blankets do indeed physically flatten a horse’s hair, their layers take the place of the horse’s natural coat. Air trapped between a horse and the layers of blanket now act as insulation.

If you want to feel for yourself how this insulation works, pay a visit to your horse in the pasture one winter day and place your bare hand between his shoulder and the blanket to get a sense of the heat trapped in there.

There are, however, other aspects to consider when choosing to blanket your horse. Blankets are necessary for horses that are thin, sick, or older; these animals typically struggle to maintain a core body temperature in the face of harsh environmental elements. Horses that have been clipped in the winter will need some level of blanketing, as well. All other adult horses may or may not need a blanket; the blanketing debate rages on, because it depends heavily on the individual horse and his immediate external environment.

If you’re questioning whether to blanket your horse in the winter, consider his physical characteristics (e.g., body condition score, overall health status, acclimation to his environment, age, and clipping status), the winter weather you’re expecting, and whether the horse will have access to shelter in the field for protection against wind and precipitation.

3. Is it dangerous to ride a horse in cold weather?

Just as you wouldn’t run a 5K in winter dressed as if it were July, winter riding requires specific preparations, but that doesn’t mean you can’t or shouldn’t enjoy hacking through the snow. One of the trickiest aspects of winter riding is preventing post-ride chills in a sweaty horse.

If you know you’ll be riding regularly throughout the winter, consider clipping your horse. With several partial clips to choose from, you can tailor your horse’s “nakedness” to your anticipated level of exertion.

The benefits of clipping are two-fold: A clipped horse doesn’t sweat as much, plus he will dry much faster after a workout than a horse with a full winter coat. However, with the convenience of clipping comes the responsibility of blanketing. Removing a horse’s natural cold-weather barrier means he will need a blanket to help keep the chill away.

To shoe or not and how are other considerations for winter riding. Regular horseshoes have poor traction on ice and snow. For this reason, some people elect to pull their horses’ shoes in the winter.

However, if you think you might ride a reasonable amount in snow or icy conditions, consider talking to your farrier about studs for traction or snow pads to prevent the buildup of ice balls under your horse’s shoes. Walking on uneven packed ice also tends to bruise a horse’s soles, which is another reason some riders elect to use snow pads.

4. Can a horse get enough water by eating ice and snow?

Most domestic horses, unless already acclimated to a severe winter environment where water is scarce, have lost their natural ability (or inclination) to consume adequate amounts of ice or snow in amounts large enough to satisfy their daily water requirements. Leaving a horse to consume only ice or snow places him in a constant state of dehydration, thereby putting him at risk of impaction colic.

Frozen water alone isn’t the only problem in winter. Horses can be picky drinkers, and many will turn their noses up at water that is deemed too cold. Studies have shown horses prefer water between 45 and 65 degrees Fahrenheit to drink. Heated water buckets and troughs are the easiest solution for winter water woes.

Decreased water intake not only increases a horse’s chance of impaction colic, but also impacts his feed intake—when a horse drinks less, he also eats less. This then further affects his ability to keep warm.

While bran mashes and other methods of adding a bit of liquid to a horse’s meal may seem like a good alternative to increase your horse’s water intake in the winter, these methods typically don’t provide enough moisture. A horse’s average water intake can vary widely due to many factors, but on average, an adult horse will drink between 5 and 10 gallons of water a day. When grazing, a lot of this water is consumed within grass.

In winter, however, hay does nothing to help with water intake, which is why it is vital to make sure your horse has continual access to clean, non-frozen (and preferably warmed) water in cold weather.

5. How should I change my horse’s diet in the winter?

Although grain has more caloric density per pound than hay, it’s actually roughage that helps keep your horse warm in the winter. Therefore, when temperatures plunge below freezing for extended periods, increase your horse’s hay ration.

Because blankets and thick winter coats easily hide a horse’s body condition, it’s important to regularly monitor his body weight, either through evaluating his Henneke body condition score (BCS) or by using a weight tape. Although tapes are notoriously inaccurate, they do catch significant changes up or down.

These objective measurements will tell you if he’s taking in too few (or too many) calories. Evaluating body weight monthly through the winter should give you a good idea about the adequacy of your horse’s diet.

Most horses do not require any further alterations to their diet during the winter. Mineral and vitamin needs stay the same as in the summer, although if your horse is a voracious salt consumer, he may appreciate some loose salt instead of a frozen salt block to lick.

This article about cold weather horse care appeared in the November/December 2021 issue of Horse Illustrated magazine. Click here to subscribe!

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Many horse owners understand the term colic to mean abdominal pain in horses. Although there are several causes of colic, equine impaction colics are one of the most frequently encountered types. Let’s take a closer look at this common cause of abdominal pain to better understand early warning signs, treatment options, and prevention.

Impaction Causes

In basic terms, an impaction refers to an obstruction of the gastrointestinal tract. This is typically caused by a clump of ingesta (feed), but can also be made up of sand or other foreign material, such as hair or bailing twine, or rarely, a growth or tumor. Equine impaction colics most frequently occur in the portion of the horse’s large intestine called the large colon, but sometimes occur in the cecum or small colon.

Due to the length, complexity, and sheer volume of a horse’s digestive tract, an interruption in the flow of material through it can quickly become a very serious issue. A horse’s large colon is 10 to 12 feet long, and along with the cecum, can hold up to 30 gallons of fluid.

Fitting all this into the horse’s abdomen requires a few anatomic hairpin turns. One such turn is called the pelvic flexure, and this is a classic location for impaction because the diameter of the colon becomes narrower here.

Once a blockage occurs, this creates a backup of material behind it, which swells and stretches the gut. This understandably becomes increasingly painful for the horse.

But why would food become a dangerous clog in a horse’s digestive pipeline? Stress, a sudden change in diet, or an abrupt decrease in exercise (like a change from pasture to stall-bound) can result in a reduction in gut motility, which can predispose a horse to developing an impaction.

Hydration also plays a large role; if a horse is dehydrated, this can also slow the movement of digesta through the colon, sometimes ceasing movement altogether.

Equine impaction colics are often seen in the winter when horses are reluctant to drink icy water. This is a classic example of mild, chronic dehydration leading to this type of colic.

Clinical Signs

Equine impaction colic presents with the same clinical signs as other types of colic, although it may be milder at first and then progress in severity if not treated. An impacted horse may glance at his flank and prefer lying down or act like he can’t quite get comfortable. He may roll or stand at the trough and play in the water without drinking. Usually, impacted horses will not eat.

As time goes by, impaction colic worsens, and clinical signs may become more obvious. The horse’s heart rate will usually be elevated, and he’ll have decreased or absent gut sounds. His gums may become dry, tacky, and pale. If the horse is stalled, you will notice the absence of any manure.

If you notice these signs, have your veterinarian come out as soon as possible. After taking your horse’s temperature and pulse and listening to his gut, the vet will sedate the horse and conduct a rectal examination.

Fortunately, the pelvic flexure of the large colon hangs below the pelvis (hence its name), and an impaction at this location can usually be palpated during a rectal examination. This can help provide a quick definitive diagnosis. However, if the veterinarian cannot feel an impaction in this location, it does not completely rule impaction colic out.

Treatment

Rehydration is the cornerstone treatment for equine impaction colic. Softening up the impaction to get it to move is the goal. This is addressed in two primary ways. First, a nasogastic tube, which is a long rubber tube that is inserted in the nostril and fed down the esophagus into the stomach, is used to administer fluids as well as mineral oil, the ultimate laxative.

Second, an impacted horse is typically given large amounts of intravenous fluids. Pain medication and buscopan, an anti-spasmodic drug, are also sometimes given to help keep the horse comfortable.

A horse with an impaction should be kept off feed while the impaction is being treated; there’s no point in adding further material to bulk up the digestive tract. However, don’t limit water intake.

Additionally, keep the horse stalled, if possible. This allows you to monitor fecal output. If mineral oil has been given, look for it to pass in 12 to 24 hours. As it typically induces soft, oily stool, it is easy to observe when an impaction has passed.

Occasionally, an impaction is severe enough that it can’t be treated medically, making surgery the only option. During colic surgery, the impaction will be located and removed. Depending on the severity, the wall of the colon may be compromised.

If this is the case, a resection is performed where the damaged section of colon is removed and the two ends are rejoined. These types of surgeries can be complicated, and depending on the extent of the damage to the gut, can have a long recovery time.

Preventing Equine Impaction Colic

Avoiding any sudden and drastic changes in your horse’s diet will go a long way in helping prevent an impaction. Ideally, the majority of his diet should consist of forage, such as pasture or hay.

Consistency in diet and exercise are key. Good dental health is also important so that your horse can comfortably and efficiently chew his food. Annual dental exams will help ensure his teeth are in the best shape possible.

Perhaps the most vital tip for helping prevent impactions is to make sure your horse has access to clean water at all times. In the winter months, if you are in an area where temperatures fall below freezing, water heaters not only prevent icing, but also encourage the horse to drink when it’s cold out.

If your horse lives in a sandy climate, talk to your veterinarian about supplements that help prevent sand buildup in the gut (see “Sand Colic,” this page).
Common sense and good, practical horsemanship can go a long way in helping your horse avoid an impaction.

This article about equine impaction colic originally appeared in the September 2021 issue of Horse Illustrated magazine. Click here to subscribe!

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Scratches to the surface of the eye, called corneal ulcerations, are the most common equine ophthalmic condition. While any eye injury should be considered a medical emergency, take heart: the majority of these ulcers heal quickly with prompt treatment. Let’s take a closer look at what an equine eye ulcer is and what can be done to help it heal.

When Your Horse Gets an Eye Ulcer

The cornea is the outside cellular layer of the front of the eyeball, which acts as a protective barrier. A scratch or rub to the cornea damages these cell layers. Superficial scratches may only damage the outer layer, called the epithelium. Deeper injuries affect the middle layer, which is called the stroma.

Extremely deep scratches or punctures can reach the very bottom layer, called Descemet’s membrane. This is the last layer of the cornea before the inner structures of the eyeball are breached and the eye ruptures. The deeper the scratch, the longer the horse’s eye ulcer will take to heal, and complications become more likely. The inciting incident—which can be anything from a protruding piece of fence, a piece of grit, or even an ingrown eyelash—will make the horse extremely reluctant to open his eye. The eye will tear excessively, and the eyelids will swell.

Your horse may become very head shy and not want to face direct light with an eye ulcer. The white conjunctiva around the eye will become inflamed and red, and depending on how long the scratch has been there, there may be a light blue spot on the eyeball itself. This is called corneal edema and is the result of fluid accumulation. If you’ve ever had anything stuck in your eye, you can easily understand how painful a corneal ulcer is.

What to Do

When finding your horse with an eye injury or an eye ulcer, the first thing you should do is call the vet. Never “wait and see” with a suspected corneal ulcer. If something is continually rubbing the eye or stuck, this can deepen the ulcer and put the horse in danger of ocular rupture. Also, the longer an ulcer goes without treatment, the more susceptible it is to secondary infection, which vastly complicates healing.

As you wait for your vet to arrive, place him in a dark stall with a fly mask, if you have one. It’s best to avoid flushing or washing the eye until your vet examines your horse, in case a foreign object is still in or around the eye.

When your vet arrives, she will likely sedate your horse and do a nerve block to the upper eyelid, which allows for a safe, comfortable, and thorough examination of the eye. She’ll then flush the eye with sterile saline and apply a fluorescein stain.

This stain is a simple, yet fantastic, diagnostic tool; this special temporary dye adheres only to the middle layers of a damaged cornea, thereby allowing your vet to immediately see whether or not the corneal epithelium has been breached and an ulcer is present. Ulcerated corneal tissue shows up as a bright, neon green.

Depending on the extent of the damage, your vet may also use an ophthalmoscope (a special handheld lens and light tool) to examine the inner structures of the eye; however, the inner eye can be hard to see with corneal edema, which makes the cornea a cloudy, opaque bluish color.

Treatment for an Equine Eye Ulcer

Once your vet diagnoses a corneal ulcer (and any other damage or disease is ruled out), treatment can begin. Equine eye ulcer treatment consists of two primary components: pain control and wound healing.

For pain control, your vet may prescribe a non-steroidal anti-inflammatory drug, such as flunixin meglumine (Banamine) or phenylbutazone (bute). A drug called atropine, usually given as an eye ointment, is also sometimes prescribed for eye pain. Atropine makes the eye muscles relax, along with dilating the pupil. For this reason, horses on atropine should be kept out of direct light.

Wound treatment typically includes a triple antibiotic ointment. When applying, hold the ointment tube parallel to the lower eyelid and squirt a ribbon along the inside of the lid. Blinking action will ensure the antibiotic covers the eyeball. Never direct the end of the tube at the eyeball itself (perpendicularly); you could accidentally poke the horse in the eye if he suddenly moves. Applied three or more times a day, this ointment helps prevent secondary bacterial infection and gives the eyeball a protective, moist covering. The cornea is remarkably resilient and can heal quickly. Superficial equine eye ulcers frequently heal within three to seven days.

One other unique medical treatment is autologous serum. Interestingly, some studies have shown that administering a horse’s own blood serum to the eye further encourages corneal healing. Your veterinarian may draw a tube or two of your horse’s blood and give you vials containing the serum if she assesses that this will help.

Sometimes, depending on the extent of the ulcer and the horse’s temperament, it can be challenging to safely administer medications in the eye multiple times a day. If your horse is resistant to repeated application of an eye ointment, a sub-palpebral lavage system may be set up.

This system uses a soft, flexible catheter inserted in the upper eyelid. Thin tubing is then extended back along the horse’s neck, so the handler can be away from the horse’s head and deliver the medication without upsetting him. This system is very handy, but it requires a horse to be stall-bound during healing and watched closely.

Horses requiring a sub-palpebral lavage system should be hospitalized for adequate observation and management. If you’re having problems administering your horse’s medications, let your veterinarian know right away.

For uncomplicated equine eye ulcers, treatment typically extends for a week or two. During this time, keep a fly mask on your horse and make sure he has the ability to stay out of the sun. For the first few days, it may be beneficial to keep your horse in a dim stall. As the eye heals, you will see the cornea clear up and the horse will experience less pain.

Complications

Depending on the depth of the equine’s eye ulcer, the inciting cause, and how long it took to initiate treatment, this condition can become infected or deepen. Bacteria and fungi can easily invade a damaged cornea.

When this happens, the ulcer won’t heal, and it is called an indolent ulcer. In these cases, topical medications may not be strong enough. Either systemic drugs will need to be prescribed, or in some circumstances, a horse may become a candidate for eye surgery.

Corneal stromal abscesses occur when a bacterial infection seeds within the corneal tissue, and these sometimes need to be scraped away. Secondary infections within the eye tissue can be stubborn and may require referral to an equine ophthalmologist for further evaluation and management.

Depending on how large and deep the equine eye ulcer is, a scar may result. These typically don’t impinge on a horse’s eyesight to a great extent but do appear as a permanent white mark on the surface of the eye.

Preventing an Eye Ulcer

Corneal ulcers in horses are typically accidental, so they can be hard to prevent. However, there are a couple good practices to keep in mind.

First, try to avoid having any hooks or sharp points in the stall. This includes handles on water buckets and hooks for hanging halters. Second, keep fences in good repair and remove broken tree branches when necessary. This also helps prevent those annoying scrapes and nicks that plague our horses at any time of year.

This article about equine eye ulcers originally appeared in the August 2021 issue of Horse Illustrated magazine. Click here to subscribe!

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