A horse who refuses to eat needs immediate veterinary attention. Even if he stops eating, he may still drink or at least play with his water. Refusal of both feed and water is a very serious sign.

Horse health issues may be common, and therefore, you need to know how to “read” your horse, what types of horse health situations are true, get-the-vet emergencies and what you should or shouldn’t do.

If the horse has a gaping wound or is flat out on the ground, it’s obvious you need the vet. But there are other situations that call for quick veterinary attention, or at least are things that you should investigate rather than just ignoring them.

The following is a list of nonspecific symptoms that should always get your attention.

Horse not eating. Horses love to eat, and if given the opportunity will spend more time chowing down than doing anything else. When appetite is gone, or even just noticeably decreased, it’s a clear sign that something is wrong.

Horse not drinking. Whenever possible, pay attention to how much the horse is drinking. A sharp drop in water intake should never be ignored. Check first to make sure the water supply is clean and fit to drink (e.g., not too cold). Low water intake will rapidly lead to problems like dehydration and impaction on top of whatever else is making the horse not drink.

Change in personality or activity level. These are easily missed if you are not observant and don’t interact with your horse daily, but should never be ignored. Horses respond differently to pain or illness — some becoming depressed, others irritable. It’s the simple fact that the horse is not acting like his normal self that’s important.

Change in amount or consistency of manure. Horse looks bloated (rounder through the flanks than normal). Liquid manure stains on the tail or hocks. Passing unusual amount of gas. Standing with the tail slightly elevated (unless it’s a mare in season). These are all signs that there is probably an intestinal problem.

Change in how rapidly the horse breathes, or in breathing pattern (e.g., very rapid and shallow). This may indicate pain, overheating or a problem in the lungs. The breathing of a horse that has just been exercised should return to normal within about 10 minutes.

Horse lying down or standing more than is normal for him (e.g., not lying down to sleep when that used to be normal). A horse that is in pain, feeling weak or is sick may lie down more, while one with foot or leg pain or balance problems may avoid being down because it is more difficult, or painful, to get up again.

Frequently standing in a stretched out position, as if to urinate. Penis may be dangling in males. This indicates a possible problem in either the intestines or the urinary tract.

Leg swelling. If only one leg is swollen, that likely indicates injury or infection. If two or all four legs are swollen, it could just be stocking up or could be a sign of a viral or bacterial infection.

If you observe one of these symptoms, do the following:

Observe the horse for a few minutes to see if you can notice anything else (e.g., one or more other nonspecific symptoms, or something more specific from below). If you can’t see anything else obvious:

Get the horse’s attention and go to his head. Put on a halter and lead shank. Ask the horse to walk and observe if he is walking normally.

Check for interest in grass, hay or water. (Never feed grain to a horse that may be ill or injured until/unless the vet approves.)

If the horse still seems abnormal to you, call a horse-experienced friend to come help you take the horse’s vital signs, with one of you holding the shank and one taking the vital signs (see sidebar above).

Call the vet, describe what you see and give the vital signs.

Some symptoms are far more obvious, requiring an emergency call to the vet as your first step. Your second call in those cases should be for help from your experienced friend who can stay at the horse’s head while you do any first aid or check vital signs. Because injured/ill horses may be unpredictable, for safety reasons you should not attend to them when you are alone.

The following are definite emergencies, along with some do’s and don’ts until the vet gets there.

Know Your Horse’s Vital Signs

Your horse’s vital signs are his temperature, pulse and respiration. They’re the first things your vet will check after observing how the horse looks in general. Everyone who owns or cares for horses should know how to do this, and also know what numbers are normal for every horse in their care. Your horse can’t tell you in words that he hurts, is weak from blood loss or feels feverish, but changes in his vital signs are clues your vet will use together with symptoms and examination findings to figure out what’s wrong. Check your horse multiple times, both morning and night, and with different environmental temperatures, to know what his normal numbers are. You should also have checked these numbers when the horse is healthy to know what’s “normal” for him. While every horse differs, normal temperature for an adult horse is 98º to 100ºF, pulse at rest is 44 beats per minute (ranges from the high 20s to low 40s), and respiration at rest is 8 to 16 breaths per minute. Foals will tend to run in the upper ranges.

Symptoms: Horse is off balancing, tripping, looks “drunk.” Head tilts. Pressing head into a wall. Seems blind. Falling/fainting/seizures.
What It Means: These are signs of neurological disease.
Do: Keep the horse in a large paddock or outside in the field, but away from other horses because they may panic or injure him.
Don’t: Attempt to move or restrain the horse. Don’t get too close.

Symptom: Heavy tearing and/or horse will not open his eye.
What It Means: Eye pain or injury.
Do: Move the horse out of the sun and into a darkened stall. (You can hang blankets to keep out light.)
Don’t: Attempt to open the lids or otherwise touch the eye.

Symptom: Saliva dripping from the horse’s mouth.
What It Means: Horse ate something irritating, has something stuck in his mouth or can’t swallow because of food being impacted in his esophagus (choke), or a neurological problem (like rabies or botulism).
Do: Keep other animals away from the horse. Remove hay, grain and water.
Don’t: If the problem started suddenly when the horse was eating, it’s likely choke. If you’re not sure, don’t examine the horse or even get close enough to come in contact with the saliva until the vet gets there. Odds are it’s not rabies, but let your vet decide what to do next after seeing the horse.

Symptom: Blood from the ear.
What It Means: Could be a head injury or a problem inside the ear.
Do: Observe for other neurological signs. Keep the horse in a quiet area, away from other animals.
Don’t: Tie the horse or pull on the halter. Don’t disturb or excite the horse.

Symptom: Blood from the nose.
What It Means: Injury to the head or a problem in the sinuses or throat structures. Could be lung bleeding.
Do: Take the vital signs. Observe for other symptoms. Keep the horse in a quiet area, away from other animals.
Don’t: Disturb or excite the horse.

Symptoms: Pawing at the floor, looking back at the flanks, lying down and grunting and looking at the flanks, lying down and repeatedly rolling or thrashing violently.
What It Means: Colic.

Do: Get the vital signs if the horse is not too violent. This is important information for the vet. If the weather is cold, cover the horse with a blanket or wool cooler. Keep the horse walking slowly unless he refuses to move (see horse refuses to walk, below). Check to see if the horse ate his last meal. Check for evidence of fresh manure.

Don’t: Feed or water the horse, or attempt to give anything orally. Don’t allow the horse to roll.

The early signs of colic, such as restlessness, looking at the sides and pawing, can be easily overlooked.

Symptom: Heavy bleeding from a wound.
What It Means: Large blood vessel(s) have been damaged. “Heavy” means either a large pool of blood where the horse was originally injured, his body below the wound is heavily coated with blood, or bleeding has continued longer than 10 minutes despite pressure. If in doubt about how much blood was lost, assume it could be heavy.

Do: If the wound is still bleeding, apply something lint-free to the wound’s surface to avoid getting fibers in the open wound. (A gauze pad or piece of clean linen is good, but even a clean piece of paper can work if nothing else is available.) Apply several other layers of absorbent material on top of that (e.g., cotton, leg wraps) and hold in place using firm pressure for five minutes. Keep the horse quiet. Check vital signs and look at the gums to see if they are a normal pink color or very pale. If the horse is shivering/shaking, blanket as appropriate for the weather.

Don’t: If bleeding has stopped but there is evidence that the wound had bled very heavily, do not hose or wash the wound until the vet gets there. It could start bleeding again.

Symptom: Horse refuses to put any weight on one leg.
What It Means: Intense pain or nerve damage.

Do: Stay with the horse until the vet arrives, offer water and hay, keep other animals from bothering him if he’s outside.

Don’t: Try to move the horse or touch the leg. If it’s a fracture, you want the horse to keep as
still as possible.

Symptom: Horse refuses to walk.
What It Means: Walking is either painful (e.g., laminitis, back problem, tying up) or the horse is afraid to move because of a balance problem (neurological, tetanus).

Do: Stay with the horse until the vet arrives, offer water and hay. Keep other animals from bothering the horse.

Don’t: Force the horse to move.

Symptom: Horse is down and refuses to get up.
What It Means: Horse is either in a lot of pain or has a neurological problem and can’t get up.

Do: Stay with the horse until the vet arrives, offer water and hay. Keep other animals from bothering the horse. If the horse is agitated and banging his head, try to get some cushioning materials (e.g., saddle pads, blankets, etc.) on the ground in the area where he is hurting himself, but don’t attempt this if you’re alone, and don’t attempt it if you have to put yourself in a position of getting hurt.

Don’t: Get within range of the horse’s legs or head and neck. Don’t try to help the horse get up before the vet can examine him, even if it looks like he wants to get up and just needs some help. If he’s injured, you could make it worse.

Symptom: Thick white, yellow or gray discharge from one or both nostrils.
What It Means: Likely infection in the respiratory tract.

Do: Take the vital signs, put the horse in as dust-free an environment as you can find, offer water and moistened feeds or soaked hay. Isolate from other horses, and do not put other horses into an area that may be contaminated by the discharge. But don’t move horses that may have already been exposed. Blanket if shivering.

Don’t: Expose to dust, direct drafts, extremes of heat or cold.

Wound-Bandaging Tip

Nonstick Telfa pads are the best material to place directly against a wound. However, trying to get them to stay in place while you put the regular bandage over the top can be a real challenge. As soon as the person holding the pad in place moves her hand out of the way to allow placing a wrap over the top, the pads tend to fall right off — or move around with the upper layers of the bandage. Try this and you’ll find that the antibiotic cream and petroleum jelly will help the pad “stick” in place. Choose a Telfa pad larger than the area you need to cover. Place antibiotic cream on the surfaces that will contact the wound. Apply a thick layer of petroleum jelly to the outer edges of the Telfa pad.

Symptom: Profuse, watery, diarrhea.
What It Means: Severe intestinal upset or infection.

Do: Take pulse and respiration, but not temperature because it may not be accurate anyway and you’ll risk contaminating the thermometer with an infection. Keep the horse where he is if that’s a stall or paddock, but move him to a stall or paddock if he’s out in a field. If possible, keep other horses away from contaminated areas. Allow access to hay and water unless he has signs of colic.

Don’t: Feed grain or allow anything to be moved that has been in direct contact with the horse.

Symptom: Wounds where the skin edges are separated or puncture wounds.
What It Means: The deep tissues (underneath the skin) have been injured/exposed. This can lead to serious infections or tetanus.

Do: Stop bleeding with pressure, hose gently with cold water, directing the spray above the wound, not on it, so that the water runs down over it. If the vet won’t be able to get there for a few hours, ask about cleaning the wound and covering it. Keep the horse from moving around. Offer hay and water, if he’s interested. Take vital signs.

Don’t: Aggressively scrub or hose the wound because that can make it start bleeding again. Don’t pull out any pieces of metal, wood, etc. that are puncturing the tissues. This can also start heavy bleeding.

Finally, be aware of situations that require an emergency vet visit even before the horse is showing obvious symptoms. These include:

Horse got into the feed bin. Horses that have gotten access to grain/feeds can easily develop colic and laminitis as a result. Allow water but no eating until the vet gets there.

Horse got loose and was eating in planted fields or nibbling on plants/shrubs in the garden. Unlimited access to fields of corn, oats, soybean, alfalfa, etc. can cause serious colic, and many ornamental plants are toxic. Don’t give any food or water until the vet gets there. Check the plants to try to determine exactly what the horse was eating.

Animal bites. Rabies is always a concern here. All animal bites should be reported. Even if a vaccinated pet bit your horse, your vet should treat the wound. Bite wounds can get nasty infections. Hose with cold water until the vet arrives.

Snakebite. Poisonous snakebites can cause a lot of local tissue damage, and even nonpoisonous bites require tetanus update, possibly antibiotics. Keep the horse from moving around. Hose the area with cold water until the vet arrives.

Horse trapped in a ravine or ditch, tangled in wire fencing, trapped in other type of fencing. Even if the horse doesn’t appear to be injured, you need to get him checked by the vet for puncture wounds, internal injuries, fractures, etc. It’s best to wait for the vet to get there before attempting to free the horse. Get as much help as possible for the rescue, including professional 911/Rescue staff. Never pull on the horse by the halter. Clear other animals from the area, and keep things quiet until help gets there. Talk to the horse quietly from a safe distance, but only if this seems to calm him.

You’ll deal with emergencies a lot better if you organize ahead of time. So make a list of important contact phone numbers, including:

Your vet

Nearby friends who can come  help

Someone you designate to make decisions regarding care in the event you cannot be reached

Police, fire and other emergency services if you don’t have 911

Nearest vet school or full-service equine clinic

Friends with a trailer or commercial shippers if you don’t own a trailer

Equine insurance company if the horse is insured

Your insurance company (in case a person is also hurt)

Contact information for all owners if you board, as well as contact information for someone they designate to act on their behalf in approving treatment, etc. if they cannot be reached

Supply Checklist

Flashlights (at least 2, the bigger the better) Extra batteries Wire cutters Pocketknife Heavy-duty scissors Shoe pullers Pliers Extra halter and lead rope Hoof pick Large-animal thermometer, equipped with a string and clip on the end for securing it to the horse’s tail One or two hoof boots Cooler blanket Supply of ice or instant ice packs in the barn refrigerator Box of freezer-storage size zip closure plastic bags (for holding ice) Sheet cotton (for leg wrapping) Large gauze sponges Assorted sizes of Telfa pads Clean cotton stall bandages and outside wraps, stored in plastic bags Vetrap or other self-adhesive wrap, 4 to 6 rolls Hydrogen peroxide Tweezers Iodine-based surgical scrub Several pairs of surgical or exam gloves Antibiotic cream Large jar of petroleum jelly and tongue depressors to remove it from the jar Spiral or bound notebook with a clear plastic pen holder with several pens taped to the outside

Whenever possible, get home phone, work phone and mobile phone numbers. Take the time to sit down and enter this information into your computer and all your phones with memories. Also print out the information, put it in a plastic cover, post it next to your barn phone and also tape a copy to your first aid supply kit.

A “designated agent” is someone you, or one of your owners if you also board horses, have authorized to act on your behalf during an emergency if you cannot be reached. Since vets and veterinary hospitals may refuse to work on a horse without the owner’s permission, it is important that you name your designated agent in writing.

This doesn’t have to be anything fancy. It can just be a simple statement to the effect:

I, (your name), designate (their name) to make decisions regarding the medical care of horse(s) owned by me in the event of an emergency when I cannot be reached.

Both you and your designated agent should then sign the paper. A similar paper should be on file for all boarders’ horses.

Choose your designated agent carefully because you will be legally responsible for the cost of any treatment that person authorizes on your behalf. If you want to put any restrictions on who you will allow to treat your horse, types of procedures or cost of procedures, you need to discuss this with your designated agent. It’s also a good idea to make these notes on the bottom of the paper that names your designated agent.

The table on page 26 lists supplies you should keep on hand in a secure place. In addition, it’s a good idea to always have a mobile phone and a watch with you at the barn. The mobility a phone offers you is indispensable when trying to juggle tending to the horse and calling all the necessary people. The watch is so that you can take your horse’s vital signs.

The supplies on our checklist are bare minimums designed to cover the most common equine emergencies. The list will also keep you organized in dealing with illnesses. Anything you can prepare for in advance will allow you to deal effectively when an emergency does arrive, and that could save your horse’s life.