Learning to Read Your Horse Before Problems Become Emergencies
Horses are stoic animals. In the wild, showing weakness makes you a target, so evolution has wired horses to hide pain and illness remarkably well. By the time most horse owners notice something is wrong, the problem has often been developing for days or even weeks. That's not a criticism — it's just the reality of working with prey animals.
The single most important health skill you can develop as a horse owner isn't medical knowledge (though that helps). It's knowing what normal looks like for your specific horse. What does their eye look like when they're relaxed? How do they stand in their stall? What are their usual eating habits? How much water do they drink? What does their manure look like? When you know your horse's baseline, deviations jump out at you.
I'm going to walk you through the most common health issues I've encountered in over two decades with horses. For each one, I'll cover what to look for, what it means, and when to pick up the phone and call your vet.
Colic
Colic isn't a single disease — it's a blanket term for abdominal pain, and it's the number one killer of horses. Every horse owner needs to recognize colic signs and have a plan in place.
Warning Signs
- Looking at or biting at their flanks
- Pawing the ground repeatedly
- Rolling or attempting to roll, especially violently
- Sweating without exercise
- Elevated heart rate (normal resting is 28-44 beats per minute)
- Reduced or absent gut sounds (press your ear to the flank — you should hear gurgling)
- Not eating or drinking
- Absence of manure or very dry, hard manure
- Stretching out as if to urinate but not urinating
- Lying down more than usual
What to Do
Call your vet immediately. While waiting, remove food but not water. Walk the horse gently if they want to roll violently, but don't exhaust a painful horse by forcing them to walk for hours. Take their vital signs (heart rate, respiratory rate, gum color, and capillary refill time) so you can report these to your vet. Do not administer any medications without veterinary guidance — giving the wrong thing can mask symptoms and delay critical treatment.
Some mild gas colics resolve on their own or with a dose of Banamine prescribed by your vet. Others require emergency surgery. You won't be able to tell the difference, so always err on the side of calling.
Lameness
Lameness is the second most common reason for veterinary calls in horses. It can range from a subtle head bob at the trot to an obvious three-legged limp.
Warning Signs
- Head bobbing at the trot (the head goes up when the sore leg hits the ground for front-leg lameness)
- Hip hike or shortened stride behind
- Reluctance to pick up a lead or turn in one direction
- Shortened stride or choppy movement
- Heat, swelling, or sensitivity in a leg or hoof
- Shifting weight from foot to foot when standing
- Resistance to being saddled or girthy behavior (can indicate back pain causing gait changes)
Common Causes
Hoof abscesses are probably the most common cause of sudden, severe lameness. One day your horse is fine; the next, they're barely touching a foot to the ground. The good news is that abscesses, while dramatic, usually resolve once they drain. Your vet or farrier can help locate and treat them.
Soft tissue injuries — strains and sprains of tendons and ligaments — are common in athletic horses. The deep digital flexor tendon and the suspensory ligament are frequent culprits. These require veterinary diagnosis (often with ultrasound) and controlled rehabilitation.
Arthritis affects many older horses, particularly in the hocks, fetlocks, and coffin joints. Stiffness that improves with movement is a classic arthritis sign. Your vet can manage arthritis with joint injections, oral supplements, and exercise protocols.
Navicular syndrome is a chronic condition affecting the navicular bone and surrounding structures in the front feet. It typically causes a bilateral (both front feet) low-grade lameness with a short, choppy stride. Diagnosis and management require veterinary involvement.
Skin Conditions
Horses seem to attract skin problems like magnets, especially in wet or humid climates.
Rain Rot (Dermatophilosis)
Rain rot appears as crusty, scabby patches — usually along the topline, rump, and shoulders — that pull away with tufts of hair attached. It's caused by a bacterium that thrives in warm, wet conditions. Mild cases respond to antimicrobial shampoos (chlorhexidine or betadine-based), thorough drying, and keeping the horse dry. Severe cases may need veterinary treatment with antibiotics.
Scratches (Mud Fever)
Scratches show up as scabs, cracks, and swelling on the pasterns and heels — particularly in horses with white legs or feathered breeds. It's a nightmare to treat once established because the area is constantly exposed to moisture and dirt. Prevention is key: keep legs dry, clip feathers if needed, and apply barrier creams before turnout in muddy conditions.
Ringworm
Despite its name, ringworm is a fungal infection, not a worm. It appears as round, hairless patches that may be crusty or scaly. It's highly contagious — to other horses and to humans — so isolate affected horses and don't share grooming tools. Antifungal washes and topical treatments usually resolve it within a few weeks.
Respiratory Issues
Horses are obligate nasal breathers with large, sensitive lungs that are prone to several conditions.
Equine Asthma (Heaves)
Equine asthma — formerly called heaves, COPD, or RAO — is an inflammatory airway condition triggered by dust, mold spores, and poor ventilation. Signs include a chronic cough, nasal discharge, increased respiratory effort, and a visible "heave line" along the abdomen in advanced cases.
Management focuses on reducing allergen exposure: soak or steam hay, use dust-free bedding, maximize ventilation, and keep the horse outdoors as much as possible. Your vet may prescribe bronchodilators and corticosteroids for acute flare-ups.
Strangles
Strangles is a highly contagious bacterial infection (Streptococcus equi) that causes fever, nasal discharge, and swollen, abscessed lymph nodes under the jaw. It spreads rapidly through barns and requires strict quarantine. Call your vet immediately if you suspect strangles — early diagnosis and proper management prevent complications and limit spread.
Equine Metabolic Syndrome and PPID
These metabolic conditions are increasingly common, especially in middle-aged to older horses.
Equine Metabolic Syndrome (EMS) is characterized by obesity, a cresty neck, abnormal fat deposits, insulin dysregulation, and a predisposition to laminitis. It's most common in easy-keeper breeds. Management involves diet restriction, exercise, and sometimes medication.
PPID (Pituitary Pars Intermedia Dysfunction), commonly called Cushing's disease, affects older horses and causes a long, curly coat that doesn't shed, muscle wasting, laminitis, increased drinking and urination, and susceptibility to infections. It's diagnosed with blood tests and managed with the medication pergolide.
Both conditions increase the risk of laminitis — a devastating inflammatory condition of the hoof — so early detection and management are critical. If your horse is an easy keeper over 10 years old, discuss metabolic screening with your vet.
Dental Problems
Horses' teeth grow continuously throughout their lives and develop sharp points, hooks, and uneven wear that can cause pain and difficulty eating.
Signs of Dental Issues
- Dropping grain or quidding (spitting out partially chewed wads of hay)
- Weight loss despite adequate feed
- Head tilting or reluctance to accept the bit
- Foul breath
- Swelling along the jaw
- Undigested grain or long fiber in manure
Every horse should have a dental exam at least once a year. Horses with known dental problems may need exams every six months. Dental floating — the process of filing down sharp points — is routine and significantly improves comfort and feed efficiency.
Parasites
Internal parasites remain a significant health concern, though our approach to managing them has changed dramatically in recent years. The old practice of deworming every horse on a rotational schedule every 6 to 8 weeks is outdated. It has contributed to widespread parasite resistance and is no longer recommended by most veterinary parasitologists.
The current gold standard is fecal egg count (FEC) testing. Your vet collects a manure sample, counts parasite eggs under a microscope, and deworms only the horses that need it. This approach reduces chemical exposure, slows resistance development, and is usually cheaper in the long run.
Key parasites to know about: small strongyles are the most common and problematic internal parasite in adult horses. Tapeworms require a specific dewormer (praziquantel) once or twice a year. Bots are the larvae of bot flies that attach to the stomach lining.
When to Call the Vet: A Quick Reference
Call immediately for:
- Signs of colic (any severity)
- Sudden severe lameness (non-weight-bearing)
- Wounds that are deep, near joints, or won't stop bleeding
- Eye injuries or swelling (eyes are emergencies)
- Fever over 101.5°F (normal is 99-101°F)
- Difficulty breathing
- Signs of choking (feed material from nostrils, extended neck, distress)
- Inability to stand
- Signs of founder/laminitis (rocked-back stance, reluctance to walk, heat in hooves)
Schedule a routine visit for:
- Mild, intermittent lameness
- Skin conditions that aren't responding to home treatment
- Weight loss or gain that you can't explain
- Changes in behavior, appetite, or drinking habits
- Annual wellness exam, dental check, and vaccination updates
Build a relationship with your equine vet before you have an emergency. Know their after-hours protocol. Have their number saved in your phone. A good vet is one of the most important partners in your horse's care.