First-aid for the horse

 Summary of a lecture by Dr. Fischer (Equine Veterinary Hospital Grosswallstadt)

Lately we had the opportunity to take part in a lecture about "First-aid for the horse" given by Dr. Fischer. We diligently took notes and would like to make them available here, because maybe they are of use here or there!

To find out if a horse is sick and needs to be looked after by a vet, or could be treated by the owner or caretaker (in case of minor injuries), you have to know by what a healthy horse is characterized, to be able to distiguish it from a sick one!

There are four parameters, by means of whom the vet can reliably assess the degree of indisposition and obtain sound clues for the possible diagnosis, if these four values have been checked in a reliable way:

It is about the three PRT-values (Pulse, Respiration and Temperature) and the color of the mucosa.


The standard values and conditions are:

  • Pulse:              28    – 40beats per minute
  • Respiration:       8    – 16 gasps per minute (one gasp = inhalation & exhalation)
  • Temperature:37,5 – 38,2°C
  • Mucosa:           pinkish color

The PRT-values refer to an average sized, healthy, full-grown horse in a quiescent state. If the horse is in motion or excitement these values increase. The quiescent values for foals are higher than with full-grown animals, too. Moreover pulse and respiration are highly dependent on the fitness level. Competitive athletes (quadrupeds and bipeds) have considerably lower values than steady „stay-at-homes“ und „couch potatoes“.

Therefore it is important to know the personal values of the horse, to be able to better judge the result of the measurement. As the quiescent values shall be determined, the horse should be calm for at least half an hour ahead of the measurement. If the test results severely deviate from the standard values, this has to be taken seriously in either case!


Proper measuring and observing:

The pulse is ausculated either with a stethoscope laterally behind the elbow and counted or palpated with a finger at the emargination of the jawbone and respectively counted. Usually you measure for 15 seconds and multiply the number by four. However if you want to exclude unsteadiness of the pulse beat you should count for at least one minute.

The respiration is more difficult to measure, as horses don't always breathe uniformly. They sniff and snuffle, breathe deeper now and lighter then. Therefore it is quite trappy to watch the movements of the nostrils, as mostly they move more frequently than the horse in- and exhales. It is more unambiguously to count the flank movements.

The temperatur is being measured with a clinical thermometer – preferably without mercury - in the anus. Most suitable are thermometers with a cord, as they should be affixed at the tail. If you use a normal thermometer you should mind to keep hold of it! Don't measure the temperature right after defecating, as it will be lower then.
For this a small cautionary note:
Never stand directly behind the horse while taking the temperature, but laterally next to the horse! But you should stand as close as possible to the horse and keep physical contact.

The mucosa is best inspected at the gums. It should be pinkish. There are three kinds of typical staining which allude as distinct indicators for a horse that requires treatment:

  • Bluish discoloration suggests an intoxication
  • Yellowish mucosa is a sign of liver disease and metabolic problems
  • A Pale mucosa idicates a high blood loss

The gums provide information about the state of circulation, too. If you squeeze the blood out of the capillaries above the incisors at the upper jaw with your thumb (press for about two secondes), so that the gingiva looks pale, it should have returned to its normal color after three seconds. Failling this the horses blood pressure is too low and the circulation is affected.

A further hint for a possible circulatory disorder due to dehydration (disturbed water supply) offers the „wrinkletest“. For this you grab for a skin fold at the horses cervix, pull it away a bit from the neck and keep track of how long it takes until the fold can't be seen anymore. The smoothing should not take more than three seconds, else the horse presumably has drunken too little and/or perspired intensely. Heavily dehydrated horses look slightly crinkled even without this test.


Overall impression:

A further criterion of course is the overall impression of the horse. Admittedly often this is easier revalued for persons that are quite familiar with the horse than it is for outsiders. But there are also attributes, which can be objectively assessed.


Features of a healthy horse:

  • Attentive and satisfied physiognomy
  • Clear and agleam eyes (without discharge) with a pinkish mucosa
  • Relaxed movement of the ears
  • Lucent fur without hairless spots
  • Evenly barrel-shaped belly
  • Loosely hold/hangig tail, oscillating with the movement
  • Relaxed posture
  • Sound legs
  • Normal ingestion of fodder


Attributes of a sick horse:

  • Personality changes of any kind (restive, apathetic, reclusive, clinging, lethargic...)
  • Changed drinking manners (much more or much less than usual)
  • Modification of the consistency of the droppings (dysentery, very solid dung) and dark colored urine
  • Bleary eyes, possibly with discharge
  • Squinting of the eyes and nostrils (pain?)
  • Modified mucosa and PRT-values
  • Frequent turning of the head or kicking with the legs towards the abdomen (pain!)
  • Lifted/contracted abdomen (pain!)
  • Discharge through the nose – especially unilateral, sticky, mucous
  • Coughing
  • Dull fur
  • (Strong) sweating or freezing (the horse shivers, possibly feels chilly)
  • The front or hind legs are exposed exceptionally distictive towards the front or rear
  • Swollen up leg(s) and other swollen parts of the body
  • Permanently relieved leg (the horse refuses to stand on a leg)


When to call the vet?

Every experienced horse owner mostly can easily judge whether his steed needs a vet, or whether he can look after him himself, e. g. because he just has a small scratch that does not need to be sutured, or if it initially suffices, to monitor the fosterling more closely for one or two days and subsequently decide whether a vet is necessary. For unexperienced owners/caregivers it is more difficult to assess the necessity of a vet. If a trustworthy person with sufficient experience can be encountered in the stable, of course (s)he can gladly be asked for advice. But by no means you should ask every attendee for their opinion, for with 20 interviewee you can be sure to get ten different proposals how to proceed. This just unsettles the already nervous horse owner even more. Besides valuable time is lost, during which the vet could already be on the way. For in case of doubt it is essential to contact the vet once more than once too little. On the phone the vet or veterinary technician can evaluate the circumstances well, especially if the PRT-values mentioned above and symptoms are disclosed. No one - fewest the horse - benefits from a group of laymen trying in a treatment, notwithstanding the fact none of them really knows what has to be done.

Here's another special case, that is often responsible for uncertainty: May I call a vet if I'm NOT the owner of the horse?

As a livestock owner you are statutorily liable to have your animal treated in case of illness by a qualified person (veterinarian). But how to proceed if the owner is absent? At first of course you try to reach the livestock owner by phone, to inform him about the condition of his animal. But if you cannot reach the owner and the horse is hard up (e. g. it shows signs of colic) you call the vet anyway. As the owner is obliged to have his horse treated, (s)he must pay the fee for the vet. You might think that every horse owner should be glad if his horse get treated and well parented even during his absence without his request – as long as no additional „check-ups“ are performed. Unfortunately there are also human beings that don't rejoyce about an unquestioned vet consultation. To avoid unnecessary bickering with such and other owners you should ask the vet for an emergency supply only with peregrine horses, until the owner could be reached and orders further treatments. You should be careful with pharmaceuticals as well (e. g. with tournament horses due to doping). To ignore the ailment of a foreign animal because you can't stand the owner or for other reasons surely is NOT a solution!


In case of emergency:

Not every horse is an urgent emergency, even though every owner wants to see his fosterling being treated quickest possible. But despite our worry and bother we should bear in mind one thing: Often besides you further owners call for the vet and of course every case is especially urgent...

What shall the vet do now? He can't divide himself! Of course he want's to plan his route in such a way that the „real“ emergencies are being treated first and he looses as little time as possible by driving. You could help the vet organizing this by giving honest indications on the phone. Cross your heart: Is your horse really an emergency?

Assume you have a horse that touches down the tip of the hoof only very cautiously and doesn't want to put the weight on the leg. Possibly he even holds the leg a bit above the ground. When leaded he founders very strongly and the hoof feels warm (suspicion of an ulcerated hoof). Such a sight can considerably unsettle a horse owner. Nevertheless the vet would prefer to treat the pony at the neighbouring village with suspicon of lumbago first, as time plays a very prominent role here. The foundering horse can still be treated two hours later. Perhaps the pony with lumbago could solely be put down then!

Cases of emergency are sick horses with life-threatening dysfunctions. Without quick, professional help the animal would sustain serious, lasting health damages – in case it survives. Therefor it is important to provide the vet with information about the horse as accurately as possible.

Of course no one likes to see his horse suffer, therefor the time to wait for the vet can often be used to administer first aid and prepare the horse for the treatment. In the first place time passes by more quickly if you have something to do and moreover the therapeutic outcome for the quadruped can usually be positively influenced.

  • The attendance of a first-aid-course for horse and rider can't ever do any harm.



Likewise it is helpful if certain things have been clarified in advance, in order that you aren't slowed down by it in an emergency. Because time might mean the difference between life and death:

  • The (family) vet of the horse should be noted down with his phone number at the stall plate or at least into the stable log.
  • Phone number and address, best with directions (not everybody has a satnav!), of the next horse hospital should be noted down in the stable log.
  • The phone number of the owner must be accessible as well, in case (s)he is absend.
  • The horse passport of your horse should be near at hand.
  • A well-assorted stable ambulance box should be accessible.
  • Does the owner have a horse trailer (with a valid vehicle inspection sticker!) and a suitable tractive unit in case the horse needs to go to a hospital?
    ? No: Then a phone number of a horse transportation company (those do regularly advertise in trade magazines) should be noted down in the stable log, as the friend with whom you always join on tournaments might actually be on holiday or for other reason unreachable!
  • Does your horse enter the trailer trouble-free? If not you should practice with him, as empirically in stressful situations it doesn't work out better than in everyday life. We'll cover the (neverending) discussion "How do I securely and reliably get my horse on the trailer?" soon elsewhere on this site.


Typical emergencies:

In these cases the veterinarian provision of the horse is very urgent:

  • Phsyical injuries: Severely bleeding wounds, large-scale and/or deep lesions, injuries close to joints, injuries of the eyes or head traumas
  • Problems with the hoofs like laminitis and piercings through nails, also ulcerated hoofs
  • Colics: The horse suffers strong pains and oftenly - but not always - contracts the abdomen, the symptoms can be very different with various horses
  • Lumbago („red-letter day disease“): A meanwhile not so common but very dangerous metabolic disorder
  • Infections: E. g. rabies, tetanus
  • Intoxications: Especially by toxic plants
  • Trafic accidents involving horses


How do I act in case of...

  • General injuries:
    • Can an amber (non pyic) liquid be seen?
      This is an urgent emergency, because what can be seen here is joint fluid. The horse needs to be veterinarily treated quickly!
    • Is the wound so large or deep that it needs to be sutured?
      Yes/maybe: Then the wound may get in contact with Wasser and iodine dilution only. Ointments, sprays or disinfection dilutions must not be used. Suturation neccessarily should take place on the day of injury, as the edges of the wound start to scuff after a few hours. In this case at first the vet would have to further cut out the wound before he could suture it. Besides the danger of an infection of the wound rises over time.
    • The wound needs to be cleaned:
      Therefor tap water is suitable (flush with a soft stream for ten minutes). Please don't use stale water (e. g. pond water or water from a rain barrel)! Also please don't use e. g. chamomile tea, this will cause irritations of the wound! If your horse lives in an open stable without a water connection it is advisable to deposit a canister with clean water somewhere in the dark or at least in the shadow. But look out: This water needs to be replaced regularly! Besides you should use a container that is as lightproof as possible, i. e. if available a canister made of black, thick-walled plastics (light or thin-walled plastics are not lightproof). If possible the canister should be made of food safe plastics, other synthetics oftenly contain softeners, these dissolve away from the material and contaminate the content of the container. The picture to the right shows the containers we use for such and other cases. Originally they were used especially for distilled or rather deionized water, so that the plastics used shouldn't emit any substances into the water filled in.
    • Self-purifcation by lesser bleedings:
      Smallish bleedings with a blood loss up to one liter look scary, but have a positive cleaning effect, as germs do get flushed out together with the blood. The wound is covered with an aseptic wound dressing and bandaged untill the vet arives.
    • Compression bandage:
      In case of strong bleedings a convoluted bandage is put on the wound dressing and wrapped with a second one, so that pressure is beeing applied onto the bleeding area. The compression bandage must not be attached for longer than two hours, should be briefly loosened every 20 minutes and if neccessary newly reapplied.
    • Injuries of the legs:
      Injuries below the carpal joint on the front legs and below the subtalar joint on the hind legs respectively are especially dreaded, as the horse does not feature any muscles below these joints. This means that in case of a deeper wound sinews, ligaments, bones and joints are immediately involved. A vet should be called.
    • If the horse stands on three legs:
      Then in around 90% of this cases an ulcerated hoof is the elicitor and only for aproximately 10% a fracture (a rupture). Control whether something can be seen extrinsically and call for the vet. The horse should not move.


  • Head injuries and injuries of the eyes:
    • Injuries of an eye are emergencies and needs to be veterinarily treated!
    • Swollen eyes needs to be controlled by a vet.
    • In case of noticeable shade-lovingness (the horse is squinting) there's reasonable suspicion for recurring uveitis (ophtalmitis). Veterinarian!
    • Use eye ointment only but never cortisone ointments, if not explicitely prescribed by the vet.
    • Head injuries are to behandled with special care likewise. As a precaution use eye ointment here as well (due to its pH-value), in case the horse smudges the ointment and something gets into an eye.


  • Internal injuries:
    • These are especially dangerous, as the injuries cannot be seen externally and because horse unnoticedly may suffer a great blood loss!
    • Reason for instance can be a kick into the abdomen.
    • It is suspicious if a horse 3 to 4 hours after an accident or a scuffle suddenly appears exhausted, his blood pressure drops and the circulation gets unstable. Control the mucosa!
    • Immediately call the vet!


To be continued...



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This page was last modified on 29/04/2015 from Sabine Brockamp