1. Home
  2. Knowledge Base
  3. Animal Guides
  4. Horses
  5. How to Conduct A Horse Health Examination

How to Conduct A Horse Health Examination

A curious horse looks directly at a close up camera as three horses congregate in the distance outside.

Updated April 10, 2020

Much like the common advice given to humans, it’s important to regularly check the health of horses with a routine physical examination rather than waiting until a horse is showing signs of distress or illness. Not only will this help you get to know what all aspects of a healthy horse looks and feels like, but familiarizing a horse with human handling might help them stay more calm in stressful situations. Be prepared to check them over at least every six to eight weeks*! For more information on why regular health examinations are important, check out our resource here.

*An Exam Every Six To Eight Weeks Means Daily Observations

Our recommendation to conduct routine health examinations every six to eight weeks must be done in conjunction with daily observations.  Caregivers should be trained to observe animals both for behaviors that are abnormal for the species and also behaviors that are abnormal for each individual, keeping in mind issues that are common in a particular species and their warning signs.  Thoughtful observation plays a crucial role in catching health issues before they progress into more serious situations.

Residents With Challenging Backgrounds

Close daily observation can be difficult with certain individuals or groups who come from challenging backgrounds. They may be more likely to hide signs of illness or injury, or may not allow you to come close enough to them to thoroughly assess their well being on a regular basis. Challenging backgrounds may include individuals who are not socialized, have lived feral, or were abused or malnourished. If you care for individuals who came from a challenging background, it is imperative to make time to foster a bond of trust so careful observation is possible.  A monthly health exam is recommended for these individuals until they exhibit signs that they feel safe and you are confident that close daily observation is possible.

New Resident? Conduct An Intake Examination!

If you are conducting an initial health examination on a new resident, check out our intake examination resource to learn about what you should check for and document!

Problem Signals

By paying regular attention to the herd, you may see some subtle cues in the event that something is amiss. A sick, injured, or otherwise distressed horse may:

  • Avoid contact or appear nervous more often than they used to
  • Change their daily schedule or general behavior
  • Have labored breathing, coughing, choking, sneezing or a constantly open mouth
  • Be immobile, inactive or unresponsive to your approach
  • Be stretched out or frequently sitting and standing in order to relieve colic
  • Frequently tremor or lack coordination
  • Be sitting far more often than usual
  • Avoid or be rejected by the rest of the herd
  • Stamp their feet
  • Grind their teeth frequently
  • Have a limp in their step
  • Have unusual or abnormal droppings including diarrhea, blood in stool, or worms
  • Be less hungry or thirsty, or drink water excessively
  • Have an odd posture like hunching over or avoiding putting weight on one of their legs
  • Have a bulge or non-uniform abdomen or belly (could indicate a serious parasite infection)
  • Have an abnormally strong odor
  • Sweat more than usual
  • Have an internal body temperature not in the range of 98-101 degrees Fahrenheit or possibly a degree or so higher if it is really hot out (a foal’s range will be slightly higher 99-102)
  • Have a resting heart rate 25-45 beats per minute. Although heart rate in the 30s is the norm for many horses, some horses have lower or higher heart rates you should know their baseline resting heart rate and speak with a vet to confirm this is normal for them and not part of an underlying health problem. (smaller and younger horses will be significantly higher)
  • Have a respiratory rate outside of 8-18 (fear and high temperatures can increase breathing rate)
  • Have pale mucous membranes
  • Have unusual abscesses on their body or in their mouths (potentially signifying a serious infectious condition called Pigeon Fever)
  • Be reluctant or averse to urinating or urinating frequently

In cases of symptoms such as the ones above, it’s especially important to conduct a health examination on the horse. Generally, the examination should begin at their head, working your way back and down. It’s important to keep regular documentation of these checkups, including weight and any abnormal findings, in order to keep an easy-to-follow set of information in case a veterinarian needs the horse’s history.

Safety First!

Horses can potentially become ill with disease that is transmissible to humans. It’s very important to wear gloves when conducting health examinations! If you have never approached a horse before, read our guide to safely being around a horse.

Conducting The Exam

Ask An Expert

Prior to regularly conducting horse health examinations, you should have a veterinarian or compassionate care expert give you hands-on training in order to be the best horse health advocate possible. Being trained to rapidly distinguish healthy conditions from abnormalities can be crucial in early health problem detection and effective treatment!

It can be easier to conduct the examination as they’re tucking in for the evening as they tend to be less fussy. Before stepping into their living space, you should take note of the horse’s behavior. Are they acting differently than they usually do? How are they getting along with fellow herdmates? These clues can say a lot about a horse’s health.

If necessary, you may have to have a second caregiver on hand to help manage the health examination or help restrain the horse with a halter. Once you have the horse calm and ready, conduct the following observations:

When In Doubt...

Unless you are a qualified veterinarian or have been trained to handle specific conditions, The Open Sanctuary Project strongly advocates that you promptly report any health concerns you find during the course of an exam to your veterinarian or care expert. Unless they’re in a life-threatening situation, you should be your resident’s advocate, not their doctor.

Check their weight and body condition

It’s important to keep regular measurements or estimates of a horse’s weight. If a horse has lost a lot of weight, this could indicate a sickness, malnutrition, worms, or other parasites. If a horse is mature and has gained a large amount of weight in a short time, it’s critical to ensure that you aren’t overfeeding them, especially with alfalfa, treats, and snacks. Obesity-related complications can regularly lead to dangerous conditions in horses.’ section_head_2=’Check their head’ section_content_2=’How are they holding their head? It’s best if they’re holding it up on their own volition. If they’re shaking, hunching, or tucking their head, this can be a sign of illness or injury. Check their head for abscesses, which could be a symptom of Pigeon Fever, which is highly contagious and requires quarantine and intervention

Check their head

How are they holding their head? It’s best if they’re holding it up on their own volition. If they’re shaking, hunching, or tucking their head, this can be a sign of illness or injury. Check their head for abscesses, which could be a symptom of Pigeon Fever, which is highly contagious and requires quarantine and intervention.

Check their eyes

A horse should have bright, clean, alert eyes. They should be free of discharge and clear, and not appear sunken. Cloudy, watery, dry, swollen, constantly blinking, or crusty eyes indicates likely illness or injury. The above symptoms could be signs of pink eye, which is highly contagious to other horses and humans. Their pupils should be about the same size and react properly to bright light (get smaller and then return to normal). Take note of the skin around their eyes- if it’s much paler than usual, it could be a sign of anemia or another disease

Check their ears

Their ears can have a modest amount of earwax or debris in them, but should be clear of any ear mites. Excessively sticky, yellow, or odorous earwax needs addressing. You can use a gauze pad to clear out excess earwax or to sample potential ear mites.

Check their nose

A horse’s nose should be free of any discharge, fluid, crustiness, or blood. Their nose should be soft and moist, and not cracked. Consistently flared nostrils could indicate breathing trouble. An excessively runny or blocked nose could be a symptom of allergies, dust irritation, Lungworms or another upper respiratory infection.

Check their mouth

You shouldn’t be able to hear a horse breathe in ideal circumstances. Their breathing should not be labored, loud, wheezy, rattly, sneezy, whistling, or squeaky. Generally, a mature horse should have between 10-24 breaths per minute. A breathing-impaired horse might have lungworms, a serious and potentially deadly infection in their respiratory system. They should not have a dry cough. Many of these symptoms could also be a result of pneumonia which horses are highly susceptible to. Abnormalities should be immediately reported to your veterinarian. If they’re reluctant to eat, they might have a problem with one or more of their teeth that needs to be managed, or problems with their throat. Now take a look in their mouth. Their gums should not be red, very dark, or muddy looking, and there should not be any sores, abscesses, or scabs in their mouth, which could be caused by parasites, flies, or by grazing on poisonous plants. If the membranes around their lips and gums are dry, this indicates dehydration. If their mucous membranes are a notably paler complexion compared to their usual appearance, it could be a sign of anemia or other concerns. If a horse has particularly bad breath, it could be symptomatic of an infection and require deeper examination.

Check their digestive system

It’s critical to check a horse for symptoms of colic. If a horse appears to be in pain, is looking at their flank frequently, is drooping their ears, has an absence of gut sounds or is making abnormal ones, is sweating excessively, has a high pulse, is lying down or attempting to roll frequently, appears dehydrated, is grinding their teeth, urinating frequently, not defecating, isn’t eating at all, is stamping their feet, has difficulty breathing, has anxiety or depression, has an impacted colon, is very gassy, or are stretching themselves out, this is a sign of colic. If you are at all concerned that a horse might have colic, contact your veterinarian as soon as possible. In cases like these, it’s crucial to keep the horse moving while waiting for veterinary intervention.

Check their skin

Check around a horse’s entire body to ensure healthy skin. This is the time to ensure you are checking and feeling every area of the individual’s body, not just those included in this list.  This thorough section of the exam is critical to ensure that nothing that can be addressed early is missed.  Their skin should not have lice, mange, itchiness, mites, nits, lumps, cuts, cysts, bruises, gangrene, larvae, maggots, dry patches, blisters, or pressure sores. Abscesses on their body could be a symptom of Pigeon Fever. Their hair should be shiny and flat against their body, not be standing on end. If you lift a horse’s skin around their shoulders, it should quickly return to its original form when you release; if it seems to droop when returning to position, this could indicate dehydration. Ensure they do not have any patchy hair loss or a dull coat, which could be a sign of parasites or a mineral deficiency. Check their tail for hair loss and parasites as well.

Check their joints

It’s important to check a horse’s joints in their legs and shoulders for swelling or tenderness. They should not be much warmer than the rest of their body. Ensure that the horse doesn’t have pain when they move their joints. There should be no cracking or crunching sounds when they move, and they shouldn’t be avoiding putting weight on any of their joints in particular. Joint inflammation or problems could be a sign of arthritis, which is prevalent in horses as they get older.

Check their hooves and feet

Carefully check each of a horse’s hooves. Make sure they are a reasonable length and free of cracks, heat, swelling, debris, or abscesses. Any of these symptoms can cause lameness, discomfort, and could possibly contribute to infections and further damage. They should be able to put their full weight on their feet and they shouldn’t limp. If they are limping, check their hoof bottoms for uncomfortable debris. If their hooves are overgrown, schedule a trimming with a farrier as soon as you can. Generally, horses should have their hooves trimmed about once every three to six weeks, depending on environment and the individual. If a horse has any of the above issues with their feet, or if you smell a foul, sulfurous odor coming from their hooves, it could be a sign of thrush, requiring immediate treatment.

Check their rear end

A horse’s rear end under their tail should be relatively clean. Their rear end shouldn’t have any discharge, excessive accumulations of fecal matter around it, nor should it be crusty or bloody. Ensure that they don’t have any mites, lice, tapeworms, or other parasites. Make sure that the rear end isn’t irritated or prolapsed (protruding). If it’s prolapsed, you need to consult with a veterinarian. If a horse has udders, ensure that they are not swollen or tough, which can be a symptom of Mastitis and requires treatment. If a horse is struggling to urinate, it can be a sign of bladder stones or another urinary tract issue and require veterinary intervention.

Check their poop

It’s important to monitor a horse’s poop recognize what healthy horse droppings look like, which can be quite diverse between horses, and even different days. A horse should poop between six and ten times per day. Healthy horse poop is greenish to brown, moist, formed in balls with no recognizable piece of food in it. It shouldn’t be runny, nor should it be too hard, nor should it look like a “cow pie”. If it’s poorly formed, watery, strong smelling, yellow, or bloody, it could be a sign of dehydration, diarrhea, parasites, illness, or improper nutrition. If you’re particularly concerned by a dropping, you can bring it into your veterinarian for analysis, though you should consider fecal testing healthy-seeming horses at a regular interval to check for internal parasites. Conversely, ensure that the horse has regular bowel movements, as a struggle to poop could signify early signs of Colic. Their urine should not be very dark and concentrated, or contain blood in it.

Isolate If Necessary

Depending on the health concern, it may be necessary to isolate the horse in order to protect the rest of the herd from a potentially infectious disease. However, with some illnesses, such as pneumonia, often once a horse is showing symptoms, the other residents in the herd have already been exposed. In these instances, you will need to weigh what is in the best interest of all of your residents. A sick horse who is isolated from their herd may become more stressed, which could delay recovery. However, if the horse is being bullied or cannot compete with the rest of the herd for food, or if you need to more closely monitor their food and water intake and fecal output, you may need to separate them at least temporarily. You may find that keeping them in a quiet space with a calm horse companion is a good compromise until they are well enough to rejoin the herd.

Writing It All Down

As you may know, regular documentation is a critical part of responsible sanctuary animal care. In order to maximize the value of your horse health examinations, we’ve developed a free printable horse health exam form for sanctuaries and rescues!


Anemia In Horses | PetMed

Overview Of Lungworm Infection | Merck Veterinary Manual

How To Know If Your Horse Is Sick | WikiHow

Colic In Horses | Pet MD

The Basic Physical Examination | The Horse (Non-Compassionate Source)

Pigeon Fever: Myths & Misconceptions | The Horse (Non-Compassionate Source)

The Scoop On Poop | Horse & Rider (Non-Compassionate Source)

Signs Of Horse Illness | Horse (Non-Compassionate Source)

Knowing When To Call The Vet For Your Horse | Dummies (Non-Compassionate Source)

Identifying Types Of Nasal Discharge In Horses | The Naturally Healthy Horse (Non-Compassionate Source)

Know Your Healthy Horse | Equisearch (Non-Compassionate Source)

Non-Compassionate Source?

If a source includes the (Non-Compassionate Source) tag, it means that we do not endorse that particular source’s views about animals, even if some of their insights are valuable from a care perspective. See a more detailed explanation here.

Updated on February 15, 2021

Related Articles

Support Our Work
Please consider supporting The Open Sanctuary Project by making a donation today! We are 100% donor-funded and rely on the support of generous individuals to provide compassionate resources to animal caretakers worldwide.
Donate Now HERE