Horse Sense

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Diseases And Problems

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Abscess, Anemia, Anthrax, Arthritis, Azoturia (Tying-Up), Bleeders, Bog Spavin, Bone Spavin, Botulism (Forage Poisoning), Bowed Tendon, Broken Knee, Broken Wind (Heaves), Capped Elbow (Shoe Boil), Capped Hock, Carpitis, Cataract, Choke, Colic, Conjunctivitis, Corneal Injuries, Coughing, Cryptorchid (Rig), Curb, Cystitis, Dehydration, Diarrhea, Dung Eating, Ear Mites, Encephalitis and Meningitis, Entropion, Fistulous Withers, Founder (Laminitis), Glanders, Greasy Heel, Guttural Pouches, Haematoma, Heart Problems, Heatstroke, Nail Pricks, Navicular Disease, Pedal Osteitis, Pneumonia, Quittor, Rain Scald, Roaring, Seedy Toe, Strangles, Tetanus (Lockjaw), Thrush, Verminous Aneurysm, Wobbles

General Signs Of Illness

Horses are creatures of habit, and any variation of or departure from their normal habits should be viewed with suspicion. By following a routine checklist each day, you may become aware of a problem in its very early stages. This will enable you to rectify the situation or to contact your vet before it becomes too serious.

Appetite: Each morning and evening you should check the feed bin to see how much the horse has eaten. If the horse has eaten very little or nothing at all, check the palatability of the feed and whether or not there has been any change in quality or type. Some horses can be fussy about their food. If there is no logical explanation for loss of appetite, this is one of the first signs of illness.

Droppings: Check the droppings in the stable, yard or paddock, morning and night. Usually there are ten to fifteen droppings per day. The presence of very few droppings could be a sign of constipation; none could be a sign of an intestinal obstruction. Very hard, small dry balls of manure indicate dehydration and/or constipation. Fluid, watery droppings indicate diarrhea. If worms, odor, mucus, blood and undigested food are observed in the manure, these are signs of varying health problems.

Coat: Depending on the time of the year and housing conditions, the quality of the coat can vary markedly. A dry, harsh coat, excessive sweating or tight skin when pinched can be signs of illness.

Urine: Normal urine can vary markedly in color from clear and colorless to cloudy and yellow and from water-like to thick in consistency. If you suspect that there is something wrong with the urine, collect a sample in a clean screw top jar and put it in the refrigerator until the vet arrives. If no urine has been passed within about twenty-four hours and the horse appears to be straining frequently, it could be indicative of an obstruction. If excessive urine is passed, it is often referred to as "flooding the box" and a sign of it is very damp bedding. This is also abnormal. Reddish-brown or blood-tinged urine is abnormal.

Eyes, nose and mouth: Discharge from any of these orifices, if excessive in volume and/or yellow in color, is abnormal. The mucous membrane lining the eyes, nose and mouth is normally a glistening pink color. If it is white, yellow, bluish or brick red in color, it too is abnormal.

Legs: The lower limbs should be hard and cool with good definition around the joints and tendons. If the leg or legs are puffy, swollen and/or hot, further investigation by the veterinary surgeon is indicated.

Position: If the horse is lying down for lengthy periods of time, getting up and down, looking at its flanks or pawing the ground, continuously, these can be signs of abdominal pain. Even if you don't observe the horse showing these signs, you can often infer their presence if the bedding is piled in a heap or strewn everywhere, or if the horse's body is covered in bedding.

Respiration: The normal respiration rate is ten to fifteen breaths per minute. Rapid, shallow, heavy or noisy respiration is abnormal and requires veterinary attention.

Please Note:

This article is for informational use only. It is not, by any means, written to contradict anything the vet recommends! It is written to give knowledge of the seriousness of some of the ailments our friends are subject to.

When in doubt, call your vet! They are here to help our family members.

(As a side note, most of the Equine DVM's I've worked with care more about their horse patients, than most human doctors I've known!)

Specific Diseases and Problems

Abscess

An abscess is a collection of pus, generally circumscribed in a sac enclosed within the tissues of the body.

Causes: Abscesses that can be seen or felt under the skin are caused, in most cases, by a foreign body penetrating the skin and underlying tissue. When rubbing its neck against the fence, a horse may cause a splinter of wood to penetrate its skin, when grazing it may pick up a grass seed in its check or when walking in the yard or paddock, a nail may puncture its foot. However, abscesses appearing under the jaw are not usually caused by penetration of a foreign body but by an internal infection such as strangles. Horses sometimes develop internal abscesses on the liver, lungs and elsewhere. These are associated with a generalized bacterial infection.

Signs: In the early stages while the abscess is forming, the swelling is diffuse, hot, painful and hard. As the abscess matures, it becomes more localized, softer, less painful, and forms to a point. At this stage, when pressed by the finger, it will often show a pit or indentation. Depending upon the size and position of the abscess, the horse may be lethargic, off it's feed, or have a temperature.

Treatment: In the early stages, if a puncture site is obvious, thoroughly cleanse the area with an iodine-based scrub or Hibiclens, removing any dirt, debris, or dead tissue. Check the wound to see that no foreign body remains embedded in it. Apply a hot forment to the area and then smear a drawing agent, such as Magnoplasm, over the swollen area. Call your vet, who will administer antibiotics and anti-tetanus vaccine. The treatment may cause the forming abscess to subside and the tissue to return to normal. If the abscess points, your vet will lance it and drain it. The would should be kept open as long as possible while draining is taking place. If there is a large pocket after the pus has been drained out, it should be irrigated twice daily by squirting a syringe full of peroxide into the cavity. Drainage can be aided by gently pressing from the outer extremities of the abscess towards the opening. This treatment should be continued until the opening has almost closed over.

Anemia

Anemia is not a disease; it is a symptom of something else. It is essential to find the casual factor or factors before treatment is initiated. Anemia is a decrease of the hemoglobin and red blood cells whereby the levels are below normal, thus reducing the oxygen-carrying capacity of the blood. A stressed horse, such as one in hard training and frequently performing, readily shows signs of anemia. On the other hand, the unstressed horse with anemia may not show any signs at all.

Causes: Anemia can be caused by acute hemorrhage, which is indicated by internal bleeding from a ruptured blood vessel, or external bleeding from a cut or puncture wound. Chronic hemorrhage is indicated by blood loss associated with blood-sucking [parasites, or blood loss associated with biting lice. Anemia can also be caused by the destruction of red blood cells; this may result from infection. Piroplasmosis is a disease caused by a blood parasite called babesia, which destroys the red blood cells and is transmitted by ticks. Also equine infectious anemia is a virus infection that causes severe anemia. Phenothiazine, which is used as a worm drench, when given in a dose above the recommended level causes the breakdown of red blood cells. Another cause of the destruction of red blood cells is isoimmune homiletic jaundice. Anemias caused by the depression of red blood cell production are associated with chronic infections and nutritional deficiencies such as lack of iron, copper and pyridoxene.

Signs: Symptoms of anemia are lethargy, loss of appetite, restlessness, loss of condition and a rough coat. The color of the tissue around the eye (conjunctiva) reflects the status of the red blood cells in the horse. The normal color is pink; white indicates severe anemia. However, in many cases, a full blood count is essential. The purpose of a blood count is threefold; recognition of the not-so-obviously anemic horse, indication of the degree of anemia and diagnosis of the cause, which will determine the type of treatment to be given.

Treatment: No treatment should be iniated until the cause has been diagnosed. Since a blood count is essential for accurate diagnosis, it is best left to your veterinary surgeon. Some cases of anemia can be avoided by good nutrition and a good worming program.

Anthrax

This is a very acute disease caused by the bacteria Bacillus anthracis. This disease occurs all over the world, affecting all animals, including humans.

Causes: The bacteria in suitable conditions can survive in soil for forty years. Infection can enter the body by ingestion, inhalation or through a break in the skin.

Signs: These can vary according to the route of infection. Generally there is a high temperature, severe depression, diarrhea and abdominal pain, followed by swelling under the jaw, chest, abdomen and in the lower limbs. Death follows in two to four days.

Treatment: Contact your veterinary surgeon immediately. Isolate the horse from all other animals while waiting. If the horse dies, do not attempt a post mortem but seek advice from the appropriate authorities regarding disposal of the body and disinfection to prevent further infection of the herd.

Arthritis

Arthritis is inflammation of a joint (which is made up of bones, cartilage, ligaments and joint capsule). The joint capsule produces fluid that lubricates the joint.

Causes: Inflammation of the joint is caused by trauma that may be due to a kick, cut, fall or penetrating foreign body. It may also result from infection entering the joint through a wound or localizing in the joint from a general infection. Poor conformation placing abnormal stress on a joint or joints may cause arthritis, and so may nutritional deficiencies (i.e. calcium).

Signs: Acute arthritis involves all the signs of inflammation. The joint is warm and painful to the touch and swollen. On or all components of the joint may be involved. The joint capsule and ligaments may be stretched or torn, the cartilage bruised or scored and the bones fractured. Acute arthritis may subside, leaving a normal joint, or it may lead to chronic arthritis. Chronic arthritis is associated with a joint that has been swollen for a long time. The swollen joint is firm or hard, often not warm to the touch, and less painful. Although in many cases movement of the joint is restricted, over a period of time it becomes permanently damaged.

Treatment: The treatment varies according to the cause. A veterinary surgeon is best able to diagnose arthritis and pinpoint the cause. While waiting for the vet, apply a pressure bandage to the affected joint. Immobilize the horse by putting it in a stable or tying it up. Cold hose the joint and pack it with ice if there are no obvious signs of infection. An antiphlogestine poultice will help reduce the swelling. Chronic arthritis varies in its response to liniments, blisters, pin firing, anti-inflammatory agents and radiation therapy.

Azoturia (Tying-Up)

Years ago this condition was called Monday morning disease because draught horses, pit horses, and other working horses in good, well muscled condition exhibited symptoms on Monday mornings after they had rested over the weekend and had been fed a high-grain diet. The physiology of azoturia is not yet fully understood. However, the condition is characterized by stiffness, pain and muscle tremor involving the muscles of the hindquarters, except in severe cases where the muscles of the forequarters may be involved as well. Tying-up is a less severe form of azoturia.

Causes: Horses worked at irregular intervals and fed high-grain diets are most susceptible to azoturia. Ingested grain is converted to glycogen, which is stored in muscles and elsewhere. If the horse is rested for periods of one or two days while on a high-grain diet, large quantities of glycogen are stored in the muscles. Glycogen is used by the muscles as a source of energy when work is being done; the waste product from the chemical change that takes place is lactic acid. If a large volume of glycogen is stored, the large volumes of lactic acid is produced when the horse exercises. If this lactic acid cannot be expelled from the muscle tissue, it damages the muscle fibers, causing the condition known as tying-up. If large areas of muscle fibers are damaged or even destroyed, azoturia results. Some horses that are not on grain diets tie up because they are hypersensitive to lactic acid or because their particular metabolism does not cope with it efficiently.

Signs: These can very widely. In mild cases, during or after exercise, the horse steps short in the hind limbs, giving the appearance of stiffness. In severe cases, the horse will show stiffness, pain, sweating, and muscle tremor. The stiffness, involving both the hind limbs and front limbs, may progress to the point at which the horse cannot move and may lie down. The affected muscles are very hard to the touch, indicating cramp, and the urine may vary in color from dark brown to reddish black, according to the severity of the condition.

Treatment: Call your veterinary surgeon, who can confirm the condition not only by its history and clinical signs but also by taking a blood count and by doing certain serum enzyme tests. Stop exercising the horse when you notice that it is tying-up. In all cases except severe ones, walk the horse for thirty minutes. If it appears no better, call your veterinary surgeon. Walking aids in the circulation of blood to the muscles with consequent removal of lactic acid, thus helping to prevent severe cramping. Keep the horse warm by seeing that it is well rugged. Tempt it with fluids containing electrolytes, which, if drunk in any quantity, will help to flush out the kidneys. With the aid of information gained from a blood count, the vet can administer a muscle relaxant, diuretics, tranquilizers and anti-inflammatory agent if required, as well as specially prepared fluids and electrolytes by stomach tube or intravenous methods. All grain should be eliminated from the diet and the horse should be offered a bran mash as a mild laxative. Horses susceptible to frequent tying-up should have a low-grain diet. Normally the grain level in the diet should be in proportion to the amount of work done. For example, if in any one week a horse works for six days, followed by a day off, reduce the quantity of grain in the feed for that day. Recovery can take place within hours, though in severe cases it may take weeks. Exercise the horse every day, even if it is just walking exercise and consult your veterinary surgeon about the regular use of a particular vitamin supplement as a preventative measure.

Bleeders

This term is not used for the equine-equivalent of human hemophiliacs. Bleeding is a condition common to racehorses. A bleeder is potentially dangerous to itself, to its rider and to other horses in the field. During races there have been cases of horses bleeding severely, collapsing and bringing down others in the field. Some owners and trainers have argued that the bleeding is caused by the nose hitting the ground when the horse collapsed. This argument has been refuted on film showing blood steaming from the horse's nostrils before its collapse and fall.

Causes: Bleeding can be due to a defect in the blood clotting mechanism, high blood pressure or fragile capillaries in the nose or lungs.

Signs: The most obvious sign is that the horse will bleed from one or both nostrils after a race, track work or sometimes swimming. The bleeding may begin during the exercise, immediately after, or sometimes hours after the exercise has finished. The blood may lie inside the nostrils, drip to the ground, or flow very freely. Some horses bleed in the lungs. The only signs of this may be labored breathing, distress and coughing. This is often the more serious type of hemorrhage.

Treatment: Contact your vet, as this problem can be fatal. The vet can evaluate a defect in the clotting mechanism by taking a blood sample and doing specific tests for clotting. Using an instrument called a rhinolaryngoscope, the vet can examine the nasal passage, throat and upper windpipe to see if a ruptured vessel in any of those areas is causing the hemorrhage. Various drugs can be used to harden fragile capillaries, reduce blood pressure and rectify the deficiency in the clotting mechanism. Rest is essential for any capillary rupture to heal properly. Feeding the horse at ground level, thus making it put its head down to eat, may help strengthen the capillaries in the nostril.

Bog Spavin

This is a soft, fluid-filled swelling located on the upper, inner side of the hock. It is associated with inflammation of the joint capsule. In many cases, the swelling is an unsightly blemish having little or no effect on the usefulness of the horse.

Causes: These are faulty conformation such as a straight, upright hock, which produces abnormal strain on the joint capsule, and stretching and tearing the joint capsule of the hock, as a result of a sudden, sharp movement commonly met in such activities as polo, jumping and calf roping.

Signs: A soft swelling on the upper and inner side of the hock. More often than not, no heat, or lameness is associated with the swelling.

Treatment: In the early phases, cold hosing, rest, immobilization by stabling and application of a pressure bandage may be recommended. In chronic cases, treatment by a vet can vary from blistering to draining the fluid and injecting an anti-inflammatory agent into the joint capsule.

Bone Spavin

Bone spavin is a bony swelling on the lower, inner side of the hock, caused by arthritis of the bones in the area. Some horses with an obvious bone spavin show little or no signs of lameness; others may be very lame but with no signs of swelling. Horses with bone spavin may still be useful, but fluctuating lameness may recur at varying intervals.

Causes: In many cases, bone spavin is due to poor conformation, such as sickle and cow hocks. Despite what many people think, the condition is not hereditary. What is inherited is the poor conformation that predisposes the horse to bone spavin. The condition can also be caused by stress and strain being placed on the hock because of participation in such activities as polo, calf roping, and racing, especially by young horses.

Signs: These include a hard, bony enlargement that can be felt and seen in the lower and inner side of the hock. Lameness is evident when the horse is cold but often disappears as it warms up with exercise, although in some cases the lameness may worsen. The lameness in characterized by reduced flexion of the hock and in shortening the stride in the affected leg.

Treatment: Accurate diagnosis is important to determine the severity of the condition, and this in turn will determine the type of treatment. The diagnosis can only be made by your vet with the aid of X-rays. Your vet may advise any one of a number of treatments or a combination of them, if necessary. These treatments include rest in a spelling paddock for a minimum of six weeks and corrective trimming and shoeing. In the latter treatment, the toe of the foot should be rasped square and a shoe with a raised heel and a rolled square toe should be fitted. This causes the leg to move in a straight line rather than deviating outwards, thus alleviating strain on the inside of the hock. Other treatments are radiation, anti-inflammatory agents, pin firing, and surgery to sever a section of the tendon that runs over the spavin.

Botulism (Forage Poisoning)

Botulism is the technical term for forage poisoning. It does not occur very often, as its cause (feeding on moldy hay or chaff and on grain contaminated by vermin) is widely known and avoided.

Cause: Botulism is brought about by the ingestion of food or water contaminated by bacteria Clostridium botulinum that multiply and produces their toxin or poison. The botulism organism is found in soil, silage, and carrion. Warm, moist and poorly ventilated conditions are suitable for the growth and multiplication of the organism. The same conditions are also suitable for the growth of molds, so that there is often an association between botulism and moldy feed. It is therefore common sense not to use moldy, damaged, decomposed hay, chaff or grain as feed. Feed contaminated by carrion or vermin should also be avoided.

Signs: These are difficulty in grasping food with the lips and teeth, drooling saliva, inability to drink, paralysis of the tongue, slow mastication, inability to swallow, wobbliness in the hind and forequarters and knuckling over and stumbling that precede going down. Signs of botulism develop five days or more after the ingestion of the toxin. When a large amount of toxin has been ingested, the horse may be uncoordinated for a short period and then collapse, with constant paddling movements of the limbs. Death usually follows quickly, but may be delayed up to forty-eight hours.

Treatment: The mortality rate from botulism is high so contact your vet immediately. While waiting, treat the horse for shock. Vaccines are available but they seldom used because of the infrequency of the disease in horses.

Bowed Tendon

Tendon is the tough, sinewy tissue that attaches muscle to bone. A tendon is made up of numerous fibrils and is surrounded with a tendinous sheath. The tendons involved in the condition known as bowed tendons are the superficial and deep flexor tendons, located in all four legs behind the cannon bone, running from the knee to fetlock. The more commonly involved ones are in the front legs. Bowed tendon is very common in racehorses, often causing premature retirement. The bow is actually caused by swelling fibrils, oozing inflammatory fluid and by capillary hemorrhage. The size of the bow varies according to the number of fibrils stretched or torn and the position of the injury. Recovery from bowed tendon is more likely with modern advanced treatment. However, unless the tendon is returned to its original state, any weakness in the form of a damaged bowed tendon is likely to show under extreme stress, such as racing.

Causes: There are many predisposing factors, including conformation (long sloping pasterns), shoeing (long toe and low heel), fast gaits, forced training (uncoordinated leg movement due to fatigue), and excessive demand (the horse at full gallop or trot is asked to give that "little bit extra"). In addition, external damage may cause bowed tendon. It is usually brought about by a blow from another foot.

Signs: In the early stages, the symptoms are swelling, heat and pain on pressure. Depending on the number of fibrils torn in the tendon, the horse may be severely lame or it may just step short with the injured leg when made to walk. The acute signs may last for weeks, but in many cases, with time, the swelling will reduce and localize, leaving a hard, fibrous bow in the tendon.

Treatment: Contact your vet. While awaiting arrival, apply cold to the swollen tendon in the form of running water from a hose for thirty minutes. The running water also has a gentle massaging effect on the tendon. Alternatively, pack ice in a towel and hold it over the swelling or bandage it with cotton wool soaked in iced water. Following the cold treatment, wrap a cotton crepe bandage firmly and evenly around the leg from just below the knee to the fetlock joint. Leave the bandage in place unless the leg swells further and causes excessive pressure. If it does, remove the bandage and reapply. Immobilize the horse by putting it in the stable with a deep bed of straw or other suitable bedding. If the tendon is grossly swollen, immobilize the horse further by tying it up. Rest is most important. Do not exercise the horse, even if the swelling is only minor, until the vets’ opinion has been sought. Veterinary treatment of bowed tendon varies according to the case. It may involve rest only, spelling a paddock from six to twelve months, the administration of antiphlogestic, anti-inflammatory, and/or internal sclerosing agents, tendon splitting, tendon transplant, or carbon filament implant.

Broken Knee

This term refers to a break in the skin over the front of the knees. This break can be anything from a slight graze to a deep wound involving the joint space. These wounds take a long time to heal, often leaving a thickened scar with telltale white hairs.

Causes: The most common cause if a fall. The horse stumbles, loses its footing and falls to its knees. Cantering on bitumen, on concrete roads, up steep rocky inclines, or over uneven ground or fallen timber increases the risk of a fall. Other causes are a kick from another horse or a piece of wood that, when trodden on, flies up from the ground and hits the horse on the knee.

Signs: The hair may be removed, with the skin bruised and oozing a few beads of blood. At the other end of the scale, a large area (about two inches square) of skin and hair, including the connective tissue underneath may be gouged away, often to the point of exposing the bone, leaving raw, bleeding flesh grossly contaminated with dirt. If the joint space is opened, a light, honey colored fluid may be seen seeping from the hole. Wounds involving the joint space are serious, as irreparable damage may be done, rendering the horse chronically lame.

Treatment: The treatment steps are very clear: control hemorrhage, and use a hose to clean the wound of debris. Spray it with a topical antibiotic and cover the wound with a sterile gauze bandage to prevent further contamination and to control bleeding and swelling. Call your vet for advice and treatment. Keep the horse confined to a stable and relatively immobile, as movement slows down the healing process. Daily cold water hosing promotes healing and reduces swelling; If the wound is infected, hot bathing should precede cold hosing. Finally, pat the wound dry and apply a wound ointment (zinc cream) or antibiotic powder. Regular treatment for a broken knee is most important.

Broken Wind (Heaves)

This term is often used for horses that are roarers. Technically the term refers to horses that have difficulty with expiration, i.e. breathing out, especially during and after exercise.

Cause: The specific cause is not known, but it has some relation to chronic bronchitis, allergy to dust in stables, feed and overexertion.

Signs: In most cases, they appear gradually. Exaggerated and lengthy expiration is the most prominent symptom. Exercise tolerance is poor and the difficulty in breathing is disproportionate to the amount of exercise taken. Over a period of time respiration is difficult, even at rest, and the horse develops a barrel chest to help compensate. Wheezing associated with a short, shallow cough is evident.

Treatment: Rest in a well-ventilated, dust-free stable is effective, coupled with putting the horse out to pasture in good weather. Dampening the feed to keep the level of dust at a minimum is also helpful. However, in case where the air sacs in the lungs have ruptured, nothing can be done.

Capped Elbow (Shoe Boil)

This is a swelling on the joint of the elbow. In the early stages it is soft and fluid filled, later becoming hard as the fluid is organized into fibrous tissue. A specially padded leather roll strapped around the pastern while the horse is in the stable will protect the elbow when the horse lies down. If the horse is hitting the elbow with in motion, corrective trimming and shoeing is indicated.

Causes: When the horse is lying down with its front legs curled under, one of its front shoes may bit or press on the point of the elbow. The shoe on the foot of the affected limb of a horse with very flexible joints and a flamboyant action may also hit the point of the elbow while in motion.

Signs: A round, soft, fluid-filled swelling up to 5 inches in diameter can be seen on the point of the elbow. In most cases the swelling is not sore to the touch and lameness, if present, is only slight and of a temporary nature.

Treatment: In the early stages, cold compresses (ice wrapped in a towel), cold hosing and reduction of exercise to walking may be sufficient to reduce the swelling. If it persists for three to four days or becomes large, call your vet, who will drain the fluid and inject a drug into the lump to prevent it refilling.

Capped Hock

This is a swelling on the point of the hock. It is soft and fluid filled, later becoming hard as the fluid is organized into fibrous tissue. To prevent capped hock, remove the horse from the stable to a yard or paddock if it is a kicker.

Causes: Horses in confined spaces such as stables, horse floats, or trailers are susceptible to capped hocks. Kicking, rubbing or striking the point of the hock against a hard object are the most common cause.

Signs: In the early stages, a round, soft, fluid filled swelling up to 5 inches in diameter can be seen on the point of the hock. The swelling is not sore to the touch and lameness, if present, is only slight and temporary. Old swellings are filled with fibrous tissue and are hard to the touch.

Treatment: In the early stages, cold compresses (ice wrapped in a towel), cold hosing and reduction of exercise to walking may be sufficient to reduce the swelling. If it persists for three to four days or becomes large, call your vet, who will drain the fluid and inject a drug into the lump to prevent it refilling.

Carpitis

This is inflammation of the knee joint.

Cause: Concussion associated with such activities as racing, polo, jumping, hunting and eventing causes carpitis; so does trauma caused by a kick from another horse, or a horse pawing at a stable door hitting the front of the knee. Forced training of immature horses and poor conformation are other causes.

Signs: The horse is lame. The knee generally may be swollen or the swelling may be in a localized circumscribed area of the knee. Recent swellings are soft, whereas old swellings may be very hard. The horse will show signs of pain when the knee is bent. Flexibility of the knee is restricted.

Treatment: The swelling, if soft, is due to excess production of joint fluid from the joint capsule. If hard, the swelling may be due to fibrous tissue, arthritic spurs (new bone growth) or a fracture of one of the small bones in the knee. Call your vet to X-ray the knee to determine the exact cause of the swelling. Treatment may involve any one or more of the following: draining the joint, rest, injecting an anti-inflammatory agent into the joint, pressure bandage, blistering, pin firing, surgery and/or radiation therapy. If the horse is not lame and the knee has a soft swelling, the owner should rest it for fourteen days, cold hose the knee for twenty minutes twice a day and apply a pressure bandage. If the swelling is still evident or the horse is sore at the end of two weeks, seek the opinion of your vet.

Cataract

The lens is the area of the eye surrounded by the pupil. Cataract is crystallization of the lens. The bluish cloudy appearance that the lens of the horse's eye develops with advancing age is not to be confused with a cataract.

Causes: Congenital causes, trauma, infection and chronic inflammation of the eyeball are all known causes of cataracts.

Signs: In immature cataracts the lens is partly or wholly cloudy but allows some light to pass through it. Some sight is present. A mature cataract is dense and silvery-white and fills the entire pupil, which is usually dilated. Light cannot penetrate the opaque lens, resulting in total blindness in that eye. A cataract can form in one or both eyes. If the horse is totally blind in both eyes it will walk into walls and other objects, often subjecting itself to severe abrasions. A horse that is totally blind in one eye will often walk into objects on that side. When approached on its blind side the horse will often jump with fright when touched. A horse partially blind in one or both eyes may shy or balk at objects unnecessarily. Again, it may have difficulty in negotiating objects when the light is subdued, as it is at dusk.

Treatment: Once a cataract starts to form, treatment cannot prevent its further development. When it has reached maturity it can be removed surgically and the horse's sight is restored.

Choke

Choke occurs when food or a foreign body obstructs the esophagus.

Causes: Horses that bolt their feed and those with teeth abnormalities are more susceptible when fed dry grains. Boluses administered orally may lodge in the esophagus. Foreign bodies such as wire, nails, and pieces of wood are often responsible for choke.

Signs: The horse is obviously distressed, refuses to eat, extends its head and neck, salivates, coughs, grunts, and paws the ground. Food and saliva may be regurgitated through the nostrils. A lump may be seen and felt on the left side of the neck. The agitation will finally give way to depression.

Treatment: Call your vet and, while waiting, try to determine the cause of the obstruction. Solid objects are more serious than a blockage caused by grain, hay or grass. Do no allow the horse to drink as the water may be inhaled into the lungs, causing pneumonia. Greedy horses that bolt their feed can be forced to eat more slowly if large stones are placed in the feed bin and if hay is put into a hay net. Check the horse's teeth every six weeks for abnormalities. Those prone to choke on dry grains can be fed boiled feeds.

Colic

Those diseases of the horse that cause abdominal pain are generally referred to as equine colic. There are numerous types of colic, ranging from mild pain and quick recovery to severe pain and eventual death. It is much easier to prevent colic than to cure it, though the cure rate has markedly improved.

Causes: The causes of colic are many. One group of causes stems directly from poor management, the other from causes unrelated to management and over which man has little control. It is necessary to look at the state of the horse's teeth. The horse has a grinding action with the teeth, which leads to the development of very sharp edges on the inside of the lower molars and the outside of the upper molars. If they are neglected, the teeth develop razor sharp edges that severely lacerate the inside of the cheeks and gums. The horse finds it difficult to grind the food; poorly digested food will upset intestinal motility and could lead to colic. Excessive low-grade roughage makes digestion difficult for the intestine. Large boluses form, which lead to impaction. Debility, exhaustion and excitement can lead to changes in intestinal motility, and therefore cause colic. Slowing of the intestinal movements’ lead to a build up of food, impaction and obstruction. Hypermotility or speeding up of gut movements can also lead to painful spasmodic colic. Lush green feed gives rise to excess gas production due to fermentation processes in the gut. This causes flatulent colic. Engorgement with grain can cause gastric dilation, resulting in some cases, in rupture of the stomach or acute founder. The immature larvae of the red worm, strongyllus vulgaris, migrate into the muscular walls of arteries, causing a fibrous swelling known as an aneurysm which can block the artery, subsequently cutting off the blood supply and bringing about necrosis (death) of the portion of the bowel supplied by that artery. Routine and correct worming procedure cannot be over emphasized in the prevention of colic.

Signs: Symptoms vary markedly with the severity of the pain as well as the length of time that the horse has been suffering from colic. Generally speaking, the signs range from the horse being restless to pawing the ground, looking at its flanks, standing with all four legs extended, sweating, looking depressed, lying down, rolling, kicking and showing little or no interest in food and water. The horse's feces can vary from none at all to reduced amounts of small hard pellets or to fluid, diarrhea-like droppings.

Treatment: If the horse is exhibiting more than one of the symptoms described, contact your vet immediately. It is important for you to observe all the horse's habits so that you can give the vet an accurate history. The vet will then carry out a clinical examination, including pulse rate, temperature, respiration rate, and stethoscope examination of the heart and intestine, as well as a rectal examination, paracentesis and a blood count. Following examination, a diagnosis can be made as to whether the case is a medical one, or a surgical one. Time is of the utmost importance if surgical cases are to be successful. Many people think that a horse with a twisted bowel is doomed to death. This is not so if the veterinary surgeon is contacted early.

Conjunctivitis

The conjunctiva is the membrane lining the inside of the eyelids around the eye, seen when you pull the upper or lower eyelid away from the eyeball. Conjunctivitis is inflammation of the conjunctiva.

Causes: These are: the entry of foreign bodies such as chaff, dust or grit, and mud into the eye, infection, both bacterial and viral and eye injury.

Signs: The conjunctival membrane is very red and swollen and produces a discharge, varying from copious amounts of clear, watery fluid that runs down the cheek to thick, yellow-green pus that lies in the corner of the eyelids, sometimes matting them together.

Treatment: Call your vet, as other complications are often associated with conjunctivitis. One such complication is ulceration of the surface of the eyeball which, if incorrectly treated, may lead to a permanently damaged eye or blindness. While waiting for the vet to arrive, bathe the eye for ten minutes four times a day, with water that is not too hot for your hand. While bathing the eye, wipe away the discharge adhering to the eyelids. If possible, keep the horse in a dust-free environment, out of the wind and out of direct sunlight. If a foreign body is present in the conjunctiva, remove it, provided that this can be done readily. If not, leave the eye alone; you may increase the irritation of the conjunctiva and may even damage the eyeball itself. There are numerous different types of eye ointments, all of which have a specific purpose. Eye ointments should not be used indiscriminately for conjunctivitis because some can make certain conditions worse.

Corneal Injuries

As the cornea or surface of the eye is exposed, it is more subject to injury than other parts of the eye. In many cases, injury is followed by ulceration. Blindness or poor vision in one or both eyes can make a horse dangerous to ride, and ineligible for racing.

Causes: Dirt or mud may be thrown up from the hooves of a horse in front into the eyes of a horse following behind. When horses are packed up tightly in a race, one may be accidentally hit in the eye with a whip. A horse being ridden around and between trees and bushes is likely to be poked in the eye by a twig. When a horse is feeding, a piece of chaff can be blown into the eye. Infection can also damage the cornea.

Signs: An obvious one is the sight of tears streaming down the check, and the eyelid or eyelids being partially or completely closed. The appearance of the cornea or surface of the affected eye can vary from a dull, hazy appearance in a small area to the whole corneal surface of the eye being opaque and bluish-white in color. A small pit, varying in depth, may be seen if the cornea is ulcerated. Often a vet using special techniques for examining the eye can only see it. Scar formation following corneal ulceration is common. Its effect on vision depends on the size, position and thickness of the scar.

Treatment: Call your vet. Early vet treatment will help to minimize scar formation and maintain proper vision. While waiting, bath the eye in hot water and clean it as well as you can, using a clean wad of cotton wool soaked in water of such temperature that your hand can just tolerate the heat. Be careful to see that you do not cause any further damage to the eye while bathing it. Remove the horse to a shaded area or darken the stable; corneal injury is very sensitive to direct sunlight. Wind, dust, and flies will aggravate the problem. If a foreign body is present and can be readily removed, do so, otherwise leave it for the vet to extract.

Coughing

A cough is basically a protective mechanism to keep the breathing passages (windpipe and lungs) clear of obstructions, so that air can move in and out freely. However, excessive coughing irritates and inflames the mucous membrane lining the respiratory tract. Horses in stables or barns are more susceptible to coughs than those in yards or paddocks, mainly because of poor ventilation. Coughing epidemics can be very costly, especially in the racing industry, where they sometimes force horses to rest for months.

Causes: These can be the presence of foreign bodies (chaff, straw, and dust) in the atmosphere, bacterial or viral infection, and the presence of parasites or allergy.

Signs: All the above causes irritate and inflame the mucous membranes that line the respiratory tract. When this becomes inflamed, it secretes a copious mucous discharge and swells, setting off a cough in an attempt to expel the source of irritation. The first signs of illness may be lethargy, depressed appetite and watery nasal discharge, followed by heavy purulent discharge and a cough.

Treatment: Rug the horse well. If it has a high temperature and is sweating, a light rug is best. Make the surroundings as draught free and dust free as possible. Rest the horse with minimum exercise, such as a ten minutes walk morning and night. Heavy exercise will aggravate the condition; air rushing in and out of the windpipe irritates the mucous membrane, and exercise will cause the horse's temperature to fluctuate. A cough elixir can be used to help sooth the throat by being dribbled onto the back of the tongue with syringe or wiped onto the base of the tongue with a wooden spoon. A nose bag or chaff bag cut to size and hung from the horse's head can be used to give it an inhalation by placing six drops of eucalyptus in the nose bag filled with straw. Call your vet if a heavy nasal discharge is present, if the horse is off it's feed and has a temperature, or if it is coughing persistently. Antibiotics do not arrest viral infections, but in most cases a primary viral infection is accompanied by a secondary bacterial one that will respond readily to antibiotic therapy. Infection sometimes spreads to the lungs, causing pneumonia, which, if not promptly attended to by a vet, may damage the lung tissue sufficiently to render the horse unsound or to cause its death. Isolate the coughing horse and remove other horses as far away as possible. Coughing is a very efficient method of spreading infection into the atmosphere in minute droplet form. Because of their size and lightness, the droplets can be carried by the wind and spread over a large area. Common areas such as barns, hosing docks, sand rolls and yards act as ideal sites for a coughing horse to spread the disease. Thoroughly clean feed bins, water buckets, bridles, grooming equipment and the contaminated clothing and hands of attendants.

Cryptorchid (Rig)

A rig or cryptorchid is a male horse with one or both testicles undescended. Most foals are born with the testicles descended and preset in the scrotum. If one or both have not descended and are not detectable by deep palpation of the groin by the time the horse reaches two years of age, it is unlikely that they will descend naturally.

Causes: The condition is inherited.

Signs: The horse exhibits the characteristics of a stallion such as crest on the neck, aggressiveness and sexual interest in mares, but if only one testicle is seen and felt in the scrotum, the horse is obviously a rig. If no testicle is evident, the horse may be a rig or an aggressive gelding. Contact your vet, who will examine the horse rectally. If the horse is a rig, the testicles will be located in the abdomen.

Treatment: With hormone treatment by a vet, the testicle or testicles may descend into the scrotum and develop to normal size. Another form of treatment is castration. In the case of a rig, surgery is a more complex procedure, sometimes involving the opening of the abdomen to locate and remove the testicles. The fact that this condition is inherited indicates that rig used for breeding are likely to sire male foals that are also rigs. Breeding societies should be aware of the existence of this inherited defect and discourage their members from using horses with one testicle for breeding. Horses with both testicles undescended are generally considered to be infertile. There is also the possibility that a retained testicle in the abdomen may become cancerous as the horse ages.

Curb

Curb is an enlargement about ten centimeters below the point of the hock, due to tearing or sprain of a ligament.

Causes: These include cow or sickle hock conformation, strain from sudden quick movements such as jumping or galloping, especially in muddy conditions and kicking walls, fences and tail gates in floats and trailers.

Signs: Seen from the side, the swelling is semicircular in shape and feels hard when pressed. The initial swelling may reduce in size a little, but in many cases a permanent blemish results. However, the horse does not go lame.

Treatment: Cold hosing, rest, and painting twice daily with a cooling lotion are all effective treatments. Contact your vet, who may treat the condition by injection or by administration of anti-inflammatory agents, depending upon the size of the curb. Unless the horse has poor conformation, complete recovery usually follows treatment.

Cystitis

Inflammation of the bladder is not a common problem in horses. Mares are affected more frequently than colts or geldings.

Causes: These include damage to the bladder or urethra (opening of the bladder) during foaling, infection of the uterus or vagina, spreading to the bladder or stones in the bladder. Horses fed on certain species of sorghum can also contract cystitis.

Signs: Frequent straining to urinate with little or no urine being passes on each occasion. The urine may vary in color from clear to dark red, indicative of blood being passed. The skin around the vulva and between the legs of mares may be scaled, due to the continual dribbling of urine.

Treatment: Contact your vet but, while waiting, collect a urine sample from the horse in a clean glass receptacle with a screw top lid. A urine sample is helpful, sometimes essential, in making a correct diagnosis. Do not use a honey jar; this may artificially affect the urine sugar level. If the vet is delayed, store the sample in the refrigerator. If the skin has been scalded by urine, wash the area with warm soapy water, dry thoroughly and apply zinc cream or Vaseline. Clean, fresh water should be available to the horse at all times. Your vet will select and administer an appropriate antibiotic for infections of the bladder.

Dehydration

Horses sweat freely, are often exposed to the environment for lengthy periods of time in a paddock, and some are regularly and vigorously exercised in preparing for and taking part in such activities as weekend trail riding, racing and endurance riding. They are, therefore, more susceptible than most animals to dehydration, that is they lose more than normal amounts of fluids and electrolytes that cannot adequately be replenished by normal diet.

Electrolytes are made up of a delicate balance of salts, including sodium, potassium, chloride, bicarbonate, phosphate and magnesium. Body fluids and cells contain electrolyte ions in varying proportions. For example, body fluids have concentrated sodium and chloride ions, whereas the fluid inside cells contains concentrated potassium ions.

When a cell functions, that is when a muscle cell contracts, potassium and other ions from inside the cell pass through the cell wall to the body fluid. Sodium and chloride ions pass from the body fluid to the inside of the muscle cell. Muscle fatigue sets in, that is the muscle becomes incapable of further contraction, when ions in the body fluid equal those within the muscle cell. When muscles are resting, the reverse action takes place.

Cramping and tying-up result if excessive loss of electrolytes in the sweat is not replaced because there are insufficient electrolytes in correct balance in the horse's diet.

Daily feeding of an electrolyte mixture will ensure that the electrolytes are replaced, as they are lost, thus preventing dehydration. However, there is a limit to the quantity of electrolytes a horse will accept in its feed. Horses in training or performance horses that require greater amounts of electrolytes can be given them by stomach tube.

Causes: There is a continual loss of electrolytes and fluid through feces (droppings), sweat, and urine. This continual loss is accelerated by the following factors: exercise, heat, travelling, diarrhea, loss of appetite, lack of access to water, and free sweating.

Signs: Dehydration may be identified by a harsh coat, sunken eyes, lethargy, loss of appetite, hard dry balls of manure, fatigue, cramping, tying-up, poor performance, and poor recovery from exercise. When the skin is pinched, lack of return or slow return to normal can indicate dehydration.

Treatment: A balanced electrolyte mixture can be administered orally by means of the feed or drinking water, by nasal stomach tube (the electrolytes being dissolved in water), or intravenously, the electrolytes being in a specially prepared sterile solution. Blood tests can be done to evaluate which electrolyte is deficient and a solution concentrated in that electrolyte can then be administered. Drugs that act on the kidney can be injected into the horse, causing retention of certain ions in the body.

Diarrhea

Diarrhea in mature horses is uncommon. When it does occur, it attracts attention and causes some alarm because often the cause is not determined and the symptoms do not respond to the treatment. Many cases of diarrhea can be prevented by proper management, including feeding, worming, teeth care, and cleanliness.

Causes: These include bad teeth, broken teeth or teeth with sharp edges, all of which five rise to incomplete mastication. Other causes are worms and poor nutrition. The quantity and quality of the food may be the cause, that is large amounts of succulent, Lucerne hay (quantity) and moldy hay (quality) fed to the horse at irregular intervals. Infection that may be bacterial, viral, or protozoal can cause diarrhea, as can excitement, such as is experienced at the races or horse shows. Nervousness or excitement upsets intestinal movement.

Signs: Diarrhea is recognized when the feces passed are cowlike, porridge-like, or just a discolored watery fluid. A horse with severe diarrhea can squirt discolored fluid a yard or more from the anus, splattering the walls of the stable. When there is evidence of diarrhea on the ground and a group of horses are in the paddock, the sick horse will, in most cases, have diarrhea matted in the tail and around the hindquarters. The color of the feces may vary from pale to yellow to black with streaks of blood and mucus.

The horse's appetite can fluctuate from normal to non-existent. Most horses with diarrhea exhibit signs of discomfort when defecating such as switching the tail, looking at the flank and tucking up the abdomen.

Horses with severe diarrhea can exhibit signs of colic. If the diarrhea continues for two or three days, they lose weight and become weak, depressed and dehydrated.

Treatment: Call your vet, who will not only treat the symptoms but will examine the horse and take a sample of its feces to ascertain the cause so that the correct treatment can be given. Treatment varies according to the cause. For example, treatment for diarrhea caused by worms is markedly different from that caused by salmonella.

While you wait for your vet, you can help the horse by isolating, reducing its total volume of feed by half or by not feeding it at all. Remove from its diet, powdered milk, bran or succulent Lucerne hay, and replace these supplements with oaten hay. Allow the horse frequent small amounts of water containing electrolytes. Check the teeth and note the date when the horse was last wormed. Assess the quality of the feed that the horse has been eating. For instance, check for moldy hay. Reduce the horse's exercise, if it is in hard work, to a ten-minute walk morning and night. If the hard work is in the form of chasing a young filly in the next paddock, up and down the fence, remove either the colt or the filly to another paddock out of sight.

Dung Eating

Eating manure, bedding and dirt is both an unhealthy and an unpleasant habit that horses sometimes acquire.

Causes: These include poor nutrition, involving vitamin and mineral deficiencies, boredom as a result of being confined to a small stable or yard, insufficient food and lack of access to natural pasture for grazing, and the presence of sweet additives in the feed, such as honey, glucose, molasses and powdered milk, which give the dung a sweetish taste.

Signs: The obvious sign is that the horse is eating dung. You should be suspicious, if, when mucking out the stable or yard, you find no dung in the bedding. (Of course, keep in mind that the horse may be constipated).

Treatment: Provide a well-balanced vitamin and mineral supplement and adequate quantities of good quality feed, and remove any sweet additives from the diet. To relieve the boredom of a stable or small yard, give the horse access to a paddock with good quality natural pasture. If a paddock is not available, provide the horse with a hay net filled with good quality Lucerne hay. Pick up and remove the dung four times a day. Regular worm treatment is essential.

Ear Mites

The presence of ear mites is not common. However, sometimes the signs are not obvious to the unpracticed eye and the problem goes undetected for a long time.

Causes: Tiny mites are present in the ears.

Signs: One or both ears tend to droop. The horse is often very sensitive to the touch of the hand on the ears or to the touch of the bridle as it is being put on or taken off over the ears. The horse may hold its head to one side, shake it and rub the ears on doorways, walls and fences. Wax may be discharged from the ear.

Treatment: Contact your vet, who will examine wax from the ear canal under the microscope. Mites in the wax give a positive diagnosis. The vet will then prescribe the correct eardrops. A twitch and/or tranquilizer may have to be used so that the ears can be thoroughly cleaned of all wax and the prescribed drops applied.

Encephalitis and Meningitis

Encephalitis is inflammation of the brain and meningitis is inflammation of the membranes covering the surface of the brain.

Causes: These are viruses, bacteria, trauma, tumors, certain migrating parasite larvae and various poisons.

Signs: Generally these can include excitement and overreaction to normal external stimuli, followed by depression, staggering, knuckling over, walking in circles, lying down, general muscle tremor, rigidity, paddling movements of the legs and coma.

Treatment: Call your vet immediately. While waiting, if possible, place the horse in an area where it will cause minimal damage to itself. Provide fluids and protection from the environment (warmth or shade). Reduce external stimuli to a minimum by keeping the noise level down and handling the horse as little as possible. Provide a bran mash to help prevent constipation.

Entropion

Entropion is turning in the eyelid that causes the eyelashes to rub on the surface of the eyeball (cornea), thus irritating it.

Causes: Some foals are born with this condition, often with both eyes affected. The lower eyelid is the one more commonly involved. Chronic conjunctivitis and lacerations of the eyelids can cause entropion in adult horses.

Signs: One sign is weeping of the affected eye, as evidenced by a continual wet patch below it. Partial closure of the eyelid of the affected eye or rubbing the eye to alleviate the constant irritation may be observed.

Treatment: Contact your vet. This condition can be successfully cured by surgery. In young foals, turning out the lid six or more times a day and applying an eye ointment may correct the affected lid.

Fistulous Withers

Fistulas or long, pipelike, narrow-mouthed ulcers may appear on the withers as non-infected, localized swellings or as an extensive weeping infection, starting at the withers and running under the skin, sometimes along two-thirds of the shoulder blade. To prevent the formation of fistulas, check that the saddle fits the withers properly. Correct saddling posture should be followed as a matter of routine.

Causes: Infection; the bacteria found in the discharge are the same as those that cause abortion in cattle and poll evil in horses.

Trauma; in most cases, injury to the withers by the saddle precedes infection. In a few cases, however, there is no observable evidence that trauma or infection is the cause.

Signs: The disease may erupt suddenly with all the signs of acute inflammation such as swelling, heat and pain, or it may develop slowly and insidiously without any obvious signs of inflammation, the first real sign being discharge at the point of eruption. Fistulas may develop on one side of the withers or on both and, in acute cases, the horse is stiff in its movements of the forelimbs. When the swelling erupts, the fluid is straw-colored, and in a few days this will changes to a whitish-yellow discharge of pus. The site of the eruption may dry up, heal and scar, but later another eruption will occur in a different spot of the withers.

Treatment: If a small, localized swelling develops on or near the withers, do not use a saddle on the horse until the swelling has disappeared completely and the skin has regained its toughness and elasticity. If the horse is in training, its fitness program can be continued by lunging, leading off a pony, and swimming. Bath the swelling four times a day for ten minutes each time, using water just hot enough for the hand to tolerate it. After bating the swelling, apply a drawing agent such as Magnoplasm or antiphlogestine. Call your vet, who will advise you and administer the appropriate antibiotics. He will take a swab from the discharge to identify the bacteria and to determine what antibiotic is the most effective. A lengthy course at a high lever of the antibiotic is administered, as the condition is apt to recur. If the infected area is extensive, involving sinuses running under the skin, surgical drainage as well as administration of the antibiotics is necessary. Place water and feed containers at an appropriate height when the horse is suffering from fistulas, as some horses refuse to end down because of the pain.

Founder (Laminitis)

The terms 'founder' and 'laminitis' are synonymous, both are used to describe inflammation of the sensitive laminae that cover the pedal bone inside the hoof. The condition can be acute or chronic and is usually confined to the front feet, although all four feet may be involved.

Causes: These include ingestion of an excessive amount of grain, particularly wheat and barley, drinking large amounts of water while still hot after exercise, ingestion of excessive amounts of lush pasture and intermittent, severe exercise on hard surfaces. Other causes are the retention of the placenta after foaling and diarrhea and other gut disorders. Some causes are unknown.

Signs: Signs of acute founder are readily observed. The horse is reluctant to move and tends to lie down or to change its weight continually from one foot to another. If only the front feet are involved, the horse will stand with its hindlegs well up under the body and its forelegs well forward, so that as much weight as possible is taken off the front feet. If forced to move, it will shuffle along, putting the heels to the ground first. The affected feet are hot because of the inflammation and increased arterial blood supply. The throbbing of the arteries running down either side of the pastern can be felt with slight pressure of the fingers. The horse refuses to eat, sweats and trembles. The symptoms reflect the pain that the horse is suffering. In severe cases, its hoof or hooves may fall off. With chronic founder, the horse is intermittently lame, putting first the feels of the affected feet to the ground. The feet are often warm, the sole is dropped and is convex instead of being concave, and ring-like impressions are present on the hoof wall. Seedy tow and excessive flaking of the sole are usually present in chronic founder.

Treatment: If your horse has acute founder, contact your vet. While waiting you can help by removing the cause if possible. For example, if the horse has been eating an excessive amount of grain, change it to a grain-free diet. You may cool the horse's feet in a variety of ways: by hosing them, by packing them in ice, or by standing the horse in a stream or a wet muddy area which, if not available naturally, can me man-made. It is a good idea to move the horse about for short periods at frequent intervals in order to stimulate circulation in the feet. Feed the horse with warm bran mash as a gentle laxative. Some horses recover completely from acute founder, depending on its cause, its severity and the speed with which the horse is treated. If rotation of the third phalanx (pedal bone) has taken place, the chance of recovery is not good.

The treatment for chronic founder is long-term, covering the use of anti-inflammatory agents prescribed by your vet. It also involves corrective trimming and shoeing, whereby the heels are trimmed and rasped as much as possible with minimal or no rasping of the ground surface of the wall at the toe.A wide bar shoe is placed on the foot to protect it and to prevent further dropping of the sole, caused by downward rotation of the pedal bone. In some cases, corrective trimming and shoeing over a long period of time can slowly but surely restore the foot to its original state.

Glanders

Glanders has been eliminated in most well developed countries, although it is still prevalent as a contagious disease in some of the less-developed parts of the world. Man is susceptible to the disease ad in some cases it has proven fatal.

Cause: The bacterium Actinobacillus mallei are the causative agent. It can survive in water for up to four weeks. It is readily destroyed by desiccation from the sun and by certain disinfectants such as iodine. Infection is mainly by ingestion but it may be by inhalation or by abrasion of the skin.

Signs: Horses that develop a chronic form of the disease show weight loss, nasal discharge, coughing, pneumonia, ulceration of the nasal cavity and of the skin, often erupting on the inside of the hock. The nodules under the skin are up to two centimeters in diameter and discharge a honey like pus.

Treatment: Isolate the horse or horses and contact your vet or appropriate authority immediately.

Greasy Heel

This is a dermatitis or inflammation of the skin at the back of the pastern and between the heels. It is found more frequently in the hindlimbs than the forelimbs.

Causes: Standing or exercising in wet or muddy conditions predisposes the skin to infection. The skin at the back of the pastern may be abraded by exercising on sandy surfaces or by rope burns. If the area is constantly wet and washed with soap, it may become irritated.

Signs: The affected areas are sore to the touch. In the early stages, the skin is inflamed, after which it becomes raw and bleeds. Hair may be lost and deep cracks with thickened skin on either side may develop. In severe cases, swelling of the pastern and fetlock accompany lameness.

Treatment: Keep the horse's legs as dry as possible by reducing hosing to a minimum, by putting the horse in a well-drained, dry yard and by working it on dry surfaces. Wipe any grit from the backs of the pasterns and from between the heels after exercise. Grip can have a very abrasive action, especially when embedded in cracks in the skin. If the condition is old, dry and hard, apply zinc cream to soften the skin and minimize cracking. If the skin is moist and oozing, apply gentian violet to dry it out. Leave the skin open to the air, as bandages often keep the surface moist as well as collecting grit that acts like sandpaper. If the pasterns are swollen and oozing, call your vet for professional advice and treatment.

Guttural Pouches

The Eustachian tube extends for about 5 inches from the middle ear to the throat. a section of it is distended to form a sac known as the guttural pouch. These pouches are only found in horses and other solipeds; their precise function is obscure.

Signs: The pouches can become infected or distended with air causing swelling below the ear where the head meets the neck, causing discomfort and difficulty in breathing.

Treatment: Surgery is the recommended treatment

Haematoma

This is a circumscribed swelling of variable size and position, located under the skin and containing blood.

Cause: The condition is caused by a horse running into a fence, crashing into a doorway, falling over, being kicked by another horse, or by any blow that damages the skin and underlying tissues severely enough to rupture local blood vessels. The blood leaks into the surrounding tissues, forming a haematoma.

Signs: Often the swelling is not sore to the touch. It can vary in size according to the size of the vessel ruptured and the size of the rupture itself. It is not uncommon to see a haematoma the size of a football. The swelling in the early stages is soft to the touch. If you tap it, it feels as though you are tapping a fluid filled cavity.

Treatment: In the early formation of a maematoma, ice packs and cold hosing help stop the bleeding and reduce the swelling. If a blood-filled cavity has formed, continue applying cold foments and call your vet. He will usually leave the haematoma for four to five days before draining it. This allows the ruptured vessel to seal itself off and the bleeding to stop before the cavity is opened. If a haematoma of any size is not opened and drained, over several months the blood may be converted into a hard fibrous swelling that will remain as a permanent blemish.

Heart Problems

The heart is a four-chambered, muscular pump, made up of special muscle fibers. The heart pumping action is controlled by electrical impulses from a small node situated in the heart muscle, but this automatic control is overridden by other factors when a horse is excited or disturbed.

The function of the heart is simply to circulate blood to the numerous tissues and organs throughout the body. Basically, blood goes from the heart to the lungs where the red blood cells are replenished with oxygen and their waste products are removed. The oxygenated blood then goes to the tissues and organs, where it exchanges its oxygen for carbon dioxide and other waste products. It is then said to be deoxygenated blood, and is then transported back to the heart and again pumped to the lungs, where the waste products are removed and the blood is reoxygenated.

Causes: The horse may be born with a heart defect. Viruses and bacteria may also damage the heart muscle and valves. An unfit horse put to hard training too quickly or a fit horse subjected to prolonged periods of stress may also suffer a heart problem.

Signs: Symptoms of heart trouble include poor performance during preparation or training, as well as fatigue and poor exercise tolerance. The horse has labored, rapid breathing and raped heart rate following moderate exercise. Another sign is that respiration and heart rate take a long time to return to normal after exercise. These signs are not specific for heart disease, but you should be suspicious if your horse exhibits them.

Heart murmur, detected with a stethoscope, is associated with incomplete closure of the heart vales. When the heart muscle contracts on a supposedly closed chamber, some blood leaks through the partially closed valves, thereby reducing the cardiac output, the oxygenation of the tissues, the exercise tolerance and the performance of the horse.

Myocarditis or inflammation of the heart muscle is detected by your vet using an electrocardiogram, enabling him to evaluate abnormalities in the heart and to assess the heart size. It is not an uncommon condition and is seen in performance horses such as the polo, endurance, event and racehorse. In some cases, horses show signs of a good first up performance when resuming after a rest or spell. Then the performances become progressively worse as the horse competes more and more. In other cases a horse racing over a distance of 1200 meters may be in a winning position at the 1K mark and racing keenly, but in the last 200 meters it fades from a winning position to finish at the tail of the field.

Treatment: If a horse is born with a heart murmur or acquires a murmur from damage to a heart valve, no treatment is available. Most of these horses lead a normal life, but some do not. If a horse has myocarditis, consult your vet who will prescribe the appropriate treatment, In training a racehorse subject to myocarditis, it is advisable to get the horse fit and at its peak a few weeks before the event, then taper the workload and keep the horse as fresh as possible with light excersize prior to the race. Space the races so that the horse has plenty of time to recover as well as using them to help maintain the horse's fitness. If the horse requires a gallop before the race, make sure it is at least four days away from the event, allowing the horse and its heart muscle sufficient time to recover.

Heatstroke

All horses subject to strenuous exercise or exposed to very hot, humid conditions are susceptible to heatstroke. They generally recover in a few hours, though those that convulse and have a very high temperature are not likely to do so.

Causes: Strenuous exercise alone over a lengthy period of time such as during an endurance ride can cause heatstroke, as can exposure to heat wave conditions, especially without adequate shelter. Another cause is confinement in a poorly ventilated, hot stable or in a horse float during transit. Unfit horses exercised on hot days can also develop heatstroke.

Signs: These include weakness, stumbling, refusal to move or eat, dry ski (sweating ceases), convulsions, collapse, coma, high temperature, and marked dilation of the blood vessels in the skin.

Treatment: Immediately place the horse in the shade and if possible in a breeze. If an electric fan is available, use it to cool the horse. Hose the horse all over from head to foot with cold water, and provide large quantities of drinking water. Stop exercising the horse for a number of days, then gradually increase the amount of work.

Nail Pricks

Causes: When the shoeing nail is placed incorrectly o the inside of the white line or, when being driven, it crosses the white line and penetrates the sensitive tissues of the foot, the horse is referred to having been 'pricked'

Signs: The most obvious is mild lameness shortly after shoeing, and this generally worsens each day. Three to seven days after being shod, the horse is acutely lame, just touching the ground with the toe of the foot. The hoof wall is warm to the touch and often the pastern is swollen. Severe pain is exhibited by the horse pulling the foot away when it is squeezed with hoof testers or pincers or tapped with a hammer. The pain is worse when pressure is applied over the offending nail. Removing the shoe is often a painful procedure. Carefully examine each nail and nail hole in the hoof for moisture, blood or pus. Arteries on either side of the pastern supplying the hoof pulsate more rapidly and strongly than normally.

Treatment: Leave the shoe off. Clean around the nail hole with tincture of iodine, removing debris and dirt. With a clean hoof knife, enlarge the hole to allow for proper drainage. Soaking the hoof in hot water for ten minutes three times a day aids in healing and relieving pain. The water, with a teaspoon of iodine-based solution added, should be so hot that your hand can just tolerate it. The level of the water should not go above the coronary band of the hoof because it tends to swell and soften. Fill the hole with a drawing agent such as magnesium sulfate paste, or paint the hole with tincture of iodine and cover the sole with Elastoplast to prevent further contamination from the environment. The administration of antibiotics and tetanus antitoxin by your vet is necessary precautions in the treatment of puncture wounds.

Navicular Disease

The navicular bone is a boat-shaped bone laying in close proximity to the pedal bone within the hoof. It lies under the center of the frog. Horses with navicular disease put weight on the toe to protect the frog and heel from concussion. In some cases, over a long period of time, lack of frog pressure leads to contracted heels. Navicular disease encompasses changes in the navicylar bone, navicular sac, or bursa and the flexor tendon that wraps around the navicular bone and attaches to the pedal bone. The disease is almost exclusively a front limb lameness.

Causes: Inherited conformation such as short upright pasterns increases the concussion and stress on the navicular bone, bursa and deep flexor tendon. Concussion associated with hard work on hard surfaces may cause navicular disease and improper trimming and shoeing may increase the stresses placed on the navicular bone.

Signs: In the early stages, the horse sometimes exhibits slight lameness that seems to fluctuate from one front foot to the other. As the disease progresses, the horse steps short in both front legs, assuming a proppy, stilted gait, particularly at the trot. The horse will often resent trotting and try to break into a canter. When turning, rather than crossing its front legs, it will tend to shuffle around in order to lessen pressure on the navicular bone.

Treatment: Because of the difficulty of accurate diagnosis and the complexity of treatment, consult your vet if you suspect that your horse has this disease. Depending of the severity of the disease, treatment can involve corrective shoeing (raised heel and rolled toe shoes) which can give good results in horses used for pleasure riding, and poor results in performance horses, anti-inflammatory and anti-coagulant agents, or desensitization of the affected part of the foot by cutting certain nerves supplying the area concerned. Whatever the treatment, the range of success varies.

Pedal Osteitis

This condition is inflammation of the pedal bone. Associated with it is demineralization of the pedal bone and formation of a roughness on its outer edge.

Causes: These include an inherited conformation that increases the amount of concussion on the pedal bone, concussion associated with hard work on hard surfaces and poor hoof care.

Signs: This is a problem of the front feet. In the early stages, lameness is sometimes present; at other times it is absent. Sometimes one cannot tell if the disease is present in the right front leg or the left front leg. As the inflammation progresses, lameness is obvious in all gaits, and is characterized by a short step. In other words, the horse fails to stretch right out. The services of your vet are essential to make a correct diagnosis with the aid of clinical examination, nerve block and X-ray.

Treatment: Consult your vet. Treatment and its success vary according to the severity and distribution of inflammation in the pedal bone. The treatment may involve rest, corrective shoeing, anti-inflammatory agents, a calcium supplement in diet or neurectomy (i.e. denerving).

Pneumonia

This is an infection or inflammation of the lung tissue. It is often seen in foals and in debilitated, stressed, or old horses.

Causes: There are numerous causes of pneumonia, namely viruses, bacteria, parasites, or inhalation of foreign material. A stomach tube being passed incorrectly by an untrained person into the windpipe and fluid which is poured down the tube, passing directly into the lungs, causes acute pneumonia. If the horse contracts pneumonia in this way, it usually dies or suffers permanent damage to the lung tissue, rendering it useless for riding. There are many predisposing causes of pneumonia such as travelling, overcrowding, malnutrition, and exhaustion, all of which lower the horse's resistance to infection.

Signs: The signs will vary with the suddenness of onset and the volume of lung tissue involved. Generally speaking, the horse will be off its food and lethargic. Respiration is rapid, and shallow. Often a cough, nasal discharge and a high temperature are associated with pneumonia. The breath may have a foul odor, and if you place your ear to the chest, moisture may be detected as the horse breathes in and out. The horse will stand in one place, not wanting to move or to lie down. In many cases, the nostrils will be flared.

Treatment: Keep in mind that good nursing is an essential part of any treatment. Consult your vet immediately, because when treatment is delayed or inadequate, 50% of the affected horses either die or suffer from permanent lung damage. Place the horse in a well ventilated, draught-free stable. Keep its temperature as even as possible by rugging or by removing the rug if the temperature is very high. Fresh water and nutritious, palatable feed should be available to encourage eating and drinking. Electrolytes in the feed or water are important to prevent dehydration. No exercise should be given for four weeks from the time of apparent recovery, otherwise the pneumonia could recur.

Quittor

Quittor is a chronic, purulent inflammation of the lateral cartilage in the hoof, characterized by discharge at the coronary band.

Cause: Injury near or on the coronary band covering damage to the cartilage and soft tissues in the area of the heel can cause quittor. Foreign bodies penetrating through the sole in the region of the heel and over-reaching are other causes.

Signs: These are redness, swelling, heat and pain in the region of the heel and the associated coronary band. Discharge from small openings or cracks above the coronary band which dry up and erupt again are also signs, and so is fluctuating lameness associated with build-up of discharge.

Treatment: Contact your vet who will administer the appropriate antibiotics and tetanus injections. This treatment may not prove effective and complete surgical removal of the diseased cartilage may be necessary. Even this treatment may not effect a cure.

Rain Scald

Some horses when exposed to the environment without shelter or protection develop a skin irritation known as rain scald.

Causes: Long periods of rain cause an irritation of the skin on the back and croup, which are flat and bear the brunt of the rain as it falls.

Signs: The hair on the back and croup mats together with inflammatory fluid that oozes from the skin. Some of the clumps of matted hair fall out but others, it peeled off, leave a raw, bleeding surface.

Treatment: Provide some form of protection from the elements such as a stable, shelter shed, trees or a rug. Wash the affected areas with warm water and an anti-bacterial soap, gently lifting any loose hair and scabs with your fingertips. Dry thoroughly. Groom gently and cautiously in the affected areas with a soft body brush. Apply lanolin to the exposed skin to keep it moist and supple.

Roaring

This is a very general term that can cover a multitude of respiratory problems. The condition that most people mean when they mention the term 'roarer', is the peculiar noise, ranging from a whistle to a roar, that some horses make when they breath in (inspiration). The noise is created by an obstruction to the airflow through the larynx during inspiration. The obstruction is brought about the paralysis of the muscles, usually on the left side of the larynx, causing cartilage on that side to collapse and obstruct. The degree of noise varies in direct proportion to the degree of paralysis of the laryngeal muscles, which in turn determine the extent of the obstruction to the airflow by the laryngeal cartilage. Most horses only show signs of the noise when galloping fully extended; a minority shows signs even at rest. The obstruction to the airflow has an adverse effect on a horse's ability to perform in events where there is stress on the respiratory system. It is rare in ponies; it occurs most often in horses’ sixteen hands or more in height and aged three to seven years.

Causes: The primary cause is degeneration of the nerve supplying the muscles of the larynx. The reason given for degeneration of the verve are numerous, and many have not been scientifically substantiated. It is known, however, that roaring is hereditary, though in itself it is not an inherited disease. The size of the horse and its conformation are inherited characteristics that can be casual factors in nerve degeneration. Respiratory viruses and infections can also cause roaring; so can moderate or heavy exercise. In particular, lengthy periods of swimming cause the horse to extend its neck, thus stretching the nerve and causing degeneration.

Signs: The most common sign is a whistle or roaring sound during heavy exercise. The horse's ability to perform is adversely affected because its air supply is markedly reduced.

Treatment: The success of treatment depends on the accuracy of diagnosis; an accurate diagnosis can be made only by a vet after giving the horse a thorough clinical exam. This includes passing up each nostril an instrument known as a rhinolaryngoscope and examining the larynx in detail. The latest surgical technique is to pull back the collapsed laryngeal cartilage and secure it permanently in its normal position by use of prosthesis. This technique has an 80-90% success rate, reducing the noise level to a normal at all paces.

Seedy Toe

This hoof condition is characterized by separation of the wall from the sole at the toe, leaving a socket or cavity running under the wall.

Cause: These are chronic founder, poor hoof trimming and shoeing and a foreign body such as a small stone wedging between the wall and sole at the toe.

Signs: If the hoof wall over the seedy toe is tapped, it emits a hollow sound. When the shoe is removed and the sole is pared back at the toe, a hollow cavity is visible, often filled with black, foul-smelling, greasy, decaying hoof.

Treatment: With a hoof knife, cut away the dead, black horn lining the cavity until you reach good healthy horn. Paint the inside of the cavity daily for seven days with a solution containing 10% formalin. Most cases that recur do so because the dead horn has not been completely cut out. If the seedy toe is of a deep nature, call your vet, as anti-biotics and a tetanus injection may be indicated.

Strangles

Strangles is a highly contagious, acute disease of young horses, characterized by abscess formation, especially in the submaxillary glands (under the jaw), and inflammation of the upper respiratory tract, with thick, white to yellow nasal discharge. Strangles and upper respiratory track viral infections are common when many horses, especially young ones, are congregated together.

Causes: The organism causing strangles is a bacterium called Streptococcus equi, which can be found in the pus discharge from the nose or from abscesses under the jaw. The bacteria in the pus are fairly resistant to the environment and their presence in the paddocks, feed, or water troughs is a source of infection. They gain entry into the body by ingestion or inhalation. Outbreaks of strangles occur most commonly when large numbers of horses are kept together. Many of these outbreaks are thought to be initiated by a carrier, that is, an infected horse, which appears normal.

Signs: The first symptoms are loss of appetite followed by a slight cough. Within a few days, a bilateral nasal discharge develops, which becomes copious. The lymph nodes of the head and neck may become inflamed and swollen, those under the jaw being first affected. If sinusitis or inflammation of the guttural pouches develops, surgical attention may be necessary. Laryngitis may develop and lead to laryngeal hemiplegia (broken wind), if the horse is being exercised. Strangles can spread to other parts of the body and localize in areas such as the lungs. If it does, it is referred to as 'bastard strangles'.

Treatment: Call your vet, who will treat the horse with antibiotics and surgically attend to any abscesses if drainage is required. While waiting for the vet to arrive, isolate the horse from any others and provide good general nursing. Early treatment often brings about a quick cure and prevents the spread of the disease to other parts of the body.

Tetanus (Lockjaw)

This disease affects all domestic animals except the cat, and is found throughout the world. It is common in horses. Tetanus is a toxemia or poisoning produced y the bacterial agent Clostridium tetani. It is characterized by spasmodic muscular contractions, resulting in death in many cases.

Cause: Clostridium tetani produces a toxin or poison that affects the nervous system. Puncture wounds of the hoof are not infrequently associated with the development of tetanus. The organism lives in the soil and horse's feces (manure). Tetanus spores persist in the found for a long time and are resistant to many standard disinfectants, including steam at 212 degrees f for thirty minutes to one hour. The entry of tetanus is usually via a deep wound. Even then, it may lie dormant for four months until conditions are suitable for tetanus spores to multiply and produce toxin.

Signs: The poison causes spasm of the muscles, resulting in stiffness and rigidity of the whole body. The third eyelids partially cover the eyes, often misleading the owner into thinking that there is something wrong with them. Muscle spasms of the head make it difficult to take food into the mouth and chew (this in known as lockjaw). The horse drools a mixture of saliva and food, sometimes misleading the owner into thinking that it is suffering from a mouth complaint. The general stiffness leads to convulsions and death in up to 80% of the cases. Death usually occurs two to three days after the onset of symptoms.

Treatment: Call your vet immediately. However, supportive therapy by the owner can be almost as important as vet treatment. Place the horse in a quiet, dark stall, with a deep bed of straw. If possible, do not handle it. Remove any objects that could cause injury. Place feed bins and water containers at such a height that the horse does not have to bend down. Feed it bran mashes to minimize the necessity to chew as well as to prevent constipation.

Thrush

Thrush is an infection located in the hooves on either side of the frog; sometimes the frog itself is involved.

Causes: Predisposing causes that provide a breeding ground for the infection are: poor hoof care, particularly lack of attention to daily cleaning and hoof trimming at the time of shoeing, damp, dirty stable conditions where the horse stands in bedding soaked with urine and manure and poorly drained yards, with the horse standing for lengthy periods in mud or other damp and dirty places.

Signs: A foul smelling, black tarry discharge can be seen in the grooves on either side of the frog. The horse may be lame if the sensitive tissues in the depths of the hooves are involved.

Treatment: Trim away any excess or infected frog and clean out the discharge from the grooves. If the sensitive tissues are involved, the horse will flinch or pull the foot away when you dig deeply into the grooves. Paint the sole, including the depths of the grooves, with a solution of 10% formalin. Be careful not to bring the skin into contact with formalin, as severe burning may result. Repeat the treatment daily until the condition has cleared up completely. Contact your vet, as antibiotics and tetanus injections may be indicated. Cleanliness is the keynote to the prevention of thrush. Daily hoof and stable cleaning are thus important. When trimming and shoeing the horse, it is essential to maintain frog contact with the ground. If this is not possible, a bar shoe should be fitted to exert pressure on the frog.

Verminous Aneurysm

An aneurysm is a localized dilation of the wall of an artery, causing the restriction of the blood flow. Aneurysms result from disease or injury. Verminous aneurysm is the most common form of aneurysm found in the horse.

Cause: The larvae of the red worm Strongylus vulgaris migrate into the muscular walls of arteries, particularly the cranial mesenteric artery that supplies the intestine and the major arteries supplying the hind limbs. The larvae set up inflammation and a fibrous swelling develops. Over a period of time, the fibrous swelling reduces the diameter of the lumen of the artery and restricts the blood flow to the intestine and/or the hind limbs. In some cases the arterial wall becomes so thickened that the blood supply is cut off.

Signs: If an artery supplying the intestine is partially blocked, recurring bouts of spasmodic colic are the most common symptom. In some cases, the arterial wall becomes so thickened that the blood supply is cut off, resulting in necrosis (death) of that portion of the intestine supplied by that particular artery. This leads to the eventual death of the horse.

If an artery supplying the hind limb is small and only partially blocked, the horse may be exercised for lengthy periods before lameness becomes evident. Severe lameness will occur immediately after exercise begins in cases where the lumen of the artery is blocked. The affected let will be cool to the touch ad show little or no sign of sweating, but the rest of the body may sweat profusely. The horse will show signs of pain and anxiety. Lameness disappears with rest.

Treatment: Once a verminous aneurysm develops, no known treatment will cause it to regress. Only signs caused by the aneurysm can be treated. Routine and correct working procedures, especially with young horses, cannot be overemphasized in preventing the development of verminous aneurysm.

Wobbles

This disease is characterized by poor co-ordination and weakness, particularly in the hindquarters. It is seen most commonly in male thoroughbreds, usually before they reach two years of age.

Causes: It is agreed that narrowing of the canal formed by the vertebrae in the neck causes damage to the spinal cord, which in turn is responsible for the wobbles condition. It is not certain what causes narrowing of the canal. The disease may be inherited. It occurs five times more frequently in males than in females and its incidence in thoroughbreds is far greater than in other breeds. Heavily muscled, well developed horses appear to be affected more often than others.

Signs: Poor co-ordination, wobbling, weakness, clumsiness and not wanting to lie down or roll are the most serious signs. They may have been present at an earlier age but not recognized because in the first twelve months of life the horses are not so closely observed or handled as they are later. Between on and two years of age, the horses are being broken in, educated and exercised; this may cause an already existing condition to reveal itself. The severity of signs may vary to include a horse appearing weak in the hindquarters and being poorly coordinated when galloping, or displaying drunken, swaying wobbling movements when being walked on a lead. The horse may go down and be unable to get up again.

The condition may remain static or progress from slight wobbling to exaggerated, drunken movements, with the horse crashing into objects and obstacles such as doors and gateways. The onset of signs may be slow and insidious over a period of months or may appear within 24 hours. The wobbler is not suitable for use as a performance horse. It is potentially dangerous to the rider and to itself, as it is prone to fall when being ridden at fast gaits.

Treatment: If you suspect your horse is a wobbler, contact your vet, who will conduct X-rays in order to confirm or dispel your suspicions. No treatment has proved effective, although temporary improvement has been observed in some cases after treatment.