Health Management

Health Management Plans

The health of horses, donkeys and mules is a key component of their welfare. Horses should be regularly assessed for health and fitness relative to any work or activity they perform. Owners and managers should maintain the health of their animals through appropriate nutrition and housing and disease prevention, detection, and treatment. Veterinarians should be involved in helping meet these animal health obligations. Depending on the circumstances, it may only be possible to seek veterinary advice via phone or other contact.

A Veterinarian-Client-Patient Relationship (VCPR) is the basis for interaction among veterinarians, their clients and their clients' animals. The exact definition for a VCPR varies between provinces, but generally the relationship has been established when the veterinarian has examined the animals or visited the farm (to gain a close knowledge of the health status and management of the animals); the veterinarian has assumed responsibility for making clinical judgments related to the health of the animals; and the client has indicated a willingness to follow the veterinarian's instructions.

Infectious Disease and Biosecurity

Health management plans (which include biosecurity and vaccinations) reduce the risk of introduction or spread of infectious diseases. Biosecurity protocols are guidelines intended to prevent the introduction or spread of diseases within a farm or to other farms. Horses that are newly introduced or returning to the farm present the greatest risk of infectious disease. Biosecurity protocols should be in writing, especially on farms with a large number of horses.

For some diseases, a horse can be a carrier of the disease without showing signs. These carrier animals can play a significant role in disease transmission. Infectious diseases can also be transmitted by people (e.g. via clothing or footwear); other animals (e.g. dogs and wildlife); and objects not adequately cleaned and disinfected (e.g. tack, grooming equipment, halters, water buckets and trailers). Appendix K provides several resources to assist with biosecurity planning.


Medications, especially prescription medications, should not be administered unless under the advice of a veterinarian. Some medications or remedies may be ineffective or even unsafe. These include: natural and herbal remedies; supplements, medications that are unlabeled, untested or unregulated; and medications used in a way that differs from the originally intended and licensed use (i.e. extra-label). Regulated sources of medication include a veterinarian, pharmacy, veterinary pharmacy, and licensed animal medicines outlet. Before administering any medication or remedy, read the label carefully and discuss its safety and proper use with a veterinarian. It is also important to store medications correctly - this can affect their efficacy and safety.


Horses must be observed as often as required to maintain their health and well-being.

Purchase medications and veterinary pharmaceuticals from regulated, reputable sources. Refer to provincial and federal regulations.

Records or receipts of treatments provided must be available.


a.establish a working relationship with a practicing veterinarian (VCPR). In the case of feedlots, it is a requirement to have a VCPR in place with a veterinarian and other experts to develop a written health management plan and review the plan in advance of making major changes to the farm

c.include the following in your health management plan:

a. protocols for biosecurity

b. protocols for the prevention, detection and treatment of disease

c. protocols for pest and control

d. vaccination deworming schedules

e. staff training

f. veterinary contact information for emergencies

Use veterinary products that are approved by Health Canada and have a valid Drug Identification Number (DIN)

ensure treatment records include a record of the animal(s) treated, date, reason for treatment, dosage, withdrawal time, if applicable, and any adverse reactions

    schedule regular preventive care veterinary visits to minimize emergencies

    outline criteria for when to call a veterinarian

    obtain veterinary advice on appropriate treatment for diseases

    ensure a competent handler is present during a veterinary visit

    inspect stabled or group housed horses at least twice a day for health 

    observe horses on open range or pasture on a routine basis     

    assess the horse's health and fitness for work/competition as a routine 

    Appendix K provides a resource on assessing fitness for competition   

    segregate new arrivals from resident horses for at least seven days and   monitor their health status.

       Pest and Insect Control

Controlling pests and flying insects is an important component of an overall health management plan. Pests and insects can transmit diseases and cause discomfort.


a. implement procedures to monitor and control pests. The ideal program prevents the entry of wildlife and pests where horses are housed and eliminates sites on the farm that provide shelter and food for pests 

b. protect horses from excessive insect burden (e.g. stable horses at sunrise and sunset, the peak insect feeding hours; apply repellant products to the horse; use a fry sheet) 

c. implement protocols to reduce insect breeding sites (e.g. remove or cover manure piles, mosquito control in water troughs and standing water).


Vaccinations offer horses protection from some infectious diseases, but do not completely eliminate disease risk. Good overall management directed at infection control remains important even for vaccinated horses. Vaccination guidelines vary by region and should take into account the risk for exposure. While there are costs associated with vaccines, those costs are generally much lower than the costs associated with an infectious disease.

Appendix K provides a reference to the vaccination guidelines of the American Association of Equine Practitioners.


a.consult a veterinarian to develop a vaccination program, including correct on-farm storage and administration of the vaccines

b.ensure broodmares receive regionally appropriate vaccines

   c.ensure foals are properly immunized with primary and booster vaccines as this affects their response to vaccines later in life

d.keep a record of the vaccinations that were administered (i.e. a record identifying the animal(s) vaccinated, date and any adverse reactions)

e.know the vaccination status of new arrivals and ensure they are properly vaccinated.

Parasite Management

While Section 4.1.3 focuses on internal parasites, external parasites (e.g. lice and ticks) also affect horses. A veterinarian should be consulted for advice on controlling external parasites.

Control of internal parasites is key to rnaintaining feed efficiency and horse health. Signs of severe parasitism include poor body condition, rough hair coat (especially in foals), weight loss, mild to moderate abdominal distension ("pot-bellied" appearance), colic, diarrhea and stunted growth. Foals and geriatric horses are particularly susceptible to internal parasites as are horses with lowered immunity.

Research shows that parasite resistance to several dewormers may be related to the traditional approach of deworming all horses evert 6-12 weeks with rotating products. A more effective alternative may be targeted treatments based on the worm burden specific to individual horses and farms combined with effective pasture management. Fecal examination for parasite eggs is an important component of a parasite control program but results must be interpreted based on a thorough understanding of parasite life cycles. For example, immature (larval) stages of worms can cause disease before egg shedding is detected.

Parasite control programs will vary but may include the following:

a. fecal examinations (to identify worm burden and estimate levels of shedding of strongyle eggs of individual horses) 

b. regular deworming of all horses or targeted treatments of horses known to have a high parasite burden 

c. fecal egg count reduction tests (to assess the efficacy of individual drugs used)

d. good pasture management (e.g. prompt manure removal, composting to kill parasite eggs, pasture rotation).


A parasite control program to prevent parasite related disease must be in place. This Requirement applies to internal and external parasites.


a.consult a veterinarian to develop a control program for internal parasites. The plan should take into consideration risk factors such as the age of the horse; stocking density; the presence of drug-resistant parasites; seasonal and geographical factors; and additional management practices such as pasture hygiene

b.consult a veterinarian to develop a control program for external parasites

c.ensure records of parasite treatments include a record identifying the animal(s) treated, date, dosage and any adverse reactions.

Sick, Injured or Compromised Horses

The list of topics covered in Section 4.2 (including 4.2.1 and 4.2.2) is not exhaustive but provides information on topics that are particularly relevant to horses.

It is essential that those responsible for horse care be able to recognize normal behaviour, signs of sickness or injury and have basic knowledge of first aid for horses. It is important to frequently check horses carefully in order to identify problems that may not be apparent from a distance. These inspections can be done during feeding or other chores.

The most common signs of illness include:

change in the horse's behaviour (e.g. lethargic, depressed, anxious)

reduced feed intake

change in water intake

change in consistency of manure

unexplained change in weight (loss or gain)

signs of pain or discomfort (e.g. reluctance to move, increased rate of respiration and sweating)

signs of colic (see Section 4.2.1)



discharge from the eyes, ears or nose 

roughing or difficult breathing 

fever (see Appendix C-Vital Signs in Horses and Donkeys).

Compared to horses, donkeys and mules are stoic animals and are less likely to show behavioural signs indicative of illness. In donkeys and mules, a reduced or loss of appetite is a significant concern.

Take action immediately if any horse is injured or appears ill or distressed. If you are in doubt about the horse's health or the most effective treatment, consult a veterinarian without delay.


Equines that are sick, injured or in pain must receive appropriate treatment without delay or be euthanized without delay. Refer also to Section 10-Euthanasia.

For sick, injured or compromised horses that are not showing improvement, horse owners or caregivers must, without delay, obtain veterinary advice on appropriate care and treatment or make arrangements for euthanasia.

Records or receipts for treatments provided must be available.

Appropriate authorities must be advised of suspected or confirmed cases of federally reportable disease, such as Equine Infectious Anemia. Refer to the Canadian Food Inspection Agency (


a.learn how to take a horse's vital signs. Refer to Appendix C-Vital Signs in Horses and Donkeys

b.consult a veterinarian when vital signs are abnormal for an unknown reason or when a horse shows
signs of illness veterinary contact information, including after-hours contact, where staff will easily see the

d.know in advance the route to the nearest veterinary hospital and have a plan in place for transport
(refer to Section 8-Transportation)

e.keep a first-aid kit on farm and in the transport vehicle. Ensure staff know its location and how to
use it

f.consult an experienced horseperson or other expert for advice on safe restraint when treating a
horse and provide an appropriate means of restraint when a veterinarian attends the horse

g.have sheltered, segregated and well-bedded sick pens/stalls for horses that are sick, injured or

h.  have isolation facilities available on the farm 

i.monitor sick, injured and/or recovering horses 

j.  ensure treatment records include a record of the animal(s) treated, date, reason for treatment, dosage, withdrawal time, if applicable, and any adverse reactions 

k.  assign responsibility for health management decisions to a competent individual if you will be away from the farm for an extended period.


Colic is a sign of a painful condition in the horse's abdomen. While episodes of colic vary in their severity, every case should be taken seriously.

The most common signs of colic are:

repeated lying down, rolling and getting up, or attempting to do so 

turning the head toward the flank; kicking or biting at the belly; 

pawing at the ground stretching out as if to urinate, without urinating

depression and/or loss of appetite

diarrhea or any change in manure output

sweating with minimal physical exertion.

To reduce the risk of colic:

a. provide safe, palatable and clean water at all times

b. maintain a consistent daily schedule for feeding, exercise and turnout

c. feed a high quality diet comprised primarily of forage (limit the amount of grain-based feeds)

d. divide the daily concentrate ration into two or more meals 

e. avoid putting feed directly in contact with the ground especially on sandy soils 

f. ensure feed sources are free from mould and spoilage

g. maintain a parasite control program in consultation with a veterinarian.

Communicable Diseases

 Infectious Respiratory Diseases

Young horses and horses that commingle with others (such as at a horse show or if living in high-traffic barns) are at particular risk for respiratory infections, such as influenza, rhinopneumonitis and strangles. These infections can be spread in the air, by nose-to-nose contact or by contaminated hands, clothing, equipment and tools (e.g. feed buckets, water troughs and grooming tools). With some diseases, the infection can be spread by horses not showing clinical signs.

Signs include fever, lethargy, nasal discharge, cough and swollen lymph nodes under the jaw (especially with strangles). Testing is often necessary to obtain a definitive diagnosis. The time between exposure to infection and the occurrence of signs (known as the incubation period) varies from a few days to two weeks. Prolonged rest periods after infection are often needed to prevent chronic problems. While many horses recover uneventfully if managed properly, some horses can develop life threatening complications. Horses showing signs of respiratory infection should be strictly quarantined and should not be worked until a diagnosis and a treatment/management plan have been established.

Equine Infectious Anemia (EIA, Swamp Fever)

Equine Infectious Anemia (EIA) is a contagious viral blood borne disease. The most common signs are fever and anemia; however, horses can appear health - but still be carriers of the infection. The most common source of infection is other horses via blood feeding insects. Transmission may also occur via contaminated instruments (e.g. needles) or transfusions of untested blood or blood products.

There is no licensed vaccine or treatment for EIA. In order to prevent the spread of EIA, testing is strongly encouraged, particularly in areas where there are known cases. Infected animals are identified by a positive blood test (the official testis known as the Coggins test). A negative EIA test is required for export of horses and to enter many competitions and stables. EIA is a federally reportable disease - all suspected or confirmed cases must be reported to the Canadian Food Inspection Agency (CFIA). Horses that are confirmed EIA carriers must either be euthanized or kept in permanent quarantine in accordance with CFIA protocols. Refer to Appendix K-Resources for Further Information.


Isolate a horse with a suspected or confirmed communicable disease, get a diagnosis, provide treatment and alert any owners of horses that may have come in contact with that horse.

Dental Care

Most dental conditions are painful and lead to other welfare issues, such as weight loss. Horses should have teeth examined at least annually and receive appropriate dental care as needed (e.g. teeth floating). Young and old horses, as well as those with dental problems, may need to be examined more frequently. Proper dental care helps horses eat better, perform better and be healthier.

Signs of dental problems include:

a. unexplained weight loss

b. quidding (dropping feed while chewing)

c. reluctant or slow to eat

d. unusual tilting of the head while chewing

e. unusually high amounts of long fibres in the manure

f. resistance to the bit or bridle due to pain

g. swelling in the cheeks or the upper or lower jaw

h. excessive salivation (drooling or slobbering)

i. unpleasant odour from the mouth or nostrils.


Horses showing signs of dental problems must be examined and treated.

Dental care procedures must only be performed by a veterinarian or competent individual working under direct veterinary supervision. Refer to provincial regulations.


a.have a dental examination done at least annually or as frequently as may be needed for individual horses. In particular, broodmares, foals, geriatrics and horses entering training should be examined for dental abnormalities

b.observe horses regularly for signs of dental problems.


Lameness is a significant welfare concern. For the purpose of this Code, it is defined as any alteration in the horse's gait that appears to be caused by pain or discomfort. Lameness can manifest as a change in performance or willingness to move, head nodding or hip hiking. Gait can be evaluated from a walk, moving in a straight line and turning in both directions; a trot may be necessary if the lameness is less severe.

Identifying the source of the lameness is essential to proper treatment. Prompt examination and diagnosis improves the welfare of the horse and can save time and money and prevent further damage (refer also to Section 6.7-Hoof Care and Section 9-Change or End of Career).

There are various forms of treatment for lameness, including rest, medication, surgical procedures, corrective trimming and shoeing, rehabilitation exercises and pain management. Pin firing is not recommended for treating lameness - the procedure itself causes pain and there is very little scientific evidence that shows that pin firing is beneficial (3,13).


Lameness must be addressed either through specific therapies or changes in management or workload.


 reduce the risk of lameness by:

a. considering the horse's physical condition and soundness when determining the type and amount of work the horse will be asked to do 

b. ensuring immature horses are not worked or trained excessively

c. providing horses with adequate rest periods between work sessions

d. ensuring good footing in exercise and turnout areas

e. ensuring regular hoof care

f. allowing low-grade injuries to heal by giving horses appropriate lay-ups (longer rest periods) 

g. obtain a veterinary diagnosis of the cause of lameness and veterinary advice on appropriate treatment.

Laminitis (Founder)

Laminitis is a serious condition that causes inflammation in the foot that may result in severe pain, abnormal foot growth and lameness. If untreated or if treatment is unsuccessful, laminitis can lead to permanent structural changes in the foot, gait abnormalities and continual or recurrent bouts of foot pain. The pain from larriinitis can become severe enough to necessitate euthanasia on humane grounds.

Known or suspected causes of laminitis include grain overload, obesity, severe infections (such as severe diarrhea), Equine Metabolic Syndrome, "Equine Cushings" (PPID, see glossary) and excessive concussion of the hooves. Diet plays a key role in triggering laminitis, particularly the consumption of pasture or feeds high in simple sugars, starches and fructans.

Signs of acute laminitis include:

a. lameness (including a cautious, stilted gait)

b. increased heat in the feet and/or a bounding pulse in the feet (felt at the pastern or fetlock)

c. shifting weight to the hind end and front feet stretched out 

d. reluctance to pick up the feet.


Horses with laminitis must receive appropriate lifelong management

and treatment,, which may include medications, dietary management and hoof care.


reduce the risk of laminitis through the following strategies:

a. do not let horses get too fat - ensure they are at an ideal body condition score and are not overfed relative to their energy needs (refer to Section 4.5-Body Condition Scoring)

b. ensure any changes to the diet are gradual

c. restrict at-risk horses from grazing on lush pasture (i.e. plentiful, bright green grass) 

d. store grains securely such that horses cannot gain access. In the case where a horse gains unrestricted access to grain, call a veterinarian immediately - do not wait for signs of laminitis to appear

e. consult a veterinarian to determine special care that may be needed for a horse that has had laminitis. Horses that have had laminitis are at increased risk of developing the disease again and the condition can become chronic

f. ensure communication between the veterinarian and farrier to determine whether corrective trimming or therapeutic shoeing may be needed.

Body Condition Scoring

Body Condition Scoring (BCS) is a tool for determining if an animal is too thin, too fat or in ideal condition. In order to be done correctly, BCS involves both a physical palpation and visual assessment of specific anatomical sites that are most responsive to a change in body fat.

Appendix D provides the 1-9 scale for body condition scoring horses and ponies. Appendix E provides the 1-5 scale for body condition scoring donkeys and mules. For the purpose of this Code, all body condition scores refer to the scales shown in either Appendix D or E.

Be aware of the following when evaluating BCS:

a.  as horses increase BCS, they appear thicker and more solid; as donkeys and mules increase BCS, they get lumps of fat under the skin

b. Thoroughbred conformation naturally has more prominent withers and back; the conformation of ponies and draft breeds is naturally more fleshy

c.  the flank and tail head area may be less reliable sites when assessing the BCS of pregnant mares/jennets in late gestation (the weight of the foal makes the flank area appear thinner and hormone changes make the tail head area appear flatter)

d.a thick winter coat can make a horse appear to be in better condition than it actually is. Palpation is essential to assess body condition.

Depending on the animal's purpose, breed and life stage, a BCS of 4 to 6 (out of 9) is recommended for horses, miniature horses and ponies. For mules and donkeys, a BCS of 3 (out of 5) is recommended.

Poor Body Condition

Excessively thin equines may be underfed, ill, heavily parasitized or have dental problems. Equines in poor body condition are less able to cope with cold temperatures - they should be given additional shelter and may not even tolerate living outside in the winter.

Excessive Body Condition

Obesity in equines is most often caused by allowing animals to overfeed. Horses that are fat (BCS 8) and extremely fat (BCS 9) are prone to overheating during warmer temperatures and experience strain to the legs and feet. Obesity is also a risk factor associated with laminitis. Overweight donkeys, ponies and miniature horses are at severe risk of hyperlipemia if starved; therefore, any feed restrictions to reduce BCS must be gradual.

BCS and Reproduction

Reproductive efficiency is maximized by maintaining broodmares at a BCS of 5 to 7 throughout breeding, gestation and lactation (14,15). Mares that are too thin (BCS >5) at the beginning of the breeding season or at foaling have lower conception and pregnancy rates. They are also at risk of excessive weight loss at lactation. Increasing the energy fed to thin mares during lactation can improve rebreeding efficiency. An excess store of body fat (BCS 7) at foaling is not associated with foaling problems.

Horses in Work

Inadequate or excessive body condition adversely affects performance of horses doing physical, competitive work. Horses at a BCS>6 doing moderate to hard work may need more time to recover compared to horses at a BCS of 5. A working horse that is too thin (BCS>4) may not have sufficient stored energy reserves for the work period.

Refer als o to Section 3-Feed and Water and Appendix K-Resources for Further Information.


For horses and ponies: corrective action must be taken at a BCS of 3 or lower and at a BCS of 8 or higher (on the 1-9 scale). Veterinary advice must be obtained if animals do not respond to the corrective action. Refer to Appendix D.

For donkeys and mules: corrective action must be taken at a BCS of 2 or lower and at a BCS of 4 or higher (on the 1-5 scale). Veterinary advice must be obtained if animals do not respond to the corrective action. Refer to Appendix E.

Veterinary advice must be obtained for geriatric equines that are emaciated (i.e. BCS of 1 or 2 out of 9 for horses and ponies; BCS of 1 out of 5 for donkeys and mules).

Equines must not be starved or prevented from eating for prolonged periods in order to reduce BCS - the change in feed to reduce BCS must be gradual.

*With the exception of horses in feedlots that are free from health conditions associated with obesity.


a.use Appendices D and E to regularly assess BCS

b.aim for the following ideal BCS ranges for horses:

weanlings and foals, 4 to 5

broodmares (throughout breeding, gestation, and lactation), 5 to 7

stallions (at the beginning of the breeding season), 5 to 7

work and performance horses (farm work, racing, endurance), 4 to 6

c.keep records - identity animals that are outside their ideal BCS range, ascertain the cause, and take corrective action.

To increase BCS to an ideal level:

a. seek advice from a nutritionist, knowledgeable, experienced horseperson or veterinarian

b. ensure the increase in energy intake does not exceed 10-15% per week 

  c. put the horse on a weight gain program that first involves an increase in forage before concentrates are added 

  d. provide "poor doers" with forage containing high digestible energy and additional energy in the form of concentrates, including added fat.

To reduce BCS to an ideal level: advice from a nutritionist, knowledgeable, experienced horseperson or veterinarian

b.ensure the decrease in energy intake does not exceed 10-15% per week 

c.put the horse on a weight loss program that first involves the reduction/elimination of concentrate. A reduction in energy intake should be accomplished without decreasing total daily dry feed intake below 1.5% of ideal body weight

d.provide a more mature hay to an "easy keeper" that is maintained on a hay diet 

e.increase the horse's activity level. Any such increase should be gradual

f.prevent overeating (e.g. limit pasture access; keep the horse on a dry lot for part of the day; use a grazing muzzle).