Train your eye to

spot seven subtle

signs that your

horse needs to

see a vet.

By  Barb  Crabbe,  DVM

I spend a lot of time in barns—not only as a vet, but also as a rider and a horse-show mom. And in these roles, even when I'm not wearing my vet hat, I often see horses with subtle signs of health problems—usually before anyone else notices there could be something wrong.

I'm going to tell you about the seven most common signs of hidden health problems I might notice in your horse. So that you can have a keener eye for them, too, I'll tell you what these signs are, what they might mean, and what you should do about them.

With this information in hand, you'll be able to detect problems early, and potentially protect your horse from having a subtle sign turn into a serious health concern. 

Sign #1: Overlong Haircoat

What it might mean: You may think your horse is just a hairy beast, but a very long hair coat, especially one that doesn't shed in summer months or seems extra curly, may mean that your horse has pituitary pars intermedia dysfunction (PPID), commonly known as Cushing's'disease. This disease, common in older horses, is the result of a tumor on the pituitary gland in the brain that causes a disruption in the balance of Cortisol—the body's stress hormone. What else should you look for? Other signs of Cushing's disease are widely varied. Your horse may begin to show a general loss of muscle tone with a dropped back and distended belly. He may also seem a little spacey, or even experience seizure-like collapsing episodes. High levels of Cortisol in his blood stream can suppress his immune system, meaning he's likely to have dental problems because of infected gums or teeth, or skin infections that are made even worse by his long haircoat. Finally, a horse with Cushing's disease is at risk for laminitis—often the most frightening complication of all. 

What to do: These days Cushing's disease is easily diagnosed with a simple blood test that measures levels of the hormone ACTH in your horse's bloodstream. Some vets still advocate a test known as a dexamethasone suppression test (an overnight test that involves measuring the impact of a dose of dexamethasone on your horse's blood Cortisol levels). It's long been considered the gold standard for Cushing's diagnosis. Either test can be less accurate if performed during fall months due to the effect of changing day lengths on your horse's own internal hormonal responses. If you called your vet in the fall, he or she may have suggested you wait until winter before trying to make a diagnosis.

A long haircoat that doesn't shed is usually the first sign of Cushing's that you'll see, and may even show up before blood tests confirm your horse has the disease. If the first test comes back negative, it's smart to keep paying attention and maybe even test annually. Many of these hairy horses do develop Cushing's disease over time. Once it's diagnosed, symptoms can be managed with a medication called pergolide, which can keep your horse comfortable for many years.

Sign #2: Squinty Eye

What It might mean: You may be accustomed to your horse's sleepy look, but a horse that seems to hold his eye just a little bit closed may be suffering from uveitis. This is a chronic, painful condition caused by inflammation of the structures deep within his eye.

What else should you look for? If your horse has uveitis, you may see other signs, including swollen eyelids; discharge from the corner of his eye; or a faint, bluish tinge to the surface of his cornea (the clear outer covering of his eyeball). Because this condition tends to wax and wane, his eye could look completely normal at times, with signs much worse at others. Thus, it's common for this condition to go unrecognized by an owner who may just think the horse's squinting is due to his sensitivity to dust or daylight.

What to do: Uveitis can be hard to diagnose. You should schedule a visit from your vet, who may be able to detect signs of chronic inflammation deep within your horse's eye. If your horse suffers from uveitis, it's important to treat it properly, not only because it's very painful, but also because the inflammation that's present can cause more serious damage to the eye over time. In severe cases, this disease is likely to progress to blindness, especially if left untreated.

Treatment for uveitis involves anti-inflammatory medications given both topically (ointments placed directly in the eye) and systemically (oral or injectable medications). Although it can't be cured, uveitis often can be managed to minimize long-term effects.

Sign #3: Super-Straight Hind Legs

What it might mean: Your horse may always have looked. "straight behind" to you, but very straight hocks and stifles, especially combined with enlarged hind fetlock joints, may mean your horse is suffering from a condition commonly known as degenerative suspensory ligament desmitis (DSLD). This condition is due to an abnormality of collagen (a type of connective tissue that helps hold ligaments together) that commonly leads to breakdown of the suspensory ligaments in the hind legs. Enlargement of the branches of the damaged suspensory ligaments cause the fetlocks to appear bigger than normal, and loss of support from the suspensory apparatus causes the fetlock to drop toward the ground. Along with these changes, the hocks and stifles gradually straighten. (Note: Due to discovery that this disorder actually effects collagen throughout the horse's body, it's been renamed equine systemic proteoglycan accumulation or ESPA.) 

What else should you look for? You may see your horse with DSLD/ESPA shifting his weight between his hind legs when he's standing in the barn aisle. In his stall, he might push shavings up against a wall where he can stand with his heels elevated. When you pick up a hind.leg, he may hold it in the air and tremble for a several seconds. If he's still working, he may become resistant, reluctant to canter, or just plain weak behind.

What to do: Call your vet if you suspect your horse may have DSLD/ESPA. This condition is extremely painful, and often goes unrecognized in its early stages because the lameness it creates is bilateral (impacts both hind legs). Stress tests of your horse's hind fetlocks are likely to be strongly positive, and that combined with the characteristic appearance maybe enough to make a diagnosis. Based on what he or she sees, your vet may recommend additional diagnostic testing, such as an ultrasound. Sadly, this devastating and progressive disease can't be treated. If your horse does have it, it's critical that you work with your vet on pain management—which is likely to include significant work restrictions.

Sign #4: Stumbling

What it might mean: Your horse may be just be a klutz, or his stumbling could mean something more. In your youngster, incoordination (called ataxia) may be due to an abnormality of the bones in his neck that puts pressure on the spinal cord—• a condition known as wobbles. Your older horse could have neck arthritis. Other diseases can also cause ataxia, usually with a more sudden onset. These include equine protozoal myeloencephalitis and equine herpesvirus.

What else should you look for? If your horse is really ataxic, he's likely to have trouble walking up and down hills and negotiating obstacles such as poles on the ground. When he does stumble, he'll have trouble righting himself. He may stand in odd positions, such as with his legs crossed or hindquarters listing to one side.

What to do: For safety's sake, you should schedule a visit from your veterinarian. He or she will perform a series of tests as a part of a neurological examination to help determine whether your horse is truly ataxic and if so, how bad it really is. Radiographs of your horse's neck might be recommended. In severe cases, a myelogram (a test to determine whether the bones are causing impingement on the spinal cord) can help to make a definitive diagnosis.

It's important to recognize whether your horse is truly ataxic. Although there are some treatments that may be suggested depending on the specific diagnosis, he may be dangerous to ride, especially in athletic disciplines such as jumping, where there's a risk of falling.

Sign #5: Walking on Eggshells

What it might mean: Does your horse pussyfoot across the gravel while you say "ouch, ouch, ouch?" His problems could be something much more than just sore feet. You should consider the possibility that he's suffering \ from laminitis. This painful foot condition is due to inflammation of the laminae, or finger-like projections within your horse's feet that form the attachment of the hoof wall.

What else should you look for? Your laminitic horse may stand in a typical "founder stance" with his front feet held out in front of his body as he shifts as much of his weight to his hindquarters as he can. He may pivot around his hind legs when he turns. His digital pulses (pulses in the arteries that supply his feet) may be stronger than normal. You should also check your horse's hoof balance. If his toes are very long or heels are under-run, there could be unnecessary stress on his laminae that are making matters even worse.

What to do: Call your vet. If your horse's sensitive feet are a new occurrence, it's important to identify an impending laminitis episode immediately to prevent it from progressing to a much more serious problem. If your horse just always seems ouchy, he may have chronic problems that should be addressed.

Of course, it's possible he simply has thin soles. Radiographs of his feet will tell you just how much to worry. Your vet will suggest trimming/shoeing modifications based on these radiographs, as well as medications not only to help make your horse more comfortable, but also to prevent a mild laminitis from becoming severe.

Sign #6: Chewing Oddly

What it might mean: You might think your horse is a just a character when he tips his head to the side and makes a funny face after you give him a carrot treat, but heads up! His odd chewing behavior could mean there's a problem with his teeth. It could be as simple as sharp points or a basic imbalance of his bite, or something as severe as a

foreign body or a loose, rotten tooth.

What else should you look for? If your horse has dental problems, you may notice wads of chewed up hay or grass that he's spit up in his stall or pasture, or he might drop grain when he chews. You could see something that looks like a swelling on one or both sides of his face—the result of feed he packs between his cheeks and gums to
protect the soft tissues from sharp points on his molars. If you ride him, he may begin to toss his head, open his mouth, or show other signs of resistance to the bit. A foul
odor coming from his mouth, or a stinky one-sided nasal discharge, are two signs that something more serious, like a rotten tooth, could be going on.

What to do: If your horse hasn't had dental work in over a year, schedule a dental appointment with your veterinarian.
If you're lucky, a routine dental balancing will do the trick. If it's something more serious like a loose or rotten tooth, your vet will detect this during the dental procedure. If it's been less than a year since your horse's teeth were done, ask

your vet whether he or she thinks there could be something out of whack. Dental issues are usually easily solved, and early intervention is the key to preventing a simple problem from becoming a more complicated one.

Sign #7: Obesity

What it might mean: Your horse is fat. You may simply be feeding him too much, or if he's a super-easy keeper, he may be insulin-resistant. If he's insulin-resistant, it means his body doesn't respond properly to insulin. This is the hormone responsible for maintaining proper balance of sugars in his blood, muscles, and internal organs. 

What else should you look for? You may not think your horse is obese, but if you can't feel his ribs when you run your hand along his side, he probably is. If he's insulin-resistant, you'll also see abnormal deposits of fat, such as a cresty neck, lumps around his tail head, or filling in the depressions above his eyes. Because your obese horse is at risk for laminitis, you also may see that his feet are sensitive or his digital pulses are elevated.

What to do: If he's just fat with no other signs, dietary restrictions and increased exercise are the keys to better health. Review your horse's ration with your veterinarian, who can help you cut back safely. If he lives on pasture or gets a lot of turnout time, consider outfitting him in a muzzle to keep his grass intake in check. Depending on your horse's fitness and condition, your vet can also help you formulate an exercise plan.

If your horse shows other signs, or you simply can't get his weight under control no matter how hard you try, your vet may suggest testing for glucose and insulin levels to determine whether your horse is really insulin-resistant. If he is, you may need to       consider a low-starch diet to help maintain proper sugar balance. In any case, don't ignore your horse's obesity problem. Take steps to control his weight before serious health problems occur. 

January 2013   HorseandRider.com