Every time we visit a patient, a full body assessment should be performed.
This includes gaining the past and recent history from the owner / handler, and doing a complete physical exam.
The physical exam can be done from head to toe, or by body systems.
Identification
Whichever approach is used, the horse needs to first be correctly identified, and this includes taking note of:
Sex. Colt (intact male under the age of 3 yrs), Filly (intact female under the age of 3 yrs), Gelding (castrated horse), Stallion (intact adult male horse of 4 yrs or older), Mare (intact adult female horse)
Age. Always compare the given age with the dental appearance. Horses can be divided in foals (horses under the age of 1 yrs still living with the mare), weanling (horses under the age of one, removed from the mare and off milk), yearlings (horse 1 yrs old) or older horses.
Colour. The basic coat colours are: Chestnut, bay, brown, and black. These basic colours may be modified by dominant pattern or diluting genes to produce grey, roan (when white hairs are interspersed to the dominant colour), pied (with large white areas of no pigment - such as piebald or skewbald), dun (or blonde with a dark line along the back - including under the mane), cream (including palomino), appaloosa, or white.
Markings. Such as brands, tattoos or microchips. These are markings that are permanent and can include nicks or tears in the ears or nostrils, broken incisor teeth, missing chestnuts, scars, firing marks, bandage marks, saddle marks, girth marks, and other harness marks.
Other obvious abnormalities (congenital or acquired)
Method
Start the physical exam by:
Engaging with the owner or handler. Owners can help us narrow and direct the physical investigation. Ensure to cover these questions throughout the visit:
- How long have you owned (or managed) this horse?
- What is its intended use?
- Has it ever been dewormed? Vaccinated? Shod/trimmed? When?
- What is the housing status of the animal?
- What is the horse fed? (including amount and frequency)
- What is the current problem? (including the signs your horse is showing)
- When did you first notice this problem?
- Has the problem gotten better or worse since it was first observed?
- If it happens intermittently, what is the frequency of occurrence?
- Has your horse been examined and previously treated for this problem?
- Has your horse had any other problems recently or previously?
- Is the problem isolated to the individual, or are other horses on the farm affected?
Distant observation. Observing the demeanour of the horse as it stands alone and as it is being caught. Look for any stereotypical behaviours or signs of discomfort (such as belly kicking, flank biting, circling, depression, etc). Always try to approach the horse from the left side ("near side") and when handling a foal, ensure one arm holds the foal in front of the chest and the other arm behind the rump, or holding the base of the tail.
Restraining the animal. Use the least amount of restraint possible in a given situation and don't become overconfident but continue to observe the animal's reaction. Nervous horses can bolt and drag the handler, scared horses can rear/kick and violently escape injuring the handlers. Common restraining methods include:
- Lead rope and headcollar or bridle – These are to be used at all times when handling a horse. Many procedures, including physical examination, can be performed with this simple restraint. The person holding the horse should always be located on the same side of the horse as the person performing the procedure.
- Skin twitch – The loose skin in the lateral neck region (just in front of the shoulder) is grasped and rolled forward.
- Nose twitch (using chain or rope twitch) - handler should stand at the horse's side and in a position that reduces the chances of injury if the horse were to strike out. Pull the horse's head toward you and apply the twitch. Handler should be on same side of horse as person performing procedure
- Ear twitch - It is not considered good practice or to be welfare friendly to hold an equine by an ear - it can make them head shy and dangerous - especially with donkeys who have big ears that are easy to twist, but very heavy heads if they bash you with them!
- Chemical restraint - through the appropriate use of sedation. Remember that excited animals respond less efficiently to sedation, and this should be used before starting any procedure which may affect the animal's emotional state.
Palpation. Following all the above, run your hand and eye over the whole body, looking for lumps, bumps, scabs, scars or areas of tenderness. Beware that the lower flank region can be very sensitive on most horses and may trigger them to kick you. Look out for signs of aggression (ears back, tail swishing and lip tightening).
Limbs and feet. There is good reasons for the old saying "no foot, no horse". Observing the feet can be extremely useful in order to spot chronic lamenesses, as the less used limb will often have a smaller, more upright hoof. Look at the feet and check for laminitic rings (deep diverging ridges that run parallel to the ground on the hoof capsule), bruising of the sole or cracks of the hoof wall. Palpate the limb and test the flexion of each joint (comparing it to the contralateral limb) as well as feeling for adhesions, thickenings or pain around the joints, and along the suspensory ligament and flexor tendons. Finally, check for localised signs of inflammation by palpating for a pulse (by locating the Digital artery over the palmar/plantar and lateral or medial aspects of the fetlock or pastern) and apply hoof testers.
Head and eyes. Check for any nasal or ocular discharge. Offer the animal some food and observe it chewing. A malodour could indicate an infection, while quidding (the dropping of part chewed food from the oral cavity) could indicate dental disease. The mucous membranes will be visible, and should be pink and moist. The eyes should be clear and open.
Rectal temperature. Normal temperature for a horse is 37-38.5 degrees Celsius. To take the temperature, stand close to the horse and on the lateral side of the hind limb. Lift the tail with one hand and advance the thermometer (lubricated) with the other. Direct the thermometer to one side of the rectum, so as that the tip touches the body wall of the rectum.
Heart auscultation and pulse rate. Normal heart/pulse rate for a horse is 28-40 beats per minute. This can be taken by listening to the heart (auscultate by placing a stethoscope behind the elbow of the horse) or by feeling a raise along the course of an artery (most frequently the Facial artery - overlying the ventral rams of the mandible, or the Transverse artery - ventral to the facial crest).
Find out more on this in the cardiovascular section.
Lung auscultation. Take the respiratory rate while the animal is at rest. Normal respiratory rate for a horse is 12 - 18 breaths/min. This can be counted by observing a rise and fall of the flank, or more accurately by placing a stethoscope over the thoracic cavity.
Find out more on this in the respiratory section.
Abdominal auscultation. Normal intestinal movements are detected by placing a stethoscope on the top/bottom left and right side of the abdomen. Stomach/small intestinal contractions usually not audible. The cecum and large colon have both mixing contractions and propulsive contractions. Mixing contractions are weak, low to moderately pitched and last 10-20 seconds. Propulsive contractions are large, deeper sounding contractions that occur less frequently. Abnormal sounds include 'pings', increased sounds, complete lack of sounds, and rubbing sounds.
Find more on this in the gastrointestinal section.