In the United States alone, it is estimated that almost 150,000 horses per year are unwanted. In Canada, 30,000-60,000 unwanted horses are processed annually in the horse slaughter industry. But what does “unwanted” mean, really?

The term is used to refer to horses that are old, injured, sick, unmanageable, or fail to meet expectations. The horse may have a lameness or illness … or he could just be the wrong colour or gender. His problem could be life-threatening, or chronic and manageable. He may have a mild behavioral problem or a severe one.

The good news is that many individuals are choosing to give unwanted horses a second chance. Whether through purchase, adoption, or rescue, the horse in the “wrong” situation has a chance to find his way to the “right one.”

Dr. Stacie Boswell’s goal is to restore health and comfort to every horse in transition, and to help him learn how to function as the horse he is expected to be — from the Thoroughbred off the track to the grade pony from the field down the road. She has compiled hundreds of case studies and in this excerpt from her new book The Ultimate Guide to Horses in Need details common medical problems and health issues that can be identified in the initial vet exam.

The Veterinary Examination

As soon as your new horse is home, call a veterinarian for a physical examination. Your veterinarian is a big part of your team—she will help you establish a medical record, legally documenting your horse’s condition on arrival. She will also identify subtle or underlying problems, perform laboratory testing, and make a plan to restore your horse to full health. As the new owner, willingness and financial ability to provide medical care supports your legal ownership, should it ever be questioned. She may also have suggestions about effective quarantine for your particular farm or situation. Finally, establishing a relationship between your horse and your veterinarian is important, because if he gets sick, she will already know him, and his normal behavior and vital signs.

As part of the examination, your horse’s body condition score (BCS) will be recorded. For now, just know that this is a system of documenting how thin a horse is, and there are established legal precedents. If you are nursing a thin horse back to health, having your veterinarian document this specific parameter is useful, especially if there is a court case pending.

Although less accurate in older horses, your veterinarian will be able to estimate your horse’s age. With this information, and taking into consideration your rescue horse’s BCS, you and your veterinarian can formulate an appropriate health care and nutrition plan.

A physical examination evaluates all body systems. If you expect to ride your horse, it is important to know neurologic status and identify lameness. This may not be possible to precisely determine for a weak horse who has a decreased muscle mass. Thin horses should be reassessed after weight gain.

If the horse has traveled, especially over a long distance, evaluating the respiratory system for any early signs of disease is necessary. His skin and hair coat should be assessed for the presence of ectoparasites such as mites, lice, or ticks. You definitely don’t want these bugs spreading through your herd. Early identification of diseases optimizes successful intervention.

Laboratory Testing

Laboratory testing for a newly acquired horse should always include a fecal evaluation and a Coggins test. Your veterinarian may recommend additional blood work. There is a lot of testing, but it helps to remember that your goal is to make life better for your horse.

This fecal sediment test revealed a large amount of sand, which can cause digestive problems.

Fecal Evaluation: A full fecal analysis looks for both sand and parasites (fig. 2.11). Under-nourished horses are more likely to ingest sand, gravel, and other footing or bedding due to starvation. When sand is identified, an individualized treatment plan for getting rid of the sand will be developed. Psyllium husk (pelleted and sold under the brand name SandClear™, among others) is used to help clear the sand.

We will discuss deworming and parasites more thoroughly in chapter 4. For now, understand that the choice to deworm a rescue horse may depend on his parasite load and overall health status. Parasites might not be a problem, and you cannot tell for sure without a fecal. It may show that deworming is not yet necessary.

Also, if a horse is debilitated, deworming him before his strength returns could cause harm. A newly acquired rescue horse has many risk factors for colic: travel, a change in food, and a change in housing. Another is killing off a large number of parasites at one time, which may result in inflammation of the gut, causing colic.

Coggins Test: In the 1970s, Dr. Leroy Coggins developed a test revolutionizing our ability to identify horses infected with Equine Infectious Anemia (EIA). EIA is also called swamp fever and is caused by a virus that is spread by biting flies like horse and deer flies. The disease primarily causes a drop in the number of red blood cells a horse has (anemia). Signs include weakness, exercise intolerance, and fever. Affected horses may also have dependent edema, which is swelling of the limbs and lower areas of the body, such as under the belly or in a male horse’s sheath. Many infected horses succumb to the virus and die. Although case numbers have decreased with effective surveillance in North America, there is no treatment or cure. Surveillance testing is the only weapon you have to reduce and eliminate the virus from your horse population—and keep your loved ones healthy. Vaccines are in development, but none are yet approved or available in North America.

The Coggins test is the gold standard of testing for EIA. It requires serum (the liquid portion of the blood after clotting). The test reveals the presence of antibodies (proteins of immunity), which indicates exposure to the virus. U.S. federal regulations require a negative EIA test dated within 12 months for any horse, mule, or donkey being entered into exhibitions, competitive events, sale barns, or moving across state lines, and when ownership changes. A federally accredited veterinarian draws blood and sends it to an approved laboratory. Paperwork accompanies the blood sample and test results and includes horse identification. A multiple-carbon-copy handwritten form with a hand-drawn likeness of the horse’s markings may be used, or the form may be completed electronically with digital photos.

Blood Work: A typical blood work panel includes a Complete Blood Count (CBC) and serum biochemistry profile. Older horses should be tested for Pituitary Pars Intermedia Dysfunction (PPID—see below). Your willingness to obtain information on your horse shows your commitment to working toward health and wellness.

The CBC and chemistry panel are primary screening tests. Abnormal results, whether your horse is sick or not, may lead your veterinarian to recommend further diagnostic specialty tests.

The CBC includes information about blood cells, their numbers, and types. White blood cells are important for immunity. Different types of white blood cells have a variety of functions, including engulfing and destroying microbial invaders like bacteria or viruses. The CBC also evaluates red blood cells, which carry oxygen using a protein molecule called hemoglobin. The CBC screens for anemia by evaluating the size of red blood cells, the number of red blood cells in a given volume of blood, and the hemoglobin content within the red blood cells. The CBC evaluates platelets, too. Platelets are tiny cell fragments that stop bleeding by sticking together when activated, making the initial portion of a blood clot or scab. Too few platelets can be a sign of serious inflammation.

The serum biochemistry panel evaluates proteins, enzymes, and other molecules present in the body. Veterinarians look at abnormal elevations or decreases in these substances, interpreting the health and function of major organs such as the liver and kidneys, and the health of muscles or imbalance of electrolytes.38

The biochemistry panel is a good screening tool for every horse, but especially for a thin animal. If there is an underlying disease process, such as kidney failure, you will have a much tougher time working on weight gain. And, you have to ask yourself, how fair is it to keep going with a horse who has a fatal disease that remains unidentified and untreated? Doing blood work helps you make educated choices about what the best, most humane plan is for a horse.

PPID is an endocrine abnormality that results in the imbalance of cortisol, the stress hormone. It was formerly known as Cushing’s disease or hyperadrenocorticism. There are a variety of specialty blood tests used to definitively diagnose and monitor PPID, but research is active and recommendations for testing strategies change often.

It is estimated that 20 to 25 percent of horses over the age of 15 have PPID (figs. 2.12 A & B).39, 40 If your new horse is over the age of 20, or if he shows any signs of PPID, he should be tested. Subtle signs of PPID may go unnoticed, so screening older horses even if clinical signs aren’t obvious is important. The classic sign of PPID is a long or slow-shedding hair coat. Horses with PPID may lose muscle over their topline, resulting in a sway back, and have inflammation and pain in their feet (laminitis). Affected individuals may also have behavior changes, lethargy, weight loss, abnormal sweating, impaired healing, an increase in infections, and (rarely) blindness.

It’s important to identify Pituitary Pars Intermedia Dysfunction (PPID) early so that treatment can commence. Abnormal hair coat on an Appaloosa (left) and fat pads above the eyes on a Peruvian Paso (right) are both common signs of PPID.

At the time of writing, there is only one treatment with research support and approved by the Food and Drug Administration (FDA): Prascend (pergolide). Testing and treatment is important because PPID negatively impacts a horse’s quality of life. Aside from providing adequate food and water, controlling PPID is the number one thing you can do to improve a geriatric horse’s health and well-being.

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The Ultimate Guide for Horses in Need: Care, Training, and Rehabilitation for Rescues, Adoptions, and Horses in Transition by Stacie Boswell, DVM, DACVS is available for $34.95 from Trafalgar Square Books here.