Every equestrian and horse owner should be able to determine if a horse is healthy. A horse’s health is based on physical, emotional and physiological factors. This article gives a brief introduction to assessing your horse’s health.


Equine well-being is a very important issue to the public as well as the goal of good horse management. It is also an extremely important ethical issue. A horse’s well-being is based on its physical, emotional and physiological states. Equestrians and observers of horses should be able to determine if a horse is healthy and in a good condition. There are many ways to assess an animal’s well-being, and it is the purpose of this paper to inform people about the different kinds of assessment. Assessment is critical to determining the humane care and treatment of horses. It serves as a barometer for horse training, exhibiting and management practices.


Two foals in pasture

Natural behavior of horses dictates that they normally desire to eat and live in groups. They are herd animals who are, in general, healthier when allowed to be outside grazing continuously with each other. When grazing, horses tend to stay in their herd. If, for some reason, there is a horse that is by itself, this could be the first sign that the animal is not feeling normal. At feeding time, horses should be in an excited state and should hurry toward the feed. Horses will demonstrate aggressive behaviors toward each other when competing for feed. Submissive ones may not get enough feed to maintain their condition, which may necessitate supplementary management measures. Horses with teeth problems will often tilt their heads to one side and may slobber or dribble feed out of their mouths. If horses are not interested in their feed, or are eating and losing weight, your veterinarian should be consulted.

Horses are prey animals, and the instincts developed over generations of surviving in the wild are still present in the domesticated horses of today. Horses are easily frightened, and their first reaction to fear is to run away. Most horses will fight back only if flight is not an alternative, or if they have learned aggressive behaviors from interactions with humans. Horses notice new environments and can be easily startled, especially in unusual or unfamiliar surroundings. This is completely natural behavior and should be expected. Trained horses will be obedient and attentive but should still appear bright, alert and aware of their surroundings.

As prey animals, horses were also forced to make physiological adaptations for survival. They have a tremendous capacity for exercise and activity for long periods of time and quickly recover from exercise when they are healthy and fit. The spleen of the horse can hold new red blood cells, and the horse can increase its heart rate five to six times its resting levels — both advantages for emergency situations. When excessive sweating, muscle stiffness, stiffness of gait, dehydration, overall dullness, depression or lethargy are evident, the horse is fatigued and exercise should cease until the horse recovers.

Body Condition Scoring

This horse has a high body condition score.


Body condition scoring is one effective assessment of a horse’s physiological well-being. This test is a visual and tactile test that evaluates the physical appearance of the horse and assesses body fat (Henneke et al, 1988). Body condition scoring determines whether the horse is too fat, too skinny, or malnourished; and it is usually a good indicator of their general health. The horse is scored on a scale of 1-9.

A horse that has scored a 1-3 would be very poor to thin. He is skinny and malnourished with bones visible throughout its body and no palpable fatty tissue. Horses in this category are not considered healthy. Horses with scores between 4 (can see ribs with vertebra ridge evident), 5 (back flat, can’t see ribs, but can feel them), and 6 (crease down back, fat deposits) are normal, healthy animals. They show moderate fat and are not obviously thin.

A horse with a body condition score of 7-9 is fleshy to extremely fat, with fatty deposits on the body appearing at the flank, tail head, withers, over the ribs, behind the shoulders and along the neck. These horses are too fat and are prone to metabolic diseases such as laminitis and to muscle problems. It is important to note that, although the extremely thin horses are often identified as having their health compromised, the health of obese horses is compromised as well, and obesity is seldom addressed as a well-being issue.

For more information on body condition scoring horses, check out our Equine Body Condition Scoring Learning Lesson.

Hair Coat and Hooves

There are other physical signs that are equally useful to assess the horses’ well-being. Hair coat is a good indicator of a healthy horse. It should be shiny and glossy. Hair coat is reflective of good nutrition and health but could certainly be improved with regular grooming (Russell and Sojka, 1993). The quality of the horse’s hair coat does depend on the season. In the summer, the horse’s hair coat should be short, sleek and shiny.

In the winter, the horse should have longer, thicker hair to keep itself warm for protection from colder weather. Springtime is when the horse will lose its winter coat, to be replaced by its summer coat. The long winter hair should shed out completely and somewhat uniformly in the spring. If the winter hair coat stays on into the spring, or the horse stops shedding, the horse may be having health problems. The hair coat quality and texture also depends on the horse’s age. Older horses generally have longer hair all year long, while younger horses shed out more in the springtime and keep this short hair all summer long. If the hair coat also appears curlier or wavier than normal, it may be an indicator of a health problem. (A notable exception is a breed such as the Bashkir Curly which is characterized by a curly hair coat).

A horse’s hooves should be round and smooth, with minimal chips and no cracks or sections missing. The hoof wall should grow approximately one-fourth to one-half an inch per month, and it should form a straight line with the front of the pastern when viewed from the side. The heels should be wide, and the frog should be supple and flexible. Horses that are shod must be re-shod and trimmed regularly to maintain this shape. Excessively long toes and toes curving upward in front are evidence of need for attention by a competent farrier.

Eyes and Ears

Horse's face

Horses’ eyes should be bright, fully open and clear, without discharge of any kind. Eyes should not be glazed or have a dull appearance. Horses can see very well at a distance but are primarily monocular in that they see with one eye at a time and often have trouble focusing on and seeing objects directly in front or behind them. If a horse allows your hand to move close to an eye or the horse bumps into objects, be suspicious of its vision in that eye. If the horse squints in the light, or if there is swelling or discharge around the eye socket, the eye should be evaluated by a veterinarian.

The horse’s ears and facial expressions indicate its mood or disposition toward others. The horse’s ears should be erect and forward if it’s in a curious or content mood. If the ears are relaxed and somewhat off to the side of the head, it generally means that the horse is bored, sleeping, resting or in a state of relaxation. When approaching a horse with this body posture, make sure it is aware that you are coming because it is in an inattentive state and can be startled. When a horse has its ears pinned back to its neck, the horse is angry, irritated or aggressive. Take extra precautions when approaching a horse that displays this body language, as the horse could try to hurt anyone who comes around it. Often horses that are not healthy are not bright and alert in their ear expression.

Hydration and Mucous Membranes

Adequate water intake is essential to horse health – especially in performance horses and during extremely hot or cold weather. Horses can dehydrate quickly if they do not drink enough water. Dehydration can lead to serious problems, including colic. It can be a problem in winter as well in warmer seasons. If the water is too cold for the horse to drink comfortably, or is frozen, the horse can become dehydrated quickly. Snow is not an efficient water source for horses and should not be depended upon.

There is an easy test that can be done to see if a horse is well-hydrated. The “skin fold test” is done by pinching a fold of skin on the horse’s neck, pulling it out and releasing it. Count how many seconds it takes for the skin to go back to its original position. One-half to one second is normal. If the skin remains in the “tented” position, the horse is dehydrated.

The mucous membranes of the horse’s gums and lips should be a healthy pink color and slightly moist. Mucous membranes that are a pale, white, yellow or deep purple color are indicators of a problem. The circulation of a horse can be tested by gently pressing the thumb against the horse’s gums, releasing the thumb and counting the number of seconds it takes for the gums to go from white back to their original color. This is called “capillary refill” and should take one to two seconds.

Manure and Urine

The manure and urine can be assessed as well. Horses generally have firm manure balls that are not loose and watery and do not show undigested grains. The presence of whole grains may indicate dental and chewing problems. Loose manure can indicate nervousness, a change of diet or more serious digestive tract infections. Urine is normally wheat-straw colored and not brown or dark red in color.

Normal Vital Signs

A horse’s pulse can be taken on the inside of the jaw or on the ankle. The heart rate can also be measured using a stethoscope behind the elbow. The resting pulse/heart rate should be between 32 to 48 beats per minute in a 50 to 80 degree Fahrenheit climate. Age (younger horses have a higher heart rate than older horses), ambient temperatures, humidity, exercise and excitement levels can all cause elevations in heart rates.

The horse’s respiratory rate is measured by watching the nostrils or flanks and counting the number of times the horse breaths out. On average, this number should be 12-16 breaths per minute. As with the heart rate, the respiration rate can be influenced by environmental factors and excitement. If the horse’s respiration rate exceeds the heart rate, the horse is in physiological distress, and a veterinarian should be contacted immediately.

The horse’s temperature can be taken rectally, using a digital or fluid thermometer and should be between 99 to 101 degrees Fahrenheit. It may increase by two to three degrees due to environmental temperatures, exercise and changes in hydration.

Physiological Measurements

Cortisol is a hormone that is released into the blood by the adrenal gland in response to distress or excitement, and it helps prepare the body to cope when it has to make an effort. Cortisol levels in a horse are not necessarily a measure of pain, but rather an indication of the overall level of excitement — both physical and emotional — caused by an experience. Thus, they are not particularly helpful in assessing well-being. The horse’s response to stress takes a while to elevate the blood cortisol levels. In order to be of any value, the amount of cortisol in repeated samples must be compared. There is a lot of variation in cortisol levels in individual animals, so numerous samples are necessary to make an accurate assessment of the animal’s state. Many horse owners think that if they record high levels of this hormone, the animal is suffering. However, cortisol increases when animals are performing pleasurable behavior as well. For example, this hormone goes up in the same way in a stallion when he is mating as when he is severely injured. Cortisol is not an adequate measurement of horse well-being by itself.

In addition, scientists and veterinarians can measure the white blood cell count and red blood cell volume in a blood sample as a way of assessing an animal’s health. These measures can be hard to interpret because there may be no symptoms of poor welfare, and the measures can be affected by many factors. Horses that are not healthy can also have lower immunoglobulins and suppressed immune systems that then fail to protect the animal from disease. Veterinarians can test for immune status and determine the horse’s health status and prognosis. This can be very useful in young, newborn foals as well as in older horses.


Horse damaging fence

Stereotypies — sometimes called vices or bad habits — are repetitive behaviors that do not have an obvious function or purpose (McDonnell, 1999). These abnormal behaviors are common in 5-20 percent of horses kept in captivity but are not seen in the wild. These behaviors can be the result of training difficulties, frustration, boredom or a symptom of pain or disease. Treatment involves addressing all the causal factors, but there is no recipe for success in every case. Oral, locomotor and self-mutilation are different kinds of stereotypies. Oral stereotypies are cribbing, tongue movements, wind sucking and lip movements. Locomotor stereotypies include head movements like bobbing, tossing, shaking, swinging, nodding, throat rubbing, pacing, weaving, fence or stall walking, circling, stomping, kicking, pawing and digging. Self-mutilation is self-biting on the flank, chest and shoulder; wall-kicking and lunging into objects.


The horse’s way of moving about is a good indicator of its condition. Horses should not show any form of lameness or injury when they are moving. A horse that appears stiff, uneven or uncomfortable is not healthy. According to the American Association of Equine Practitioners, there are degrees of lameness, with a horse being considered obviously lame when the lameness is consistently observable at a trot under all circumstances; there is marked nodding, hitching or shortening of the stride; or there is minimal weight-bearing in motion and/or at rest and inability to move. In most competitions, a horse that is obviously lame is disqualified, and its rider must be asked by the officials to leave the arena or competition.

Soundness is a term meaning that the animal is physically fit and showing no signs of weakness or illness. Many veterinarians are asked to do pre-purchase soundness exams that include examination of the legs for absence of lameness as well as soundness in sight, respiration and possibly reproduction. Experienced horsemen can determine the presence or absence of obvious lameness, but a more complete pre-purchase soundness exam should be conducted by an equine veterinarian prior to buying a horse. It is important to remember that the veterinarian makes a judgment based on that examination, and it is not a guarantee of future soundness.


Occasionally, horse owners fail to provide what horses need in order to maintain health and well-being. This frequently stems from an ignorance of the horse’s needs rather than a conscious unwillingness to meet those needs. According to Indiana law a “person having a vertebrate animal in the person’s custody who recklessly, knowingly, or intentionally abandons or neglects the animal commits cruelty to the animal,” a class B misdemeanor. The public most commonly suspects neglect when they see thin horses outside in a paddock or overgrazed pasture without feed, water or shelter.

Cruelty and Abuse

In the state of Indiana, animal cruelty and abuse are addressed legally as “a person knowingly or intentionally tortures, beats, or mutilates a vertebrate animal resulting in serious injury or death of the animal commits cruelty to an animal and this is a Class A misdemeanor (note, this is different from the class B misdemeanor above, which addresses neglect or abandonment). The enforcement of these acts is usually vested in the local municipality or county authorities, and it is important that concerned citizens follow the process as directed by these agencies. Obviously, the well-being of the horse is compromised by any abuse, and all states have laws or guidelines to protect the animals’ well-being in extreme cases.

There are serious consequences for any abusive action toward horses, and most horse organizations that sanction events have statements addressing this behavior. The following are just examples of association position statements:

“An action, or failure to act, which a reasonable, prudent person, informed and experienced in the customs, accepted training techniques and exhibition procedures or veterinary standards would determine to be cruel, abusive, inhumane or detrimental to horses’ health.” NSBA Official Handbook, 2003, pg. 38.

“No person on show grounds, …… may treat a horse in an inhumane manner which includes, but not limited to:

  • Placing an object in a horse’s mouth so as to cause undue discomfort or distress;
  • Tying a horse in a manner so as to cause undue discomfort or distress in a stall, trailer, lounging or riding;
  • Use of inhumane training techniques or methods.” Official Handbook of Rules & Regulations, AQHA, 2003, rule 441, pg. 128.

“All animals must be sound, humanely treated and healthy”…..”The judge must excuse any animal from the ring he/she deems unsafe, bleeding from the mouth or in any way being treated inhumanely;” Indiana 4-H Horse & Pony Handbook, 9th ed., 2003, page 6.


The majority of horse owners in the United States keep horses for recreation, family enjoyment and/or sport. It is important that owners are able to assess the well-being of their horses as a guide to ensuring proper care and management. On occasion, someone else is needed to assist in this process, and it is best that it be an experienced horse manager or equine veterinarian. It has been the intent of this paper to provide horse owners and others concerned with assessing the well-being of horses the tools and considerations with which to knowledgeably conduct the evaluation.

Colleen Brady, Ed Pajor, Janice Sojka, Nicole Buck, John Berends, Mark Russell Department of Animal Sciences, Purdue University; Department of Veterinary Clinical Sciences, Purdue University; and Department of Animal Science, Michigan State University


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