The Basic Physical Examination
Owners should know the basics of a physical exam--what their horse's normal temperature, pulse, and respiration parameters are and how to take them correctly. This most basic of information can potentially save a horse's life.
Photo: The Horse Staff
You have owned your horse for one year now, and it has been smooth sailing up until today. No episodes of colic, no mornings of being off feed, only some minor scrapes from romps in the paddock. Today, however, is a different story, and your horse obviously is not well. You call your veterinarian, but you can give him no clues as to the severity of the illness, only saying, "He's depressed and not eating." Your veterinarian asks what the horse's temperature is, but you don't even own a thermometer...
This scenario is all too familiar for a veterinarian. Some horse owners have no knowledge of how to perform the most basic examinations on their animals. Owning a horse is a wonderful experience, but it also comes with responsibility.
All horse owners should know the basics of a physical examination—what the normal temperature, pulse, and respiration parameters are for a horse and how to take them correctly.
By being able to relay this basic information to the veterinarian about the parameters of an "unwell" horse, owners or farm managers can aid a practitioner in determining just how serious the problem is and how quickly the veterinarian needs to respond.
For example, if in the above scenario the horse owner could tell the veterinarian that the horse's rectal temperature was 104°F and the heart rate was 60 beats/minute, the veterinarian surely would see that horse the very next call, rather than possibly triaging the horse until later in the day.
Another classic scenario occurs when a horse owner notices that the horse seems quiet in the morning and not terribly interested in his morning grain. He or she thinks it a bit unusual, but goes off to work anyway. When the horse owner returns from work after 5 p.m., things are much worse. Again, if the owner had known how to perform a basic physical examination (temperature, pulse, and respiration), he or she would have known that the horse was very ill and called the veterinarian immediately.
I am not stating that the owner's or caretaker's basic physical examination takes the place of a veterinarian's examination. I am merely of the opinion that becoming familiar with these techniques can help you (the owner or caretaker) recognize a problem and be able to relay the information to your veterinarian. This most basic of information can save time, and potentially save a horse's life.
Above all, talk to your veterinarian. Make sure he or she understands that you are interested and want to learn how to care for your horse better. Furthermore, have your veterinarian observe you while you perform a basic physical examination. Then he or she can help in any areas you might not understand or not do properly. Also, take that time to ask your veterinarian what information he or she would like in the case of an emergency.
To perform a basic physical examination, it will help to have a few supplies—a thermometer, a stethoscope, and a watch that allows you to count seconds. Most lay people like digital thermometers because the time for a reading is much less—about one minute—for a digital compared to three to five minutes for a traditional glass thermometer. In the case of foals, it is probably kinder and possibly safer to use the soft digital ones rather than the rigid glass types, especially if the foal is particularly rambunctious. You can purchase the aforementioned thermometers in any drug store or well-equipped tack shop.
The stethoscope, of course, is an instrument that magnifies sound. This will allow you to hear the heart beating clearly and better distinguish the sounds of breathing. There are many different types of stethoscopes, but for your purposes, a very inexpensive one can be purchased at a drug store or through a horse supply catalogue.
The Power of Observation
I always have believed that the beginning of a really good physical examination first involves observing. This applies to veterinarians, physicians, and any good horse person. A great deal can be learned just by observing posture, attitude, and the environment. It is a skill that usually must be taught, or at least honed, as not all of us are naturally observant.
Most of the time learning to be more observant just entails learning what to watch for—patterns of lying down to rest, normal responses to exercise, normal appetite, etc. Observation from outside the stall or paddock can give valuable information. For example, did the horse eat or drink last night, how many piles of manure were passed, is the pain mild (flank watching) or are there paw marks and evidence of rolling in the stall or on the horse?
By using your powers of observation, you can determine what is normal and abnormal behavior. And, by observing every day, it can become an almost unconscious part of your daily examination, which can help alert you to a potential problem.
The Basic Examination
After observing your horse, you determine that he is not well or is injured. If the injury/illness is mild (small wound, mild colic), you can perform your basic physical examination first before calling your veterinarian. Obviously if the horse is in severe pain (thrashing, rolling, or severely bleeding), you call your veterinarian first, then perform your physical examination. Or, you can perform your examination while waiting for your veterinarian to call you back if he/she must be paged.
Your powers of observation can help determine what is wrong. For example, is there any nasal discharge or coughing? That might indicate a respiratory infection. Is the horse walking comfortably in the stall, or has he remained in one spot all morning? That could indicate that his muscles or feet are sore. Is the mare's udder dripping with milk? That indicates the foal is not nursing and is sick!
The rectal temperature can be taken easily on most horses. Approach the horse from the side—do not stand directly behind the horse in case he decides to kick—shake the thermometer down if using a mercury type. Place a small amount of lubrication (petroleum jelly or KY Jelly) on the thermometer; then insert it gently into the rectum. Make sure the thermometer is tied to a clip and attached to the tail to avoid losing it in the stall (or the horse). If using a glass thermometer, you can move on to the heart and respiratory rate at this time.
The normal rectal temperature of a horse is 99.5-101.5° (A neonatal foal's normal temperature is between 100.0-102°F). Hypothermia (low body temperature) is very dangerous for foals, so keep them warm if their temperature shows up below normal and you're waiting for your veterinarian to return your call. A fever indicates some type of severe stress—often infection somewhere within the body.
Pulse and Respiration
The heart rate (pulse) and respiratory rate can be taken without a stethoscope, if one is unavailable. The stethoscope just makes it much easier.
The pulse can be taken from the lingual artery, which is on the bottom side of the jaw, where it crosses over the bone. The pulse can be taken for 15 seconds, then multiplied by four to achieve the heart rate in beats/minute. If a stethoscope is available, then listening to the heart is easiest on the left side of the horse, just behind the elbow. Each "lub-dub" of the heart is considered one beat. The normal heart rate for a horse is 24-36 beats per minute (bpm). The heart rate for foals varies depending on age. Newborn foals have a heart rate of around 80 beats per minute (bpm). Foals within the first few weeks of life vary between 70-100 bpm.
The respiratory rate can be taken by watching the horse breathe or feeling the air come out of his nostrils. The stethoscope can be used to listen to the breaths as they travel across the trachea or in the chest. The trachea should sound clear.
The "character" of respiration should be noted. Is the horse taking shallow or deep breaths? Are there abnormal sounds associated with the breathing? The normal respiratory rate for adult horses is eight to 12 breaths/minute. Newborn foals have respiratory rates that are quite high, ranging from 60-80 breaths per minute. Foals within the first weeks of life have resting respiratory rates from 20-40 breaths per minute.
Please remember that if your horse or foal becomes excited for any reason during your examination, it can elevate the heart and respiratory rate temporarily.
Another indicator of wellness is the color of the mucous membranes or gums. Healthy horses have nice pink gums that are moist to the touch. Capillary refill time also can be performed while looking at your horse's gums. Press your finger on the gum, then release—the time it takes for the area to turn from white (where you pressed out the blood) back to pink is the capillary refill time. It should be around two seconds. Gums that are dark red, bright or brick red, blue, or even white with a prolonged capillary refill time, usually indicate one of the various forms of shock. Your veterinarian should be summoned immediately.
Your veterinarian's examination will be much more detailed. The veterinarian will not just listen for the respiratory rate, but will evaluate the entire lung field for abnormal sounds. Evaluation of the heart includes not just the rate, but also the rhythm and the presence or absence of a murmur. If a horse is displaying signs of colic, the abdomen will be ausculted for sounds of a healthy, moving gastrointestinal tract, or the more ominous silence of a GI tract in stasis. Depending on the problem, your veterinarian will perform many other procedures to determine the extent of the problem and the treatment necessary for resolution.
How to Use Your Information
I always recommend that you examine your horse when he is healthy to establish a baseline of normal parameters. Recording the normal temperature, heart rate, and respiratory rate for your horse allows you to inform your veterinarian what is normal for your horse when giving him or her the horse's physical parameters when he becomes sick.
Not all horses display obvious signs of abnormalities. For example, a stoic horse might have a very serious form of colic, but his only outward sign is that he is off feed. There is no rolling or pawing. However, if his heart rate is 70 beats per minute, you know it is very abnormal and indicative of a serious problem.
Finally, when you have trained yourself to observe your horse on a regular basis, you often can see the subtle "red flags" that there is a problem that warrants further evaluation by you, and your veterinarian.
About the Author
Christina S. Cable, DVM, Dipl. ACVS, owns Early Winter Equine in Lansing, New York. The practice focuses on primary care of mares and foals and performance horse problems.
POLL: Colic Surgery