Dr.
Art King
A
Systematic Method of Examination
The vet check is a critical factor with endurance competition. However,
it is very useful in day-to-day management as well. Every horse person
should learn how to check a horse's physical condition for any telltale
signs of illness, injury, or fatigue. Many potentially serious conditions
can be picked up at an early stage by this simple series of tests. No
sophisticated equipment or tests are required. A stethoscope, a watch
capable of indicating seconds and a thermometer (preferably with a clip
attached) is all the equipment one needs along with a basic understanding
of the difference between what is normal and abnormal for the various
areas of the horse that can be examined. With a little practice, one
can examine the horse in less than five minutes using a systematic method
of examination.
A
complete examination involves two parts: an examination of the horse
at rest and in motion.
The
horse at rest
Choose an open area such as a large box stall or wide alleyway. If the
horse is quiet, it can be tied or have an assistant hold the horse for
you. Once the horse has been adequately restrained in a safe and suitable
location, the examiner should approach the horse's head from the front
and to the left of the horse. First of all, note the horse's general
condition and attitude. Is the horse over or underweight? You should
be able to feel the ribs when you run your fingers across, the the rigs
should not be obvious. Is the haircoat sleek or dull? Is the horse alert
or lethargic? Since a temperature reading with a conventional mercury
bulb thermometer takes about one minute, time can be saved if the thermometer
is placed into the rectum and restrained there with the clip attached
to the tail while continuing with the examination.
Head
and neck area
Starting at the horse's head, lift the upper lip and note the colour
of the gums. Normally, this mucous membrane surface is a healthy pink
colour and slippery to the touch. A tacky or dry surface can indicate
dehydration. Colors such as pale white, jaundiced, brick-red, blush
or purplish, or muddy are indicative of a problem and warrant further
investigation. The capillary refill time is tested by blanching an area
of mucous membrane above the teeth with the thumb, releasing the pressure,
and counting the seconds that elapse while the colour returns to the
blanched area. Normal time is up to 1.5 seconds. Delays of two to three
seconds are cause for concern. Delays beyond four seconds are serious
and exercise should not continue. Delayed capillary refill time is an
indication of reduced blood circulation due to reduce volume (blood
loss or dehydration) and/or decreased blood pressure (shock).
Next,
check the nostrils for discharge. Normally there is no discharge, or
a slight watery, clear discharge may be present. Any bloody, purulent,
yellowish, creamy-white or greenish coloured discharge is abnormal and
should be investigate. Check the bit and bridle areas for sores (check
inside the mouth as well).
The
jugular refill time, like the capillary refill time, is an indicator
of the status of the circulatory system. This is checked by running
the thumb or forefingers down the jugular groove with enough pressure
to squeeze the blood from the vein. Digital pressure is then maintained
over the vein while it refills. The refilling is seen as the collapsed
vein becomes distended as it refills. A refill time of up to one to
two seconds is normal. As with capillary refill time, a delay beyond
four to five seconds is cause for limiting further exercise.
While
dehydration leads to changes in a number of the areas that are examined
(i.e. capillary and jugular refill, gut activity, attitude, and impulsion),
the most common means to quickly check hydration is the skin pinch test.
As the animal becomes dehydrated, the skin elasticity decreases due
to loss of water from the skin. Take a fold of skin between the thumb
and forefinger, lift it away from the underlying tissues, twist slightly
and release. This procedure should be done with a light touch, without
causing pain to the horse. The skin will normally snap back into place
almost immediately. A skin fold or "tent" that remains for
over two seconds indicates dehydration of about 3%. A delay of five
seconds is serious as it indicates that dehydration may be approaching
10%. Skin elasticity is affected by a number of factors such as age
of the horse and location of the skin on the body. For this reason it
is important to test the same area of skin each time to maintain consistency
of results for comparison purposes. The skin at the point of the shoulder
is the most commonly used at endurance events, but the neck and eyelids
can also be used.
The
heart rate
The heart rate is determined by counting the number of beats over a
short period of time and multiplying by a factor required to get a beats
per minute reading. Usually the count is for 15 seconds and the number
multiplied by four. The heart rate should be regular, however, dropped
or skipped beats are common in well-conditioned horses at rest. The
heart beat is heard as a lubb-dub, lubb-dub, ..., each lubb-dub being
one heart beat. Heart rates vary widely depending upon the horse's physical
condition and mental state at the time of the examination. Rates of
25 to 40 beats per minute are normal in resting horses. A fit horse
should recover to a heart rate of 64 to 68 beats per minute within 10
minutes of the end of heavy exercise. Higher rates may indicate overwork,
pending exhaustion, hyperthermia, pain, illness, or excitement.
Gut
sounds
Gut sounds are evaluated with the stereoscope by listening over the
upper and lower flank on both left and right sides. Normal gut sounds
are heard as bubbling and gurgling or like the sound of waves rolling
gently against a shore. The horse person should practice listening to
normal horses to get an understanding of the normal gut sounds. Abnormal
sounds such as pinging, ringing, or echoes of water dripping into a
well would be causes for concern. The sounds can vary not only in quality
and character but also in frequency. The absence of gut sounds is very
serious and usually warrants treatment if no improvement is noted within
30 minutes.
Respiratory
rate
Step back and note the character, quality and rate of respiration. The
rate and depth of respiration can vary widely among horses. Normally,
the respiratory to heart rate ratio is one to four at rest (about 8
to 12 breaths per minute), but a number of factors can alter this ratio.
The rate and/or depth of respiration are not as important as other characteristics
such as presence of heaves, laboured inspiration or expiration, wheezing,
grunting or groaning sounds. Panting is a means that the horse can use
to help cool itself. The presence of panting is usually an indicator
that the horse is hot and many horses may even pant at rest on a hot
and humid day. Because so many factors affect the respiratory rate at
any one time, it is not possible to correlate respiratory rate and depth
to physical fitness.
Checking
the body
The withers, shoulders, back, croup/rump and girth areas should be palpated
for evidence of sores, pain, bumps and tight musculature. This examination
is often subjective. The degree of pain that may be elicited will depend
upon the examiner's technique. The aim of the examiner is to detect
any pain, sensitivity, or tightness that would impair the horse's athletic
ability or cause pain and suffering during exercise. The left foreleg
is palpated for pain, swelling, heat, etc. especially in the joints,
ligaments and tendons, and splint area. Lift the foot and check the
condition, type and general fit of the show. Note any cracks, founder
lines, etc., that may be evident on the hoof. Repeat this examination
on the left hindlimb and then go to the right fore and right hindlimb.
Checking
the temperature
Remove the thermometer, note the temperature, and check the tail and
anal tone. The anus should constrict immediately in response to slight
digital pressure. The tail should clamp in reflex when first touched.
A flaccid tail and loose anus are found in exhausted horses as well
as in some nervous system diseases such as rabies.
The
Examination for Soundness
The examination in motion is done with the assistance of the handler
who will trot the horse first in a straight line for about 40 meters
(125 feet) away from and then toward the examiner. Next, trot the horse
in either a clockwise or counterclockwise circle of about 6 to 10 meters
(10 to 30 feet) in diameter, or if space permits, in a figure eight
pattern. The footing in the trotting area should be level, even and
reasonably firm. Avoid slippery or uneven surfaces as this makes it
difficult to properly assess the horse in motion. In some instances
it may be beneficial to examine the animal's
trot on both a hard surface, such as a paved or hard-packed roadway,
and a soft surface of sand or loose soil.
The
handler should trot the horse on a loose rein at a steady slow trot,
taking care to travel to the left of the horse, rather than in front
of the horse. This ensures that the examiner's view is not obstructed.
Do not hold the horse with a short lead as this exaggerates or restricts
normal head motion. The horse should then be trotted in circles or the
figure eight at a steady trot. The examiner is looking for evidence
of lameness, gait abnormalities and quality of movement. Note any of
the following motions: hiking, head bobbing or swaying, hopping, winging
or paddling, base-wide or base-narrow motion, as well as head, back
and tail carriage. Stride length and height, as it relates to quality
of gait and impulsion, should also be noted. Listen for any unevenness
of hoof beats on the ground.
Cardiac
Recovery Index
The cardiac recovery index is a useful indicator of a horse's condition,
especially if it is used at rest stops during a competition or during
recovery following exercise. The examiner takes the horse's heart rate
immediately prior to trotting the horse a distance of 125 feet away
and then back to the examiner. The heart rate is taken one minute following
the START of the trot. The two heart rates are compared and should be
within a few beats of each other. If the post-trot reading is eight
or more beats/minute higher than the pre-trot reading, the horse should
be carefully evaluated. Assuming that excitement did not cause the higher
reading, one should consider injury, fatigue, dehydration or other causes
that may be the underlying cause of the elevated reading. While the
horse is trotting out and back for the cardiac recovery index, the attitude,
impulsion and quality of gait can be observed at the same time.
Summary
Throughout the entire examination, the examiner is looking for evidence
of cuts, wounds, and skin lesions as well as noting from observation
and by questioning the handler the horse's appetite, level of thirst,
defecation and urination. Following this systematic procedure, the examiner
has quickly evaluated the horse's major systems. He or she should have
a general impression of whether the horse is in need of further medical
attention for determining the cause and treatment of any problems that
may have been identified.
Guidelines For Performing
The Vet Check On Your Horse
Parameter
|
Green
|
Yellow
|
Red
|
Eyes |
Bright,
clear |
Glassy |
Fixed
stare, sunken eyeball |
Mucous
membranes |
Pink,
moist |
Pale,
tacky |
dry,
purple, blue |
Capillary
refill |
0
- 1 seconds |
2
- 3 seconds |
4+
seconds |
Jugular
refill |
1
- 2 seconds |
2
- 3 seconds |
4+
seconds |
Skin
pinch |
0
- 1.5 seconds |
2
- 3 seconds |
4+
seconds |
Heart
rate
(after
strenuous exercise)
|
<68
in 10 min. |
68
in 10 - 30 min. |
>68
in 30 min. |
Gut
sounds |
Normal |
Reduced/increased |
Absent |
Respiratory
rate |
Relaxed/regular |
Panting/inversion |
Labored/abnormal |
Joints/legs |
No
heat or swelling |
Heat/swelling |
Heat/swelling/pain |
Wounds/
saddle/back |
No
visible marks |
Heat/swelling/tender |
Pain/raw/bleeding |
Muscle/back |
Relaxed |
Tight/tender |
Very
tight/pain |
Anal
tone |
Tight |
Slightly
loose |
Anus/penis
relaxed |
Rectal
temperature |
<38.6
C pre-ride
<39.6 C during ride |
39.5
C - 40.5 C during ride |
>40.5
C |
Impulsion |
Free,
willing |
Stumble/short
stride |
Stiffness |
Attitude |
Bright/eats/drinks |
Depressed/lethargic |
Dull,
uninterested absence of thirst, appetite, urination or defecation |
Gait |
No
abnormal gait |
Slight
gait change |
Consistent
gait change/non-weight bearing |
The
contents are copyrighted but may be copied,
on condition that the Equine Research Centre be
acknowledged for the use of its information.