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Topic:Clinical Signs
Clinical signs in horses refer to observable physical or behavioral manifestations that may indicate the presence of disease or injury. These signs can include a range of symptoms such as changes in appetite, alterations in gait, abnormal respiratory patterns, or variations in body temperature. Recognizing clinical signs is an integral part of equine veterinary practice, as they provide initial insights into the health status of the animal. Veterinarians rely on these signs to formulate differential diagnoses and guide further diagnostic testing. This page gathers peer-reviewed research studies and scholarly articles that explore the identification, interpretation, and diagnostic value of clinical signs in equine health management.
[Retrospective evaluation of equine blood cultures sampled between 2022 and 2024]. In this study, the results of equine blood cultures sampled during the period from 2022 to 2024 were evaluated. Samples were submitted as routine samples by veterinary practices to a veterinary diagnostic laboratory in Germany. The study focused mainly on the differentiation of the bacterial isolates. In order to place the results in a clinical context, the study was complemented by a questionnaire sent to the practices enquiring for sepsis-associated clinical signs. Unassigned: The study was carried out retrospectively. A total of 199 blood culture samples submitted by practices located in Ge...
Heavy metals in horses: A review of the toxicity, clinical consequences and expected safe tissue concentrations. Trace elements arsenic, cadmium, lead, chromium, mercury, nickel, and zinc are high-density, naturally occurring metals notable for their toxicity and environmental persistence. Cadmium and mercury are particularly concerning due to their capacity for bioaccumulation and biomagnification within the food chain. Dispersed through both anthropogenic and natural sources, these elements pose significant threats to ecosystems and animal health. In equines, they induce oxidative stress by disrupting mitochondrial function, generating reactive oxygen species, and inhibiting antioxidant enzymes, leadin...
Complete atrioventricular septal defect in Thoroughbred foals: echocardiographic and postmortem findings. Complete atrioventricular septal defect (AVSD) is rarely reported in horses. We retrospectively reviewed three Thoroughbred foals (2017-2023) with necropsy-confirmed complete AVSD and summarized their clinical presentation, transthoracic echocardiographic findings, and postmortem anatomy. All foals showed early signs of congenital cardiac disease including weakness, failure to thrive and cardiac murmurs. Echocardiography demonstrated a common atrioventricular junction with a single atrioventricular valve and combined atrial and ventricular septal defects; all were classified as Rastelli type C...
Evaluation and Management of the Horse with Head and Neck Disorders. Recognizing possible causes of equine head and neck problems requires a careful and systematic evaluation. While for some disorders reaching a diagnosis and treatment plan is relatively straightforward, for others this can be a complicated road requiring extensive diagnostic techniques, treatment trials, and management strategies. The ability to determine whether the patient is in a painful state, experiencing functional deficits, or in a combination of pain and dysfunction is critical to developing an effective treatment plan. Frequently, behavioral concerns often associated with pain must be...
Successful Use of Vincristine in a Quarter Horse Gelding with Immune-Mediated Thrombocytopenia. This case reports the successful use of vincristine in a Quarter Horse with presumed immune-mediated thrombocytopenia. A 15-year-old Quarter Horse gelding presented for a pinch skin graft procedure on the left forelimb over the cannon bone. On day 10 of hospitalization, the horse developed a fever (102.6°F, RI: 99-101°F), and severe petechiae of the mucous membranes. A complete blood count (CBC) (Advia 2120i) revealed a severe thrombocytopenia (16,000 platelets/μL, RI:100,000-400,000/μL). Diagnostic testing was negative for Anaplasma phagocytophilum by PCR, Theileria equi and Babesia cabal...
Case Report: Neurologic signs following rattlesnake envenomation. Rattlesnake envenomation is a common emergency in horses in California. Rattlesnakes belong to a group of venomous snakes: pit vipers. The Northern Pacific Rattlesnake (), a subspecies of the Western Rattlesnake, is the most widespread rattlesnake in California (1). A 5-year-old miniature horse mare presented for a presumed Western Rattlesnake bite. The owners found the horse the morning of presentation with severe facial swelling and the horse was housed in an area where rattlesnakes are commonly observed. The horse was reported to be normal the day prior to presentation. On blood examination...
Adult Equine Optic Nerve Head Measurements Using Spectral Domain Optical Coherence Tomography. To compare equine optic nerve head (ONH) measurements using spectral domain optical coherence tomography (SD-OCT) to detect clinically relevant ONH cupping. Methods: Forty-five eyes from 34 horses were categorized as CONTROL or CUPPED based on indirect ophthalmoscopy and were measured using SD-OCT: Bruch's membrane opening (BMO), optic cup width (OC), anterior laminar depth (ALD), prelaminar thickness (PLT), and cup-to-disk ratio (OC: BMO) at superior (sup.), central (ctr.), and inferior (inf.) ONH locations. Results: The OC:BMO was 0.61 ± 0.09 (sup.), 0.64 ± 0.09 (ctr.), and 0.55 ...
Fungal endometritis in broodmares: clinical presentation, prevalence in Ireland and diagnostic performance of cytology. Fungal endometritis is an uncommon uterine condition associated with poor fertility. Objective: This study aimed to 1) provide a descriptive summary of 11 cases of fungal endometritis, 2) assess prevalence trends of fungal endometritis over time, 3) assess fungal species distribution in diagnostic samples, and 4) evaluate the diagnostic accuracy of cytology. Methods: Study 1 reviewed records of 11 mares diagnosed with fungal endometritis for history, presentation, treatment, and outcome. Study 2 analysed 6,727 uterine samples (swabs and lavages; 2019-2024) for factors influencing fungal cultur...
Evaluation of episcleral silicone matrix cyclosporine implants for presumed equine immune-mediated keratitis: a retrospective study. Immune-mediated keratitis (IMMK) is a chronic inflammatory corneal disease in horses. Long-term topical therapy with cyclosporine is often impractical, highlighting the need for sustained-release alternatives. Objective: To assess clinical response, tolerability, and duration of effect of episcleral silicone matrix cyclosporine implants (ESMC) in horses with presumed IMMK. Methods: Medical records of 12 horses (14 eyes) treated between 2019 and 2023 were retrospectively reviewed. IMMK subtypes were classified as epithelial (n = 3 eyes), anterior stromal (n = 9), or mid-stromal (n =â€...
Advanced Imaging of the Cranium and the Cervical Spine for Equine Neurologic Disease. Diagnostic imaging is essential for evaluating and managing neurologic disease in horses. Following clinical lesion, neurolocalization imaging modalities are often necessary to further characterize the disease process. However, which technology to use depends on various factors, including the patient's size, clinical signs, and the anatomic region. Current advances in imaging technology, in general, and the adaptation of different modalities for equine patients, in particular, have substantially improved our ability to evaluate the equine central nervous system. This article will summarize the...
Caudal esophageal achalasia in a Quarter Horse colt. Achalasia is the most common motility disorder of the esophagus in humans and has been diagnosed in cats and dogs. We describe a 4-month-old Quarter Horse colt with failure to thrive, recurrent colic episodes, and aspiration pneumonia, in which fluoroscopic evaluation identified a caudal esophageal motility disorder consistent with achalasia. Necropsy examination confirmed achalasia.
Physical vs. Behavioral Clinical Signs in Horses with Squamous and Glandular Gastric Ulcers. Equine Gastric Ulcer Syndrome is a highly prevalent condition, yet its clinical diagnosis remains challenging due to the nonspecific nature of many associated signs. The relationship between the anatomical location of gastric ulcers and clinical presentation is still poorly defined. This retrospective study aimed to evaluate the association between gastric ulcer location and the clinical signs observed in horses. Medical records of 52 horses diagnosed with gastric ulcers by gastroscopy were retrospectively reviewed. Clinical signs were classified as physical, behavioral, or mixed, and ulcer lo...
The 2025 outbreak of equine influenza among draft horses at Obihiro Racecourse, Hokkaido, Japan. In 2025, an outbreak of equine influenza occurred among draft horses at Obihiro Racecourse in Hokkaido, Japan. The number of horses showing clinical signs increased dramatically in April. The proportion affected was significantly higher in 2-year-olds than in older groups. The proportion that developed fever during the outbreak was significantly higher than that observed among Thoroughbreds during the 2007 outbreak. In non-epidemic periods, the geometric mean hemagglutination inhibition antibody titer of 2-year-old draft horses was significantly lower than that of 2-year-old Thoroughbreds. The...
Multi-state equine botulism outbreak in the United States linked to contaminated feed: an epidemiologic, clinicopathologic, and regulatory investigation. A multi-state outbreak of equine botulism occurred between December 2022 and March 2023 in the United States. Follow-up and testing were performed on 42 horses, including 24 that died or were euthanized in the outbreak that affected ~98 horses. Affected horses had all been exposed to the same commercial feed. Clinical signs included progressive muscle weakness and tremors, recumbency, and colic. No significant gross or microscopic abnormalities were observed on autopsy. Feces and gastrointestinal content were tested for various infectious agents, including botulinum toxin; fecal samples from 2...
New Diagnostic Score for Sepsis in Adult Horses with Acute Gastrointestinal Disease. Colic is a leading cause of mortality in horses, particularly when associated with systemic inflammation and organ dysfunction. In human medicine, these complications are associated with sepsis, defined as organ dysfunction caused by a dysregulated, life-threatening host response to infection. However, no consensus sepsis score exists for adult horses. This retrospective study aimed to develop a diagnostic sepsis score for adult horses. Medical records from 295 horses admitted for colic to the Oniris equine emergency department (Nantes, France) between July 2011 and November 2021 were analyzed...
Sequential Application of Autologous Platelet Rich Plasma and Muscle-Derived Mesenchymal Stem Cells for Acute Tendon Injuries in Horses: Early Clinical and Ultrasonographic Outcomes in a Randomized, Double-Blind Controlled Study. Tendon and ligament injuries are frequent in sport horses and are prone to recurrence due to incomplete healing. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) are increasingly used, but data controlled on the early effects of autologous MSCs remain limited. A prospective randomized, double-blind, placebo-controlled trial was conducted in horses with naturally occurring tendinopathies. After standardized PRP pretreatment, non-responders were randomized to receive intralesional autologous muscle-derived MSCs (mdMSCs, = 17) or placebo ( = 6). Clinical and ultrasonographic paramete...
Decoding moody mare syndrome: Retrospective study and tiered diagnostic framework. Behavioral issues, such as persistent or strong estrus, non-specific pain, and performance challenges in mares are frequently attributed to the estrous cycle. Objective: The objectives of this study were to analyze retrospective data on mares presented for estrus-related behavioral complaints, and to propose a structured diagnostic framework for categorizing cases during work-up at different levels of care. Methods: A retrospective study was conducted using patient records of a total of 14993 mares. Results: In this data set, behavioral problems, pain, or poor performance were not repeatably v...
Orthoflavivirus-associated neurological disease in a UK horse. Keesjan Cornelisse and Andra-Maria Ionescu discuss the clinical presentation, investigation and diagnostic approach to a case of orthoflavivirus infection in a horse in south-west England.
Topical treatment of equine aural plaques with nitric acid and zinc solution. Equine aural plaque caused by equine papilloma viruses is common worldwide and affected horses can show severe clinical signs. Due to its viral aetiology, in some countries affected horses are not allowed to compete. Since lesions persist, showing no spontaneous regression, effective and safe treatment is required. Currently, the only treatment with consistent efficacy is imiquimod. Treatment time is prolonged and adverse effects are common. In humans, papilloma warts are successfully and safely treated with topical nitric-zinc complex solutions inducing a painless caustic effect. Objective: T...
Starch Overload and Cecal Alkalinization: Impacts on the Intestinal Microbiota and Health of Horses. Starch overload induces dysbiosis primarily through a reduction in cecal pH. This study aimed to evaluate the cecal microbiota following excessive starch intake, with or without the administration of an intracecal buffering solution. We hypothesized that the buffering solution would mitigate changes in the intestinal microbiota and associated clinical signs. Ten horses were randomly assigned to two groups, each receiving distinct treatments (Group I: saline solution [WSa] and starch-buffer [SB]; Group II: buffer-water [WB] and starch-saline [SSa]). Following starch overload (17.6 g/kg body wei...
Modified Medial Canthoplasty for Correction of Euryblepharon in Two Horses. To describe a medial canthoplasty surgical procedure in two horses for correction of euryblepharon, secondary to microphthalmia, and following excision of retrobulbar fat prolapse. Methods: A 1 year old thoroughbred mare was presented for small globes and chronic ocular discharge bilaterally. Ophthalmic examination revealed microphthalmos, euryblepharon, medial canthal pocket syndrome, and dacryocystitis bilaterally with no visual impairments. A 2 year old Appaloosa gelding was presented for evaluation of a smooth, subconjunctival mass anterior to the right globe in the medial canthus. Oph...
Equine neorickettsiosis: A global perspective of the natural habitat of the bacteria and clinical disease. Equine neorickettsiosis (EN) is an infectious, non-contagious systemic disease of horses caused by the closely related obligatory intracellular bacterial species Neorickettsia risticii and N. findlayensis. Clinical cases are considered endemic in multiple regions across the United States and Canada, as well as in parts of South America, including Uruguay and Brazil. Neorickettsia spp. are obligate endosymbionts of digenean trematodes, which have complex life cycles involving a molluscan first intermediate host, a wide range of invertebrate or vertebrate second intermediate hosts, and a vertebr...
Gaps Between Awareness and Prevention of West Nile Virus Among Horse Owners in an Endemic Country: A Cross-Sectional Study from Romania. West Nile virus (WNV) circulates endemically in Romania, yet prevention of WNV infection in horses largely depends on owner-driven decisions that require accurate risk perception and veterinary guidance. A cross-sectional online survey was carried out between May and November 2025 to evaluate the knowledge, attitudes, and preventive practices (KAP) regarding WNV among 227 horse owners from various Romanian regions. In total, 67.4% of respondents had previously heard of WNV. The main transmission route was correctly identified as mosquito bites by 49.8% of participants, while 32.2% answered "do...
Septic arthritis caused by Streptococcus equi subspecies zooepidemicus: a case report. subspecies (SESZ) is an uncommon zoonotic pathogen in humans but can cause severe joint infections. Reported cases are often linked to exposure to horses, dairy products, or raw pork, though infections may occur without an identifiable animal source. Unassigned: An 84-year-old man with multiple comorbidities presented with acute left shoulder pain, fever, and chills. Synovial fluid aspiration yielded turbid fluid containing calcium pyrophosphate dihydrate crystals, while Gram stain was negative. Despite empiric broad-spectrum antibiotics, his symptoms persisted, requiring surgical irrigation...
Associations among beta-endorphin, ACTH, cortisol concentration, age, and clinical signs indicative of pituitary pars intermedia dysfunction in geriatric horses. Limited published data are available regarding the relationships among clinical signs associated with pituitary pars intermedia dysfunction (PPID), age, and concentrations of proopiomelanocortin-derived peptides and cortisol. Objective: Identify clinical signs associated with age, beta-endorphin (β-END), adrenocorticotropic hormone (ACTH), and cortisol concentrations and compare β-END and cortisol concentrations between horses with PPID and geriatric controls. Methods: A total of 113 horses aged 18-32 years. Methods: Cross-sectional study. Clinical signs were scored, plasma β-END, ACTH, an...
Clinical Manifestations and Behaviors Associated with Equine Head and Neck Disorders. Equine head and neck disorders can present with a wide range of clinical manifestations, depending on the structures involved and disease process. Important components of the gastrointestinal, respiratory, ophthalmological, neurological, and musculoskeletal systems are contained within the head and neck, and clinical signs of disorders will result in expected clinical signs. However, clinical manifestations of disease are sometimes subtle, and when not recognized can lead to behavioral changes including undesired behaviors and poor sleep. Recognizing behavioral phenotypes of horses with proble...
Updates on Seizures and Epilepsy in the Horse. The goal of this article is to provide the equine practitioners with a framework for a diagnostic algorithm for the patient presented with possible seizures/epilepsy. Using a comparative approach, a review of companion animal and human research is provided with the intention of expanding our current knowledge on seizure/epilepsy, as well as diagnostic and treatment strategies for equine patients.
Pulmonary fibrosis in horses associated with spontaneous Crotalaria juncea intoxication. We report an outbreak of Crotalaria juncea intoxication in horses exhibiting progressive weight loss and respiratory distress in northeastern Brazil. Necropsy revealed firm, non-collapsed lungs with extensive interstitial fibrosis, bronchiolar epithelial hyperplasia with club cells proliferation, and marked pulmonary arterial remodeling. Hepatic lesions consisted primarily of centrilobular necrosis, probably resulting from hypoxic injury related to anemia and prolonged agonic death. Pasture inspection identified significant invasion by shrubs of C. juncea in various phenological stages.
Update on Idiopathic Trigeminal-Mediated Headshaking. Idiopathic trigeminal-mediated headshaking is a painful neuropathic disorder characterized by sudden, violent, predominantly vertical head movements of unknown etiology. Clinical signs may be seasonal or persistent and triggered by light, sound, exercise, or tactile nasal stimulation. The pathophysiology is multifactorial, involving abnormal trigeminal nerve excitability influenced by hormonal, environmental, and dietary factors. Treatment is challenging and typically multimodal, aiming to reduce trigeminal hypersensitivity and improve quality of life.
