Veterinary Checkups for Horses: What to Expect in an Annual Wellness Exam

Even when your horse appears healthy, regular veterinary examinations are an important part of preventive care. Horses can hide early signs of illness, and a veterinarian may detect subtle changes in body condition, dental health, heart and lung function, or other aspects of health before they develop into more obvious problems.

A wellness exam is an opportunity to confirm that your horse’s preventive healthcare plan still meets their individual needs.

Your veterinarian will typically ask about your horse’s health, diet, exercise, medications, parasite-control program, dental and farrier care, and any changes you have noticed. They will then perform a physical examination. Vaccinations, dental care, fecal testing, nutrition, and other preventive measures may also be discussed.

Knowing what to expect can help you prepare for the appointment and make the most of your time with your veterinarian. Keep reading to explore what typically happens during a horse wellness exam and how a routine checkup supports your horse’s long-term health.

What Is an Annual Wellness Exam for Horses?

A wellness examination is a routine veterinary appointment to review your horse’s history, discuss any concerns, and assess their current health. Many veterinarians also use this appointment to perform annual or semiannual procedures, such as vaccination, deworming, and dentistry, based on the horse’s needs for the coming months.

An annual wellness exam also ensures you maintain a valid veterinary-client-patient relationship (VCPR) with your veterinarian. While it’s ideal when horses remain healthy and don’t require unexpected veterinary care, allowing more than 12 months between visits may result your practice changing your status to “new client” at your next appointment. Depending on the practice, this could affect access to emergency care, costs associated with care, or requesting prescription medications.

For horses without significant health concerns, wellness examinations are generally recommended once a year. More frequent examinations may be necessary for horses with chronic conditions such as: ^[1]

• Osteoarthritis or other lameness issues
• Dental disease
• Pituitary pars intermedia dysfunction (PPID)
• Equine metabolic syndrome (EMS)
• Other health concerns that require frequent monitoring

What happens during a wellness exam largely depends on your horse’s individual needs. Ask your veterinarian which procedures they plan to perform.

Table 1. Common components of an equine wellness exam ^[1][2][3]

History & Management Review

Many wellness examinations begin with questions about the horse’s medical history and current management. This information gives the veterinarian important context for their assessment, particularly if it is their first time evaluating the horse.

Topics covered during this part of the exam may include: ^[4]

• The horse’s age, breeding, and current use
• Previous illnesses, surgeries, or injuries
• Current diet
• Current workload or exercise
• Turnout and housing
• Insurance status
• Hoof care
• History of preventive care, including dentistry, vaccination, and parasite control
• Current medications and supplements
• Past and planned travel or competition
• Changes in weight, appetite, behavior, or performance

Have this information available for the appointment. Owners of boarded horses may not know the details of their horse’s diet, turnout schedule, or housing, so ask the horse’s caregivers about these topics in advance.

Accurate information about how your horse is managed helps the veterinarian make recommendations that fit the horse’s routine.

×

Enjoy $10 Off From Us

What's your top priority with your horse's health?

🦴 Joint Health 🐎 Hoof Health 💪 Topline & Muscles 🥕 Gut Health & Digestion ⚡ Metabolic Health 🏆 Athletic Performance 🌿 Behavior & Calming 💨 Respiratory Health

• Yes, send me expert advice on horse health and nutrition

* Limit one per customer

Physical Examination

A physical examination gives the veterinarian an overview of your horse’s current health. It may reveal subtle abnormalities that are not apparent during day-to-day care, allowing the veterinarian to recommend appropriate follow-up.

The veterinarian begins by observing the horse’s general attitude, posture, and appearance. ^[4] They also assess the horse’s body condition score, a standardized measure used to determine whether a horse is over- or underweight.

They then perform a regional examination, carefully assessing different areas of the horse’s body. This process may include: ^[4]

• Evaluating the eyes, nose, and ears
• Measuring pulse, respiratory rate, and temperature
• Listening to the heart and lungs
• Evaluating hydration status
• Checking capillary refill time to help assess circulation
• Listening to the digestive tract
• Identifying areas of heat, swelling, or discomfort

Based on the assessment, the veterinarian may create a problem list that records abnormal findings. Depending on those findings, they may recommend further diagnostic testing, monitoring, or treatment.

Lameness Examination

A basic lameness examination can be valuable for any horse and is particularly important for horses in work. A thorough assessment may identify early changes in soundness. Some causes of lameness are progressive and may worsen over time, so early identification can support prompt treatment and management.

Components of a basic lameness examination include: ^[4]

• Evaluating the limbs for pain, heat, or swelling
• Assessing the hooves, including hoof testing, which applies pressure to identify a pain response
• Observing the horse’s posture while standing
• Watching the horse walk and trot to identify gait abnormalities

Some veterinarians also perform flexion tests. These tests involve holding the horse’s limb in a position that stresses one or more joints. After releasing the limb, the veterinarian watches the horse trot and looks for changes in gait.

If the veterinarian identifies a gait abnormality, they may recommend additional diagnostics. These may include regional anesthesia (“nerve blocks“), in which nerves or joints are numbed to help localize pain, or diagnostic imaging to assess bony or soft-tissue changes.

Preventive Care Procedures

Preventive care procedures help protect your horse from common health problems and maintain routine records needed for travel, competition, and long-term management.

During a wellness exam, your veterinarian may update dental care, vaccinations, parasite control, infectious disease testing, and other routine procedures based on your horse’s age, sex, lifestyle, and health history.

Not every horse needs the same preventive care at every visit. A horse that travels frequently, competes, lives in a busy boarding barn, or has a history of dental or parasite-related concerns may need a different plan than a retired horse kept at home.

Your veterinarian can help determine which procedures are appropriate during the appointment and which should be scheduled separately.

Dentistry

Horses’ teeth erupt continuously throughout much of their lives and wear as they chew. Because of the shape of the equine skull, teeth may wear unevenly, producing sharp points that can injure the tongue or cheeks. This makes regular dental care an important part of preventive medicine for horses.

A wellness examination is an appropriate time for your veterinarian to assess the horse’s teeth and chewing movements. Veterinarians generally recommend a dental examination at least once per year, with more frequent assessments for horses with a history of dental problems.

A thorough dental examination generally requires sedation. Sedation keeps the horse calm and relatively still, allowing the veterinarian to inspect the mouth closely. A dental speculum holds the horse’s mouth open during the examination. ^[2] Mirrors, picks, and probes help the veterinarian assess each tooth and identify disease that may not be obvious during an initial inspection.

The veterinarian can often perform necessary dental care during the same appointment because the horse is already sedated. This approach can reduce the number of sedation events and associated costs per horse. The veterinarian may use powered dental tools, hand floats, and other equipment to correct abnormalities and support normal chewing function.

Vaccination

Many equine vaccines are administered annually, making a wellness examination a convenient time to review and update the horse’s vaccination status. Vaccine selection depends on individual risk, including the horse’s location, lifestyle, travel, and show plans for the coming year.

The American Association of Equine Practitioners identifies core vaccines that all horses should receive annually. These vaccines protect against life-threatening diseases to which any horse may be exposed, regardless of travel history. The core vaccines are: ^[5]

• Rabies
• Tetanus
• Eastern and Western equine encephalomyelitis
• West Nile virus

Your veterinarian may also recommend risk-based vaccines, including: ^[5]

• Anthrax
• Botulism
• Equine herpesvirus
• Equine influenza
• Equine viral arteritis
• Leptospirosis
• Potomac horse fever
• Rotavirus
• Snakebite vaccine
• Strangles

These recommendations require a complete picture of the horse’s lifestyle. Discuss your horse’s housing, contact with other horses, travel, and competition plans with your veterinarian when developing a vaccination schedule.

Vaccines are typically given by intramuscular injection or intranasal spray. Some vaccines, including rabies vaccination in certain jurisdictions, must be administered by a veterinarian to meet legal requirements. Owners may administer other vaccines with veterinary approval and training.

Table 2. Core vs. risk-based vaccines for horses

Fecal Floatation & Deworming

Horses are vulnerable to internal parasites that live in the digestive tract. These parasites can contribute to digestive disturbances, including diarrhea and colic, making parasite control an important part of preventive care. Veterinarians may prescribe dewormers, or antiparasitic medications, to manage a horse’s parasite burden.

With increasing use of dewormers over the last 50 years, parasite populations developed resistance to these medications. ^[6] Frequent, non-specific deworming is a major contributor to anthelmintic resistance because treatment kills some parasites while resistant individuals remain in the digestive tract and reproduce.

The development of new deworming medications has been limited, so veterinarians focus on preserving parasite susceptibility to existing products. ^[6] A fecal egg count can help estimate an individual horse’s parasite burden and risk of parasite-related disease. Horses with a low parasite burden may require deworming only once or twice a year, depending on veterinary recommendations.

To perform a fecal float, the veterinarian analyzes a sample of the horse’s manure and examines it for parasite eggs under a microscope. Counting the eggs provides a fecal egg count. ^[6] The veterinarian interprets the result to determine whether deworming is appropriate for that horse.

The veterinarian also considers the time of year and parasite species when creating an individual deworming plan. Follow their recommendations for product choice and timing. Excessive or inappropriate use can increase dewormer resistance on the farm, potentially reducing future treatment effectiveness and increasing the risk of parasitic disease.

Sheath Cleaning

Stallions and geldings retract the penis into the sheath, a double fold of skin that helps protect it from injury. Smegma, a waxy secretion produced around the penis, can accumulate within these folds and form compacted masses.

This buildup may cause discomfort during urination or when the horse drops the penis. Sheath cleaning removes accumulated material and allows the area to be inspected.

Although many owners clean their horse’s sheath themselves, veterinarians can also provide this service during a wellness examination for horses who may not tolerate the procedure without sedation. The appointment may be a convenient time because the horse is often already sedated for a dental examination.

Sedation allows for thorough cleaning and inspection, and the veterinary team can identify abnormalities, such as masses or signs of infection, that may require monitoring or treatment.

Health Screening & Nutrition Review

Wellness exams may also include screening tests and nutrition discussions that help identify health concerns before they become more obvious. These assessments are especially useful for senior horses, horses with chronic conditions, and horses with changes in weight, appetite, performance, or behavior.

Bloodwork, metabolic testing, and nutritional review do not replace the physical examination, but they can provide additional information about the horse’s internal health and management needs.

Your veterinarian may recommend these services based on the horse’s age, medical history, body condition, workload, and risk factors for conditions such as PPID, EMS, obesity, or digestive problems.

Coggins Testing

The Coggins test is used to test for equine infectious anemia (EIA), a viral infection found worldwide. EIA is primarily transmitted through blood-feeding insects. ^[7] It can also spread through contaminated equipment, including dental floats, needles, syringes, and medication bottles. ^[7]

EIA is a chronic, lifelong disease with no cure or vaccine. Infected horses may develop life-threatening acute disease, with clinical signs such as: ^[8]

• Fever
• Poor blood clotting
• Low red blood cell count
• Profound hemorrhage and bleeding throughout the body
• Muscle weakness and atrophy
• Sudden death

The main preventive strategy is identifying carriers to limit exposure to other horses. The Coggins test is the primary diagnostic test used to identify chronic carriers. In the United States and Canada, EIA is a reportable disease, meaning confirmed cases must be reported to government authorities. Regulatory action may include euthanasia of the affected horse to protect other horses from exposure. ^[7]

Many horse show organizations require a negative Coggins test from within the previous 12 months before a horse can compete. Testing may also be required for transport across state or provincial borders or into another country. Work with your veterinarian to determine the testing requirements for planned travel.

Bloodwork

Bloodwork can be an important part of a wellness exam, particularly for horses with chronic conditions that require monitoring. Senior horses may also benefit from routine testing to identify age-related health changes and support prompt follow-up.

A standard equine bloodwork panel may include a complete blood count, which measures the numbers and proportions of different blood cells. ^[2] A chemistry panel may also be used to evaluate electrolytes, minerals, proteins, and enzymes that can provide information about organ function.

For horses with PPID or EMS, regular bloodwork may be recommended to monitor the condition. ^[9][10] These tests can measure hormones such as insulin or ACTH and help the veterinarian determine whether the horse’s current management plan is adequately controlling the disease.

Nutritional Assessment

Veterinarians may offer nutritional assessment and counseling during wellness examinations. They review the horse’s current diet, including forage, grain, and supplements. ^[3] Recommendations may be adjusted based on the physical examination, medical history, body condition, workload, and management.

Conditions that may require nutritional changes include:

• Equine gastric ulcer syndrome
• Pituitary pars intermedia dysfunction
• Equine metabolic syndrome
• Obesity
• Hard keeping tendencies (difficulty maintaining condition)

Follow your veterinarian’s recommendations closely. They may adjust the amount or type of feed the horse receives or recommend management changes, such as limiting access to pasture. A forage-first feeding program should be evaluated within the context of the horse’s complete diet and health needs.

Your veterinarian may refer you to an equine nutritionist for a comprehensive diet evaluation. The nutritionist can assess forage, concentrates, supplements, and feeding practices to help ensure the overall diet is balanced for the individual horse.

Intro to Equine Nutrition

Gain a deeper understanding of your horse's nutrition needs. This free introductory course provides a foundation for horse owners to learn how to balance your horse's diet.

Enroll Now

Preparing Your Horse for a Wellness Exam

Before the wellness exam, make sure your veterinarian has access to the horse’s available health information. If the horse is new to the practice, ask the previous veterinarian to forward the medical record. Gather the following details:

• Current medications and supplements
• Vaccination history
• Deworming and fecal testing history
• Recent illnesses or injuries
• Changes in appetite, weight, behavior, or performance
• Dental and farrier care history

Write down your questions and concerns so they are easy to discuss during the appointment. Useful questions may include:

• Is my horse at an appropriate body condition?
• Which vaccines does my horse need?
• Does my horse require deworming at this time?
• How often should my horse receive dental care?
• Is my horse’s diet appropriate for their lifestyle and medical history?
• Would you recommend any additional preventive testing?
• When should my horse’s next wellness examination be?
• Are you concerned about any signs of early disease?

Most horses require minimal preparation on the day of the exam. Follow any specific instructions from your veterinarian. For example, they may ask you to fast the horse before insulin testing.

At the appointment time, have the horse caught and safely restrained by a competent handler before the veterinarian arrives. Provide a clean, quiet, horse-safe work area, such as an arena, individual paddock, cross-tie area, or barn aisle.

Horses that are uneasy with routine care may benefit from prior training to stand for veterinary procedures.

Frequently Asked Questions

Here are some frequently asked questions about horse wellness exams:

Summary

A wellness exam is an important part of preventive healthcare for horses, even when they appear healthy.

• A wellness exam typically includes a complete physical examination and a review of the horse's medical history and management
• Vaccinations, parasite control, dental care, nutrition, hoof care, and body condition may all be assessed
• Bloodwork and other diagnostics may be recommended based on age, history, risk factors, or examination findings but are not necessary for every healthy horse
• Senior horses and horses with chronic health conditions may require more frequent monitoring
• Preparing medical records and a list of questions or recent changes can help owners use the appointment effectively