Dealing With a Down Horse

A horse that is unable to stand faces serious problems.

Photo: iStock

A horse that is unable to stand faces serious problems. Learn how to right a recumbent horse and what factors influence his survival.

You head out to feed on a crisp, idyllic morning. One, two, three, four eager faces greet you at the fence, all nickering for breakfast ... but wait, where’s the fifth? Concerned, you hop the fence and stride out into into the pasture beyond the rest of the herd and see something that paralyzes the hearts and minds of most horse owners and even some veterinarians. Your gelding is down and struggling to rise.

You know instinctively that horses function better upright, so of course the sight of a down horse—especially one you know and love—elicits a visceral reaction and can derail your brain. But the decisions you make to manage a horse in this situation significantly impact his future health and even survival, so clear and quick thinking are critical.

Let’s examine some tools for coping with the half-ton creature that’s managed to wedge himself into the only mud bog at the bottom of the hill against the fence. How does the decision tree begin?

Analyze the Situation

John Madigan, DVM, MS, Dipl. ACVIM, professor of medicine and epidemiology at the University of California, Davis (UC Davis), leads the school’s Veterinary Emergency Response Team and has plenty of experience dealing with down and stuck horses. The first step, he says, is getting past the initial shock or fear and analyzing the situation. “Break it down into how you define the down horse,” he says, recommending owners “stand back and look for a second.”

He suggests trying to answer the following questions to determine your course of action and to communicate to your veterinarian:

  • How long does the horse appear to have been down?
  • Does the horse appear to be ill (actively colicking, for instance) or injured?
  • Is he responsive?

“Each one is a bit different,” Madigan says.

Safety First

Gather at least three to four able-bodied people to help a horse roll over and stand.

Photo: Courtesy East Bay Regional Park Fire Department

Madigan stresses the importance of understanding the surroundings and keeping yourself safe. Like applying your own oxygen mask on an airplane before helping the person beside you, owners can’t help a horse if they are putting themselves in harm’s way. “Approach (the down horse) safely,” he says. “Stay away from the legs; always approach from the back of horse. “

Madigan suggests owners “always have someone else present when approaching a down horse. Like having a (scuba) dive buddy. The situation can change rapidly.”

Ideally, having at least three to four able-bodied (can lift at least 75 pounds normally) people to work as a team will help with tactics such as rolling and helping the horse stand.

What Happened?

Once you’ve made a safe approach, check the horse’s mental and neurologic status by clucking at him to see if he responds, Madigan says. 

Also try to figure out why the horse is down. Is he down for medical reasons such as colic (see if he’s responsive to voice or food), neurologic disease (he’s uncoordinated in his struggle to rise), muscle disease (showing signs such as muscle tremors), or injury (he has obvious cuts, scrapes, or swellings)? Or is he down for mechanical reasons such as positioning and footing? Then, note whether the horse is trying to get up.

Jean Feldman, DVM, a practitioner in  Hamburg, New York, says, “The first thing (owners must) figure out is whether the horse is down because they can’t get up or because they’re stuck.”

If the horse appears to be down because he’s sick, Madigan recommends first taking the horse’s rectal temperature. The risk of an infectious cause in down horses is roughly 10%, he says, adding that “in the world of horses, the big worry is equine herpesvirus. It can have a very sudden onset.”

If the horse has a fever or other signs of infectious disease, such as nasal discharge or lack of responsiveness, biosecurity for the entire barn becomes a concern, Madigan says. Be sure people working with the horse don’t handle other horses without washing and changing clothing and footwear first. Also, later, once the horse is up, minimize his contact with others.

Feldman suggests another simple test to rule out illness in the down horse. “Do a feed test,” she says, suggesting offering a bit of hay or grass to see if he is interested in food. “A lot of horses that are down are busy eating, so they’re unlikely to be (sick).”

If there is any possibility the horse is colicking or otherwise sick, or injured, call a veterinarian immediately.

Now, Scan Your Surroundings

Basic assessment complete, now look around to plan your next move. Evaluating footing and obstacles such as fences, walls, trees, and cliff edges will help you determine if it’s possible to help the horse up from his current position, or if you will first need to move him to more friendly terrain.

In California’s Central Valley where Madigan lives and works, the horse’s wintertime enemy is mud. Where the footing is bad, he reiterates the need for prioritizing safety. “Don’t get stuck in the mud next to the horse,” he says. “Have a partner, loop a rope around your belt, and secure it to a solid object on dry ground.”

For Feldman’s upstate New York patients, snow and ice are the opponents. “I had one down on ice,” says Feldman. “The pasture was solid ice, like a skating rink.”

Simply Stuck

Occasionally an otherwise healthy horse decides to lie down and roll in an inconvenient spot, casting himself against a wall or fence or simply “falling asleep” there. Owners can resolve these fairly simply.

If the horse has cast himself against a stall wall, Madigan suggests using the tail to try to pull the horse away from the wall to give it space to get up. 

For the old horse that has gone down for a nap and is too weak to stand, both Madigan and Feldman advocate rolling the horse over. “Once you change them to the other side, they have a renewed interest in getting up, a new outlook on life,” says Madigan. “Plus, the muscles that have been crushed are no longer on the down side (against the ground).” 

Feldman points out that some older horses can be repeat offenders when it comes to getting cast. She surmises that these horses might have enough musculoskeletal pain that they are too weak to stand for long periods or get themselves back up again. With these horses, she recommends owners consult with their veterinarian regarding appropriate long-term pain management to minimize the arthritic pain and weakness that can cause the horse to get stuck.

Indeed, if the footing is good, simply rolling the horse from one side to the other might be enough for it to get up. To roll a horse, place a 15-foot length of large diameter soft rope or webbing around the pastern of each down-side leg, if possible. Haltering the horse first can allow one person to steady the head with the halter and lead while the others use the leg ropes to roll the horse to the other side.

You can use rope webbing and a glide to move a recumbent horse, but be sure to do it under veterinary and/or rescue team supervision.

Photo: Anne M. Eberhardt/The Horse

Sometimes, however, the ground makes rolling a horse difficult to impossible. For instance, Feldman, her figure skating patient, and the horse’s owner needed firm footing on which to stand. So Feldman and the owner created a makeshift path to help the horse stand and walk to the barn. “We stripped the stall and ran a trail of manure out to the horse, pouring water on it. It was freezing as we went,” she recounts. “I had her throw cat litter all around the horse, got a longe line on it, and the next time it got up I guided its head.” Feldman says the cat litter and frozen manure provided extra traction where the horse got to its feet and along the path back to the barn. She also suggests sand or wood chips to add texture to slick footing.

Once you’ve rolled the horse over, you might be able to help him stand by using both a tail tie (loop the tail over a section of the rope, then use the rope to tie the looped tail) to guide the horse and what Madigan calls a “forward assist.” To make a forward assist, drop a long rope or strap over the back, just behind the withers, bringing each end of the strap up between the front legs. Pulling forward on the strap ends where they exit from between the front legs engages the withers, rib cage, and front legs, says Madigan, adding that most horses tolerate a forward assist well. If the horse is stuck so that he needs to be pulled from a bog or ravine backward, handlers can use a rear assist by dropping the strap over the hips and flank and passing it under the hind legs.

If the horse does not stand readily after being rolled or the terrain is working against you and the horse, you might need to move the horse while he’s still down.

You can use commercial rescue glides to drag a recumbent horse safely to better terrain. If you don’t have a rescue glide, you can use a large piece of plywood or even a tarp. Madigan recommends veterinary supervision, because proper training is necessary to move the down horse safely.

Risks of Recumbency

As for down horses, says Madigan, “there are no hard and fast rules. You can’t tell by looking at a recumbent horse whether it will stand.” 

However, there is one consistent factor influencing a down horse’s survival: time. The longer a horse is down, says Madigan, the more likely it is that “the primary problem gets erased by secondary problems: myopathy (muscle damage), poor gut motility, gas distension, urine retention, head trauma, poor perfusion (blood circulation) of the kidneys, congestion in the down lung, ocular (eye) trauma.”

In a 2014 study examining case outcomes of 148 down horses admitted to the UC Davis Veterinary Medical Teaching hospital, Madigan and colleagues found that the survival rate for these horses overall was low at 26% (38 horses), and multiple factors altered the outcome.

Of the euthanized horses in the study, 76% (83 of 110 horses) were put down within the first three days. Horses were more likely to be euthanized if the clinician gave a poor prognosis due to severity of disease or injury or if they didn’t tolerate recumbency or a sling. Additionally, horses that had shown clinical signs for less than 24 hours before being admitted to the hospital were more likely to survive—showing the importance of prompt treatment.

Madigan says a horse’s ability to tolerate being down or in a sling has a huge impact on outcome. “A horse that hates being down, that has a massive evolutionary response that says ‘down equals dead’ can be in trouble in a matter of hours from fighting exertion.”

Take-Home Message

Dealing with the down horse is not a one-person job. Have your response team ready. In addition to having skilled handlers present, Feldman suggests enlisting someone who is used to working with physics and machinery. “Garage mechanics are aces when working with (down horses),” she says. “They understand weight can hurt you. They don’t have to be horsemen; they just have to understand the mechanics of the stuff,” including leverage, pulleys, winches, etc.

Assessing the situation, assembling the team, and preparing equipment such as ropes and padding in advance can help protect both humans and horse. Remember, protect your human handlers—people cannot assist if they’re injured.

If you can’t get the horse to his feet without a veterinarian or extra help, padding the head, moving obstacles or objects in the stall or pasture on which the horse or humans could be injured, and protecting the down eye can help prevent further injury.

About the Author

Christy Corp-Minamiji, DVM

Christy Corp-Minamiji, DVM, practices large animal medicine in Northern California, with particular interests in equine wound management and geriatric equine care. She and her husband have three children, and she writes fiction and creative nonfiction in her spare time.

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