How to Tell if Your Horse Is Sick: Early Signs Every Owner Should Know
- Horse Education Online
- May 30
- 7 min read
Updated: Jun 1
It’s not always easy to tell when a horse is unwell. Unlike humans, horses won’t cry out or show obvious signs when something’s wrong. In fact, they’re instinctively wired to hide pain and discomfort—a trait that once helped them avoid predators but now makes early detection a challenge for caretakers.
That’s why knowing how to spot the early, often subtle signs of sickness is one of the most important skills you can develop as a horse owner. Catching issues early can mean the difference between a simple treatment and a full-blown emergency.
In this guide, we’ll walk you through the behavioral and physical changes to watch for, when to take action, and how to build a routine that helps you notice small problems before they turn serious.
Why Early Recognition Matters
Horses won’t tell you they’re sick—but their bodies will.Because horses instinctively mask discomfort, serious conditions can go unnoticed until they’re well advanced. By the time clear signs appear, the illness may already require more aggressive treatment, longer recovery, or even emergency intervention.
That’s why early recognition isn’t just helpful—it’s essential.
1. Small signs often signal big problems
Minor changes like a slight drop in appetite, mild lethargy, or unusual posture can be your first (and sometimes only) warning. Learning to spot these small red flags allows you to intervene before things escalate.
2. Early detection improves outcomes
The earlier you catch a problem, the more treatment options you have. Acting quickly can reduce the risk of complications, minimize discomfort for your horse, and even save you money in vet bills.
3. Knowing your horse’s “normal” is the key
Every horse is different. A heart rate of 44 bpm might be normal for one, and a sign of stress in another. When you routinely check vital signs, observe eating habits, and track behavior, you create a mental baseline. That makes it much easier to notice when something’s even slightly off.
4. Prevention is better than crisis
Some issues—like colic, laminitis, or respiratory infections—can progress rapidly. Catching early signs may mean the difference between a mild intervention and a trailer ride to the emergency clinic.
Behavioral Changes Indicative of Illness
Horses rarely show dramatic symptoms right away. Instead, they often communicate discomfort through subtle shifts in behavior. Recognizing these small but meaningful changes can help you catch health issues early.
Decreased energy or unusual lethargy
If your horse appears dull, uninterested in their surroundings, or lacks their usual spark, this could be an early sign of illness. They might move slower than usual, seem disinterested during turnout, or take longer to respond to cues. While fatigue can sometimes result from heat or overexertion, persistent lethargy is a red flag worth investigating.
Changes in appetite or water intake
A healthy horse will have a consistent appetite and drinking pattern. If your horse suddenly refuses grain, leaves hay untouched, or stops drinking, it may signal discomfort, digestive issues, dental pain, or even early colic. Also watch for changes in chewing behavior, such as dropping food (quidding) or excessive time spent chewing, which may indicate mouth ulcers or sharp dental points.
Withdrawal or irritability
Behavioral withdrawal—such as avoiding touch, turning away, or separating from the herd—can reflect pain or stress. Conversely, some horses may become uncharacteristically cranky or reactive when groomed or tacked up. This can be a subtle cue that they’re physically uncomfortable, especially in the back, flanks, or girth area.
Restlessness or repetitive behaviors
Horses that start pacing, pawing, weaving, or stall walking may be experiencing discomfort, anxiety, or internal irritation. If these behaviors appear suddenly or increase in frequency, it's time to take a closer look. Restlessness is often one of the first signs of colic, ulcers, or other internal distress.
Unusual posture or movement
Watch for horses that stand with stretched front legs, frequently shift their weight from limb to limb, or show reluctance to lie down or rise. You might also notice stiffness when turning, a shortened stride, or a tilted head. These can be signs of musculoskeletal pain, laminitis, neurological issues, or general discomfort that warrants further evaluation.
For a professional overview on identifying discomfort through behavior, refer to AAEP – Recognizing Equine Pain.
Physical Signs to Monitor
While behavioral changes offer early clues, hands-on physical checks often provide the clearest indication of whether something’s wrong. These routine assessments are essential for early detection—and they don’t take more than a few minutes a day.
Temperature
The normal body temperature for an adult horse is 99.5°F to 101.5°F. A fever above 102°F may indicate infection or inflammation. Readings below 99°F can point to shock or hypothermia. For a full guide on temperature and other vital signs, refer to The Horse’s Vital Signs.
Heart rate
A healthy adult horse should have a resting heart rate between 28 and 44 beats per minute. Elevated rates can signal stress, pain, fever, or illness. Use a stethoscope or feel the facial artery under the jaw, count for 15 seconds, and multiply by 4. If you’re not sure how to take an accurate reading, see Average Heart Rate for a Horse: What’s Normal and How to Check It.
Respiration rate
Normal respiratory rate at rest is 8 to 16 breaths per minute. Anything above this—especially without recent exercise—can indicate pain, heat stress, or a respiratory issue. Shallow or labored breathing should always be taken seriously. To understand how stress and nervous system activation can influence breathing, visit The Equine Nervous System.
Gum color
Healthy gums are light pink, moist, and smooth. Pale gums may indicate blood loss or shock. Bright red gums can signal infection or fever, while blue or purple tones require immediate veterinary attention. If you notice discolored gums along with other signs like fever or lethargy, it could point to an infection such as Potomac Horse Fever.
Capillary Refill Time (CRT)
To assess circulation, press your thumb against your horse’s gum and release. The color should return within 1 to 2 seconds. A longer refill time suggests poor circulation or dehydration—both early signs of systemic issues. This is part of a complete vitals check explained further in our Vital Signs Guide.
Hydration
Use the skin pinch test on the neck or shoulder. The skin should snap back immediately. A delayed return suggests dehydration, which increases risk for colic and overheating. Dehydration often appears alongside other signs like dullness or decreased appetite.
Discharges
Occasional clear discharge may be normal, but thick, yellow, or green discharge from the eyes or nostrils could signal respiratory infection, allergies, or more serious conditions. Always track changes in consistency, color, and smell—and consider a broader health check if discharges appear suddenly.
Digestive Health and Gut Sounds
The equine digestive system is sensitive; signs of distress include:
Absent or Excessive Gut Sounds: Both can indicate gastrointestinal issues.
Colic Symptoms: Pawing, rolling, looking at the flank, or restlessness.
Appetite Loss: Refusal to eat may signal discomfort.
Abdominal Distension: A bloated appearance can be a red flag.
See our article A Guide to Gut Sounds and Gut Health for a deeper dive into the realm of gut sounds.
When to Contact a Veterinarian
Some changes in your horse’s condition require more than observation—they need professional attention. Knowing when to stop monitoring and start making a call can make all the difference in outcomes.
Here are key signs that warrant immediate contact with your veterinarian:
Fever: Temperature exceeds 102.5°F
A mild temperature can sometimes be monitored, but anything over 102.5°F indicates fever and possible infection. If paired with lethargy, poor appetite, or sweating, call your vet promptly.
Elevated heart rate: Above 60 bpm at rest
A resting heart rate consistently above 60 bpm is a strong indicator of pain, stress, or systemic illness. If you’re unsure how to check, refer to this guide on taking a horse’s heart rate.
Prolonged Capillary Refill Time (CRT): Over 2 seconds
If the gums take more than 2 seconds to regain color after pressing, this suggests poor circulation—often a sign of dehydration, colic, or shock. Combine this with gum color and heart rate for a more complete assessment.
Gum discoloration: Pale, blue, or bright red
Normal gums should be pink and moist. Pale gums may signal blood loss or anemia. Blue or gray gums are an emergency, often tied to oxygen deprivation. Bright red can indicate sepsis or toxicity.This visual gum chart from Pro Equine Grooms is helpful for comparison.
Respiratory distress or collapse
Labored breathing, flared nostrils, heaving flanks, or collapse are all red flags. These can be signs of respiratory infections, heat stroke, or systemic failure. Call immediately and move your horse to a shaded, calm area while you wait.
Sudden behavioral changes
Aggression, depression, disorientation, or reluctance to move may signal neurological issues, pain, or internal stress. When behavior shifts quickly and significantly, it should never be ignored.
Daily Health Monitoring Tips
Weekly Vitals Check: Regularly record temperature, pulse, and respiration.
Behavioral Logs: Note feeding habits, energy levels, and demeanor.
Trust Your Instincts: Investigate any unusual behavior or signs.
Essential Tools: Keep a thermometer and stethoscope readily available.
Reference: Mad Barn
Further Reading
Educational Videos
Taking Your Horse's Vital Signs: Watch Video
Recognizing Colic Symptoms: Watch Video
FAQ: How to Tell if Your Horse Is Sick
How often should I check my horse’s vital signs?
For healthy horses, checking vital signs once a week helps you establish a baseline for what’s normal. This becomes especially valuable during seasonal changes, after travel, or following a vaccination. If your horse is recovering from illness, showing mild symptoms, or under stress (from competition or transport), daily checks may be appropriate until stability returns.
Can changes in behavior indicate my horse is sick even if the vitals seem normal?
Absolutely. Horses can show early signs of illness through mood, posture, or social behavior before vital signs shift. For example, isolating from the herd, refusing to be caught, or unusual irritability during grooming may signal discomfort. Always consider both physical and behavioral cues together when assessing your horse’s overall health.
What is the skin pinch test, and how accurate is it?
The skin pinch test is a quick hydration check where you gently pinch the skin on your horse’s neck or shoulder. If the skin snaps back immediately, hydration is likely normal. If it takes more than 2 seconds to return, your horse may be dehydrated. While useful, this test should be paired with other signs like gum moisture and drinking behavior for a full picture.
When should I call the vet even if the symptoms seem minor?
If your horse is showing signs of distress, even mild ones, that persist for more than a few hours—or if you observe anything significantly out of character—it’s best to consult your vet. Early contact is especially important with elevated heart rate, abnormal breathing, discolored gums, or signs of pain. A call could save you time, money, and possibly your horse’s life.
Is it normal for vital signs to vary during hot weather or after exercise?
Yes, heart rate and respiration naturally increase after exertion or during warm weather. However, they should return to resting levels within 20 to 30 minutes. If your horse’s heart rate or breathing stays elevated beyond that window, or if they seem weak, lethargic, or disoriented, it may indicate overheating or another underlying issue.
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