Emergency 911: Horse Show Edition

Critical conditions that can strike when you’re at a competition, and how to handle them

It’s what you’ve been building up to all year: show season. Your horse is in peak condition and ready to strut his stuff. Your truck and trailer are tuned up, loaded, and ready to haul halfway around the country. Usually, horses come and go to venues big and small and return home unscathed. Yet sometimes things go wrong, and you might be faced with an emergency on the road.

The possible horse show health scares are as varied as the injuries and ailments that can occur at home, but certain show-related hazards can amplify your horse’s chances of getting hurt. To summarize what you might want to look out for, two experienced sport horse veterinarians—Rob Boswell, DVM, of Equine Sports Medicine Group, in Wellington, Florida, and Peter Heidmann, DVM, Dipl. ACVIM, of Montana Equine Medical and Surgical Center, in Three Forks—have weighed in on show horse emergencies veterinarians frequently see.

The Most Common Emergencies at Horse Shows

Orthopedic problems

As athletes, horses are subject to the normal litany of wear-and-tear injuries as well as acute orthopedic problems from missteps or accidents. Fortunately, breakdown injuries or acute severe lamenesses from fractures are not as common at horse shows as they are in disciplines where horses compete at top speeds. Heidmann says he mostly sees orthopedic problems such as soft tissue injuries to tendons and ligaments, as well as muscle issues such as tying-up, acute muscular trauma, or chronic muscle injury flare-ups—many of which can be attributed to conditioning level.

“Unfit horses, just like unfit people, are more likely to develop muscle problems,” Heidmann says. “The excitement of ­competition—for both horse and rider—may cause horses to perform beyond their level of training and fitness. This can lead to muscle soreness and fatigue and, sometimes, obvious signs of tying-up. Muscle weakness also increases the risk of tendon or ligament injury.”

“Soft tissue injuries are relatively common and include bumps, bruises, and, more severely, injuries to the suspensory ligament apparatus and/or superficial and deep digital flexor tendonitis,” Boswell says. “Advanced diagnostic imaging, new treatments, and rehabilitation are improving the outcomes of horses with traumatic soft tissue injury.”

Ice is an excellent first-aid treatment for any acute lameness injury and/or swelling while awaiting veterinary ­attention.

Heidmann also recommends applying cotton wraps to injured legs while waiting for the vet. “Even a magazine or newspaper wrapped around the lower limb and secured with duct tape works as a temporary splint if bandage material isn’t available,” he says.


One emergency condition every horse owner dreads is laminitis. “Because many pony hunters and Warmblood horses are kept at heavier body weights than recommended, this increases the risk of laminitis,” says Boswell.

Weight-related hormonal and metabolic changes are complicated by the fact that many show horses have had joint injections and/or been on systemic corticosteroids. “Owners are advised to be circumspect about the use of steroid medications,” says Boswell. “The ‘anxiety’ of thinking that there is a need to inject joints routinely to keep a horse sound and competitive at horse shows has the potential to create catastrophic results. Far too often joint injections in show horses are performed without even a minimal diagnostic work-up, including testing for equine metabolic syndrome (EMS) and Cushing’s disease,” two conditions with ties to laminitis.

Respiratory problems

“Horses may develop shipping ­fever—a respiratory ­condition—soon after arrival at the show grounds,” says Boswell. “Most are fevers of unknown origin, possibly from fatigue, stress, or a virus or bacterium; infectious causes often remain ­unidentified.”

He says coronavirus is a recently recognized cause of high fever in show horses: “This virus is frustrating, as many horses continue to be relatively bright and alert, despite a very high fever that lasts for several days despite treatment with NSAIDs (non-steroidal anti-inflammatories).”

“Taking a temperature twice daily is a great, cheap, safe ‘screening tool,’ ” says Heidmann. “A rectal temperature exceeding 101.5 degrees Fahrenheit should prompt a call to a veterinarian. If taken once daily, temperature checks are best done between 4 p.m. and midnight, as many low-grade fevers are typically found in the evening hours.”

Early detection of a fever can make all the difference in a successful outcome for a respiratory infection. “Horses, like people, are most susceptible to infection when stressed due to depression of the body’s immune function,” says Boswell. “Coupling this with the fact that a horse lives in an environment full of pathogens makes them more susceptible to infections and, in particular, a respiratory form such as shipping fever.”

Often a fever is the first indication of a respiratory infection, but other clinical signs might also appear, such as cough or nasal discharge, as well as lethargy and reduced appetite.

Emergency 911: Horse Show Edition | Keeping Horses Cool

Heat stress and dehydration

“With increasing numbers of equine athletes traveling longer distances to show, many horses show in climates to which they aren’t accustomed,” says Heidmann. “Performing in hot and especially humid climates may create heat stress even for animals habituated to warm weather. Yet this tends to be worse for horses that have traveled from cooler climates.”

Travel in hot weather can also cause a horse to arrive at the venue in a somewhat dehydrated state. Horses suffering from anhidrosis, or the inability to sweat, are most at risk of developing heat stress at horse shows, says ­Heidmann.

A horse that takes a long time to recover to a normal heart rate after exercise, is breathing heavily via flared nostrils, and/or has a rectal temperature above 103.5 F is likely suffering from heat stress. Soaking the horse with cool water and continuously scraping it off and reapplying is a good starting point to help bring down his internal temperature.

In hot weather Boswell urges ­competitors to keep horses in the shade as much as possible and/or run stall fans in the stables, provide free access to ample drinking water, and sponge bathe or apply water with a hose to maximize evaporative cooling.


The ever-lurking bane of the horse world—colic—is an emergency condition that requires immediate attention. “Horses at shows are usually under considerable stress associated with shipping, crowded conditions, environmental changes such as extremes in heat or cold temperatures, changes in diet (mainly hay), and changing routines, along with increased performance frequency,” says Boswell.

With some shows running for as long as 12 weeks, riders often feel pressured to show their horses more frequently to keep up with points or their competition, says Boswell. “Gastritis, ulcer disease, and large colon issues are not uncommon” in these horses, he says, due to the stresses and changes described.

Heidmann adds, “As horses become dehydrated during work, especially when competing in a hot climate, they are at increased risk of impaction colic. Dehydration or changes in feed also can lead to intestinal slowdown (ileus) and abnormal gas formation, resulting in some of the more severe cases of colic pain.”


While uncommon, choke—esophageal obstruction—can also occur at horse shows. It might be obvious as green material draining from the nose with the horse coughing incessantly and stretching his neck. Or, the horse might simply display coliclike signs of pain and distress. Choke requires immediate veterinary attention to avoid aspiration pneumonia.

“Horses that tend to gobble their food are at an increased risk of choke, especially when fed dry pelleted feeds,” says Heidmann. “Even normally careful eaters might ‘bolt’ food since they may be hungrier than normal with more intense workloads. Placing a large rock in the feed tub helps slow them down. Routine dental care also limits the likelihood of a horse trying to swallow incompletely chewed food.”

Wetting or soaking pelleted feed and ensuring access to water are other strategies to minimize choke risk.

Emergency 911: Horse Show Edition | Eye Injuries

Eye injury

Horses commonly injure their eyes while at horse shows due to trauma from bumping against something, fly irritation, pieces of debris in the eye, or scratches to the cornea. Anytime a horse has excessive eye drainage, squints and is sensitive to bright light, has swelling of the eye or surrounding tissues, redness of the conjunctiva, and/or his eyelashes are pointing downward, the owner should call a veterinarian.

“A painful eye may be rinsed carefully with sterile saline (contact lens ­solution) to irrigate away a foreign body, but a horse owner should take care not to touch the cornea,” says Heidmann. “A cold compress may provide relief.” This can be accomplished by wrapping an ice pack in a soft towel and applying it gently to the closed eyelid.

Treating the horse with anti-­inflammatory medications is appropriate if the veterinarian prescribes it, he adds.

Wounds and hemorrhage

Inevitably, a wound appears at the most inconvenient time, and there is nothing like being prepared with an antiseptic solution and bandaging materials to tide you over until the veterinarian can examine and assess the injury.

If a large blood vessel or artery is severed, the wound might spurt blood and bleed profusely. Even a little blood can look like a lot. Discuss with your veterinarian the best way to apply a pressure bandage until he or she arrives. Resist the temptation to keep peeking beneath the bandage—clotting takes at least 12 minutes in most cases.

Neurologic conditions

Neurologic problems that occur at horse shows are always a significant concern to everyone involved, but they are especially important right now because of recent documented outbreaks of equine herpesvirus myeloencephalitis, the potentially fatal neurologic form of equine herpesvirus-1 (EHV-1). Isolate any horse with neurologic signs immediately, restricting and carefully monitoring traffic in and around the horse’s stall.

“The risk of possible spread of an infectious neurologic disease is amplified when animals are closely congregated, especially at a confined show grounds,” says Heidmann. “EHV-1 can lie dormant for years, possibly ‘hiding’ in a horse’s trigeminal ganglia (a mass of nerve tissues) in the head. But this virus may recrudesce (reappear) when a horse’s immune system is challenged through a heavy workload and travel along with changes in routine, feed, and climate.”

Biosecurity practices are critical to minimizing infectious disease spread. 

Getting cast

Horses confined to stalls or paddocks can become stuck in a corner or floor depression and unable to rise. This is an especially risky problem with big horses housed in small stalls on show grounds. People attempting to help a horse right himself should stay out of the way of flailing legs and head by ­approaching the horse from the withers, if possible, and using ropes to help flip the horse away from the wall, door, or fence.

Faced With an Emergency

When trouble strikes, “owners are strongly cautioned against the temptation to use Dr. Google or other nonveterinary sources for their diagnostic and therapeutic recommendations,” says Boswell. “Since horse shows of significant size and duration usually attract large numbers of veterinary and nonveterinary service providers, often there is a temptation to explore health care options that competitors wouldn’t normally pursue. I strongly urge owners and responsible persons to be each horse’s best advocate and seek care from an equine veterinarian before consulting others.”

If an owner obtains a second opinion that opposes the first veterinarian’s recommendations, seek a third opinion, he adds.

Heidmann concurs: “It is critical to obtain a definitive diagnosis of the horse’s problem; otherwise treatment (or lack of treatment) can be risky and ­counterproductive.”

A definitive diagnosis enables the veterinarian to recommend the most appropriate therapy options as well as provide the most accurate prognosis. And in the case of contagious disease, it can prevent what could be a major outbreak with logistical and economic consequences such as impaired horse transport in a region.

Be Prepared

Before heading to a horse show, map your route and identify veterinary clinics or hospitals along the way. If you’ll be traveling through rural areas, call ahead to determine nearby facilities’ office hours. Consult your home vet for clinic references.

Keep a complete first-aid kit fully stocked and up-to-date with fresh medications when you travel with your horse. Have veterinarian phone numbers handy, along with your equine insurance agency’s contact information. 

Know how to take vital signs, and monitor your horse regularly for anything that seems abnormal. It is always best to consult a veterinarian if you suspect a problem, rather than waiting until it spins out of control. The rider, owner, or trainer’s primary objective is to make sure an injured horse incurs no further harm. This means:

  • Don’t ride a horse with a swollen tendon;
  • Have lamenesses evaluated;
  • Have painful eyes checked;
  • Tend to a wound or laceration;
  • Don’t ignore a horse’s waning appetite; and
  • Always check rectal temperature if the horse is off his feed or isn’t acting normal.

By taking precautions and being prepared, you’ll be best equipped to sail through a successful show season.