Keeping the Aging Horse Comfortable

Here’s how to manage senior horses’ aging teeth, joints, lungs, and more.

As a kid, I never thought about horses getting “old,” probably because the ones I saw and rode and read about were always so young and active. I didn’t think about the effects of advancing age. So imagine my surprise, decades later, when every horse I owned was living at least into his or her late 20s and even 30s.

My more than 40 years of horse ownership have given me a chance to know them as individuals, to see them grow, to admire their beauty and power, and to learn alongside them. After their careers have come to an end, I have the opportunity to care for my horses as they age, looking after them as best I know how.

But good intent might not be enough for my aging equids or yours, according to 2012 study results based on a survey by Catherine McGowan, BVSc, Dipl. ECEIM, PhD, of the University of Liverpool, in the U.K. In it she notes that owners of horses aged 15 and older who are concerned about their animals’ health, welfare, and quality of life might not be caring for them as well as they think.

Her survey results, collected in her role as head of the equine division and director of veterinary postgraduate education, show that these horses’ (particularly retirees’ in the U.K.) management declines as they age, and they are receiving insufficient preventive health care.

We know the senior horse population is larger than ever, so what can we do to ensure these animals remain healthy and comfortable as they age? How can we prevent or manage potentially painful conditions such as dental disease; joint pain and arthritis; pituitary pars intermedia dysfunction (PPID or equine Cushing’s disease); recurrent airway obstruction, now called equine asthma; and eye problems? How can we turn those good intentions into sustained optimal care for our old equine friends in their remaining years? Let’s break it down by topic.

Make Dental Health a Priority

Dental disease is probably the most overlooked and least recognized problem by owners, says Mary Rose Paradis, DVM, MS, Dipl. ACVIM (LAIM), associate professor emerita at Tufts University’s Cummings School of Veterinary Medicine, in North Grafton, Massachusetts.

RELATED CONTENT: Older Horse Dental Problems (Podcast)

She recommends having a veterinarian perform a dental examination on your senior horse every six to nine months.  

“In severe dental disease, horses may require a gradual correction of the problem and (owners may need to follow) dietary recommendations,” she says. “Dental changes occur in all older horses because the teeth continue to grind down.” She adds that even if these horses—and their teeth—have had the best care all their lives, their ability to grind forage will eventually diminish. This can lead to problems such as impaction colic.  

Janice Sojka Kritchevsky, VMD, MS, Dipl. ACVIM, a professor of large animal internal medicine at Purdue University, in West Lafayette, Indiana, agrees, noting that “there have been surveys done of (veterinarians caring for) old horses, and teeth problems were found in a large number of the horses examined—although most of the time the owners felt the horse was fine.”  

Among the dental problems older horses face are sharp hooks, points, loose teeth, and diseased roots, including the recently recognized condition equine odontoclastic tooth resorption and hypercementosis, all of which can make chewing painful and difficult.

“An aged horse needs twice-yearly dental inspections with floating or other treatments done if required,” says Kritchevsky. “A speculum, a device with a … type of adjustable headstall designed to hold a horse’s mouth open, should be used so that the entire upper and lower dental arcades can be visualized.”

Some senior horses might have few to no teeth at all, and “the fewer teeth a horse has the harder it is to feed them without choke (esophageal obstruction),” she says. “Often horses choke on poorly chewed forage or grain. They swallow hay that is still in long stems. Those stems catch other feed particles in them like a net, and before long there is a solid clump of feed that the horse cannot move into the stomach on its own. The worse the teeth, the more likely the problem.”

If a horse’s teeth are starting to cause problems and you’ve determined he’s prone to choke, you can make some feeding changes to improve his quality of life, says Kritchevsky. Try slowing down the horse’s eating—as “bolting” feed contributes to choke—by:  

• Using a slow feeder (a feeder with slats or grids) or slow feed haynets with small holes or tight mesh so a horse can only eat so much at a time;
• Spreading the hay over a large area; or  
• Adding good-sized rocks or other objects to the bucket that horses must maneuver around to eat their feed.

Kritchevsky adds that she has successfully managed aged horses with no teeth for several years by feeding a softened pelleted feed.

Other evidence that your senior horse could be experiencing dental issues is odd small bundles of hay or grass on the ground near where your horse eats, which are signs of quidding.

“Quidding is the act of dropping partially chewed balls of feed out of the mouth,” says Kritchevsky. “A horse that quids either has bad teeth or a neurologic problem that prevents it from chewing and swallowing normally.” It’s also another sign your horse needs his teeth checked.  

Know that a horse’s dental changes might signal another important health concern, says Margaret Brosnahan, DVM, PhD, Dipl. ACVIM, a clinical assistant professor at Midwestern University, in Glendale, Arizona. The inability to chew affects his nutritional status and, therefore, body condition and overall health.   

Maintaining Good Weight

“Most of us have the impression that older horses are thin, but survey research shows that less than 5% of owners classify their older horses as thin,” says Paradis. “Many of the older horses are normal weight or obese,” the latter of which can cause further wear on already-creaky joints.

If your older horse is heavy, she says, you might want to test for equine metabolic syndrome (EMS), a collection of insulin metabolism abnormalities that can lead to the development of the hoof disease laminitis. If your veterinarian diagnoses insulin resistance, be sure to talk with him or her about restricting the horse’s pasture access and instituting a weight-loss diet low in sugars and starches.

Paradis warns owners against grabbing any low-carb grain off the shelf for your overweight senior, as many advertised to be suitable for EMS horses are still 20% or more carbohydrate. These feeds have fewer sugars and starches than mainstream commercial horse feeds, but not so few as to be safe for the EMS horse. Rather, she says, look for special feed formulations of less than 12% sugar and starch.   

RELATED CONTENT: How to Feed Senior Horses

If you’re struggling with the opposite issue, and your aged horse is thin, first work with your veterinarian to try to determine why. Teeth and mouth problems might make it difficult or painful to eat. Or a horse might have neck arthritis, for example, that makes eating off the ground painful. In the latter case, reposition the feeder to shoulder height to see if your horse starts eating more readily.  

You might also need to feed older horses separately from the rest of the herd to give them time to eat without competition.  

Sudden weight loss can also be due to other health problems, such as cancer, liver disease, or internal parasite infections, which is why it’s crucial you have your veterinarian rule these out.  

“If you can find no medical reason for your horse’s low weight, adding fat (e.g., rice bran, soy oil, flaxseed) as a form of calories is a good idea,” says Paradis.  

It’s a fact of life that horses lose muscle tone as they age, says Kritchevsky. Owners should offer senior feeds or supplements that have the correct amino acid balance to promote muscle tone. If your horse loses muscle tone rapidly, your veterinarian might consider examining him or her for other problems such as neurologic or muscle disorders.

Don’t Ignore Chronic Pain

As a horse ages, musculoskeletal problems might arise due to changes in and wear on joints, cartilage, and tendons, says Paradis. These structures weaken over time.  

“It is important not to put these arthritic horses in a stall full-time,” she says, calling on the old adage that if you don’t use it, you lose it. “Movement—even if it is just grazing—tends to keep them more limber. Judicious use of anti–inflammatory drugs is helpful in keeping them comfortable, especially if they are still being ridden.”  

If your aged horse is still competing, remember that it will take longer to condition him for work than when he was younger, says Paradis. “Work with it daily, and don’t be a ‘weekend warrior,’ ” she says. “An older competitor will tire more quickly, as well, so an extensive warm-up before a class is probably not the best.”

When these horses are stalled, whether as a part of your daily management routine or while recovering from injury, make that area comfortable, says Kritchevsky.

“Research has shown that horses don’t care too much about the surface they are standing on but want a comfortable place to lie down,” she says. “Stalls should have pads over any cement or concrete and thick bedding.

“It should be comfortable enough for a person to stand on and slightly springy when stepped over,” she adds. It’s also very important that old horses have a grippy surface beneath the bedding. “They may not have the agility and strength to stand up if they lie down on a slick surface.”   

Be gentle on these horses’ joints during routine hoof picking and trimming, and ask a veterinarian if your horse might need joint supplements or a pain management plan.

Monitor for PPID

One disease specific to aging horses affects an estimated 25% to 30% of horses over the age of 20. It can be difficult to detect in its early stages.

“Only the most astute owner may notice that her or his horse sheds out two weeks later than other horses in the barn,” says Paradis.  

RELATED CONTENT: Cushing’s Characteristics, Clinical Signs at Diagnosis

The disease, PPID, is a degenerative endocrine condition in which pituitary-adrenal gland communication does not function normally. (The endocrine system is comprised of glands that communicate with other glands, which then communicate with organs—all through hormone signals sent through the bloodstream.)   

Pituitary pars intermedia dysfunction can progress to the point when the horse shows the most obvious clinical sign—a long shaggy hair coat that doesn’t shed out. Beyond that uncomfortable coat, however, are greater problems: chronic infections, hoof abscesses, increased water intake and urination, and loss of muscle mass. The disorder also can predispose horses to developing laminitis. That’s why early diagnosis, testing for high levels of insulin in the blood, and proper treatment are critical.  

If your aged horse has PPID, talk with your veterinarian about starting pergolide, considered the gold standard PPID treatment, to help control disease progression. Keep your horse comfortable by body clipping his coat as needed.

Keep Lungs and Eyes Clear

The older a horse gets, the more susceptible he is to chronic breathing problems and coughing. But the problem is not due to aging of the lungs, says Paradis. Instead, it is most likely due to recurrent airway obstruction—now called equine asthma because of its similarities to human asthma—which tends to worsen as affected horses age.

Fortunately, there are steps you can take to help your horse breathe better. First and foremost, make sure his housing has excellent ventilation or keep him turned out. Be sure his forage is not dusty or moldy, and soak it, if needed, to remove allergens. Check with your veterinarian about providing your horse with appropriate inhaled anti-inflammatory drugs.

Aging-related vision changes do occur in a large proportion of older horses, and many of these defects are difficult to detect. If an older horse seems disoriented or bumps into things, it is time for an eye exam. The chances of corneal ulcers, cataracts, uveitis (moon blindness), and other degenerative changes developing increase with age.

Maintain a Social Network

Horses are definitely herd animals, says Paradis. The importance of companionship in keeping an aging horse comfortable is an idea worth considering and might be best addressed on an individual basis.

Paradis says she has known horses that were inseparable, and the death of one led to depression in the other. But she also has seen survivors thrive despite the loss of a friend.   

“It is hard to predict,” she says. “Horses feel more protected with another horse on guard against the scary world sometimes. It is possible that the human is part of that herd.”

Take-Away Tips

With all this in mind, here are some general tips to remember when managing aging horses:

• Be observant “Potential problems caught early are generally easier to treat than those that have been going on for a long time,” says Brosnahan.
• Prevent problems from developing Schedule a wellness exam with body condition scoring and fecal egg counts, as well as twice-yearly dental exams.
• Base changes in how you manage your horse’s care on the individual. “Don’t switch to a senior diet or discontinue athletic activities just because the horse reaches a particular age,” says Brosnahan. Wait for the horse to tell you with his body changes.
• Embrace the saying “with age comes wisdom.” Aged horses might need a bit more support physically, but the experience they have is invaluable and not something that can be replaced just by getting a younger animal. Many horses in their late 20s do wonderfully in lesson programs. Treasure your older horse for all the wonderful moments he has given you, says Brosnahan.
• Know the signs of declining quality of life. Talk to your veterinarian about any changes you see, says Brosnahan, and have a plan ready for when it’s time for euthanasia. A horse that can’t maintain good body condition or lie down and get up with ease is of concern.