Vaccines, deworming protocols, good nutrition, joint care—all of these are important facets of equine care. But the cornerstone of your horse’s wellness isn’t a product or procedure, it’s an event: the physical examination. Many veterinary practices refer to this type of appointment as a wellness visit, for others it’s a health check. Whatever they’re called, these visits and their physical examinations tend to have similar goals and results.

When Susan and I established our veterinary practice, Werner Equine, back in 1979, the term “wellness” wasn’t as widely used as it is today. But that concept was firmly at the center of our mission. Wellness is a whole-horse approach to equine care that aims to prevent illness, injury and poor performance, rather than simply reacting to problems as they come up.

Establishing a baseline

In keeping with this philosophy, we implemented wellness visits and exams before they were commonplace. Very quickly, this initiative became the foundation of the care we provided for our clients’ horses. Our wellness visits established a baseline of health for each horse, confirmed that vaccines and other preventive measures were current and suitable, and facilitated conversations with the horse owner, free from distraction or the stress of dealing with the pressing issue of injury or disease.

The benefit of this approach soon became evident in a practical and measurable way: Our practice received far fewer out-of-business-hours emergency calls as our patients stayed healthier—something everyone involved appreciated. Even more important, our wellness exams facilitated an ongoing dialogue with each horse’s owner. This provided us with valuable information about the horses in our care, while giving our clients peace of mind and guidance on optimal management. Even now, with our practice closed and our work scaled back in retirement, we believe so much in the importance of wellness exams that we continue to educate our colleagues on the topic, as well as horse owners like yourself.

If you aren’t currently taking advantage of your veterinarian’s wellness services, I hope you keep reading as we share how we conducted our exams, as well as the real-life benefits they yielded. And if you’re already participating in a wellness program for your horse, I hope my observations will help you to become an even better partner with your veterinarian in protecting your horse’s health.

What wellness exams are and aren’t

Before we get into the specifics of wellness exams, I’d like to address common misperceptions about them.

One criticism you may hear, for example, is that wellness visits are “fishing expeditions” done just to find problems to solve. In a sense, that’s right; it’s a part of a veterinarian’s job to look for problems. But we don’t need wellness visits and exams to keep ourselves busy. Veterinarians are busy enough.

In fact, the majority of wellness exams don’t turn up any unexpected findings, and veterinarians think that’s great. That said, over four decades my wellness exams have detected a variety of problems (see sidebar below). Many of these concerns were minor, but their discovery was still a big deal—because if you find a problem early, the treatment is often less difficult and less expensive. What’s more, some minor problems left unaddressed can become emergencies, and no one wants to be standing in the barn at midnight with a very sick horse.

Even if a condition can’t be cured or successfully treated, the diagnosis is beneficial. We can usually manage conditions to keep the horse as comfortable as possible, plus we can recommend additional measures to keep the rider safe and reduce the risk of injury or secondary problems.

For instance, I might notice some ocular sclerosis—the very beginning of a cataract—during an exam. When I point it out, the owner might say, “I’ve had this horse for a long time with no problems. But now that I think about it, when there’s a change in lighting, he does get a little spooky.” The wellness exam provides the opportunity to pull together disparate facts and observations so that problems can be addressed before someone gets hurt or the horse’s condition worsens.

Why even healthy horses benefit from wellness exams

Another comment we hear is, “My horse has always been healthy. Why do I need wellness visits and exams?” In those cases, we will point out that wellness visits offer an opportunity to have the veterinarian’s undivided attention to discuss anything you’d like. You can ask questions about conditioning, nutrition or other topics you’ve been wondering about. You don’t have to go through a receptionist or send an email and wait for a response—the veterinarian is right there, listening to you and ready to respond. Take advantage of the opportunity.

A typical wellness exam

Different practices and different veterinarians implement wellness programs in their own way, but the basics of the physical examinations tend to be similar. Most wellness visits are conducted in spring and fall when the seasons and equine activity levels change.

Whenever an exam takes place, the owner’s participation is vital. I want them to share their concerns about their horse or observations they’ve made. These discussions can be an ongoing conversation throughout the exam. Share your concerns, even if you think they are irrelevant. Wellness visits are specifically designed to foster a conversation and allow veterinarians time to answer questions. Here’s how my basic wellness visits would unfold:

Initial impressions:

After I pull into the farm and say my hellos, I ask the client to tell me how the horse is doing. I want to know any concerns they have right up front. Many times, they’ve jotted down notes and questions they want to be sure they ask. That’s great. Before the visit, we’ve instructed the clients to leave the horse in the stall. I like to see the horse at rest, even if he’s turned out in the small paddock. I’m looking at how he stands—his posture and demeanor. Is he alert? Or is his head hanging low? I fill out a form as I’m doing the exam, and the first block that I check concerns the horse’s general behavior and attitude.

Surroundings:

Something that doesn’t appear on the exam report form is my assessment of the barn environment. As I’m walking up to the horse, I’m looking around: How does the hay look? What is the air quality in the stall? Is the horse’s hayrack hung too high? If I see something that concerns me, I can bring it up during conversation. I’m not trying to be judgmental, but if there’s something in the horse’s environment that could adversely affect his health, I’m going to mention it.

Vital signs:

Then I move on to vital signs. I take the horse’s temperature and pulse and check his capillary refill time. I’ll also use a stethoscope to listen to both sides of the chest, while noting his respiratory rate. These findings give me a picture of his health in the moment. I note this data on the exam form, which serves as a baseline to which I can refer later.

Eyes, nose and throat:

After that, I examine each of the horse’s eyes. With a penlight and ophthalmoscope, I’m looking for signs of trouble, like clouding of the lens or sensitivity to light. If I noted any condition previously, I’m looking for signs of progression. As I’m standing at the horse’s head, I’ll sniff his breath. Any foul odor could indicate a dental infection.

Digestive:

For a gastrointestinal check, I’ll look around the stall or paddock for signs of manure and urine. If I don’t see any, I might ask what time the stall was cleaned, or the owner’s impression of how much and what type of manure the horse is producing. I use the stethoscope again to listen for gut motility—sounds that indicate the gut is moving ingesta along at a normal rate.

Skin and coat:

Next, I’ll look over the horse’s skin, hair, and coat. I’ll run my hands over the horse’s body, giving him a scratch on the withers and admiring the shine of his coat. I’m not just being polite as I do this: I’m actively looking for signs of hair loss or lesions.

Biomechanics and soundness:

Now it’s time to take the horse out of the stall. I always bring a technician with me to handle the horse at this point of the exam. This allows us to focus fully on the exam and the discussion we are having. I’ll have the technician walk the horse in hand and jog as I watch. I’m looking for signs of lameness or neurological problems. I’ll also pick up each leg and examine each hoof. This isn’t an in-depth lameness exam. I’m just looking for anything out of the ordinary or potential problems that merit further investigation. As I move along, I describe what I’m doing and why to the owner and make notes on the wellness exam form.

Parasite and disease control:

Next, I’ll have my technician collect a sample for a fecal egg count so the horse can be categorized as a high, medium or low shedder. I will also talk with the owner about a deworming schedule according to that designation, not just based on the calendar. If appropriate, I’ll also administer any vaccines that the horse needs based on his specific condition, risk factors and age.

Weight and body condition:

Finally, I assign the horse a score of 1 to 9 based on the Henneke Body Condition Score scale and take photos to document how the horse looked at this visit.

Dental examination and care: In our practice, a dental exam and treatment can also be part of the overall wellness visit. Typically, we sedate the horse and use a dental speculum to examine the entire oral cavity.

From the beginning to the end of a wellness visit, I’m considering the entire horse. Each observation contributes to an overall picture of the horse’s health. For instance, when I take a horse’s temperature, I will note the degree of resistance when I lift the tail, which can reflect neurologic health. I will also take photos during the exam. If I see a skin lesion, I take a photo and send that as part of the record of the exam so we can all refer to it later if need be.

Wellness follow-up

After that, I still have work to do: At the office later, I’ll fill out the exam form completely with details and specific observations, attach any photos and round out my wellness report, which is then sent to the owner for their files. I know owners keep these reports and refer to them—even years later—to track the progression of conditions or simply provide an overview of how their horse is aging. If the horse is ever sold, those reports can provide valuable information to a new owner.

I was always glad when a wellness visit didn’t turn up any problems, and as mentioned before, many exams don’t. If there is an issue, we most likely address it at a follow-up appointment. Our spring and fall schedules are already packed and we can’t typically extend visits. Of course, we aren’t going to leave a horse in a dire situation, either. Some findings of a wellness exam are worth noting but don’t require immediate action. In these cases, we leave owners with information on what we’ve found so they can decide what route to take later, if the time comes.

Regardless of the specifics of your veterinarian’s wellness visit, you’ll want to keep one important fact in mind—veterinary medicine isn’t static because research continues to yield new findings and greater understanding of equine disease and injury.

As regional disease profiles change, knowledge bases expand and new therapies and treatments are developed, veterinarians adapt their wellness visit recommendations. Wellness care ensures your horse is getting up-to-date medical care based on the most informed thinking.

Over the years, our clients embraced wellness visits and exams, whether their horses were elite athletes or recreational mounts. Upper-level sport horses, Western horses, donkeys, mules and draft horses—every horse and owner received the same attention and quality of care. Wellness care served all of them well.

About the authors

Harry Werner, VMD, practiced equine medicine and surgery in New England after graduating from the University of Pennsylvania School of Veterinary Medicine. His time at UPenn emphasized the importance of keeping horses healthy and active through wellness care, plus timely and appropriate client education and communications. These factors guided the Werners during their 47 years of delivering successful veterinary care for their equine patients.

Werner served as 2009 President of the American Association of Equine Practitioners. In 2020, he received the AVMA Animal Welfare Award, which recognizes achievement in advancing the welfare of animals via leadership, public service, education, research/product development and/or advocacy.

Susan Werner is her husband’s business and writing partner. In addition to managing Werner Equine, she designed marketing and business management/communication tools for veterinary practices and worked as a development consultant for an international practice-management software company. Throughout their joint careers, the Werners published numerous articles on veterinary and management topics, served as practice consultants and mentors, and spoke nationally and internationally on such topics.

Now retired from active veterinary practice, the Werners are enjoying the animals on their small Connecticut farm. Werner continues to consult on patient cases and serves on various AAEP committees. In addition, the Werners continue to write together on veterinary and management topics.

To read more: Click here to learn the 7 veterinary skills every horse owner needs.