As a Diplomate of the American College of Veterinary Internal Medicine (ACVIM), I am trained to handle some of the most complicated illnesses that horses can develop, ranging from severe gastrointestinal and cardiovascular disease to neuromuscular disorders, respiratory impairment and neonatal problems.

Diplomates are typically the veterinarians you are referred to when your horse has a serious or complex disorder that requires more than the basic level of diagnostics and care. Our additional years of training—four or more years beyond veterinary school—prepare us to solve the toughest problems in equine health. As a result, we tend to see many cases of rare and severe equine disease.

In recent group discussions among ACVIM Diplomates, it was clear that an alarmingly high number of cases they see involve complications from tail alterations, which are medical procedures done solely to change the function and position—essentially the appearance—of the tail. Usually done for show ring gain, the most common tail alteration procedures are numbing the tail (“blocking”), nicking one of its tendons or amputating its tip. But their consequences are far more than just cosmetic. Complications resulting from these procedures can cause permanent disfigurement or disability that in some cases lead to death.

Even without complications, tail alteration is cruel because it changes the way a horse can use his tail and sometimes prevents him from using it at all. Tail function is important to equine well-being. In addition to using his tail to swat flies, a horse may clamp it down to protect sensitive, hairless areas from cold winds, and he raises his tail to defecate. A horse’s tail also plays a vital role in equine body language—the ability to raise and swing his tail helps him to fit into a stable, functioning herd.

Because of their negative impact on the horse, practices that alter tail carriage and function for cosmetic or competitive purposes are strongly opposed by many breed associations and veterinary groups, including the American Association of Equine Practitioners (AAEP), the American College of Veterinary Internal Medicine— Large Animal Internal Medicine (ACVIM–LAIM) and the American Veterinary Medical Association (AVMA). Unfortunately, riders and trainers in several disciplines still consider these procedures a necessity for high-level competition, and altered tails are still rewarded in the show ring.

The “quiet tail”

Perhaps the most dangerous tail alteration procedure is tail blocking, which the AVMA defines as “numbing the tail to cause it to hang limply.” This practice is most often performed on horses competing in Western disciplines, such as pleasure or reining classes, where horses are penalized for wringing, raising or moving the tail side to side excessively.

Blocking the tail is not the same as blocking a joint, a procedure done during many lameness examinations. A joint block involves sterile preparation of the site and injection of a sterile local anesthetic, such as lidocaine or mepivacaine, into a joint by a licensed veterinarian. These blocks last for a few hours at maximum, and they carry no long-term effects and a low risk of infection.

In contrast, the technique used to block a tail is to blindly inject ethanol along either side of the bones near the base of the tail, seeking to affect the function of the nerves that activate the muscles controlling movement. Ethanol is very destructive to tissues—it can kill nerve cells and destroy proteins. The effects of a “block” can last four to six months in most horses, but the overall impact of the procedure on a horse depends on numerous factors, including the volume of ethanol used, the location injected and how far or to what tissues the solution eventually migrates. Because tail blocking is considered inhumane and unethical, it is not taught in veterinary schools. Thus, any individual who performs the procedure most likely has had no veterinary training and may have minimal knowledge of the anatomy and function of the tail.

The tail of a horse that has been “blocked” or “deadened” cannot be lifted above the horizontal plane. Many trainers and exhibitors claim that a block still allows a horse to move his tail from side to side, thus allowing him to continue to swish at flies—a belief that makes the procedure acceptable to many people. However, although a few animals may retain this function, many do not and suffer continuously as a result.

This procedure is unpleasant for the horse from the beginning: The very act of injecting alcohol into the tissues is painful. Once the burning sensation of the alcohol has dissipated, far more serious problems can develop. In many cases, the injection for a tail block is not sufficiently sterilized, raising the risk of abscesses or worse—potentially fatal infection with clostridial bacteria commonly found in the environment is a possibility.

What’s more, some of a horse’s basic bodily functions can be adversely affected by a tail block because the nerves and muscles that enable a him to move his tail are intimately associated with those that control the ability to urinate and defecate. The alcohol can also spread through the tissues to reach parts of the spinal cord as well as the nerves that control movement of the horse’s hind limbs, which can cause neurological deficits or even paralysis.

Multiple cases of adverse effects related to tail blocking procedures have been documented in the veterinary literature. Reported complications include permanent nerve damage that leaves a horse unable to completely empty his bladder or rectum. Chronic urine retention can lead to bladder infections and ascending infections of the kidney. Horses who are unable to defecate normally are likely to develop impaction colic that is difficult or impossible to permanently resolve. Animals with chronic urinary or fecal incontinence often must be put down because of persistent colic or the intense care they require. Infection of the vertebral bodies or spinal canal can lead to severe ataxia0 and pain, leaving horses unable to move normally and making them a danger to themselves and their handlers. One must consider whether the loss of the horse’s ability to perform these most basic functions is worth risking for the appearance of a quiet tail in the show ring.

Our group has encountered many owners who were encouraged by their trainers to have a tail block performed with no idea of how devastating the results could be. On numerous equine blogs and online forums, owners say their trainers told them that getting the tail blocked was “nothing” and “people do it all the time.” Some trainers lead their clients to believe that getting the horse’s tail blocked is as necessary and routine as having his feet trimmed or teeth floated. Other posts claim that if the procedure is done “right” there are no real adverse effects aside from the initial discomfort of the injection.

Rules and detection

Blocking tails is against the rules of most major show and breed organ-izations. White hairs, which often develop at the injection sites, are telltale signs that a horse needs to be examined more closely.

Testing protocols for a horse suspected of having a blocked tail involve thorough physical examination of the tail and surrounding structures, assessment of his ability to move the tail and application of specialized electro-diagnostics. When the anus of a horse with a normal, unaltered tail is massaged, the horse lifts the tail above the horizontal plane, and many will lift the tail into a vertical position. Musculature of a normal tail is symmetrical and has no dimples. The muscles around the tail head are likewise symmetrical and free of divots and scar tissue. Also, when a horse tries to raise a tail that has been blocked, it will take on a concave arc instead of the normal convex appearance.

Electromyography (EMG) is the official diagnostic test used by the American Quarter Horse Association (AQHA) to identify destruction of the nervous control of the muscles involved in tail movement. Electromyography involves the insertion of small needles into the muscles around the tail to measure electrical activity. Muscles that have been denervated by an alcohol injection will show spontaneous, disorganized electrical activity. Trained veterinarians use EMG to identify horses with blocked tails at AQHA shows. Any horse whose tail block is confirmed is banned from competition in AQHA-sanctioned events for at least a year—longer if the function of the tail remains abnormal. Despite statements in the AQHA rulebook that specifically prohibit tail blocks, I have found that the procedure is still shockingly common.

Other breed associations involved in Western disciplines discourage the practice but do not clearly ban it. The American Paint Horse Association (APHA) states that, “A judge may, at his discretion, penalize a horse for excessive or exaggerated switching of the tail or for a seemingly “dead” tail that merely dangles between the legs and does not show a normal response.” However, while the APHA rulebook states that “any item or appliance that restricts the movement or circulation of the tail” cannot be utilized while on show grounds, there is no statement barring the practice outside of the show grounds.

The Appaloosa Horse Club (ApHC) states that, “No horse is to be penalized for the manner in which he carries his tail nor for normal response with his tail to cues from his exhibitor or when changing leads.” Unfortunately, despite these statements that imply that tail paralysis is not to be tolerated, there are no specific testing strategies in place to identify horses whose tails have been blocked.

What we can do

Several organizations within the veterinary community, including the ACVIM–LAIM specialists and the AAEP, have been working to raise awareness of tail-altering procedures and to encourage competitors, judges, trainers and other veterinarians to end this appalling practice. While organizations like the AQHA already have strict protocols and penalties in place to prohibit tail altering, we are encouraging others to follow suit.

Unfortunately, these practices have been around for decades, and it likely will take a long-term plan and the involvement of many branches of the equine industry to abolish them. There are few legal statutes in place to protect horses against such inhumane practices, so prosecution is difficult or impossible.

Instead, we need to encourage the horse industry, including individual owners, to take action to begin discouraging this practice at the grassroots level. Here are some ways you can help:

• As a horse owner, educate yourself on all procedures and medications recommended by your trainer or veterinarian. Read any information you can find on websites belonging to veterinary organizations such as the AAEP and AVMA, and talk to other veterinarians not closely involved in your breed or discipline. Remember, you may be held responsible for an inhumane practice, even if it was done without your knowledge. If your trainer recommends a procedure you’re uncomfortable with, heed your instincts and just say “no.”

• If you see something, say something. No, you don’t need to confront other owners. But if you see horses at shows whose tail carriage seems suspicious, have a word with the judges, show officials or anyone in authority who will listen. Practices won’t change until people speak up against the status quo.

• Proper instruction at judges’ education events is essential for dis-continuation of tail alteration. Once abnormal tail carriage is no longer rewarded in the show ring, there will be no need to continue this practice to maintain a competitive edge. Less emphasis needs to be placed on the appearance of a horse’s tail and more on the horse’s performance. Again, associations are more likely to respond to pressure once their own membership starts speaking up.

As with any change to a long-standing practice, stopping people from altering equine tails will likely be a prolonged battle—but it is a necessary one to improve the welfare of our horses. Please join the concerned equine veterinarians in doing your part to end this inhumane, unnecessary and potentially life-threatening procedure.

Sidebar: Tail alteration: docking

Docking the tails of workhorses—amputating the distal bony part of the limb—is an old tradition that was originally performed to keep the tail from getting caught in the harness or equipment. If the horse hooked his tail over a rein and clamped down, for example, the driver could lose control of the team, and it was also done to keep the tails out of the way of farmers who walked close behind plows and other equipment. Today, docking is done mainly in draft breeds, primarily for cosmetic purposes. For the show ring, the appearance of a short tail can be achieved by trimming and/or braiding.

Docking may be done either surgically or by ligature—placing rubber rings or other binders around the end of the tail to cause tissue to die. Surgical removal must be done by a licensed veterinarian in states where the procedure is legal. Pain relating to the procedure itself is not the primary welfare issue; instead the concern is the permanent disfigurement that leaves the horse unable to swat flies or use his tail to communicate.

The docking of equine tails is banned or regulated in 11 U.S. states and many European countries. In New Hampshire, it can be done only by a licensed veterinarian and only after the state veterinarian has granted permission. In some states, tail docking is prohibited unless it is deemed medically necessary and/or of benefit to the horse. In others, it is banned outright.—Kate Hepworth-Warren, DVM, DACVIM

Sidebar: Tail alteration: “nicking”

Tail nicking is primarily seen among American Saddlebreds, Tennessee Walking Horses and other breeds in which a high tail set is desired.

In the nicking procedure, tendons that attach to the underside of the tail are cut to allow the dock to be placed into the desirable upright position by a tail set, which is a harness-like device that holds the tail in place while the injury heals. After a nicked tail has healed, a horse will likely wear a tail set most of the time when he’s not being ridden.

Although many horsepeople think that the nicking of a horse’s tail is harmless—and some horses who have undergone this procedure do retain the ability to move their tails—a number of complications can arise.

The most troubling story of tail nicking gone wrong was published in the Journal of the American Veterinary Medical Association (JAVMA) in 1992; it describes a 2-year-old Tennessee Walking Horse colt who developed colic and eventually died as a result of having his tail nicked. A postmortem examination of this colt showed that the incisions from the nicking had become infected, and the pus had migrated into the abdominal cavity.

Other reported complications of this procedure include development of wry tail (tail held to one side) or the inability to put the tail down into a normal position.

The United States Equestrian Federation (USEF) implemented a rule for American Saddlebreds that “prohibits tail carriage alteration procedures on foals of birth year 2014 and thereafter.” Additionally, the USEF emphasizes that horses’ tails are not to be kept in any tail-setting device while on show grounds, but it does also state that, “The fact that a horse’s tail has once been set does not exclude participation.”

In the Morgan section of the USEF handbook, more explicit guidelines are in place stating that judges must penalize unnatural tails that have evidence of tail setting, a vertical breakover or wry tail. Conversely, the National Show Horse division has no guide- lines prohibiting or even discouraging tail alterations.—Kate Hepworth-Warren, DVM, DACVIM

This article first appeared in the May 2017 issue (#476) of EQUUS magazine

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