Accident & Emergency Care

Grass Sickness

Clinical signs are attributable mainly to stasis of the entire alimentary tract, and include depression, inability to swallow, lack of appetite, gastrointestinal distension and impaction, abdominal pain, sweating, elevated heart rate, muscular tremors, weight loss and drooping eyelids. There is no specific treatment for the disease. The majority of affected horses are euthanised on humane grounds, but some horses with mild chronic grass sickness may survive with intensive nursing care.

Acute Grass Sickness

This is the most serious. It is of rapid onset, the horse is severely distressed, has an elevated heart rate, and patchy sweating, may be dull and depressed. Moderate quantities of green fluid may be produced from the nostrils (this should always be considered a serious signs in a horse). There is lack of gut movements, and usually no faeces will be produced. There are often muscle twitches involving the muscle of both fore legs. Horses with acute grass sickness are often confused with colic, but rarely roll or go down. Veterinary attention is required urgently. Often when a stomach tube is passed a vast quantity of grass fluid will flow back. Destruction on humane grounds is the only option.

Subacute Grass Sickness

Affected animals rarely have gastric reflux (green discharge) but will show most of the signs displayed by the acute cases. An inability to swallow is a prominent sign along with drooping of the upper eyelid. Subacute cases are always fatal; the course of the disease is 2 – 7 days.

Chronic grass sickness. These cases are less severely affected than subacute cases and may be able to eat small amounts of food. Some of these horses may survive for considerable periods of time and may respond to treatment.

However many are left permanently damaged, and unfortunately euthanasia is the common outcome. Currently there is no way of treating this disease.

Risk factors include:

  1. Recently introduced to new pasture.
  2. Previous history of grass sickness on pasture.
  3. No hay or conserved feed being fed.
  4. Aged 2 to 7 years.
  5. Highest incidence April – July (but can occur all year

It must be stated however that all horses can be affected by grass sickness. Grass sickness is caused by widespread severe damage to the neurons (nerves) in the autonomic nervous system (this is the part of the nervous system that helps control the intestines).

Patchy sweating is common in all forms of grass sickness.

It is not possible to protect your horse 100% from grass sickness. The following advice may help:

  1. Always feed some conserved forage (hay) even when horses are turned out 24 hours a day.
  2. Don’t put horses in the at risk age group (2-7 years) out onto pasture where there has been previous cases.
  3. Make sure your horse is healthy with regular worming or fecal egg count monitoring.

The cause of grass sickness has remained a mystery for the last ninety years. Research workers have recently made some interesting advances, but there is still much left to find out about
grass sickness. We need to raise awareness and we need more funding for research.

Recurrent Airway Obstruction (RAO)

Recurrent airway obstruction (RAO) is a common condition in many different types of horses. It is a performance limiting problem commonly caused by an allergic respiratory response. Signs include:
– chronic cough
– nasal discharge
– increased respiratory rate (tachypnoea) and effort (dyspnoea)

Episodes of RAO are usually caused by exposure of susceptible animals to common allergens. The most common culprits are organic dusts mwhen horses are stabled, bedded on straw, and fed hay (in particular round bales). Removal of these causal agents will usually result in remission of any signs. It most commonly starts at around 9 years of age, although 12% of mature horses have some degree of allergen induced lower airway inflammation. There is no breed or gender predilection, but there does seem to be a heritable component to susceptibility.

Clinical Signs

Signs of RAO include flared nostrils, increased respiratory rate (tachypnoea), cough and if the problem has been going on for long enough then the horse can have a heave line. Breathing usually includes a prolonged, laboured expiratory phase. Usually a cough is heard when the horse is exercised or being fed. Mildly affected horses may present with minimal signs at rest but coughing and exercise intolerance are noted during increased performance.

Some horses can demonstrate signs during summer, which, usually indicates sensitivity to pollens and certain moulds and this is called summer pasture-associated obstructive pulmonary disease. Management of this is similar to RAO except with the addition of pasture avoidance.


Most commonly diagnosis is made on clinical exam and history alone, routine blood samples are commonly unhelpful in this scenario, x-rays of the chest are also not commonly not beneficial. Bronchoalveolar lavage (BAL) is usually not required in horses with obvious clinical signs and can be contra-indicated in horses with breathing difficulties at rest.


The most important aspect of treating RAO is to limit exposure to the causal agents. Medical treatment will stop the signs and symptoms but these will return as soon as it is stopped if management chenges haven’t been put in place. Medical treatment consists of a combination of drugs to open up the airways (bronchodilators) and steroids to reduce inflammation.

Tying Up in Horses

Tie Up

Tie up is one of the alternative terms for a condition called exertional rhabdomyolyisis (ER). There are a number of possible causes but the most common of these is over exertion.  This causes damage to muscles, particularly in the hindlimbs and hind quarters, leading to the clinical signs of the condition.


The classic signs of ER are extreme stiffness and reluctance to move. Other signs that may be seen are sweating, hard, painful muscles over the hind quarters, increased respiration rate and dark/red urine.


A diagnosis of ER may be possible based on history and clinical signs alone. However, in many cases your vet will take a blood sample to check for any elevation in the muscle enzymes, creatine kinase (CK) and aspartate aminotransferase (AST), to confirm their diagnosis. These enzymes are released by damaged muscle and the extent of their increase reflects the severity of the damage.

Follow up bloods may be taken to monitor your horse’s recovery.

It may be necessary to conduct further blood tests and take urine samples to check the health of your horse’s kidneys. This is important because the characteristic red urine that ER can cause is due to myoglobin being released from the damaged muscle cells. Myoglobin is toxic to kidneys and their function must be monitored for any sign of damage to ensure your horse receives the required treatment.

Shotter & Byers has a blood machine that allows us to conduct these tests in house to ensure we rapidly have the information we need allowing us to provide your horse with the very best care.


Treatment of ER is dependent on the fundamental cause. Although it usually involves box rest to allow the damaged muscle to recover.

Anti-inflammatories may be given to decrease inflammation and provide pain relief. It may also be warranted to give more stronger pain relief, sedation and anti-anxiety drugs to calm your horse and aid muscle relaxation.

The risk ER poses to the kidneys makes it is extremely important that your horse is well hydrated. Depending on the severity of the ER and level of dehydration this can involve passing a nasogastric tube to give water or the administration of intravenous fluids.

How to Avoid?

ER can be avoided by ensuring your horse stays fit and that they are well warmed up before strenuous exercise.  An hour of exercise a day is better than 5 hours in one day! In some cases, the risk of ER can be lowered by decreasing the amount of concentrate feed. Good quality forage is the most important part of your horse’s diet. If your horse requires extra calories, these can come from the addition of oil to the feed without predisposing for ER.

Digital Radiography – X-RAYS

Digital Radiography

At Shotter & Byers we are proud to own five top of the line wireless Eklin digital x-ray machines.  These allow us to take exceptional quality images that can be viewed instantly beside your horse without the constraints of wires.

We also have a wired system that displays the images instantly and a number of x-ray generators to be used with more traditional digital x-ray plates that are developed at our office.

This array of x-ray equipment allows us to provide you and your horse with an exceptional and fast veterinary diagnostic service.



Most horses will suffer from colic at some point in their lives. There are a huge number of possible causes for colic and they vary greatly in severity however they can all share similar symptoms.  It is very important that you are able to recognise the signs of colic so your horse can receive the appropriate medical care as soon as possible.

What is colic?

Colic itself is not a disease but is a term used to describe abdominal (belly) pain in horses.

Signs of mild colic

  • Pawing or scraping the ground.
  • Turning the head to look at the abdomen (‘flank watching’).
  • Kicking or biting at the abdomen.
  • Stretching out as if needing to urinate.
  • Restlessness – getting up and down frequently

Signs of severe colic

  • Rolling
  • Lying on its back.
  • Recumbencey (unable to stand)
  • Increased respiration rate
  • Increased heart rate
  • Red/purple colour of mucous membranes (gums and eyes)

What causes colic?

There are many causes of colic and it is often impossible to pinpoint the exact cause. However, there are a few risk factors:

  • Change in diet
  • Change in management
  • Change in exercise
  • Heavy worm burden

What should I do if I think my horse has colic?

  • Remove any feed from your horse and contact us for advice.
  • If you are able to, take your horses temperature, heart rate and respiration rate.
  • If your horse is rolling, keep your distance and stay away from harm. When possible remove any objects that may injure your horse while rolling.
  • If the colic is mild and your horse is calm it is acceptable for them to lay down quietly in their stable.
  • In some cases hand walking your horse may ease mild colic signs and reduce their urge to roll.
  • Your horse may become more violent and distressed, desperately wanting to go down and roll. In this case it may be safer for you and them to let them roll in a well bedded stable than it would be for them to go down while walking in the yard.
  • Do not give your horse any medication unless instructed to by your vet. Some drugs, particularly finadyne, can mask colic signs and prevent an accurate diagnosis.

Choke – Oesophageal Obstruction

Choke – oesophageal obstruction

What is choke?

The term choke can be misleading. Choke in horses refers to an obstruction of the oesophagus, not the trachea as in humans.  This means while choking your horse will be able to breathe, despite being in distress.

What causes choke?

  • Poor dental health
  • Horses with dental abnormalities such as missing teeth, malocclusions or sharp points are unable to chew effectively. This puts them at a far higher risk of choking compared to those that have good dental health.
  • Bolting feed
  • Some horses eat too fast and do not chew properly leading to choke. This can be avoided by placing large stones in with their hard feed which they must eat around, slowing them down.
  • Dry food
  • Dry food is often harder for your horse to swallow than damp or wet food. This cause of choke is easily avoided by slightly wetting your horses feed. This is very important for sugar beet which must be properly soaked before feeding.
  • Foreign objects
  • Occasionally your horse may eat something it shouldn’t, such as a piece of wood, which could get stuck in their oesophagus

Signs of choke:

  • Distress
  • Coughing
  • Not interested in food.
  • Difficulty swallowing.
  • Head and neck extended in a downwards position.
  • Nasal discharge
  • Saliva drooling from the mouth

What to do if your horse is choking

You should remove any remaining food from your horse and call us for advice.

Your vet will likely sedate your horse and give them some anti-inflammatory medication.  This will help your horse relax and may release the blockage.

Some obstructions require your vet to pass a stomach tube through your horse’s nose. This allows them to lavage the blockage with water to remove it through the tube, this can be a time consuming process if the blockage is large.


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