THE PEDESTRIAN’S GUIDE TO WRITING HORSES
6: Illness and Injury
First, a basic Cover My Back announcement:
I am not a vet. I have twenty-odd years of experience with horses and I’ve seen a lot of things in that time, but I do not have the training, the skills, or the expertise of a real vet. The descriptions of common equine ailments and their treatments that follow should be used only for reference when writing fiction and not applied to the real world. If you have or encounter a horse you believe is ill or injured contact a licensed veterinarian immediately.
With that out of the way…
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Horses can suffer from a variety of illnesses found among humans as well. They can get cold viruses, the flu, even rabies (though this is rare). Today there are effective vaccines that, provided they are administered regularly, render these illnesses practically nonexistent. (Horses are vaccinated once or twice annually, depending on the vaccine and the risk factor; consult a vet for details.)
Bacterial infections, such as pigeon fever, have no such vaccines, and must be treated with antibiotics. If your story is set in a pre-penicillin era without an alternative, such infections could quickly become life-threatening.
Though horses can contract equine versions of human illnesses, they do not pass between the two species very often.
When kept up-to-date on their booster shots horses are usually healthy animals, sickness-wise. But they have other ways of keeping your life interesting, such as…
Colic
Colic is probably the most common life-threatening injury a horse can suffer. I call it an injury, even though most colicking horses are described as “sick,” because colic just means there’s something wrong with their digestive tract that’s causing them intense pain. Causes for colic that I have personally encountered include:
- Gas. Just like in humans; this will usually clear itself out in a few hours.
- Fecal compaction. Basically this is just really, really bad constipation. Usually easily treated with muscle relaxants (injected) oil (by mouth) and enemas (guess where).
- Sand. Collects in the horse’s hind gut if not flushed out with fiber; can cause a compaction (blockage) of the intestines, or make them crimp, or even tangled. If the intestines are merely blocked, it can be treated with muscle relaxants and mineral oil to wash the sand out. If the intestines become compromised, it is a life or death situation and very painful for everybody.
- Entroliths. Like kidney stones, but huge! They form from the distilled clay of the horse’s diet, slowly growing larger as they accumulate more layers. Common in horses with a history of sand colic. Small entroliths can pass with little or no trouble, but large ones can cause blockages, and therefore colic.
- Benign tumors. These are more common in older horses; they grow globs of flesh along their intestines. These growths are not cancerous or are not harmful in of themselves, except that they can interfere with the functions of the intestines, and therefore the horse’s life.
There are many other ways in which a horse can colic I am sure. Consult a veterinarian if you need inspiration.
Colicking horses will present as under the weather, uninterested in food, and tired. They will lie down flat out, and sometimes roll in pain.
Standard treatments for colic start with forcing the horse to walk: walking makes their bowels move, and will help work out the muscle cramping. Muscle relaxants can also be administered. In extreme cases sedation, anesthesia and surgery are also options. Obviously not options if you’re in a pre-industrial society—unless you’ve got some very specific magic spells.
A horse coming out of colic will be given free access to water and gradually reintroduced to food—especially fiber-rich feed like grass or oat hay. Alfalfa and grains are usually avoided for a few days.
Horses who have had colic in the past are more prone to subsequent episodes, but with proper care it can be avoided—mostly. Colic is sort of like lightning, and can strike at any horse, anywhere, any time.
Colic is scary, but it passes quickly. Either the horse gets better… or they don’t. Unlike another common injury…
Hoof Abscesses
Just like a regular abscess, only inside the horses’s hoof! Hoof abscesses can be caused by anything from a stray shoe nail, a stone that has become wedged deep in the horse’s hoof, untrimmed feet cracking and splintering, to internal bruises becoming necropsied and infected.
A horses with an abscess with let you know. The pain is intense and acute: they will not walk on the foot that has the abscess. This can be quite alarming to see, but abscess are fairly easy to treat, and as long as they are not too big or too close to the bone they are not life-threatening.
Once diagnosed, vets will start by attempting to carve a drain into the horse’s hoof, so that the infected fluid can drain out, relieving the pressure (and thus the pain) and the hoof may begin to heal. Even if they are unable to tap the abscess, soaking the foot in epsom salt water can help draw it out.
Once an abscess has burst the horse will immediately begin to feel better. If little or no damage has been done to the rest of the hoof by the abscess, they may even present as sound. However, you will be able to see the fluid draining from their hoof, and this is moderately disgusting. Most abscesses will drain through the bottom—across the sole of the hoof—but some will burst along the coronet band and spill down over the outside. Both kinds of wounds must be kept clean to prevent re-infection. For bottom-draining abscesses, you can douse them with betadine, pack with gauze, and then cover with a cast made of duct tape. Yes, duct tape. I have also heard of vets packing larger abscess holes with betadine-soaked sugar, to lessen the sting and prevent bacterial growth.
The last time my horse had an abscess, it drained through her sole and her coronet band. I had to use gauze soaked in betadine for the sole, and a human diaper to cover the cornet band—before securing the whole assemblage with duct tape and vet wrap.
A good duct tape bandage can last for days, but often it will need to be removed at least once a day to dress the wound.
Once burst, abscesses can take anywhere from a couple of days to a week to drain thoroughly. If the infection hasn’t spread to the bone, most horses make a complete recovery in a matter of weeks.
The other most common cause of acute lameness in horses is…
Laminitis
This is also known as Founder. But though they are related, they are actually two different things.
Laminitis is inflammation of the laminae, the little fibers that connect the outer shell of the hoof to the coffin bone (the hoof-shaped bone inside the hoof). Laminitis can be brought on by many things, such as a sudden influx of rich food into the horse’s system such as tender green grass or a lot of sweet feed. The exact mechanics are too complicated for me to explain here, but the gist is that the horse has trouble metabolizing all the sugar, and this causes an imbalance in their blood chemistry, which causes the laminae to become inflamed. Laminitis can also be caused by stress injury and by lack of blood flow.
Horses with laminitis will present as tender-footed—sore on both front feet, and hind feet as well. If it is really bad, they may even look like they’re trying to walk on their hind feet, to take some weight off their front ones. If the laminitis is only present on one hoof, they will favor it as they would any other sore foot.
Laminitis can usually be halted or reversed by judicious application of anti-inflammatory medicine, a change of diet, and special hoof-care such as barefoot trimming or corrective shoeing, and dietary supplements.
Left untreated, laminitis can be fatal. With the laminae damaged, the coffin bone is no longer fully supported and can begin to sink or even rotate within the hoof. In extreme cases, the bits of the coffin bone will even poke through the sole of the hoof. This is when laminitis turns into founder. It is torturously painful for the horse, and usually the only recourse is euthanasia.
In rare cases, instead of breaching the sole of the hoof, the coffin bone will begin to chip off and disintegrate. This is also incredibly painful for the horse, and since there is no way to grow the bone back, the poor animal usually has to be put down.
There are many more reasons for a horse to go lame: everything from a stone caught in the hoof to horrible things like ringbone. A vet once told me that 95% of all lameness is from the coronet band down, and in my personal experience she was right. However, abscesses and laminitis are probably the most common, and in the interest of not using up all the words on the internet, they are all I’m going to cover here. For other fun (read, horrifying) ways horses go lame, try googling the words “ringbone” “navicular syndrome” and “keratoma” in conjunction with the words “horse” and “hoof.” Or consult the nearest vet.
Other ways horses can injure themselves (without any help from humans with pointy sticks), are by getting themselves tangled up in their fencing (lacerations, torn ligaments, friction burns), becoming stuck under a fence or wedged in their stall (anything from abrasions to broken bones), and running headlong into things that leave them with huge, gaping wounds.
I once showed up at the stables one morning to find my horse had acquired a four-inch-long gash in her flank. I don’t know how she did it. The vet who cleaned and stitched it up said that it went so deep she could get her whole hand inside. They had to install a drain and everything and I had to give her (my horse, not the vet) injections of penicillin twice a day for three days. Took almost a month, but it healed up nicely and aside from some loose skin there’s nothing even resembling a scar. But still. I have no idea how she did it.
To give them due credit, horses can be incredibly resilient and come back from horrific injuries. There are some things, however, that even the best intentions of humans cannot save them from.
You may have heard of race horses breaking a leg and having to be put down. This can be startling to someone who doesn’t know horses, so let me explain:
The horse’s circulatory system requires them to spend most of their time standing on their feet. Having the pressure of supporting 1,000 + lbs. of weight on their hooves is how they get blood into and out of them. Without being able to stand, indeed without being able to walk, they loose circulation in their feet—which can lead to laminitis and all sorts of other bad things.
So once the feet are irreparably compromised, there is no way for the horse to live without pain.
A horse cannot simply spend a month on its butt with its foot in a sling while it waits for the bone to heal. It must be kept standing. Today there are intense, expensive procedures involving pools of water and slings, but even these don’t always work.
So most of the time horse owners will spare themselves and their animals the agony and just have them put down. It is one of the harshest aspects of horse-ownership, but people don’t do it without a reason. Usually, a very good one. Google “ruffian race horse” if you want a heart-wrenching example.
While most euthanasia is performed by vets using a combination of drugs (much like what is used to euthanize dogs and cats, just on a larger scale), sometimes it must be performed in an emergency in the field. This is why so many people who own horses in isolated, rural areas own and know how to use guns. To kill a horse humanely with a gun (DON’T TRY THIS AT HOME KIDS!) requires you to shoot it in the head between the eyes—but that’s not always easy, especially if they’re thrashing around in pain.
Keep that in mind before you casually write your horse into some horrible accident.
I want to take a moment here to talk about certain injuries horses rarely suffer, and injuries that their riders commonly do.
Horses do not rear up, fall over backwards, and break their backs… very much. Oh, I’m sure they do, but it would be considered a bit of a freak accident. Like someone tripping over a laundry basket and tearing their ACL. What is common is for horses to rear up, never minding that they are in a small space, and crack their heads open on whatever is directly above them. Also more common: horses rearing up, falling over backwards, rolling to the side and getting up with nary a scratch… and leaving what is left of their rider a bloody pancake.
Falling from a horse can cause a rider all sorts of injuries: from strained muscles to bruises to broken bones to concussions. Falling from a horse and then getting landed on by your horse usually means you get an ambulance ride. If you’re lucky. If not, you get a ride in a hearse.
If a horse lands on your leg, you are lucky. You just have a broken leg. It might not even be a compound fracture. If a horse lands on your lower half there is a good chance you’ll have a fractured pelvis. If it lands on your upper half…
Well, remember back at the beginning where I said horses are so big and heavy it takes a backhoe to move a dead one?
What do you think that weight will do to the pitiful human ribcage?
Yeah.
So if your villain falls under his horse don’t think he’ll be able to get up again. Unless he is secretly a robot. And only then if he’s super strong robot.
If you take away anything from this chapter, let it be this: never underestimate the amount of damage a horse can do to itself or its rider or the things immediately surrounding it.
Backhoe, remember?
Of course there is a lot more to the ailments of horses—many people have made careers out of studying them—but this should give you a solid grounding. In the next and final chapter I’ll be closing out this series by going over the books that, in my opinion, got the horses right—and I’ll also mention a few to be wary of because of how wrong they were.
On to Chapter 7: Further Reading ->
Goldeen Ogawa has been working with and around horses since she was five years old, has been a horse-owner since 2000, and currently rides every week. If you have any questions about horses not answered here you can email her at goldeenogawa@gmail.com or peck at her on Twitter @GrimbyTweets. There you can also follow her weekly horse pictures under the #TweetsFromHorseback hashtag.
