Senior horse care: health in the later years

A health check every year

Thanks to better veterinary care, nutrition and management, many horses now live into their 30s. Most show the first signs of ageing in their mid to late teens, though every horse ages differently. The British Horse Society suggests an annual health check with your vet, to find developing problems while early treatment can still help.

Signs of ageing include a dull coat and poorer skin, weaker immunity, poorer sight and hearing, dental problems, a hollow or sway back, less strength to carry a rider, and stiff joints.

This guide covers the health conditions. For feeding, exercise and retirement, see Caring for an older horse, and for the hardest decision, End of life.

PPID (Cushing's disease)

Pituitary pars intermedia dysfunction, or PPID, is a long-term, progressive hormonal disease. The pituitary gland, at the base of the brain, is normally kept in check by dopamine. In horses with PPID the brain doesn't make enough, and hormones, particularly ACTH, rise too high.

The University of Edinburgh's vet school says PPID affects over 20% of horses over 15. It isn't only a disease of elderly ponies: it can occur in middle-aged horses and in any breed or sex.

Signs

The BHS lists:

• a long or curly coat, or difficulty shedding the winter coat
• unusual sweating, not linked to exercise or weather
• laminitis
• drinking and urinating more than usual
• lethargy or low energy
• weight loss, and muscle loss, especially along the topline, back and hindquarters
• fat deposits in unusual places, and bulging of the hollows above the eyes
• infections that keep coming back, such as sinusitis or dental problems, and recurrent hoof abscesses

Edinburgh adds that horses with PPID can be quieter than they used to be, which is easily put down to old age. It calls laminitis the most concerning risk for horses with PPID.

Diagnosis and treatment

Your vet will take a blood sample to check ACTH levels. Results usually take a few days. If you take your horse to the vet for the test, the BHS advises letting it rest for at least 30 minutes first, so the result isn't distorted.

• PPID can't be cured, but it can be managed well. The usual treatment is pergolide, which acts like the missing dopamine. It is usually given as a tablet, hidden in feed or a treat; watch to make sure your horse eats it.
• Treatment is usually for life, so it's a long-term financial commitment. Order refills in advance.
• Test every year. PPID progresses slowly, so Edinburgh encourages annual testing to keep the dose right. Your vet may adjust it over time.

Day-to-day care

The BHS suggests clipping in warmer months if your horse can't shed its coat, rugging when it turns cold, keeping a healthy fat score to cut the risk of laminitis, and keeping up dental care, worm control and the farrier. Watch closely for infections. Some horses with PPID also develop insulin resistance, managed like Equine Metabolic Syndrome: follow your vet's advice.

Laminitis

Up to 90% of laminitis cases are linked to hormonal disorders such as PPID and Equine Metabolic Syndrome, and extra weight can more than double the risk. Keep an older horse at a healthy fat score of 2.5–3 out of 5: the BHS notes that an overweight older horse is as much of a concern as an underweight one. Laminitis is always an emergency; see Common illnesses and Weight and fat scoring.

Arthritis

Arthritis, inflammation of a joint, can cause pain, lameness and poorer performance. It can affect horses of any age, but is more common in older horses after years of wear on the joints, and more likely after a joint injury or infection, or a demanding athletic career.

A horse with arthritis in the neck or forelegs may find pulling hay from a net, or lowering its head to graze, painful, and eat less as a result. Long warm-ups and cool-downs help stiff joints. Exercise an older horse only if it is sound, healthy and under veterinary guidance.

Teeth

Teeth wear about 2–3 mm a year and keep erupting to make up for it, until, by the mid to late twenties, there is nothing left to erupt: the tooth "runs out". Bransby Horses estimates that a healthy horse on an ideal diet has teeth that last around 25 years before they wear out completely.

Older horses are more prone to gaps between the teeth, where food packs and causes painful gum disease; loose or displaced teeth that may need removing; decay; and smoother grinding surfaces that chew less well. Poor chewing raises the risk of colic, choke and weight loss.

• The BHS strongly advises a dental check every 6–12 months for older horses. World Horse Welfare advises every six months once a horse is over eighteen.
• Feed soaked, softer feeds if your horse struggles with hay, divided into four or five smaller meals, because soaking adds bulk.

See Dental health.

Eyes

Cataracts make the lens cloudy, like frosted glass, and can gradually lead to blindness. Signs include:

• stumbling, tripping or bumping into things
• trouble picking the feet up over small obstacles, such as the step into an arena
• shying, jumpiness or spooking
• a cloudy or white look to the pupil
• difficulty walking straight

If you notice these signs, ask your vet to check your horse's eyes.

Melanomas

Melanomas are the most common skin tumour in older horses, especially greys. Many stay non-cancerous but grow slowly over years, and cause problems when several grow in one area. Look for them when grooming, particularly under the tail and around the anus, around the genitals, below the ears and behind the jaw, and around the mouth. Ask your vet about any you find.

Feet, worms and keeping warm

• Feet. Older horses' hooves grow more slowly, but the BHS still advises farrier visits every 4–6 weeks, as your farrier advises. Overlong, unbalanced feet strain the joints. Pick out the feet daily, because a weaker immune system makes infections such as thrush harder to fight. When you lift a foot, keep it low and close to the horse's midline.
• Worms. Older horses can have a weaker immune response, leaving them more vulnerable to a heavy worm burden. Keep up a risk-based worm control plan. See Parasite control.
• Warmth. Older horses can find it harder to keep warm. If yours loses weight over winter, make sure it has shelter, rugs and extra feed.
• Weight. Unexplained weight loss or gain can be linked to many age-related conditions, including dental problems and PPID. Fat score regularly, and ask your vet to look for the cause.