Veterinary Care of the Geriatric Horse


What and when is geriatric?

The true definition of “geriatric” in horses has not been defined. Furthermore, there is not a direct correlation between human years and horse years.

Individual variation can be great. While one horse may show significant signs of aging in their mid to late teens, others may not fall into the geriatric category until they are in their twenties.

It is important to keep up with routine veterinary care, in order to identify when your horse is displaying normal and abnormal signs of aging.

Routine veterinary care, more important than ever!

More often then not, there is no additional veterinary care needed for the geriatric horse. However, routine veterinary care becomes more important, as minor issues in younger horses can quickly become severe problems in older horses.

There are changes in the horses circulatory, respiratory, musculoskeletal, digestive, endocrine and urinary systems as the horse ages than can be detected by a veterinarian during a routine physical exam, before they become a serious problem.

Some diseases, such as degenerative heart disease, heaves, arthritis, Cushings, weight loss and dental disease can be addressed during regular physical exams, dental floats and vaccine visits (more on these diseases later.)

“Routine” veterinary care

    Vaccines: Our recommendations for vaccines for an adult horse include a 5-way vaccine (Eastern and Western encephalitis, tetanus, influenza and rhinopheumonitis) and a West Nile vaccine once a year as well as a Flu/Rhino booster six months after the administration of the 5-way.

    Dental Exam: Each horse should have a full dental exam at least once every 12 months to look for sharp points, missing teeth, ramps, waves etc. (For more info on dental care, please see my article at our website

    Physical Exam: One advantage to having a veterinarian administer vaccines and evaluate dental health each year, is it gives you a chance to discuss any concerns you may have with your horse’s health, lets the veterinarian do a quick once over of your horse, and is a good time to discuss feeding, housing and deworming programs.

    Other aspects of general care

    Feeding: A solid, consistent feeding program of high quality feeds is essential to any horse’s health. Clean, fresh water should also be provided.

    Deworming: Every horse should be dewormed every 8-12 weeks on a rotational schedule. This also applies to geriatric horses.

    Exercise: All horses should be allowed some form of exercise daily. This is especially important in older horses.

All of the above can be discussed with your veterinarian to develop the best program for your individual horse.

The physical exam

Good care of the older horse includes a physical exam every six months to a year.
The physical exam should include listening to the heart, lungs and gut sounds as well as evaluation of the eyes, teeth, mobility of the horse and body condition.
The importance of a yearly physical exam in a geriatric horse cannot be over emphasized!

Dental considerations in the older horse

Historically, many horses died due to wearing down of the teeth and subsequent weakness/starvation.

Advancements in dental care for older horses is one of the most important changes in veterinary care that has extended the life span of the average horse.

As the horse ages, his/her teeth wear down, sometimes to the gum line. Routine dental floats can prevent uneven and accelerated wear.

In addition, a lost tooth by a horse can cause debilitating changes in the horses mouth in as short a period of time as six months, if the problems are not addressed.

A veterinarian can recommend diet changes to help the horse with severe dental disease maintain body condition and live a healthier life.


An older horse with a good dental arcade, one that maintains good weight, and is not in heavy work, may be fed as any adult horse would (good quality roughage, salt and mineral block, fresh water and possibly limited concentrates.)

Horses with dental disease, chronic weight loss, cancer, severe arthritis/chronic pain or other chronic illness may need additional caloric intake.

Additional calories may be obtained through concentrates or senior feeds.

A few notes on “Senior Feeds”

Senior feeds have enabled horses to cope with many health problems that would otherwise shorten their life spans. However………Not all senior feeds are created equal.

Some are actual feeds, meant to be fed as the horse’s sole feed (they include hay, vitamins and minerals.)

Some are more like grains, fed to younger horses. These feeds need to be given in addition to hay or another source of roughage.

The best way to go about figuring out how much of a particular feed to give is to have your vet estimate your horses weight and body condition, then evaluate all feed given to the horse.

Commonly, an older horse only needs a better, more complete feeding program to keep him/her looking and feeling young.

Annual Blood Work

Annual blood profiles cost less than $100, and give your veterinarian a very good idea of what is going on inside your horse.

The blood work may identify any existing infection, anemia, kidney/liver disease, protein loss, electrolyte imbalance and other conditions

In addition to identifying lurking problems, it also creates a baseline, should your horse begin to act ill.

It is my recommendation that any horse over the age of 25, or one showing significant sings of aging, have yearly blood work done.

Common Diseases in Older Horses: 

Heart Disease

Changes and weakening of the valves of the heart is a common occurrence in older horses.

These changes can usually be heard by a veterinarian while listening to the heart. This is called a murmur, an arrhythmia, or sometimes a horse will have both.

While these changes usually do not affect a retired horse, heart murmurs should be considered when sedating a horse, or when the horse is still in work.

Common Diseases in Older Horses: Heart Disease

Signs of heart disease include

No signs at all
Exercise intolerance or severe decline in energy while working.
Weight loss
Difficulty breathing
Many others

 Recurrent Airway Obstruction

A respiratory disease in middle aged to older horses, usually those housed in confined areas with poor ventilation.
Signs of RAO include coughing, exercise intolerance, nasal discharge, abnormal respiratory noises, weight loss, difficulty exhaling and a “heave line”.
In some cases there is a seasonal component to the disease.
In almost all cases, the disease is severely exacerbated by confined housing, dusts, molds and pollens.
Also called “heaves”

 Recurrent Airway Obstruction

The most important aspects of treating heaves is to change the environment and eliminate the inciting cause (dust, mold, pollen etc.)
Horses usually do best on 24 hour turnout.
Wetting of the hay may help reduce exposure to dust, though some horses do best on a all pellet/cube diet.
Anti-inflammatory therapy in the form of corticosteriods is usually implemented.
Bronchodilator therapy may also be beneficial.
Owners should be aware that there is no cure for heaves, only management of the disease.


Any horse that has done a moderate to high level of work in his/her life will have some arthritis (inflammation of the joints).
Signs of chronic arthritis include being stiff at the beginning of a workout, lack of forward impulsion, stopping at fences, switching leads, back soreness, a “bad attitude”, blatant lameness and many more.
One of the most important aspects in managing your horse’s arthritis is to provide regular, low intensity exercise in the form of riding or turnout.
The worst thing you can do for an arthritic horse is to keep him/her confined to a corral for a few days, then ask him/her to perform at a high, or even a moderate level.
Slow, gradual warm-up will prevent injury, and make your horse more comfortable throughout work.

Common Diseases in Older Horses: Arthritis

There are numerous options for the treatment of arthritis, each with their own pros and cons, they include, but are not limited to:
NSAIDS (bute and banamine)
Glucosamine by injection (Adequan)
Joint injections (steroids and HA)
HA by intravenous injection (Legand)
Oral Glucosamine and Chondriton Sulfate
Rest and planned exercise program
Regardless of the severity and age of the horse, a horse that is expected to perform into their late teens and twenties are going to need a little help.

Equine “Cushings”

What is Cushings?

    Technically called Pituitary Pars Intermedia Dysfunction
    An endocrine disease that involves the pituitary and adrenal gland.
    A disease that causes the adrenal gland to produce more cortisol than normal.
    A disease in older horses.

What is Cushings NOT?

    The same disease as Cushings in dogs or people, they are different disease processes.
    Metabolic Syndrome

Cushings causes a long hair coat that does not shed out, muscle wasting along the back and hips, a pot-bellied appearance that tends to hide weight loss, chronic infections and abscesses (commonly in the mouth) that do not heal, and laminitis.
The signs seen are due to an increase in circulation of cortisol.
Testing involves blood testing before and after administration of dexamethasone.
Treatment consists of body clipping, treatment for laminitis, diet adjustment and a medication called pergolide.
There is a lot of bad information about Cushings out there, be careful what you read, and always check with your veterinarian.

Weight Loss

Common causes for weight loss include poor dental health, not enough groceries, chronic infection, chronic pain, heart disease, lung disease, bullying by other horses at feeding time, cancer and other disease processes.
Many times in older horses, there is more than one issue that needs to be addressed in order to help a horse achieve optimal body condition.
“Old horse” is NOT a reason for a horse to be underweight. With proper management, most older horses can maintain their weight.

Other Conditions in Older Horses

Changes in the eyes
Changes in the hooves
Decreased immune function
Decrease in reproductive ability
Changes in exercise tolerance and performance

What else can the average horse owner do?

Provide high quality feed and water that is free of mold, dust, dirt and other unwanted additions.
Provide consistent work programs.
Stick with what works and avoid quick fixes and trends.
Listen to your horse!