📋 At a Glance
⚠️ Schedule an Exam Sooner Than Annual If
- Any new lameness, behavioral change, or performance decline that has persisted more than 48–72 hours
- Significant unexplained weight loss or difficulty maintaining condition
- A horse over 10 showing any sign consistent with PPID: long curly coat, muscle wasting, increased drinking/urination, recurrent laminitis
- A chronic health condition is being managed — these horses benefit from more frequent monitoring
- A significant change in management, workload, or housing that warrants a health reassessment
- Any horse returning from a significant illness, surgery, or prolonged rest
What Happens During a Complete Annual Wellness Exam
The annual exam is an opportunity to assess your horse's complete health picture while they are healthy — which is the only time you can reliably establish what 'normal' looks like for that individual horse. Your veterinarian performs a systematic head-to-tail physical examination alongside a review of management, nutrition, vaccination and deworming history, and any concerns you want to discuss.
| Exam Component | What the Vet Is Assessing | Why It Matters |
|---|---|---|
| Vital signs | Temperature, pulse rate, respiratory rate, capillary refill time | Baseline values; deviations from normal are significant; CRT reflects cardiovascular function |
| Body condition score (BCS) | Standardized 1–9 Henneke scale assessment of fat coverage at specific sites | Documents nutritional status; trend over time is more meaningful than single score; identifies obesity (EMS risk) and underweight (systemic disease, dental, parasite) |
| Eyes | Pupillary response, corneal clarity, discharge, eyelid conformation | Early detection of uveitis, corneal disease, eyelid pathology that owner may not notice |
| Nasal passages & lymph nodes | Nasal discharge character, submandibular and parotid lymph node size | Respiratory infection, strangles carrier status, dental abscess drainage |
| Mouth — preliminary | Incisor wear, obvious pathology visible at front of mouth | Not a substitute for sedated speculum exam but identifies obvious issues |
| Heart & lungs | Auscultation for murmurs, arrhythmias, abnormal lung sounds | Cardiac murmurs are common and usually benign; new or progressive murmurs warrant further investigation; lung crackles suggest airway disease |
| Abdomen | Gut sounds in all four quadrants, abdominal shape, palpation | Silent or reduced gut sounds at wellness = early colic or motility concern; bloating may indicate dietary or parasite issue |
| Musculoskeletal | Limb palpation, hoof condition, gait observation | Tendon/ligament changes, joint effusion, hoof abnormalities, subtle lameness |
| Skin & coat | Coat quality, skin lesions, dermatitis, evidence of parasites | Coat abnormalities may indicate PPID; skin conditions caught early are more manageable |
| Reproductive (if relevant) | Mare: external genitalia, mammary gland; stallion: preputial exam | Routine; identifies cancers, conformational issues, infection |
| Cresty neck score | Palpation of the nuchal ligament fat deposits | Elevated cresty neck score (3+) correlates with EMS and insulin dysregulation risk |
Bloodwork — What It Adds and When It's Valuable
Routine bloodwork is not always required at an annual exam for a young, healthy horse with no health concerns. However, it adds meaningful information in a number of situations — and establishing baseline values in a healthy horse is genuinely valuable for comparison if the horse becomes ill later.
| Test | What It Detects | When to Consider |
|---|---|---|
| CBC (Complete Blood Count) | Red cell count, white cell count, platelet count; anemia, infection, inflammation | Any horse with weight loss, poor performance, or history of significant illness; excellent baseline |
| Serum Chemistry Panel | Liver enzymes (AST, GGT, ALP), kidney values (BUN, Creatinine), total protein, albumin, electrolytes | Horses on long-term NSAIDs; horses over 15; any horse with weight loss or decreased appetite; excellent baseline |
| ACTH (for PPID) | Pituitary adrenocorticotropic hormone level — elevated in Cushing's disease | All horses over 10 annually; any horse with suspicious signs (curly coat, muscle wasting, recurrent laminitis) regardless of age |
| Insulin + Glucose | Fasting insulin; glucose:insulin ratio — identifies insulin dysregulation (EMS) | Horses with obesity, cresty neck score 3+, recurrent laminitis, or suspected EMS |
| Triglycerides | Elevated in hyperlipemia — serious condition in ponies, miniatures, and donkeys | Ponies, miniatures, and donkeys that are off feed or stressed; can be rapidly fatal |
| Coggins (EIA) | Equine Infectious Anemia — virus with no treatment or vaccine | All horses annually; required for interstate transport and most competitions; often done at annual visit |
The Importance of ACTH Testing — Detecting PPID Early
One of the most impactful changes in equine senior care over the past decade has been the normalization of annual ACTH testing for horses over 10. Pituitary Pars Intermedia Dysfunction (PPID, Cushing's disease) affects approximately 20% of horses over 15 and a meaningful percentage of horses over 10 — yet many go undiagnosed until laminitis or advanced muscle wasting has already occurred.
Annual ACTH testing changes this picture. A horse identified with early PPID and started on pergolide (Prascend) before laminitis episodes begin has dramatically better quality of life and career longevity than one identified only after the first serious founder episode. The test is a single blood draw added to the annual visit.
Important: ACTH levels have a physiological seasonal rise in late summer and fall (August–October in the Northern Hemisphere). Testing in this period requires applying seasonal reference ranges — a horse that would test normal in spring may fall above the spring reference range in fall without having PPID. Your veterinarian interprets results in the context of season.
Getting the Most from Your Annual Visit
The annual wellness visit is most valuable when both the owner and the veterinarian are prepared. It is not just a vaccination appointment — it is a clinical assessment and planning conversation. Come prepared with observations about your horse, your management questions, and your plans for the year ahead.
Prepare Before the Visit
- Note any behavioral changes, performance concerns, or physical changes you've observed since the last visit
- Bring vaccination records and deworming records (FEC results if you've been doing them)
- Have current hay and feed information ready — type, quantity, supplier, and any recent changes
- Think about the year ahead — any travel, major competitions, changes in use, or plans to breed
- List specific questions you want answered — there's no such thing as a question not worth asking
Topics Worth Raising at Every Annual Visit
- Body condition score trend — is your horse gaining, losing, or maintaining appropriate weight?
- Current forage quality — when was your hay last tested for NSC and nutritional content?
- Exercise and work appropriateness — is the current workload appropriate for this horse's age, fitness, and health status?
- Farrier schedule — is the current interval producing good hoof balance? Any recurring foot concerns?
- Dental exam scheduling — is the dental exam included, or should it be scheduled separately?
- Upcoming changes — new horses arriving, major event schedule, pasture changes, boarding facility changes
Annual Exam for Senior Horses — Elevated Standard of Care
Horses over 15 benefit from biannual examinations rather than annual. Age-related changes accumulate faster, multiple conditions often compound each other (PPID + dental decline + joint disease is a common triad), and early detection of these changes while the horse is otherwise well allows proactive management.
A biannual senior exam typically includes: ACTH measurement at each visit, body weight trending, body condition score, a detailed musculoskeletal assessment with emphasis on joint health, dental examination with focus on progressive wear and diastema, and a conversation about quality of life and management adjustments.
✅ Preparing for Your Annual Wellness Visit
- Schedule the visit when you have adequate time — an annual wellness exam deserves 45–60 minutes, not a rushed barn call
- Bring your health records — vaccination dates, deworming log, FEC results, and any notes from previous veterinary visits
- Request ACTH testing if your horse is 10 or older — add it to the visit; one blood draw
- Request a BCS assessment and ask what score is recorded — track this across visits as a nutrition and health trend
- Discuss the deworming program — bring FEC results if available; let your vet confirm the program makes sense
- Ask about dental scheduling — confirm whether the dental exam is part of this visit or needs to be separate
- Raise every concern — if you've noticed something over the past year, now is the time to ask about it
📋 Annual Exam Discussion Topics for Your Vet
- ACTH result and whether pergolide is indicated or dosage needs adjustment if already on treatment
- Body condition and nutrition — is the current diet providing appropriate calories and nutrients?
- Appropriate exercise and work level for this horse's current health, age, and fitness
- Farrier schedule assessment — is the current interval appropriate for hoof quality and balance?
- Dental exam timing and findings from the current or most recent dental procedure
- Bloodwork interpretation — what baseline values look like, and what to watch for before the next exam
- Coggins timing — confirm it's current for the travel and competition season planned
Questions to Ask Your Veterinarian
- What is my horse's body condition score today, and is that where it should be?
- Based on this exam, are there any emerging concerns I should be watching between now and the next visit?
- Given my horse's age and use, do you recommend any bloodwork at this visit?
- What is the ACTH result and how does it compare to the seasonal reference range?
- Is the current vaccination and deworming program appropriate, or are there changes you'd recommend?
- Is there anything about my management or feeding program you'd suggest I reconsider?
