Veterinary Care of the Heavy Horse

Good quality general health care and management of draught horses is essential for their well-being and usefulness at work, whether it be in the fields or forests or on the showground.

Some common ailments and diseases are mentioned below, but the intention of this article is to steer owners on a sound course as far as their animal’s welfare is concerned.


Stabling is all-important for the welfare of a horse. You can put a perfectly good horse into the wrong stabling and it will become a perfectly bad horse, for psychological or physical reasons, or both. A relaxed horse will digest its food properly and be much less prone to colic than one which is stressed for any reason.

Stable Size

Modern heavy horses are larger than their predecessors. The average working horse used to be 15.2-16 hh. Today, they can be as tall as 19 hh, especially showhorses. The original stalls and loose-boxes in old stables are frequently not big enough. The traditional concept of housing a working horse in stalls where they were fed, groomed, harnessed and kept is now changing. Large loose-boxes are much more satisfactory from the point of view of the horse. He can get up and down easily and avoid two of the problems he faced previously – capped elbow and capped hock. Self-inflicted injuries caused by the difficulty of disposing of his shod feet when getting up or down are much reduced.


It is vital for a horse to have adequate and permanent supplies of fresh drinking water in a large water-container. Small buckets are not sufficient for a large horse and are apt to get knocked over. Either a drum, or better still a water-trough with a ball-valve, is a better solution.


Bedding should be generous. Use a peat base or straw. Many people object to horses eating their straw bed, but they’ll usually come to no harm if properly fed otherwise. Using plenty of clean bedding will also assist the horse to get up and down without injury.

Doors and Windows

Doorways should be free of obstructions. In the old days, horses often injured their heads going in and out of stables. Many had poll evil as a result of repeated blows to the top of the head. Hip injuries as a result of going through narrow doorways with projections were also common.

There should not be glazed windows in the front of a heavy-horse box. Air should be able to circulate freely. A top door needs to be fitted in one or two boxes only in a larger stable: these are only needed very occasionally, for instance to examine a horse’s eyes in the dark. Otherwise there is no need for a top door at all.

Mites can live in stable woodwork, and some horses can get an allergic reaction to these. Keeping stables clean is vital – there was a very good reason for the traditional whitewashing which used to be done regularly on farms.


A horse breathes in and out an amazingly large volume of air. On a cold frosty morning, a horse can fill the stable with water vapour in three or four breaths. Generally, owners do not take nearly enough notice of the need for air changes. Old contractors’ stables often had elaborate ventilation arrangements and were built with high ceilings – I would commend lofty stabling for heavy horses. Given adequate ventilation, coughs or colds will not necessarily be transmitted to all other horses as you might expect.

Owners should be very conscious of the risks to the horse of dust and mould spores. These can lead to allergic problems in the horse’s lung, which were commonly known as broken wind or heaves, but are now known to be chronic obstructive pulmonary disease (COPD). This can be avoided by making sure that stables are clean, and dust-free feed is vital.

Social Life

Ideally, stabled horses ought to be able to see each other. Some sort of grille or other device so that the horse can know who is in the next box is idea. #it is completely against the nature of a gregarious animal to be separated from its fellows. Modern stables with verandah, allowing horses to put their heads out and look about in all weathers, are very suitable. However, at feeding times horses do need to be kept separate because the arrival of food will encourage bad behaviour. A mare will fight her foal for food, and vice versa. Smell is enormously important too.

Social Life

Ideally, stabled horses ought to be able to see each other. Some sort of grille or other device so that the horse can know who is in the next box is idea. #it is completely against the nature of a gregarious animal to be separated from its fellows. Modern stables with verandah, allowing horses to put their heads out and look about in all weathers, are very suitable. However, at feeding times horses do need to be kept separate because the arrival of food will encourage bad behaviour. A mare will fight her foal for food, and vice versa. Smell is enormously important too.

Vet Care

If your horse needs a vet to come visit, the call-out fee will typically be £20-50, with any treatments/medication charged in addition to this. If you have an out of hours emergency the call-out fee will usually be between £80-200 again with treatments/medication on top.
Vets will normally require payment immediately. If you do not have the funds to pay for treatment, putting the bill on a low interest credit card would generally be the best option. Some vets may offer a payment plan. If neither of those options are available to you, an instant payday loan may be an alternative. If you have poor credit then there are no credit check payday loans available. You should always compare lenders to get the best rates, and only use payday loans as a very last option.


The principle thing to remember about the horse’s digestive tract is that the stomach is small, and so the horse must eat almost continuously. The stomach of a Shire will hold, at best, 3 gallons. The hind gut will hold 30 gallons. Think about those proportions! The normal habit of the horse is to eat – left by itself it will eat for 16 hours a day out of 24. It will also lie down for 2 or 3 hours. This is why fields are particularly suitable, as a horse can relax so much better lying flat out on a good field.

Correct Grazing

Ideal grazing pasture consists of a mixture of grasses on well-limed, ragwort-free land, preferably with sheep and/or cattle to assist in natural parasite control.

Two acres would be appropriate for a single heavy horse. Grazing must be adequate otherwise various veterinary problems can occur. For example, if the grass provided is not long enough and a horse is made to crop too close on light and sandy ground it will pull up sandy soil with the grass and consume it, resulting in a very good chance of developing sand colic. Horses will bark trees, which may not do the horse much harm, but will certainly harm the trees. Occasionally horses will eat acorns and oak leaves; a few will not hurt but too many will cause impactive colic. It is important not to allow horses to graze on fattening pastures. This can cause laminitis. Horses will not commit digestive suicide if they can possibly avoid it – if the correct food is available they will take it.

Toxic Plants

Great care should be taken to ensure that a horse does not have access to toxic plants. Yew should be removed from horse pasture, although a horse will not eat it unless he is a foal lacking experience or desperate for food. Yew is instantly poisonous. Ragwort (often preserved by local authorities!) is another plant about which owners must be vigilant. Seeds will blow into your field from verges. Do not let this plant get a hold. It can be difficult to exterminate, but can be pulled out quite easily (pulling is the best method of eradication).

Ragwort is a common cause of hepatopathy, in which the liver cannot function properly. The effect of this on a horse can be tested by examining the liver enzymes in a blood sample. It is possible for all types of horse, including heavy horses, to get ragwort poisoning, and ultimately the liver damage is compounded by nerve damage. Symptoms include headaches and sight and balance difficulties. Putting the horse down is the only solution to this problem. The Government has ordered the extinction of ragwort, but it is ignored.


Parasitic worms can cause damage both on pasture and in the stable, but there are methods of controlling them from spreading. Horses dung in particular areas within a field, and these can usually be recognised by a strong growth of nettles. Worm larvae are passed onto these dunged areas, either already hatched or in egg form, and if the horse does not eat too close to the dunging areas the larvae have difficulty getting back into the horses again. Horses are selective grazers and they are more likely to eat close to such areas if the grazing is poor.

One problem in stables is a very small worm called a cyathostome, which can complete its life-cycle inside a stable. These is also the red worm, which causes damage to blood vessels, and the large round worm, which can be up to a foot long. The eggs of these worms have to be out on the pasture for some time before they can ‘hatch’ and become infective larvae. Larvae accumulate during spring, summer and autumn, and tend to die out during winter. By using restricted dunging areas, as described above, the horse can largely avoid reinfection.

Many good worming remedies are available. It is important to use certain ones at the correct times of the year. Equest, for instance, is very good at dealing with migratory phases of the red worm through the gut, and is best used four times a year. This is very important to a horse’s health because its use can discourage an embolism (blockage of blood vessels) in the mesentery, and consequential colic and then possibly twist.

Grass Sickness

Grass sickness is a particular problem in the northern part of the country and in some localised conditions. There is much that is unknown about this disease and research continues. If diagnosed, it is, regrettably, almost always fatal. In its acute form it appears much like colic, and can produce acute diarrhoea, fluid from the stomach running down the nose and severe constipation. A horse that survives it never regains its previous form.


Owners are often unaware of the problems of sunburn on the white parts of horses. Use a factor 15-20 sun cream on the muzzle.

Size and Fencing of Pasture

It is essential to have adequate fencing for the welfare of the horse. Post and rail, wire or electric fencing are the choices available. If a field is fenced with barbed wire it is vital that it is as tight as a violin string. Loops or barbed wire can be dangerous. Horses will paw their feet, get them tied up in the wire and damage themselves. Rails or electric tape are more appropriate and much respected by horses. This type of fencing will save the owner unnecessary veterinary bills.


It is vital for horses to have an adequate supply of clean water in their pasture, ideally in a ball-valve tank. There should be no mud, and the tank should stand very firmly. Where a river adjoins the pasture it is preferable to have a separate water supply, because horses can get stuck in bank mud.


Horses need shelter in summer. There is no need for a shelter in winter. In bad weather they seem perfectly happy with their rears to the wind and rain or covered in frost. In summer, however, when plies are at their worst, they must have a place to which to retreat. Horse flies, stable flies and Stomoxys calicitrans, which lives in the ear, are a very great nuisance. Head-shy horses are often suffering from such flies. Ear caps are a useful protection, and ought to be compulsory in summer. Fly fringes can also be very valuable. Generally, owners do not provide nearly enough suitable field shelter. Flies are active morning and evening, never at midday or at night. Grazing times need to take account of this.


Feed and health go hand in glove. Remember the great disparity between the horse’s front stomach and hind gut. They are hind-gut digesters and need to eat continuously. In stables, there must always be an adequate supply of hay. It is preferable for the horse to feed ‘downwards’. The length of the head and neck are designed to meet the ground, the horse’s natural position for eating. They eat and digest much better if they eat and swallow downwards, and no dust gets in their eyes. Hay nets are a mixed blessing – although they control the rate of eating and stay tidy, horses can get hooked up and eat part of the net. Also dust gets in their eyes. Place the hay on the ground and always in plentiful supplies. If left hungry, a horse will eat ferociously when it is fed and is likely to contract colic.

It is not necessary to chop hay into chaff unless horses are working. Traditionally, this was one to halve the job of chewing. Heavy horses should not be fed a heating ration. Oats need only be fed if a horse is working. Feed can be kept safe from mice and rats using a regular wheelie bin storage chest. For a heavy horse hauling timber all day, oats and chaff is the best feed – a high intake of fuel enables the horse to digest quickly and efficiently and convert the food into energy.

Horses which stand all day need only good quality hay, and if they need a feed at all you can make your own out of bran and horse nuts. An average horse, which has finished growing and is not working, will do very well on minimal short feeds and hay. As a food, hay will be as good as the grass it came from. Much also depends on the way the hay has been harvested. Bad hay should not be fed. Good hay is wonderful for horses; their digestive system is completely adapted to it – they have been living on it for five million years.

What about the various composite feeds on the market?

Adapt your feeding regime to the work you expect from the horse. Small amounts of highly concentrated amino acids will give you good results in a short space of time. There is no shortage of good advice and no shortage of good horse feeds. What you must not do is feed high-energy rations to a horse which is not exercised.

Mineral and Vitamin Supplements

Mineral and vitamin supplements are a good idea, and a salt lick is always appreciated by animals. In some areas where there are mineral deficiencies feeding appropriate supplements to balance their diet will be very important. In copper-deficient areas, watch out for pale rings around the eyes. Limestone and chalk pastures are ideal, owing to their richness in calcium. Mineral supplements are a must for growing or pregnant animals.


Just as we say ‘No foot, no horse’, we can equally say ‘No teeth, no horse’, since it is important that a horse’s teeth should meet properly. Overshot or undershot jaws can be coped with, but do not buy a horse with such a condition. Molars must be lined up so that top and bottom sets are the same length. If there is irregularity it is possible that a hook will form at one end of the other when the unworn molar grows down.

Owners must check that the horse is eating well and managing to get his food down properly. An imperfection in the teeth will lead to food being balled up in the cheeks or dropped onto the floor again, i.e. quidding. This is a dental matter and can be dealt with. Pre-molar or wolf teeth can get in the way of the bit, in which case they need to be removed. Horses start with an amazing head-full of teeth; the sinuses are some 5 inches long in a big horse. As the teeth come down, the sinus almost empties of teeth. Incisors need a certain amount of watching as they can get injured, and may need to be removed. As horses get older, their teeth can get longer and longer, and the expression ‘long in the tooth’ applies literally to some horses.

Ageing a horse by its teeth involves making an informed guess, and one is usually 2 or 3 years wide of the mark, depending on the individual horse and its feed. Horses’ teeth wear better if they are fed on feeds containing a good deal of silica with a lot of chew in it rather than on grass all the time.

Feet and Legs

Special attention must be paid to the feet of heavy horses. This need is greater in heavy horses than in other horses because of the sheer weight placed on the feet. A large heavy horse weighs nearly a ton. Five hundredweight is transmitted down to each foot. Keep the hooves well trimmed; do not allow them to crack and spread. Regular visits from the farrier are essential.

Whether heavy horses need to wear shoes at all times is debatable. If the feet are properly trimmed and the horse is working on soft ground, it is not always necessary to shoe the hind feet. However, it is probably a good idea to shoe the front feet. Horses working on roads must be shod all round. The essential element to good shoeing is to get the balance of the foot right. There should be plenty of heel and a vertical drop through the centre of the hoof. 50% of the shoe should be behind the centre and 50% in front. Very often too much of the shoe protrudes in front. In northern England the provision of caulkins for extra grip has been traditional, but caulkins on the hooves of horses kept in stalls was a major cause of capped elbow.

Shoeing for Shows

It is complete nonsense to shoe a horse to make his feet appear as big as possible for showing. However, in North American the so-called Scotch shoe results in an almost square foot and no judge will look at a horse without these shoes. It is not unknown for car body filler to be applied. This type of shoeing produces an exaggerated action in the horse, and can also be used to correct an action. However, horses are not worked in these shoes. The equivalent in the UK is the big bevel shoe of our show Shires.

It is uncommon to find a horse spoilt by shoeing in the UK today since most shoeing is sensible. It is important, however, not to forget about the horse’s hooves and shoes once he is turned out. Left on too long they can become loose, damaging the hoof and causing infection where nail holes are left.

Foot Care

If horses stand for any length of time in bad conditions, infection of the frog and frog area can occur. It is rare to see true thrush, where puss is oozing out of the frog, but usual to see and smell decay. It is not at all uncommon to find flyblow. Blow flies lay their eggs in the frog area and a nest of maggots is found in the foot. Maggots eat dead tissue, so in effect they are carrying out a useful clean-up job! In horses, they do not do much harm.

Feather Care

This is largely a question of hygiene – feathers must be kept clean and any sign of infection must be dealt with, whether caused by parasitic mites or moulds. The Dermatophilus mould, called rainscald on top of the body and mud fever on the legs is one of the most usual conditions.

Care of Legs

An important element in the care of horses’ legs is parasite control. Many heavily feathered horses get small chorioptic mange mites in the skin, leading to irritation and discomfort. Grease is a secondary infection due to failure to maintain healthy skin. Mud fever is also a secondary infection of chapped skin, caused by a fungal parasite called Dermatophilus congolense. Avoid infection in the first place through good management and prompt treatment.

Nowadays we can use a number of traditional parasite controls such as flowers of sulphur and oil, but active compounds such as Gammexane  have been withdrawn due to potential harmful effects to others in the food chain. However, newer compounds are available, for example, Aludex, Ivermectin and its associated compounds such as Dectomax.

A great many leg problems stem from irritation of the skin. A horse will start stamping and kicking, predisposing him to arthritic conditions of the foot and limb, colloquially known as ringbone and sidebone. Sidebone is ossification of the lateral cartilages in the foot. Whether it is a disease or a normal occurrence is arguable. Ringbone can have a bad effect on joint articulations, but having extra bone round the pedal bone does not matter if it does not actually make the horse lame. Relate that problem to the usefulness of the horse and the working tasks he is doing. It is conventional for vets making a veterinary examination for a perspective owner to turn down horses with these conditions. It would be better to judge them entirely on whether there was interference with the soundness of the horse for the job it was doing.

Further up the limb, a badly managed heavy horse can fall down in front and break his knees. This is very much a matter of the way in which he is driven. If he goes down in front it is the fault of the driver; if he goes down behind it might be bad luck, but it ought not to happen.

Nowadays there is a growing incidence of OCD (osteo chondritis dessicans) – a degenerative disease in the hocks of large horses. This is often associated with tendon problems. Growing too rapidly can give rise to chronic lameness and uselessness if the owner is not careful. This can be controlled by management, especially by lowering the rate of nutrition. There should be, as is said with cattle, a ‘store’ period, where the horse is allowed to get a bit plain and not ‘do’ very well, until nature has sorted the matter out.

Occasionally we meet classic lamenesses – the luxating patella (the kneecap which comes off) – very often in a youngish horse. This is a question of growth and development, and given time and exercise in straight lines, it sorts itself out. There are still odd cases of disorders like string halt – a snatch of the leg, which is a nerve disorder. If it happens it is an unsoundness, but it might not interfere with the usefulness of the horse. There is nothing that can be done about it.


Modern heavy horses do not work in the way they used to. Most arthritic problems suffered by working horses have disappeared. Forty to fifty years ago, thousands of working horses in towns pulled loads of 1-2.5 tons across cobbles and between tram lines with considerable camber. Their feet were always turning. Today the incidence of osteo-arthritic conditions of the foot or hock are much lower. Neither do horses get spavin like they did. Changed circumstances have remove a complete range of problems.


Laminitis is nutrition-associated. Some people producing horses for show are prone to over-feed their animals, which has seen some horse’s feet collapse with chronic low-grade laminitis. Laminitis can also be caused by grazing a horse on grass which is too rich in nutrients, say after the first flush of growth in spring. In this disease there is a separation of the bony and soft laminae in the foot. The pedal bones comes away and is in great danger of poking through the sole of the foot. Another tragic but typical laminitis situation relates to foaling problems. A retained afterbirth can lead to toxic laminitis. This has the same effect, with the mare being unable to stand. This is a severe problem in a big animal.

Harness Fitting

The fit of a collar to a horse is very important, and will affect the ability of the horse to work. Where a collar fits badly, shoulder injuries will result, and the only treatment is to stop working the horse and let the injury mend. In addition, it is vital that the collar does not sit on the windpipe. Also, collar which fitted last year may not fit now – horses may get fat, or change shape on the shoulder due to increased work. In earlier days the police would stop horsemen if a horse looked uncomfortable and perhaps find a sore beneath the collar. Carefully fitted bits and bridles are also vital. If badly fitted, they can cause lip injuries and sore faces. Blinkers have to be arranged so that the horse can see things properly, and bridles must not pinch the head. Properly fitting harness is all a matter of good management. There is no necessity for injuries from harness.

Diseases and Immunisation

Working heavy horses must be immunised. It is important to immunise against tetanus, which in country life is everywhere. Vaccinating against influenza should be related to where the horse is travelling. Shows expect owners to have protected their horses from this disease, but equine influenza is not everywhere and there is no special need to keep them perfectly immunised. Nowadays, we can also vaccinate against the equine herpes virus.

Take veterinary advice on this: so much depends on the individual situation. The Shire Horse Society now insists on blood testing for equine viral arteritis for Shire stallions, but this, again, is very rare.


If you are considering breeding working horses it is worth remembering that not every mare is worth breeding from. It is pointless to take a poor mare on a long journey to a premium stallion, which will cost you a lot of money and time, if you are unlikely to get a decent foal. If you have a good mare, it might also be worth considering crossing her with a thoroughbred to produce a heavyweight hunter, for which there is currently a steady demand. If your mare has bad conformation or is not very good-tempered, it is best not to breed from her, but to use her for work.

A mare should be prepared for breeding by ensuring that she is in good condition but not too fat. Start breeding at age four. A mare which is not in the habit of breeding is unlikely to be a successful candidate. The owner of a mare and the stud to which she is taken should agree whether to swab before service. Consult your vet in individual cases. The birth of a foal is a management matter. It is preferable for a mare to foal in a large box or a field depending on whether it is night or day, and adequate help should be on hand. The chances of losing a foal go up in proportion to its size. If you find that the foal has a leg back, help is needed instantly. Repositioning everything can be very difficult. After the birth, the first essential is to get the foal onto its feet and to dress the naval. If there is any worry, use antibiotics. The main concern with the mare is to prevent post-partum metritis (inflammation of the uterus): this is more likely with a retained afterbirth or following a difficult birth. This is also the time when you may be faced with post-partum laminitis. Mastitis must also be avoided. To help prevent this, the udder should be handled before the birth. Also make sure that the foal suckles quickly; again this is a matter of management.

You may need help with the mare – if she is squealing and kicking and because of her sheer weight and size, it is advisable to call your vet. Nowadays adequate sedation is available, as well as substitute milk.

Foal Rearing

Foal rearing is best done in small numbers rather than large. Cross-infection is far less likely when there are fewer animals. Treatment for colic in foals has altered dramatically, and nowadays injections will usually solve the problem.

Older Horses

Getting cast, going down and being unable to get up is a particular difficulty with older, large heavy horses. Older horses also get more diseases. Bute is a splendid drug which enables many horses to live much longer by reducing excess inflammation. An old horse with ostea-arthritis can continue living for a number of years if bute is used under proper conditions. Unfortunately bute is currently being considered for withdrawal as some humans can be sensitive to it through the food chain. In the UK, where horses are not eaten, it seems unnecessary to ban it, however. Euthanasia is sometimes necessary, and is often the kindest approach if an old or ill horse simply going to get cold and miserable in a field. It is totally unfair to keep crippled horses who cannot breathe because of wind problems or cannot move because of limb problems.

This is a subject which must be faced up to. Conventional shooting is instantaneous.

Conformation and General Points

Modern heavy horses are being bred with the showing scene or public relations in mind. Tall rangy animals are required for big teams. This trend is developing an animal which is over-straight on the pasterns, and therefore too upright. A certain degree of angle to the pastern, the fetlock joint, is associated with better movement and therefore better health.


A horse with cataracts may become blind, but can sometimes carry on with some work. Arthur Young, the rural historian rode on one.


Sarcoids are tumours brought on as a result of a virus. A variety of treatments are now available, and this should be discussed with the vet.


Heavy horses seem to have remarkably sound hearts and heart attacks are very rare.


Please leave tails on, as nature intended. They are very useful as a fly switch. If they are in the way for work or show, braid them up.

Genetics and Temperament

Many diseases contracted by lighter horses are avoided by heavy horses. Often this is because particular characteristics have been bred out. Many characteristics are genetically conditioned. A tendency to laminitis and broken wind, for instance, can be inherited, and affected animals should not be used for breeding. It is vital to choose good healthy stock from which to breed. Temperament is inherited, and a good temperament is worth its weight in gold.

Don’t breed from the barmy – eat ’em!


Heavy horse feeding information.

Pasture / Field

Heavy horse pasture and field management.


Grooming & Rugs

Heavy horse grooming and rugs.


Shire Horse

Shire horse information and breed guide.


Clydesdale information and breed guide.


Suffolk information and breed guide.


Percheron information and breed guide.


Ardennes information and breed guide.


Native and working crosses information and breed guide.