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The Whole Horse Exam Approach

Annual "vaccine only appointments" are a thing of the past. It is no longer accepted for a vet to walk up to a horse, declare it healthy, vaccinate it, and leave without any additional evaluation of overall wellness. You wouldn't accept this for your annual check up with your medical doctor. Why accept it for your horse?


by Dr. Keaton Massie


I'm explaining how balanced heels will benefit this horse's overall performance and improve her movement during a whole horse evaluation

The whole horse exam is an equine treatment paradigm that involves carrying out a comprehensive physical exam on a horse (from head to hoof) to evaluate all aspects of its health. The concept of the whole horse annual exam is a treatment philosophy that has become a cornerstone of my practice because I have frequently observed that a horse is only as good as the sum of its parts. Oftentimes horses show clinical signs which are not always associated with where the problem is. One example being limb lameness originating from spinal injury or trauma. Every time I examine a horse for any issue, I conduct a whole horse evaluation and I share those findings with the owner.


Horse owners need to understand that every individual horse is made up of interdependent parts, and issues in one area can have far-reaching and long lingering effects on other parts of the body.

The whole horse approach seeks to restore the horse's overall well-being by taking a holistic viewpoint of every bodily system and considering all factors that may be affecting its health, including the environment.


Evaluating joint health on a performance horse stallion during an annual whole horse exam provides a baseline for joint exams down the road

What do I Check for in a Whole Horse Evaluation?

My whole horse exam starts before the horse even gets into the clinic or is brought truck-side on a farm call. By observing how the horse moves just unloading from the trailer and walking across the parking lot, much information can be observed like postural compensations and gait fluidity. Following this is a thorough evaluation of the horse's medical history and any prior health problems, dietary requirements and management techniques. This discussion will involve evaluating the horse's environment, and level of work -- looking for any potential hazards or sources of stress.


Of course the physical exam involves routine things such as vitals, but more importantly where it goes from here is where it sets it apart. Every single part of the horse’s body, from the face to the soles, is observed to gather valuable information. The horse's overall musculoskeletal, soft tissue and fascial health are also evaluated, including joint range of motion.


This thoroughness is key regardless of the visit reason. I often say if a horse shows up for a dental we check its feet and if a horse shows up for lameness we check its teeth. This type of thoroughness also educates our clients on how to evaluate their own animal, system by system.


Why a Whole Horse Examination?


Finding musculoskeletal asymmetries during a whole horse evaluation helps me help the owner develop a conditioning plan for the year. Asymmetries seen here along the spine are found during a whole horse evaluation.

The old saying an ounce of prevention is worth a pound of treatment, this can especially be true in horses where early identification of potential problems can reduce the financial and injury burden later on. In order to truly know a patient, you need a baseline of all body systems; behavior, biomechanics, and nutrition, for total wellness. And this is why the whole horse exam is so important. First, a whole horse examination allows me to catch potential health issues early before they become severe and more difficult to treat. With horses, everything might not be what it seems. They are very stoic animals. Additionally, many times there is more than one source of a problem in a horse, especially with lameness. Many times veterinarians look for a source of lameness and stop there if they potentially find something. The whole horse approach helps me identify lingering issues which contribute to the main problem.


The whole horse exam is also important as it allows me to identify potential management issues that may be impacting the horse's health. Sometimes, a horse might adversely react to certain conditions in its environment or the way it is being groomed. Observing the horse holistically can help to notice and correct this.


Checking teeth during a whole horse annual exam can address eating difficulties, weight issues, and comfort in the bridle.

How to carry out a whole horse eXAM


There’s no hard and fast rule to this program. The important part of the exam is the thoroughness. And a reminder that regardless of why the exam was scheduled the exam is always complete.


Depending on the individual needs of the horse, the exam should be tailored to focus more heavily on specific areas of concern. For example, a horse with a history of lameness may require a more in-depth evaluation of their musculoskeletal system, while a horse with a history of colic may need more focused attention on their digestive system. That being said, here are simple steps to take when performing a whole horse exam:


  • Start by simply observing the horse as it exits the trailer and walks across the parking lot. How are the owners handling/interacting with the horse? Evaluate the horse's gait and movement, looking for any signs of lameness or stiffness.

  • Followed by reviewing the horse's medical history, including any previous health issues, medications, and vaccinations.

  • Observe the horse at rest, looking for any signs of discomfort or pain. Watch its demeanor and look out for behavioral issues.

  • Check the horse's vital signs, including heart rate, respiration rate, and temperature.

  • Run your hands over the whole horse's body starting at the poll. Go all the way down to the tail base on one side and back up the other. Look for any indications of weight loss or gain as well as muscle imbalances as you assess the horse's body condition. Feel for any heat or reactions by the horse over certain areas


Myofascial changes can be addressed during a whole horse annual exam. Here I am feeling and adjusting for cranial balance.
  • Continue by next running your hands down each limb, assessing for any swelling, heat, or fluid. Assess the horse's range of motion by flexing and extending each joint and note any signs of discomfort.

  • Pick up and thoroughly evaluate each hoof independently. Discuss trim and shoeing schedule.

  • Final portion of the physical exam is a thorough dental check. Personally, I put my hand in the horse's mouth and feel each individual tooth from the back to the front on all four rows of teeth.

  • Evaluate the horse's nutritional needs and feeding regimen, including the type and amount of feed, supplements, and hay.

  • Evaluate the horse's care, including exercise, turnout, and stall conditions.

  • Assess the horse's environment, looking for any potential hazards or sources of stress.

  • Based on the exam findings, develop a comprehensive treatment plan that addresses any health issues or areas for improvement.

  • Follow up with regular check-ups and re-evaluations to monitor the horse's health and well-being over time.


A whole horse evaluation is a vital component of equine health care that I recommend to every horse owner. It helps to evaluate every aspect of the horse’s well-being and develop solid plans for helping them lead better, healthier lives. By catching potential health issues early on, the whole horse exam can help ensure that horses receive the best possible care and lead healthier lives. Does your horse need a whole horse exam? Contact me and let's get you scheduled.




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