🐴 Why Your “Down Horse” Matters: A Vet’s Guide to Recovery in 2025 | Dr Duncan Houston BVSc

Meta description: 🩺 A vet’s 2025 guide by Dr Duncan Houston on handling, treating & preventing a “down horse.” Learn immediate steps, recovery, complications & Ask A Vet support.

As a vet with years of equine emergency experience, I’m often called to assess a “down horse.” That’s a horse lying down and unable or unwilling to get up. While horses do lie down, they’re built to be on their feet—so when one stays down, it’s a red‑flag 🚨.

1. 🧐 What is a “Down Horse”?

A “down horse” is a horse that’s recumbent and can’t or won’t rise. They’re naturally prey animals, made to sleep standing—but sometimes, illness, injury, or other issues knock them down for longer than nature intended.

While lying down briefly is normal, extended recumbency can trigger dangerous complications like colic, pressure sores, pneumonia, kidney damage, dehydration and worse. If you find your horse not getting up for over 30 minutes, it’s time for vet intervention.

2. 🔍 Causes of Recumbency

A down horse can result from diverse issues:

• Neurologic disease: botulism, EPM (Equine Protozoal Myeloencephalitis), encephalitis, herpesvirus, West Nile Virus
• Muscle disorders: tying‑up, myopathies
• Organ dysfunction: severe colic, liver or kidney failure
• Trauma: fractures, lacerations, casting in stall
• Electrolyte imbalance/dehydration
• Arthritis, laminitis: especially in older horses
• Entrapment: stuck in mud, behind trees or fencing
• Environmental stress: hypothermia, extreme heat, parasitism, neoplasia

3. 🕒 How Long is Too Long?

Horses generally lie down for 30 minutes to 3 hours daily. Going beyond this risks serious complications:

• Colic due to gut inactivity
• Lameness or paresis from pressure nerve damage
• Pneumonia from lying flat
• Pressure sores and urine retention
• {...} more

If your horse remains down longer than usual, interest in food or movement, call a vet ASAP. Even safe encouragement may save a life.

4. 👣 Vet-Safe First Response

When your horse is down:

1. Evaluate surroundings: is the horse behind bars, stuck outdoors by a hazard?
2. Approach from the head or rear—never the legs!
3. Stay alert; keep feet under you & be ready to move fast.
4. Have help and a phone ready.
5. Speak calmly; sudden noises can spook them.
6. Give space—ensure there's room to maneuver.

5. 🧠 Detailed Assessment

Two key questions I’ll ask:

• How long has the horse been down?
• Is there evidence of colic, trauma, or fever?

You can check temp (98–101.5 °F normal) if safe, and offer hay or grain. Interest in food suggests they’re unwell but not severely injured.

6. 🚚 Vet Treatment: Step‑by‑Step

✔ Temperature & Feed Test

If fever or food refusal is observed, it suggests underlying illness—call the vet immediately.

✔ Rolling a “Cast” Horse

Some horses get “cast” (trapped lying down). In safe conditions, gently slide them away from walls, then roll. Use assistants and possibly straps/slings. If they’re older or arthritic, they may lie down from pain and need careful help.

✔ Emergency Measures

Your vet (like me) may use slings or vertical lifts to support recovery. We focus first on diagnosing—via bloodwork, imaging—and treating:

• IV fluids to support circulation
• Anti-inflammatories/pain meds
• Rolling on brain swelling or colic, when needed
• Wound care or fracture management

✔ Watching for Secondary Risks

• Pneumonia—lying flat suppresses respiration
• Kidney injury from poor perfusion
• Skin sores from pressure—use padding and bedding
• Muscle weakness from prolonged immobility

✔ Knowing When Euthanasia is Kind

In severe cases, such as untreatable fractures, colic that fails therapy, permanent neurologic damage, or chronic arthritis, humane euthanasia may be the most compassionate choice. These are made on a case-by-case basis, always with owner and vet input.

7. 🛏️ Support During Recovery

While waiting for full recovery, you can help by:

• Offering reachable fresh water and hay
• Keeping them warm with blankets if cold, or cool if overheated
• Ensuring a clean, padded space with no hazards
• Using fans or shade in heat

8. 💪 Long-Term Recovery & Complication Watch

Recovery length depends on:

1. The initial cause (illness vs mechanical)
2. Duration spent down
3. Lasting secondary injuries

Complications like colic, pressure sores, pneumonia or lameness may arise. Most healthy horses with short recumbency recover in days; more complex cases need weeks/months with tailored rehab.

9. 🛡️ Prevention is Key

Keep your horse healthy to reduce risk:

• 🏥 Regular vet check-ups (bi‑annual)
• 🦷 Annual dental exam
• 💉 Timely vaccinations
• 🔧 Routine farrier care and hoof trimming
• 🪱 Fecal egg counts & deworming
• 🩺 Prompt attention to concerns like lameness or colic

Safe stabling and good turnout also reduce risk of entrapment or environmental stress.

10. 🩺 How Ask A Vet Supports You

• 24/7 access to experienced vets like me for emergencies 🩺
• Photo/video triage for recumbency at any time, from anywhere
• In-app rehab guidance, reminders for treatments and check-ins
• Community access to live webinars on equine emergency care

With Ask A Vet, you’re never on your own—especially during scary moments like a “down horse.”

11. 📝 SEO-Friendly FAQs

How long can a horse stay down?

Ideally under 30 minutes; more than 1 hour raises serious concern.

What to do if my horse can’t get up?

Keep them calm, safe, offer hay/water, then call a vet right away.

How do vets lift a down horse?

Using slings, vertical lift harnesses, or special equipment with multiple handlers.

Can a horse be down from colic?

Yes — severe colic often causes a horse to lie down and refuse food; call your vet immediately.

12. ✅ Final Takeaway

“Down horse” is an equine emergency demanding swift intervention. As a vet, my goals are:

• Safely assess the situation
• Diagnose underlying cause
• Implement life-saving supportive care
• Guide long-term rehabilitation
• Prevent future occurrences

Ask A Vet puts professional support in your pocket. You can share videos, get immediate advice, and receive rehab plans—all guided by me, Dr Duncan Houston. 💙

🐾 Want more help?

If your horse is down or if you're preparing your horse health plan, chat with me anytime in Ask A Vet. We’re here 24/7 to walk you through emergencies, rehab tips, and prevention strategies—so your equine friend can thrive.