🐴 Problems in a Recumbent Horse: Emergency Vet Protocols in 2025 🛌⚠️

By Dr Duncan Houston BVSc

It’s not unusual to see your horse lying down for short periods during rest or sleep—but when a horse remains recumbent (lying down) for too long, it becomes a medical emergency. In 2025, we now understand that prolonged recumbency can rapidly cause internal damage, including kidney failure, lung issues, and muscle death. Whether it’s from trauma, illness, or being trapped, knowing how to respond can mean the difference between life and death. 🚨🐎

🛌 Normal vs Dangerous Recumbency

Horses do lie down as part of their natural sleep cycle. Studies show that:

• 🛏️ The average horse lies down for about 23 minutes during deep sleep
• ⏱️ Maximum normal lying time is typically under one hour

When lying down stretches into multiple hours, dangerous consequences start to unfold internally—even if the horse appears calm. ⏳💥

⚠️ What Happens in a Recumbent Horse?

If a horse is down for more than two hours, the following physiological risks develop:

• 🩸 Circulation is reduced to muscles and organs
• 🫁 Lung compression limits air intake and can cause lung collapse or congestion
• 🧬 Reperfusion injury occurs when circulation returns—damaging tissues further
• 💥 Muscle death leads to toxin release (myoglobin) that harms the kidneys
• 🔋 Potassium levels rise, risking dangerous heart arrhythmias

These internal effects escalate the longer the horse remains recumbent. 🚑

🧠 What Is Reperfusion Injury?

Reperfusion injury is tissue damage that occurs when blood flow returns after a period of oxygen deprivation. The sudden flood of oxygen and inflammatory cells can:

• 💥 Kill already-compromised muscle cells
• 🫁 Damage delicate lung tissues
• 🧪 Release dangerous toxins like potassium and myoglobin

This creates a cascade of secondary issues—including kidney damage and heart irregularities. 🧬⚠️

🔬 Lung Risks of Prolonged Recumbency

When a horse is down for hours:

• 🫁 Air sacs compress and collapse, reducing oxygen exchange
• 🌫️ Lung fluid can accumulate, leading to congestion or infection

Both the heart and lungs are compromised due to physical pressure and lack of movement. 💔🫁

💉 Kidney & Heart Complications

As muscles begin to die under the horse’s own weight, cells rupture and release myoglobin. This protein:

• ⚠️ Is toxic to the kidneys
• ⛔ Can clog renal tubules, leading to acute kidney failure

Meanwhile, high potassium from muscle breakdown alters heart rhythms—potentially triggering fatal arrhythmias. 🫀💣

📛 Causes of Extended Recumbency

Horses can become recumbent for several reasons, including:

• 🏚️ Trapped or pinned (e.g., barn collapse, fencing)
• 🧠 Neurological disease (e.g., EPM, Wobbler syndrome)
• 🦴 Orthopedic trauma (e.g., fractures, severe arthritis)
• 🦠 Severe colic or systemic infection

No matter the cause, if a horse has been down for more than 4 hours, immediate intervention is necessary. ⏱️🛑

🚨 What to Do If Your Horse Is Down

Don’t wait and watch. Act fast:

1. 📞 Call your veterinarian immediately
2. 🚪 Ensure the horse is not trapped or stuck under fencing or objects
3. 🧼 Keep the area quiet, shaded, and soft
4. 🩺 Monitor for signs of respiratory distress, colic, or abnormal posture
5. 📸 If safe, take a photo/video for your vet to assess positioning

Never attempt to force a horse up on your own—this could cause injury to both of you. Use professional lifting equipment if available. 🐎🔧

🏥 Treatment & Recovery

Referral centers often use slings and hoists to lift recumbent horses safely. Once standing, treatments may include:

• 💧 IV fluids to support kidneys and circulation
• 🧪 Blood tests to monitor toxins, kidney function, electrolytes
• 🩻 Imaging to rule out spinal or limb fractures
• 🔁 Gradual, supervised walking or movement therapy

Survival depends heavily on the duration of recumbency and the underlying cause. The golden window is ideally less than 4 hours. ⏰

📲 Ask A Vet for Emergency Help

If your horse is down and won’t rise, visit AskAVet.com or use the Ask A Vet App for immediate triage advice and expert guidance. 📱🚨

Dr Duncan Houston and the team can assess your horse’s symptoms and help determine the urgency, while working alongside your vet or directing you to an emergency facility. 🧠🐎

🏁 Final Thoughts

In 2025, equine vets know that prolonged recumbency is one of the most critical emergencies in horse care. While it may begin with a quiet horse resting in a stall or pasture, if that horse doesn’t rise within normal limits—act fast. 🚑

With rapid response, veterinary intervention, and proper equipment, many horses can recover. Don’t wait to see what happens—because time is tissue. ⏳💔

For emergency support, visit AskAVet.com and get fast, expert advice when every second counts 🐴🩺