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Geriatric Horse Care

Horses aged 15 and over may be classed as ‘aged’ however we all know that doesn’t necessarily mean they slow down at this age! The following information is an overview of conditions to be aware of and clinical signs to recognise in older horses, ponies and donkeys.

Dental care

Like people, horses’ teeth deteriorate with age. It is therefore very important to maintain regular dental exams for your horse. Concerns for older horses include:


These are gaps that form between teeth where food material can become compacted, causing irritation to the gingiva (gums) and bacterial overgrowth. The inflammatory response that occurs from this is detrimental to the integrity of the structures that secure teeth in place and can lead to further issues such as periodontal disease, apical bone infections and secondary cheek ulcers.

Diastemata can occur at any age but senile cases are usually a result of natural narrowing of the teeth and decrease in rostro-caudal angulation, often due to shallower tooth root depth

Ccommon signs to look out for are quidding and weight loss.


This stands for Equine Odontoclastic Tooth Resorption and Hypercementosis and is a condition where the tooth roots of incisors start to be resorbed. It can become very painful and you may see signs of your horse being reluctant to pull at hay or grass and lose condition. Your horse may be reluctant to be bitted and their teeth may change in appearance, looking longer or at a different angle. The gingiva may look raised or 'dotted' around the gumline. This is something we always check for on routine dental exams and can start a treatment plan to keep your horse comfortable.

Infundibular Caries

Essentially this is decay in the infundibular structures in the cheek teeth. If the cementum wears away food matter can pack into the small gaps and lead to tooth infections or in severe cases, the tooth can fracture. These are picked up on in routine dental exams and can be treated if found in the early stages

Losing teeth

There are various causes to tooth loss.

Loss of cheek teeth can cause occlusal overgrowths, reducing effective chewing. Teeth can fracture or lead to apical infections if loose. This, therefore, reiterates the importance of regular dental exams.


One of the key requirements of a horse’s diet will always be a high fibre content, regardless of age. This is vital for digestive health and motility of the gastrointestinal tract.

Furthermore, diet may need to be adjusted due to teeth, endocrine disorders and reduced body condition. Many aged horses have a reduced body condition and need a higher calorie intake, both to gain condition and to generate body heat secondary to digestion. On the other hand, some horses may remain good doers, particularly if they are retired from work/exercise. For these a low-calorie veteran diet would be more appropriate.

For all older horses it is important to provide a good vitamin and mineral intake, is many cases easily achieved with a veteran balancer or mineral mix in their feed.

A higher proportion of the aged population are diagnosed with PPID or similar, and require a very low starch low sugar diet to reduce laminitis risks. For these it is important to feed an appropriate calorie and nutrient intake still, hence why we recommend soaked hay and a well-rounded laminitic friendly balancer or mineral supplement in their diet.

With age comes disease and again some horses may be diagnosed with conditions where organs function at less than optimum, and diet needs to be adjusted for this, for example liver disease would require a lower protein diet. It is always recommended to discuss these diet changes with your vet and a qualified nutritionist (most feed manufacturers have experienced professionals who are happy to discuss what would be ideal in each case).

Dental conditions also require dietary changes. EOTRH would require a larger holed haynet or loose hay/long grass grazing where they do not need to pull or grip food with much effort. Most cases require further supplementing with a soft food source such as grass nuts or fast fibre (again still including a balancer). Soaking hard feeds, or making them soup-like in consistency helps when dentition is a problem. Diastemata can be exacerbated by short chopped fibres such as those found in chaff, so we recommend substituting chaff for forage replacers or mashes.


This is described as the degeneration of the joints, particularly of the cartilage and is both an inflammatory and painful condition.

This occurs more commonly with age, due to wear and tear of the joints.  The changes that occur can be managed with a range of medications including joint injections with stem cells or steroids and/or feed supplementation.

Being aware of your horse's level of stiffness is key to managing their comfort levels.  It is important to keep your horse moving as this can slow down the degeneration of the joints, so turn out and light exercise are beneficial.

If your horse is still in regular work, being aware of their limitations or need for longer warm up and cool down sessions will also benefit their musculoskeletal system.


Many older horses do well on supplementation for joints, especially if started earlier in life (e.g. mid-teens) As a veterinary clinic we provide many of our own supplements with high concentrations of the necessary nutrients and minerals. The main ingredients we suggest a supplement include for joint health are: Glucosamine, Chondroitin Sulphate, MSMs, Hyaluronic acid (99%), Omega 3 and Boswellia.

BozMerix is also a very effective supplement in reducing and managing joint inflammation, and even in some cases Danilon/Equipalazone can be given in low doses for anti-inflammatory purposes too.

Other supplements to aid hoof health and issues such as liver function and gut health are also available, each older horse/pony is an individual and if there are any concerns any of our vets would be happy to have a chat about what supplements would be most beneficial on a case by case basis.

Endocrine Disorders

PPID- (AKA Cushings)

Pituitary Pars Intermedia Dysfunction is commonly seen in horses and ponies aged 15 years onwards but has been diagnosed in horses as young as 5. A condition where the hypothalamus and pituitary gland do not produce enough dopamine, which controls hormone release, therefore an excessive amount of hormones are released, including ACTH (adrenocorticotropin hormone). There is a long list of clinical signs, most commonly; a long coat that doesn’t shed well, abnormal fat dispositions, loss of muscle mass, increased drinking and/or urination, increased laminitis etc. The website is very informative.

We can test for this with blood tests and then treat it medically.


Equine Metabolic Syndrome can again affect horses and ponies of any age, mainly aged 5-15 years old for onset, and can occur concurrently with PPID as well as exacerbating the risk of laminitis.

An increased store of adipose tissue, insulin resistance and hyperinsulinemia are all factors that increase body condition, therefore increasing the risk of developing EMS. So, weight and dietary management are key for preventing this.

Again, this can be tested for via blood tests and treated medically.


The Immune System ages with the horse. It is a common misconception that once horses stop travelling/competing or coming into contact with new horses, that they won’t require vaccinations.

Age related conditions such as PPID can also weaken their immune system further.

Tetanus can affect any animal and it is important to continue boosters for life. This horrible disease can be contracted from simple cuts in the field at any age.

Influenza can still reach those horses not in direct contact with others, as it can spread via aerosol droplets in the air, and on fomites such as your boots, walkers passing by, buckets, vehicles etc.

Therefore, we will always still recommend keeping up to date with vaccinations, even if your horse is alone in a field away from others.

This is only a brief overview of conditions and things to be aware of, if you wish to discuss anything in more detail or have any concerns about your aging horse, do not hesitate to contact one of the vets for a chat

Dr Rebekah Wright, BVetMed MRCVS.