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Rehabilitating a Neglected Horse: A Caregiver’s Guide

It’s an important issue. You can help.

There is an abundance of neglected horses in the United States today. This situation was exacerbated by the past economic downturn that caused many horse owners to give up horses they could no longer afford to keep. Some other common reasons for the abandonment or neglect of horses include illness (of the owner or horse), injury to the horse, old age and improperly trained horses posing a threat to others or becoming a burden. Neglected horses can be any age and of any training level or background. If you have made the decision to rehabilitate a neglected horse, we have compiled some important steps and considerationsto help you.

Get an overview of the horse’s condition.

Your first step should be to have a veterinarian conduct a complete physical exam of your horse to check for immediate concerns and overall health. This will reveal if there is a serious disease that requires more advanced care and treatment.

Know your horse’s Body Condition Score

Body condition score (BCS) is an important indicator of the rehabilitation steps your horse may need. Determine the BCS of your horse using the Henneke System to understand the severity of its weight loss.

Weighing your horse without a scale.

Using an equine weight tape, measure in inches your horse’s heart girth. Measure across the highest part of the withers and keep the tape as close behind the elbows as possible. Next,
using two people, measure in inches your horse’s body length from the point of the shoulder, straight back along the horse’s side, to the point of the buttock or crease. Depending on your horse’s age, use one of the following equations to estimate weight.

  • Adult horse: (Heart Girth x Heart Girth x Body Length)÷ 330 = Bodyweight in pounds
  • Yearling: (Heart Girth x Heart Girth x Body Length)÷ 301 = Bodyweight in pounds
  • Weanling: (Heart Girth x Heart Girth x Body Length)÷ 280 = Bodyweight in pounds

The right diet can make a big difference.

Malnourished horses

Horses with a BCS of 3 or higher can normally be brought to the target BCS of 5 in aboutsix to eight weeks. These horses should be fed a balanced diet at 1.5% of their bodyweight in four or five feedings per day. A balanced diet would constitute 50% good quality hay and 50% concentrate feed. The amount of feed can be gradually increased to 2.5–2.8% of  bodyweight with hay offered free choice and grain being fed two or three times a day (with a maximum 0.5% bodyweight per feeding).

Complete feeds, such as SafeChoice Senior, are well-suited to feed neglected horses due to their controlled starch, high digestibility and easy-to-chew attributes. Additionally, neglected horses are often salt-starved. Therefore, salt should be introduced gradually at one to two ounces per day and increased until it can be given free choice. At all times, fresh, clean water should be available.

Starved horses

Horses with a BCS of 1 or 2 have often experienced actualstarvation. These situations typically happen over 60 to 90 days without feed or more often three to four months with very poor water and forage. Horses in these situations are often hypoglycemic and hyperkalemic due to muscle mass and fat loss. If the horse is able to get up and has lost less than 45–50 % of its bodyweight, it can normally be rehabilitated. If it has lost 45– 50% of its bodyweight and is not able to get up, be aware that the chances of successful rehabilitation may be reduced significantly.

Alfalfa hay option

Quality alfalfa hay is a good base for a high protein, low starch diet. Frequent, small amounts of quality alfalfa hay should be fed, with the amount of alfalfa slowly increasing for each meal. The number of feedings should decrease gradually over 10 days, and after 10 to 14 days, the horse can be given free-choice feeding. If the horse’s dental condition is poor, alfalfa cubes or pellets may be used and soaked prior to feeding.

Senior Horse Feed Option

Senior horse feeds with a controlled starch design, added amino acids, prebiotics, probiotics, balanced trace minerals and vitamins are the best option to give a neglected horse the nutrients it needs. The feed should be introduced at a rate of 0.5% bodyweight in several small feedings per day. Over a 10- to 14-day period, the amount of feed should slowly increase per meal while the number of feedings gradually decreases. By the end of this period, the horse should be at a normal feeding rate according to feeding directions. The feed can also be soaked in warm water for up to 15 minutes to form a mash for horses with poor teeth.

Additional necessary care to aid recovery.


Working with your veterinarian, once your horse has enough weight and body condition to be dewormed, a larvicidal treatment controlling strongyles, roundworms and pinworms may be used. After four weeks, ivermectin or moxidectin may be administered. Your veterinarian should also create a parasite control program (often this will utilize tools such as fecal egg counts to optimize dewormers). If your veterinarian suspects heavy parasite infestation, particularly with roundworms in young horses, a reduced dose may be considered for the first deworming. This can reduce the risk of intestinal blockage.


Frequently, the medical history of neglected horses is unknown, and previous deworming information and vaccination records are unavailable. Working with your veterinarian, your horse can be vaccinated for endemic diseases in your geographic area. There are five core vaccines (from the American Association of Equine Practitioners) that will most likely be administered: Tetanus, West Nile Virus, Eastern and Western Equine Encephalomyelitis and Rabies. The vaccines should be spread over several days to avoid overwhelming the horse’s system, especially in neglected horses, as most often have a heavy parasite burden and compromised immune system. It is also normal for neglected horses to receive primary doses (two doses spread several weeks apart) of the vaccines as an added precaution.

Hoof Care

Normally, hoof care involves farrier visits every four to eight weeks, but for a neglected horse unique issues can require special measures with shorter schedules. It is imperative that
you work closely with a credible farrier, especially to address the special needs of neglected horses with little previous care. Radiographs of all hooves may be needed to detect any
internal damage and to create a plan to address angles and trims. Note that neglected horses must have enough weight to stand for farrier care (readiness can be determined by your
farrier). Neglected horses will need a long-term program for hoof care. Since the hoof capsule regenerates, a healthy hoof can be grown in less than a year if proper nutrition and veterinary care are provided.

Additional information and resources.

With the abundance of neglected horses today, it has become important for those wishing to aid these horses to have a good understanding of the special needs and steps to rehabilitate these magnificent animals. With the proper nutrition, veterinary attention and caretaking, you can give a neglected horse a second chance at a healthy, productive life.

AAEP Website