By Laura Waitt, DVM, DACVIM
In my work with Skagit Animals in Need (SAIN) and as a large animal veterinarian, this is a tale I hear all too often. “Well, we got this horse at the auction, from a neighbor, from the kill pen, from a friend.....” Standing before me is a bag of bones that good-hearted people want to care for. There are three main reasons for a horse to be thin:
1) inadequate nutrition
2) bad teeth
3) parasites
Obviously there are other diseases that can result in a horse being thin, but these three are the most common.

Body Condition Scores
1/9: Emaciated and essentially skin and bones, these animals often die despite treatment
2/9: Emaciated: all ribs, spine and pelvis visible with obviously concave gluteal muscles.
3/9: Extremely thin: ribs, spine visible, flat gluteal muscle
4/9: Thin: ribs can be seen but reasonable muscling
5/9: Light ideal, can't see ribs, the fast look- endurance horses, race horses look good here
6/9: Heavier ideal, the rounder look-quarter horses, drafts and dressage horses look good here
7/9: Ribs cannot be palpated, neck is cresty
8/9: Obese, obviously fat with a cresty neck, tail head and shoulder fat deposits
9/9: Morbidly obese and in danger of foundering. I usually cannot hear their hearts with a stethoscope.

First thing when you get one of these animals is to KEEP IT ISOLATED from your healthy stock. It is debilitated and even though it might not show signs of disease, it could pass on respiratory disease, parasites, or strangles to your horse. I keep them completely separated for 3-6 weeks. At least 3 weeks past any last signs of disease. If you cannot protect your animals with reasonable isolation perhaps you should reconsider obtaining this rescue animal.

Veterinary Care
Next step is to call your veterinarian. They will help you determine the body condition score (BCS- see chart above) and weight of the animal and come up with a safe de-worming and nutrition plan for you to follow. If your horse is strong enough for a dental procedure they may pursue this. Often the horses that enter SAIN are too thin to be safely sedated and we prefer to get them up to a 3/9 BCS prior to the dental. Usually I wait until the horse is in ideal or nearly ideal condition to vaccinate them against diseases.

A few tips for re-feeding a starved horse: With horses that are truly starved, re-feeding must be very slow or these animals can go into organ failure when exposed to too many nutrients. For example: SAIN took in a 1/9 BCS mare whom I fed 1 pound of soaked alfalfa pellets every 4-6 hours for 3 days until I could gradually increase the amount and decrease the frequency of feeding over a 2 week period until she was getting 12 pounds of alfalfa pellets twice daily.
Alfalfa has been shown to be the safest feed to give to a starved animal. I stay away from large amounts of grain. Three pounds of sweet feed would have killed the aforementioned horse on day one. Truly starved horses should be monitored by your veterinarian through this process. Most thin rescue horses can benefit from free choice local hay and Equine Senior feed. I go with free choice hay for a week- remember these horses aren't used to feed. Then I add 1 pound senior daily for a week, then 2# daily for a week, then 3# daily etc,etc,etc. The rule of thumb about weight gain is you may change 1 body condition score per month. So if you had a 3/9 it will take you 3 months to get to a nice ideal BCS of 6/9.

Tips for deworming a starved horse:
*Do not use Quest or Quest Plus until the horses are in ideal condition.
*I find that dosing appropriately for weight with Fenbendazole (Panacur or Safeguard) followed in 2 weeks by an ivermectin/praziquantel combination (Equimax or Zimectrin Gold) is a reasonable place to start.
*Then obtain a fecal egg count from your veterinarian 2 week after that. If still shedding we may suggest a Panacur Powerpak or Safeguard Superdose to kill larval stages.
*Often these horses have lice and using a topical dusting product twice 10 days apart can get rid of them.

When in doubt, please call your veterinarian for advice. The last thing we want is to be rescuing horses from the people attempting to save the horses in the first place.
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