Our equine internal medicine service is led  by RCVS and ECEIM recognised internal medicine specialists.  They provide a highly specialised 24 hour internal medicine service for the investigation and treatment of a diverse range of internal medical problems  (eg. neurological diseases, respiratory diseases, liver and kidney diseases, diarrhoea, recurrent  colic, weight loss).  Horses may be referred from our first opinion practice or other practices as outpatients for investigation only or admitted to the hospital for more involved investigations, round-the-clock observation, treatment or critical care. Animals with contagious, or suspected contagious diseases, can be admitted into the isolation facitilites and animals requiring critical nursing care admitted into the intensive care unit. The large on-site Laboratory means that rapid analysis and interpretation of blood and other samples is possible. In addition, we have state-of-the-art ultrasonography, endoscopy and other imaging equipment that plays an important role in the investigation of medicine cases.

Some of the investigations available for common disorders are listed below:

Respiratory Diseases

Excellent diagnostic imaging equipment including radiography, ultrasonography and videoendsoscopy allows imaging, visualisation and sampling of the respiratory tract including the paranasal sinuses and guttural pouches. Samples can be rapidly analysed in the on-site Laboratory. Overground endoscopy is also available for the diagnosis of upper respiratory tract disorders in exercising horses.  In house referral of horses to the surgeons for videoendoscopic  direct laser surgery on the upper respiratory tract under videoendoscopic guidance or thorascopy  can be easily arranged.

Cardiac Diseases

Heart abnormalities are relatively common in the horse and can range from being insignificant to life-threatening. Heart disease may result in heart murmurs, dysrhythmias or exercise intolerance. Suspected heart problems  can be evaluated with a combination of auscultation, echocardiography and colour-flow Doppler ultrasound examination.  Electrocardiographs (ECGs) can be obtained at rest over a 24 hour period and during exercise using a portable recorder.

Eye injuries and diseases

Eye injuries and diseases in the horse are common and if inappropriately treated can result in permanent damage to eye resulting in loss of vision or even loss of the eye. Many eye conditions require very intensive treatment, often hourly administration of drops to the eye day and night which means that they are difficult to treat at home but can be successfully treated in our hospital environment which is staffed by vets and nurses throughout the day and night.

Weight loss investigation

There are many causes of weight loss in the horse. Investigation into causes of weight loss includes physical and dental examination,   blood sampling, dynamic absorption testing, faecal analysis,  ultrasonography of the abdomen.  Laparoscopic examination of the abdomen can be used to allow visualisation of the abdominal cavity and when appropriate full surgical exploration of the abdomen may be required.

Investigation of liver disorders

Liver disease often present insidiously with non-specific signs but can be very debilitating. Initial diagnosis of liver problems is usually based on the results of blood sampling  and liver function tests.  However, more specific diagnosis of the type of liver pathology requires ultrasonographic examination of the liver and liver biopsy.  Andy Durham, who leads out internal medicine department, has a particular interest in liver disease and has published and lectured extensively on this subject.

Neurological disorders

Neurological diseases in the horse can be very subtle. Careful and thorough neurological examinations are  required to determine the site of the disorder.  Scintigraphy and radiography can be useful to image the spinal column to identify areas of possible bone damage.  Cerebrospinal fluid collection can be useful in the investigation of these cases but require immediate analysis as it does not store well which fortunately can be done in our on-site laboratory. Horses with severe neurological disease, that are very ataxic or unable to stand, can be safely stabled in our padded box with overhead electronic hoist for lifting or slinging if necessary.


Skin problems in horses are common and can be difficult to diagnose. Our hospital offers routine appointments and accepts referrals for all types of dermatological conditions, including allergies/immune mediated conditions; bacterial, fungal, parasitic, protozoal or viral diseases; chemical and toxic dermatoses or endocrine disorders.

Foal Medicine

Sick, premature or dysmature foals require intensive nursing and veterianry care and can deteriorate and die rapidly without such care. Our intensive care unit is equipped to provide specialist care and 24-hour monitoring of critically ill foals by our experienced clinicians and excellent nursing team.