What you see. The starting point for addressing any equine health related issue is your observation.


Blood on Vet's Sleeve Following Rectal Exam


Rectal examination of horses is a routine part of the practicing vet's day. When performed properly and with adequate restraint of the patient, it is a low risk procedure. That said, there is risk that is greater in certain classes of horses and in horses with certain conditions. Because rectal exam is so routinely performed, it is not practical for vets to always discuss the risk.

It is said in veterinary practice that if we perform enough rectal examinations, eventually we will have a rectal tear. I have not had a serious tear personally, but numerous times have had blood on my sleeve.

When this happens, it is accepted practice for the veterinarian to tell the horse owner that there is blood on the sleeve and that the best thing is to investigate the severity of the problem causing this. The risk of not doing this is the potential for a tear that needs treatment not getting it.

There are several ways for a vet to investigate the rectal wall to determine the severity and it will be up to them how to do that. The tears are actually graded by severity. The rectal wall is composed of 3 main layers. The severity of a rectal tear depends upon which of these layers is involved in the tear.

The least tears only involve the lining layer, called the mucosa. The higher grade tears involve the muscular and finally the outer serosal layer. If the tear is clear through all the layers, the abdomen becomes contaminated, resulting in fatal peritonitis if aggressive surgical treatment is not instituted right away. The more severe tears are a life-threatening emergency which usually requires referral to a surgical center.

It will be up to your vet to tell you the best course of action. The simple tears as I describe above required no special care.

The key to a good outcome in this situation is forthright communication with your vet. It is not necessarily anyone's fault. This accident can happen even when the technique is perfect and can be undetectable until the vet pulls his arm out of the rectum. But an examination of the rectum and a decision about a course of action will be needed.

The best thing you can do for your horse is remain calm and have an honest discussion with your vet. Discuss whether you should to monitor the horse over a period of time, and what to look for.

your role


What To Do

What Not To Do

Do not panic. Most of these instances do not involve all the layers. Do not blame anyone. The severity of the injury will become clear later. Blaming will put your vet on the defensive and your horse may not get the best care.

your vet's role

Questions Your Vet Might Ask:
  • How severe do you think the rectal tear is?
  • What is the best course of action?

Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

Very Common
more treatments

Author: Doug Thal DVM Dipl. ABVP