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


Tongue Sticking or Hanging Out


A horse with its tongue sticking out of its mouth, and seemingly unable to get it back into its mouth, is a rare thing. This could result from actual swelling of the tongue, due to ingestion of an irritating compound or toxin, or a traumatic injury to the tongue.

Weakness or paralysis of the tongue may also result from neurologic dysfunction at the level of the brainstem, or the nerves that control the muscles of the tongue. Horses with botulism can present this way, and immediate treatment is vital. Horses with severe infections of the mouth, head and tongue itself may also not be able to retract their tongues.

Horses that are severely debilitated can also show this sign. Strength of the tongue muscles is an indicator of general muscle strength. Old horses that have lost their front (incisor) teeth tend to stick their tongue out between their lips.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • If this problem seems severe and has come on suddenly.
    • If you notice apparent wobbliness or weakness, in addition to this sign.
    • If the results of the Whole Horse Exam (WHE) in the resting horse indicate fever (Temp >101F/38.3C) or heart rate greater than 48 BPM.
  • Code Yellow

    Contact Your Vet at Your Convenience for an Appointment
    • If you consider this a chronic and relatively mild problem that is not changing rapidly.
    • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.
    • If the horse is very old.

your role


What To Do

Assess your horse's general health using the Whole Horse Exam (WHE) paying particular attention to attitude and appetite, rectal temperature. Walk the horse in circles to each direction to assess its movement. Assess their mouth (wear gloves) looking for any other abnormalities.

your vet's role

Your vet assesses the mouth and tongue itself to determine the nature of the problem. They assess general health, especially the neurologic system, and look for other signs of neurologic disease that might relate.
Questions Your Vet Might Ask:
  • What is the appearance of the horse's tongue?
  • Does your horse seem normal otherwise?
  • When did you first notice this?
  • What is the horse's age, sex, breed and history?
  • Do you notice sores on the horse's tongue?
  • What are the results of the Whole Horse Exam (WHE)?

Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

Very Common
Less Common
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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
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Author: Doug Thal DVM Dipl. ABVP