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


Membranes of Mouth, Gums appear Blue or Purple


There are a few areas on the body that provide important information regarding the state of a horse's circulatory health. These areas include the gums, the pink membrane inside the nostril, the whites of the eyes, and the pink inner vulvar membranes of mares. That said, the simple act of evaluating the color of your horse's gums is actually a very important skill.

Generally purple or blue gums indicate poor oxygenation of the blood and is seen in a variety of severe disease processes. This sign usually indicates that a horse is suffering from a serious illness, and is usually exhibiting other signs of distress. But in an otherwise well horse, local areas of dark blue or purple discoloration of the gums might also indicate traumatic injury and bruising.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • 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 Orange

    Call Your Vet at Their First Available Office Hours
    • If the horse's appetite and attitude are normal and you see nothing else wrong.
    • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.

your role


What To Do

Reexamine your horse's gums in different light. Always check both sides of the mouth if you think your horse's gums are a strange color. Wipe the gums clean with a moist paper towel. There may be material on the gums that is confusing your interpretation. Get a sense of whether the purple color looks more like a local bruise, or the gums are generally that color.

When in doubt, assess your horse's general health using the Whole Horse Exam (WHE), paying particular attention to capillary refill rate and heart rate. Look for other signs of illness or disease. Look at the whites of the eyes and color of the nasal membranes. Call your vet to discuss your concerns. Keep in mind also that bruising of the gums can cause areas of dark blue or purple. Could the horse have sustained trauma here?

your vet's role

Your vet may advise you to take a "wait and see" approach or suggest that they examine your horse. Much of this will depend on history and the presence or absence of other concerning signs. Your vet will assess your horse's general health with a physical examination, and try to determine the nature of the finding. Horses that truly have blue or purple gums often are very ill otherwise. Blood work may be important to provide additional information.
Questions Your Vet Might Ask:
  • Does the horse have a normal appetite?
  • Does the horse appear normal other than this finding?
  • Does the horse have a normal attitude?
  • Do you notice other signs of a problem?
  • What are the results of the Whole Horse Exam (WHE)?
  • If a mare, what is the color of the vulvar membranes?
  • Does the horse have a history of trauma to the area?
  • Do you notice any other signs of trauma?
  • Have you compared the appearance in this horse to that in your other horses?
  • Have you looked at both sides of the horse and accounted for different light?
  • Do the whites of the horse's eyes look normal?

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