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


Drainage from Face or Head


Drainage from the face or head can indicate a past or present traumatic wound. However, there are other conditions that result in drainage here. Dental and sinus infections can ultimately rise to the surface, and finally break open and drain pus. Drainage from bone or dental infections usually has a pungent odor.

The head is unusual because of the very thin skin covering over bone. Wounds to the head can fracture the skull, or can simply scrape off the protective covering (periosteum) of a section of bone. Either situation can result in bone that has lost its blood supply. This piece becomes isolated, dies, and acts as a foreign body. Technically, this is called a sequestrum, and this unhealthy bone must be removed in order for a wound to heal and drainage to stop.

Bacterial infection can abscess and break open and drain pus as well. The classic example of this is Strangles (Streptococcus equi equi) infection, but other types of infections in the face can do this as well. There is usually very little smell associated with Strangles drainage. Oral foreign bodies can abscess and drain.

Under the base of the ear, Dentigerous Cyst can appear as a small draining tract, little swelling and crusting of honey-like secretion.

  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If this problem seems severe and has come on suddenly.
  • Code Yellow

    Contact Your Vet at Your Convenience for an Appointment

your role


What To Do

First, recognize the signs of Strangles. If there is risk of Strangles, your first job is to quarantine the horse and prevent spread of disease to others. Wear latex gloves when assessing wounds and drainage of the face.

Perform the Whole Horse Exam, paying particular attention to the location, odor and appearance of the drainage. Rectal temperature, heart rate, attitude and appetite (ability to chew and eat) are important. Notice whether there is swelling surrounding the drainage.

Notice whether there is respiratory noise. If you can safely do it, look in the mouth for wounds or foreign bodies.

You can clean the wound off gently, apply an antibiotic ointment, until your vet can assess the horse.

your vet's role

Your vet first assesses your horse's general health, which in itself can give clues to the origin of the drainage. They then assess the drainage, trying to locate its source.

In many cases your vet will conduct a quick clinical exam. Sometimes, diagnostic tests may be needed. Radiography is used to diagnose fractures, dead bone, sinusitis and infected teeth. Ultrasound occasionally can be helpful to locate foreign bodies, abscesses and fractures. Bacterial culture can sometimes be needed to rule out Strangles.
Questions Your Vet Might Ask:
  • When did you first notice this?
  • Where does the drainage seem to be coming from?
  • Tell me more about the color, smell, and quantity of the drainage.
  • Can you detect that the drainage or discharge has an odor?
  • Do you see swelling below or behind the jaw, drainage or discharge from areas around the face?
  • Is the drainage pus or blood?
  • What are the results of the Whole Horse Exam (WHE)?
  • What is the horse's rectal temperature?
  • Did you notice swelling in this area prior to the drainage?

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
more diagnoses

Author: Doug Thal DVM Dipl. ABVP