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What is Recurrent Diarrhea?

Recurrent diarrhea in horses can be a cause for concern just as that which is found in humans. The presence of diarrhea brings with it the danger of dehydration and the associated physical issues that go with it, including the potential for death. Emergent medical care is required if the diarrhea is acute while ongoing care will likely be required for chronic types of recurrent diarrhea.

Diarrhea is defined quite simply as an increase in frequency, volume and the fluid content of stools. If it lasts longer than two weeks, it is considered to be a chronic condition but if it is acute, it is considered an emergency situation requiring urgent medical attention.

Symptoms of Recurrent Diarrhea in Horses

The symptoms of diarrhea are fairly standard between the species. The symptoms noted below are some that you would likely see in your horse in some degree of severity, ranging from mild and occasional to severe with many episodes daily. Cause for concern increases with the severity and duration of the symptoms:

  • Soft, loose, watery stools 
  • Increased frequency of loose, watery stools

In the event that you note any of these symptoms, seek medical assistance emergently:

  • Blood, mucous or foul odor in feces
  • Diarrhea that continues past 8 to 12 hours of duration
  • Behavior changes like appetite loss or depression
  • Increased body temperature or fever
  • Colic symptoms
  • Increases in heart rate
  • Laminitis symptoms


There are basically two types of recurrent diarrhea found in horses:

  • Chronic - The horse can have looser than normal stools but not be losing large amounts of water which the equine can’t replace
  • Acute - Diarrhea in horses results in the loss of massive quantities of water, sometimes in an explosive manner; rapid dehydration can occur in a short period of time which can lead to the death of the horse

Causes of Recurrent Diarrhea in Horses

Determining the cause of diarrhea can be difficult and sometimes treatment will be very nebulous in type. The causes of chronic diarrhea are harder to tie down and, for the most part, usually aren’t positively determined before treatment is begun. Here are some of the categories into which the various causes of recurrent diarrhea in horses have been placed:

  • Parasitic and bacterial infections
  • Changes in the microbes located in the intestinal tract
  • Changes in feed habits or the food being fed (includes large amounts of carbohydrates and lush pastures)
  • Inflammatory bowel disease
  • Tumors in the gastrointestinal tract
  • Dysfunction of various organs, for example heart failure can cause the bowel to become swollen with fluids
  • Sand that finds its way to the large intestine
  • Idiopathic, meaning that its origin is not known

Diagnosis of Recurrent Diarrhea in Horses

Though the precise cause of chronic diarrhea is very difficult to nail down, the veterinary community does have quite an array of testing processes which can be utilized to try. Here are some of the things that your veterinarian may choose to utilize to obtain a definitive diagnosis:

  • Basic blood counts
  • Fecal specimen cultures
  • Serum biochemistry panels
  • Serum protein 
  • Peritoneal fluid analysis - this an analysis of fluids within the body cavity
  • Rectal mucosal biopsy
  • D-xlose absorption tests (this test measures to determine if nutrients are being properly absorbed in the digestive system)
  • Radiography (x-rays) of the abdomen
  • Exploratory surgery is even a later option

Even with this impressive array of specialized testing, veterinarians are frequently still hard-pressed to obtain a definitive diagnosis for those cases which are chronic versus acute. If the acute diagnosis can be determined, appropriate treatment will be initiated though it may not vary significantly from that which is recommended for chronic cases.

Treatment of Recurrent Diarrhea in Horses

One of the first line treatment regimens that will likely be recommended by your vet, regardless of whether a definitive diagnosis has been obtained, will be to stabilize your horse. Steps must be taken to re-hydrate and maintain appropriate hydration, attempt to get some control over the inflammation taking place in the gastrointestinal system, aiding intestinal healing as well as absorption of toxins which may be present, gaining control over the possibility of any toxemia which may be present and easing some of the discomfort of the equine.  Other treatment options will depend on the how severe the diarrhea and the condition of the horse and may include, but not limited to:

  • Non-steroidal inflammatory medications to help ease the pain (such as Banamine)
  • I.V. fluids for hydration
  • Activated charcoal to help absorb any toxins which may be present
  • Bismuth subsalicylate (active ingredient in Pepto Bismol) to help coat and protect the intestine
  • Probiotics to help repopulate the intestine with good bacteria

Other steps which may be recommended are:

  • Isolation of the affected horse from other horses as some causes of recurrent diarrhea in horses is contagious to other species, including humans and other horses
  • Specific and special sanitation precautions will be needed to avoid contamination of the stable area, paddock area and pastures with the diarrheal feces
  • Special attention must be given to the handler’s personal hygiene habits especially after handling the affected equine to include wearing disposable boot covers, using a disinfectant dip foot dip located at or near the stall door, wearing latex gloves when working on an affected horse as well always washing your hands after handling the horse
  • Using separate buckets, grooming tools, rakes and other utensils used on the affected horse will also help to avoid cross contamination of the cause of the diarrhea to other animals

These are basic steps which may be recommended for general recurrent diarrhea cases. However, in those cases for which a cause has been determined, appropriate treatment options will be initiated based on the cause.

Recovery of Recurrent Diarrhea in Horses

For the most part, once the diagnosis has been obtained, if one is found, and the appropriate treatment initiated, whether those mentioned above or the administration of medications to treat parasitic or bacterial infections for example, the affected equid should be able to return to normal activity levels in a time frame commensurate with the type and level of recurrent diarrhea which has been diagnosed. Close observation of the equine will be needed thereafter, as well as the maintenance of sanitation levels will need to be continued, and steps taken to intervene in the event the episodes repeat. 

Some otherwise healthy horses will react to changes in feed, feeding habits and even stressful situations, like those trailering trips to the veterinarian, or shows or races. Sometimes, those same horses will adapt to these changes and the temporary recurrent diarrhea will subside. For those who don’t return to normal, don’t hesitate to seek medical evaluation and possible intervention as soon as possible.

Recurrent Diarrhea Questions and Advice from Veterinary Professionals

Qtr horse
12 Years
Fair condition
0 found helpful
Fair condition

Has Symptoms

Weight Loss
Chronic diarrhea,
Pain in right flank area
Occasional lethargy

I have a 12 yr-old mare that has had chronic diarrhea for 1.5 yrs. it started when we moved to Florida within about 8 days. We tried many different things and had the vet out several times. We did fecal egg counts (always zero) sand clear remedies, biosponge, blood work ( always normal), every probiotic there is, metronidazole ( which made her worse). We wormed her with Panacur power pac and her stools were perfect for about 3 days only to go right back to loose. Her fecal counts are strangely zero throughout the last 1.5 yrs. We have since moved again only to have her diarrhea get worse and now she’s dropped a lot of weight. We wormed her again with Panacur power and once again her stools became perfectly normal for about 3 days only to regress to loose. We are now treating her for ulcers and she has gained a small amount weight back but not what I would like to see. Diarrhea is still loose but not as watery. Vet says just give up and deal with it but I’m not ready to do that yet. Is it possible she has cyanthostomasis? I don’t see worms in her stool but she does act like she’s not feeling well at times. Sometimes she reacts to pressure on her right side as if it’s painful.

Dr. Michele King, DVM
Dr. Michele King, DVM
Dr. Michele King DVM
1611 Recommendations
Thank you for your email. You certainly have been trying for quite some time to clear up this diarrhea! Without seeing her, I can't comment on her situation, but it may be worth seeking a second opinion from another veterinarian, or a referral from your veterinarian to a speciaist? I agree that you should be able to clear up this diarrhea. I hope she feels better.

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