National Equine Health Survey (NEHS) 2015
Report prepared by: Professor Josh Slater (Royal Veterinary College and BEVA)
Date: 12th August 2015
Headlines
 Further increase in participation with a 35% increase over 2014
 Almost 15,000 horses returned in 2015, up one third on 2014
 The 2015 data were consistent with previous years underlining the validity and value of the syndromic
data collected by NEHS
 Two thirds of horses taking part were healthy and one third had at least one disease syndrome recorded
 The Top Five disease syndromes accounted for 40% of all problems recorded. The Top Five were the
same as previous years: lameness (i.e. degenerative joint disease), sweet itch, back problems, recurrent
airway obstruction and PPID (‘Equine Cushing’s Disease’)
 Non foot lameness (e.g. degenerative joint disease/arthritis) affected almost 1 in 5 of horses in the
survey and continued to outstrip foot problems by 3:1 but foot problems remained common 4.5%
reinforcing the importance of foot care
 Laminitis was again commonly reported in 2015 (6.4% overall prevalence, with 41% recorded as first
episodes and 60% recorded as repeat episodes), continuing the trend seen over 2013-14. PPID (Equine
Cushing’s Disease) was commonly reported, continuing the trend from 2013-14
 Sweet itch continues to be the most common skin problem recorded and overall 1 in 6 horses in the
survey was affected by skin disease (sweet itch, mud fever or skin parasites)
 The prevalence of reported atypical myopathy increased from 0.1% in 2013-14 to 0.4%, which might
reflect increased disease surveillance or true increase in prevalence
 The number of horses recorded as overweight or obese increased from 17% in 2014 to 23% in 2015.
Almost all owners/keepers of overweight horses and ponies took steps to manage their weight with
restricting hard feed, strip grazing and soaking hay the most commonly used weight control methods
suggesting that there is a good level of awareness of the importance of obesity and weight
management. The number of owners using weight tapes increased from 50% in 2014 to 64% in 2015.
 The majority of owners/keepers (80%) intended to treat for encysted cyathostomins over the winter of
2014 but almost one third used products not licensed for this purpose and 7% used a product for which
resistance has been documented
Survey method
 The seventh NEHS survey ran in May 2015. The survey was led by the Blue Cross, was conducted on-line
and was open to respondents to complete for one week
 The survey used the same format as previous years with owner-reported syndromic surveillance
capturing a snap-shot of the spectrum of problems noted by owners for each horse under their care on
the day they chose to complete the survey
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The 2015 survey used the same disease syndrome descriptors to provide continuity of data with
previous years. The number of supplementary questions about management practises were reduced but
key questions about weight management and anthelminthic use for encysted cyathostomins were
retained. As in 2014, disease syndrome descriptors were grouped into broad categories (eye problems,
respiratory problems, internal medical problems, dental problems, lameness and laminitis, skin
problems and back problems) to facilitate completion of the survey by respondents and a free text
category to allow respondents to report other problems not listed in the syndrome descriptors
32 disease syndrome descriptors covering the presenting signs for common diseases and the major body
systems were used.
Owners were asked to report their horses’ fat (body score) using the 0-5 scoring system by assigning
their horse to one of three descriptors: overweight (score> 3.5), ideal/normal weight (score 2.5-3.5);
underweight (score 0-2.5). Respondents were asked how they managed weight in horses that were
‘good doers’ or overweight and how they estimated weight.
As in the 2014 survey, a question was included on atypical myopathy with respondents asked to record
the number of confirmed Atypical Myopathy cases they had had in the previous year.
Results (demographic information)
 The number of people taking part in the 2015 survey increased by 35% to 4,951 (up from 3,675 in 2014
and 1,246 in 2012) continuing the sharp upward trend in participation
 Records were returned for 14,952 horses, an increase of 36% on 2014 (up from 11,002 in 2014) and an
increase of 216% on 2012 (up from 4,730 in 2012)
 The significant increase in both numbers of people taking part and the number of records returned
shows that NEHS is increasing its reach, is becoming embedded in the annual routine of horse owners
and is receiving a good level of support from stakeholders across the industry
 Most respondents kept or owned a single horse (41.3%), 29.5% kept or owned 2 horses, 13.3% 3 horses
and 15.9% of respondents returned records for more than 3 horses, with 13% (641) returning records
for between 4 and 10 horses and 3% (144) returning records for more than 10 horses (Fig.1). These
results are what would be expected from previous surveys of National Equine Database records showing
that the majority of UK horses and ponies are single ownership.
 Most horses (90%) were kept in livery yards (47.5%) or private yards (43%). This is a similar figure to last
year (88%), which suggests that NEHS continues to sample a population representative of the general
UK horse and pony population. Only 0.4% of returns were from welfare charities and 0.3% from RDA
establishments which suggests that data from these sectors are not a source of bias in the overall
dataset (Fig. 2)
 The number of people returning records for horses kept at livery yards increased by 7.6% from 2014.
 The activities that horses were kept for was very similar to 2014 with 37.4% of horses used for leisure
use and hacking (37% in 2014). 21.7% were used mainly for equestrianism (eventing, dressage and show
jumping) up from 18% in 2014, 9.5% used for showing (9% in 2014). 0.5% of returns were made from the
racing sector (an increase from 0.2% in 2014) (Fig. 3).
 Broad geographical coverage of the UK was achieved, again an important point when extrapolating
NEHS data to the national herd.
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The distribution of ages of animals included in the survey was similar to previous years and was normally
distributed (Fig. 3) with ages being recorded for almost all returns (97.5%). The majority of animals were
in the age range 5-10 years old suggesting that the NEHS dataset is broadly representative of the
national equine population.
Taken together, these results suggest that NEHS 2015 collected data that were valid and representative
of the majority of the UK horse industry in the three key areas of age, type of use and geographical
distribution.
As with the previous surveys, the majority (64%) of horses were returned as healthy (compared to 63%
in 2014 and 62% in 2013), reinforcing a consistent overall picture that a snapshot of equine health is
that around two thirds of horses are disease free at any particular time.
Results (disease syndrome information)
 The results of disease syndrome recording in the 2015 survey were very similar to results from previous
surveys, strongly suggesting that NEHS data produces consistent trends and reliable, reproducible data
(Fig. 5).
 There were no differences in ranked syndrome prevalence for 2015 compared to 2014.
 The top five disease syndromes were (in order of decreasing prevalence): lameness (not relating to the
foot) (13.5%), sweet itch (8%), back problems (7%), recurrent airway obstruction (6.7%) and PPID
(‘Equine Cushing’s Disease’) (6.4%).
 Highlights from the horse and pony data include (Figs 5 and 6):
o Non foot lameness (e.g. degenerative joint disease/arthritis) was the again the most prevalent
syndrome recorded (13.5%), compared with 18.5% in 2014; 18.6% in 2013 and 13.8% in NEHS
2010-12. Foot lameness was recorded in 4.5% of returns, a similar figure to previous years,
reinforcing previous messages that foot care is vital.
o The prevalence of laminitis in the 2015 survey was 6.4% with 41% recorded as first episodes and
60% recorded as repeat episodes. These results are similar to 2014 (7.1% overall prevalence
with 43% first episodes and 67% recurrent episodes) and higher than 2013 (4.4% overall
prevalence of laminitis with 25% first episodes and 75% recurrent episodes) and NEHS 2010-12
(overall prevalence 3.6%). The reasons for these year-to-year variations warrant further
investigation, in particular to spring weather patterns and management practises.
o Back problems continue to be commonly recorded (7% in 2015, 7.7% in 2014; 5% in 2013 and
3% in NEHS 2010-12).
o Sweet itch was again the most frequently recorded skin problem (8%) with a very similar
prevalence as in previous years. Overall, skin diseases as a whole (sweet itch, mud fever and
external parasites) were frequently reported again (17.2% of returns, compared to 18.3% in
2014, 14.6% of returns in 2013 and 15.2% in NEHS 2010-12). Mud fever remained prevalent
(6.2% of returns, compared with 7.7% in 2014) and external parasites were recorded in 3.1% of
returns (2.8% in 2014).
o As in previous years, recurrent airway obstruction was the most frequently recorded respiratory
problem (6.7% of returns compared with 6.9% of returns in 2014, 4.2% in NEHS 2013 and 3.6%
in NEHS 2010-12) and accounted for 72% of all respiratory disease. Strangles was recorded as
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having occurred in 1.2% of horses (124 horses) in the last 12 months and other infectious
respiratory diseases were recorded in 0.3% returns (38 horses). This supports the view that
strangles is a common infectious respiratory disease although comparison with other infectious
respiratory diseases is not possible because the strangles result is from a 12 month period,
whereas the other infectious respiratory disease data is from the single day snapshot in May.
Confirmed or suspected PPID (‘Equine Cushing’s Disease) was recorded in 6.4% of returns in
2015, continuing the high level of recording seen in 2014 (5.6%) and possibly reflecting
increased surveillance through sponsored testing programmes as opposed to true increases in
prevalence from the pre-2014 surveys.
Sarcoids were again commonly reported with very similar prevalence to previous years (5.6% of
returns), reinforcing the importance of this skin tumour. Melanoma was reported in 1.7% of
returns, a similar figure to previous years (2% in 2014) acting as a reminder that this is also an
important skin tumour in horses.
Wounds were again frequently reported (4.0%; 3.9% in 2014; 1.4% in NEHS 2013 and 3.6% in
NEHS 2010-12), reinforcing this as a common problem encountered by horse owners.
Colic continued to be a commonly recorded problem with an overall prevalence of 3.8% (4.1% in
2014, 2.1% in NEHS 2013 and 5.6% in NEHS 2010-12). As in previous years, and in line with
published data, the majority of colics were medical with a ratio of medical to surgical colics of
5:1 (6:1 in 2014 and 2013, 7:1 in NEHS 2010-12).
Equine Grass Sickness continued to have a low prevalence (0.14%), very similar to previous years
(0.2% in 2014, 0.1% in 2013, 0.15% in NEHS 2010-12) and myopathies (tying-up) also had a
relatively low prevalence (0.7%) again similar to previous years (5.6% in 2014, 0.3% in 2013;
0.4% in in NEHS 2010-12).
45 confirmed cases of atypical myopathy were recorded over the year 2014-15 compared to 13
from 2013-14, producing an approximate prevalence of 0.4% in NEHS 2015 compared to 0.1% in
NEHS 2014. It is not clear whether this represents a true increase in disease prevalence or an
increase in awareness and surveillance but acts as a reminder that owners and vets should
remain vigilant for this disease, especially at high risk times of the year.
Equine Metabolic Syndrome was recorded in 2.4% of returns (2.1% in 2014, 0.9% in 2013).
Again, it is difficult to know whether this represents a true increase in disease or improved
awareness and surveillance.
Recording of fat score (body score) produced some interesting results again in 2015. 23.2% of
horses were assessed as being overweight (score 3.5-5) continuing the upward trend seen in
previous years (16.9% in 2014 and 7.8% in 2013). 73% of horses were assessed as being score
2.5-3.5 and 3.8% were assessed as being underweight (score 0-2.5) (Fig. 6). These results
underpin the messages from welfare organisations that obesity is a growing problem and more
efforts are required to tackle it. There is good evidence from the 2015 NEHS survey that
respondents were not only aware of the importance of obesity but that they took active steps to
manage it. Only 4% of owners/keepers of overweight horses and ponies said they did not
change their management to try to control weight. The large majority (96%) took active
measures including (in order of decreasing prevalence): reducing hard feed (20%), strip grazing
(15%), soaking hay (13%), restricting turn out time (12%), grazing in a bare paddock (11%),
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reducing forage (9%), changing hard feed (6%) and using a grazing muzzle (5%). A wide range of
measures is therefore used suggesting that research to establish an evidence base into optimal
method(s) of weight control would be useful.
Around two thirds of respondents used a weigh tape to estimate their horse’s weight (64%). This
figure was a significant increase over the previous year where 51% used weigh tapes. It is not
clear whether this increase reflects increasing awareness of the importance of measuring
weight, as opposed to visual estimation, as a result of educational campaigns. As in 2014, the
2015 NEHS data suggest that owners are actively engaged with weight management and aware
of its importance.
Headshaking was recorded in 2.6% of returns (2.2% in 2014, 1% in 2013 and 1.5% in NEHS 201012)
Stereotypies were recorded in 1.3% of returns (1.2% in 2013, 4.1% in NEHS 2010-12)
Eye problems were again frequently recorded (3.8%; 3.4% in 2014, 2.6% in 2013) with uveitis
(0.68%) and cataract (1.12%) more frequently recorded than corneal disease (0.5%), reflecting
data from previous NEHS surveys.
11% of free text answers recorded gastric ulcers providing an insight into the prevalence of
equine gastric ulcer syndrome in the principally leisure horse NEHS population
As last year, the large majority (80%) of respondents intended to treat their horses for cyathostomins
over the winter of 2014 and almost all of these (90%) knew which product they had used. A variety of
products had been used although the majority (64%) had used moxidectin either as solo therapy or in
combination with praziquantel (compared with 71% in 2014). Of the remainder, 22.5% had used
ivermectin (18% in 2014), 7% had used fenbendazole (10% in 2014) and 6.3% had used either pyrantel
or Praziquantel (Fig. 7). Approximately one third of treatments therefore used products that did not
have a marketing authorisation for treatment of encysted cyathostomin larvae (Ivermectin, Praziquantel
or Pyrantel) and 7% used a product for which cyathostomin resistance has been documented
(fenbendazole). Of the 20% of owners/keepers who did not administer a dose intended to treat
encysted small redworm and provided a response, 60% said they elected not to treat for encysted
cyathostomins because of low egg counts and 23% said they elected not to treat because the horse
looked in good condition. Almost 1 in 5 (18.3%) said they did not know about encysted small redworm
(Fig. 8). These results suggest there is still a lack of understanding about appropriate anthelminthic use
and about equine intestinal parasites which needs to be addressed through awareness campaigns and
better engagement between owners/keepers and their veterinary practitioners.
The relatively small number of donkey returns (325; 181 in 2014) makes interpretation difficult;
however, broadly similar trends were seen as in horses and ponies in all categories.
Figures for NEHS 2015
Fig. 1. Number of horses kept or owned
Fig. 2. Where horses were kept
Fig.3. Main activity
Fig.4. Age distribution of NEHS returns
Fig. 5 Ranked prevalence of disease syndromes recorded in NEHS returns
Fig. 6. Fat score (body score)
Fig. 7. Anthelminthics used to treat encysted cyathostomin larvae (winter 2014)
Fig. 8. Reasons for not treating with anthelminthics