Sizing Rooms for Equine Hospitals - Business Solutions for Equine Practitioners | EquiManagement

Sizing Rooms for Equine Hospitals

Whether adding a room or building from scratch, you only have one chance to get your hospital room sizing right.
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vet clinic waiting area

Large equine hospitals might need or want a generous client area to accommodate a greater flow of people.

Whether you are planning a large hospital or a one-room, haul-in clinic, our advice is to think big. Creating rooms that are large enough is half the battle in designing a well-functioning equine veterinary facility. In this article, we will share our best tips for right-sizing equine veterinary spaces so they are easy to use and cost effective.


Let’s begin with stalls. Most horse people are familiar with 12-foot-by-12-foot stalls, as this is the basic module in the United States. Many products are manufactured to create stalls to this standard. However, 12-foot-by-12-foot stalls are too small for larger breeds of horses (drafts and warmbloods), for a mare and foal, and for ICU or neurological stalls, where having more space to work around the horse is very important. Our advice is to use 14-foot-by-14-foot modules for specialized medical stalls and large breeds, and to use at minimum 12-foot-by-18-foot or 14-foot-by-18-foot stalls for foaling or mare and foal. One of the easiest way to accommodate a foaling stall is to remove a partition to create a double-wide stall.

Barn Aisles

Most barn aisles are either 10 feet or 12 feet wide. The latter is the width that works best for cross-tied horses. For medical barns, we prefer 14 feet in width because it helps reduce accidental transmission of disease, and it is less stressful to walk a frightened horse through a slightly wider space.

If your horses have the ability to extend their heads from their stall doors, a wider aisle will also help prevent accidental contact between the horse in its stall and one being led through. If you plan to do workups in the medical barn, enlarge the aisle space to 16 feet in width, but remember that cross-ties are dangerous in a wide aisle.

Examination Spaces

The building block for the equine medical facility is an examination space. The minimum size for a safe examination space is a 16-foot-by-16-foot clear space. If you have a wall of cabinets, enlarge the space by two feet in that direction to maintain the full 16-by-16 clear space. An exam space can be used for a basic exam, taking vitals, ultrasound, mobile X-ray, etc.

In busy hospitals, it might be necessary to accommodate more than one horse in the same examination space. Each examination area will need its 16-foot-by-16-foot module, plus you will need 8 feet of additional clear circulation space to prevent interference between horses that are being walked through and examinations being performed. For example, a room that contains three examination spaces would likely be (16 feet plus 8 feet) x (3(16)), or 24 feet by 48 feet in size, to be used comfortably for three horses simultaneously.

Examination/Treatment Space with Stocks

The minimal size for a treatment space that includes stocks is 18 feet by 24 feet. This assumes the horse can be walked straight through the room via a separate entry and exit. This size module is efficient for rooms such as standing surgery and dental.

If the room is planned with only one exit, then it must be enlarged to be safe enough to turn the horse and exit the room from the same door. With a room that is 24 feet by 24 feet or larger, increasing it to 24 feet by 30 feet will feel safer if the room only has one entry/exit.

Induction and Recovery Stalls

When we design induction stalls, we begin by speaking directly with the surgeon, as he or she likely has been trained a specific way for inducing and recovering horses, and this will influence the size of the space.

In the case of recovery, the stall size is critical to maintaining the safety of the horse. For horses recovering unassisted, most people agree that the stall should be a standard 12-foot-by-12-foot module (padding will slightly reduce the room size) to prevent the horse from crashing around while recovering.

However, if the veterinarian prefers assisted induction with a squeeze gate or assisted recovery with ropes, the stall might need to be enlarged to allow room for this assistance. Spaces that are 14 feet by 14 feet or 12 feet by 16 feet are typical sizes for enlarged induction/ recovery stalls.

Combination Induction and Procedure Areas

In the smallest hospitals, a veterinarian might create a padded knockdown stall where procedures are done in the stall. This is not optimal, but it can be done when there are no other possibilities.

A typical 12-foot-by-12-foot induction/ recovery stall will be too small for this purpose, and a larger 14-foot-by-14- foot or 16-foot-by-16-foot stall might be used. As a reminder, this stall will not be an ideal size for unassisted induction or recovery, and it will be a little small for working in, so the space is compromised for both of its functions.

Surgery Rooms

If a hospital is large enough to have a dedicated surgery room, it should put its resources toward sizing this space for well-run surgeries. Our rule of thumb for the smallest efficient general surgery room is 20 feet by 25 feet from wall to wall, with the table placed in the center parallel to the long dimension.

For a more generously-sized general surgery room, enlarge the room slightly to 20 feet by 30 feet, as the long dimension can be confining in the smallest module. While this room might sound big, it’s actually too small for large orthopedic surgeries. Orthopedic and other specialty surgery rooms need even more space. For example, 25 feet by 30 feet is common in larger hospitals and 30 feet by 30 feet in referral and teaching settings where more people might be present, in addition to tools and carts and anesthesia equipment.

Specialty Imaging

Do not proceed with designing specialty equipment rooms without aligning the exact sizing of the room with the equipment to be installed. For example, scintigraphy and overhead X-ray typically have gantries supported by steel structures that are specific to the equipment. Clearly, the room needs to be sized to at least accommodate the steel structure, and to provide some space in front of the equipment for staging either the standing sedated or anesthetized horse.

For those few hospitals incorporating human medical equipment such as human CT machines or human models of hi-field MRI, the sizing of a room becomes more complicated. It must be upsized for a horse, rather than planned around a typical human model. Hospitals planning for this type of expensive equipment should visit other university and referral hospitals to understand what works and what does not before proceeding.

Central Supply and Pharmacy

As hospitals grow over time, supply needs grow. Supply and pharmacy rooms can get cluttered, and cluttered supply spaces can make inventory control more challenging.

When sizing your pharmacy and central supply areas, consider all the items you need to store, and estimate their spatial requirements. We often articulate needs in terms of “linear feet of shelving.” This will help you anticipate the true need for the room size. It is typical for a full-service busy hospital to need at least 12 feet by 16 feet for stocked materials.

Central supply rooms get much larger if planned to allow ambulatory trucks to pull in for stocking. In this scenario, the supply room will become a garage-like space with large oversized bays. For example, 15 feet in width in each bay and 30 feet in depth will allow for shelving on both sides of the truck and at one end.

We also have observed larger stocking areas in facilities serving rural areas and in practices with a large ambulatory service, where central supply might need to serve many farms or farms in a wide region.

Laboratory It is easy to size a laboratory space, as it is nothing more than an equipment coordination exercise. Make a list of all of the lab equipment that your lab needs to contain (now and in the near future), and work with your designer to provide the counter space to accommodate the equipment, along with some seating stations.

Ask your designer to “walk you through” the laboratory area by looking at all the cabinets and equipment properly placed and the outlets located. This will help you get a lab that is just right in size.

Lobbies and Client Spaces

Last but not least, put some thought into the client spaces of your hospital. Because these spaces don’t make money (at least not directly), they tend to receive little focus. A small sitting area sized to accommodate a few comfortable chairs, a television and a coffee station is sufficient for small- and medium-sized hospitals. This space might be dimensioned like a generous office—or 10 feet by 12 feet or 10 feet by 14 feet in size.

Large hospitals might need or want more generous client areas for gathering groups or to accommodate a greater flow of clients.

Take-Home Message

Whether you’re designing a one-room addition or a large hospital, proper room sizing is an important balance of cost and function. In addition to starting with the guidelines we have offered in this article, visit several hospitals and talk with your colleagues to get a good feel for the best sizing of your working spaces.

Remember, you only have one chance to get it right.