Injury Risk and Prevalence in Equine Practice

In February 2018, EquiManagement conducted an online survey to assess injuries to equine veterinarians. Four hundred sixty-six (466) respondents completed the 19-question survey. To follow up on the prevalence of getting hurt on the job, we conducted a similar survey in June 2025 of members of the Facebook group Equine Vet-2-Vet and received responses from 183 equine veterinarians.  

To carefully define “injury,” both surveys began with the statement:  

“Injury in equine practice is fairly common, as horses are unpredictable. In the following questions, injury is defined as suffering a trauma, puncture, contusion, laceration, strain, fracture, hematoma, etc. that was of sufficient significance that you applied a bandage, ice, or other treatment or took a pharmaceutical compound (e.g., ibuprofen) at least once.”   

Not surprisingly, with this definition, 96% of respondents in both surveys reported being injured during their work as equine veterinarians. One respondent in the 2025 survey reported three incidents: 

• A kick to the chest, resulting in a hospital visit. 

• A kick in the leg while doing a nerve block, causing a large hematoma over the femur.  

• A kick to the hand and subsequent laceration with the needle they were holding.  

Another described a kick resulting in splenectomy. Needless to say, our profession comes with its fair share of physical risk. 

Injury Severity and Missed Work 

When considering the severity of the respondents’ injuries, 45.9% missed no time at work from their injury, and 18% missed one day or less. A little over 20% of respondents reported missing two weeks or less from their work. Eleven percent of respondents missed more than two weeks of work, with 4.37% reporting missing more than 90 days (see Figure 1). One veterinarian described a six-month recovery from surgery to repair traumatic shoulder dislocation. In contrast, 5.6% of 2018 respondents missed more than 90 days.  

It was not common for veterinary respondents to be hospitalized as a result of their injuries, with 12.6% admitted to the hospital in the 2025 survey compared to 18.4% in the 2018 survey. In both surveys, 48% of respondents reported visiting the emergency room. A whopping 36% of 2025 respondents and 32% of 2018 respondents reported sustaining a broken bone from an injury received at work. The most commonly reported bones fractured were ribs, followed by toes and fingers, as well as tibial plateaus, facial bones, skull, vertebrae, patella, and radius.  

A shocking 52% of respondents in both surveys reported receiving an injury to their face or head during their work as an equine veterinarian. The most commonly reported head injury was a laceration, followed by black eyes and concussions. One respondent said, “I was kicked while injecting a tarsometatarsal joint. The horse was sedated and twitched. I had already injected the left hind, and when I touched the needle to the patient I think it startled him and he kicked me. His cannon bone hit me in my upper lip, split it open, and the force spun me around into a wall box, and I sustained an 8-inch laceration across the top of my head. A bit of a mess.”  

In both surveys, three quarters of respondents reported being struck by a patient’s forelimb, and 89% reported being kicked by a hind limb. Bites were also common, with 73% of respondents reporting being bitten by a horse while on the job. None of their comments indicated the bites caused anything more than bruising and minor skin disruption. Over 75% of respondents reported being slammed or crushed against a wall, but only two experienced serious injury—fractured ribs in one case and chronic SI joint subluxation and vertebral facet injuries in the other. Another veterinarian “had a horse fall on top of me in a set of stocks without anyone present to help.” 

Just over a quarter of 2025 respondents and a third of 2018 respondents indicated they suffered permanent physical limitations or chronic pain from any injury received during their work as equine veterinarians. In both surveys, 2.2% were permanently disabled and unable to continue as equine practitioners.  

Risky Activities 

The occupational activities equine veterinarians commonly perform can be sources of injury (see Figure 2). Responses in both surveys were broadly similar: Needle placement incited about 21% of injuries. Thirty-five percent of respondents indicated “Other” causes, including recovering a horse from anesthesia, loading a client’s horse on a trailer, sheath cleaning, euthanasia, activities in the horse’s mouth, radiographing, neurologic horses, and applying a twitch.  

“I was approaching a needle-shy horse that was snubbed to a 6-by-6 post,” said one respondent. “He was frightened and started to sit back and fight the tie rope. I started to back away from him. As I backed away, he broke the tie rope, and his head hit me in the head. The force sent me 20 feet. I had an instant hematoma on my forehead the size of a fist and ended up having a small fracture in my skull and a minor intracranial bleed.”   

Close to half (44.5%) of 2025 respondents reported that at the time of their most severe on-the-job injury, the patient had received sedation. This was consistent with results in 2018. In 2025, 36% of patients were restrained by a practice employee and another 31.4% by the owner or their agent at the time of the worst injury. In 2018, 33% of respondents indicated that at the time of their worst injury the patient was restrained by the owner or their agent, and 27.4% reported that the patient was restrained by a veterinary technician or assistant. Surprisingly, in both surveys about 11% of horses were not restrained.  

Experience in Practice Matters 

In the 2025 survey, at the time of their worst on-the-job injury, 48.6% of respondents had been practicing for five years or less and 29.6% during Years 6-10 (see Figure 4). This differs from the 2018 results, when 52.2% of the worst injuries occurred during the first five years of practice and 22.6% during Years 6-10. Perhaps this signals an increased acceptance and prevalence of sedation, use of restraint devices such as stocks, and employment of veterinary assistants/technicians. However, the first decade of practice, when early-career veterinarians are generally eager to please clients and build their reputations, appears to be the most dangerous, despite this cohort’s generally superior physical condition compared to those of advancing age. 

Of the 21.3% of 2025 respondents in their first five years of equine practice, 7.7% reported they’d been hospitalized, and about a third had visited an emergency room, broken a bone, or sustained an injury to their head or face. Three quarters had been struck with a forelimb, 82% had been kicked, and 76% had been bitten. Almost 80% had been crushed or slammed into a wall, and a quarter were already reporting permanent physical limitations or chronic pain from injuries received during work. All of this in their first five years of practice!  

Increased confidence and competence in clinical skills with more years of experience undoubtedly plays a part in veterinarians’ injury rates. The data strongly suggest that experience reduces chances of injury. 

Client Pushback

In the 2025 survey, we asked new questions about the attitudes of clients and practice owners/colleagues with regard to sedation. Just over 70% said they had received pushback from a horse owner or trainer for wanting to sedate a patient for examination or treatment.   

“Most advocate for sedation and safety, but there are some who are more afraid of what sedation does to the horse than my personal safety,” said one veterinarian. 

Other comments included, “I always control the situation, not the client,” and “If they don’t want me to sedate and I do, then we sedate the patient, or I walk away. Not risking my safety!”  

Nearly 81% of respondents said they had never received pushback or negativity from practice colleagues for wanting to sedate a patient for examination or treatment. Ninety-three percent reported having to decline to examine or treat a horse based on its behavior. “Human safety is always paramount,” said one veterinarian. “It has taken me a while to learn to say ‘no,’ but I am confident in doing so now,” acknowledged another.   

Interestingly, while only two-thirds of early-career respondents received pushback from horse owners or trainers for wanting to sedate a patient for examination or treatment, 31% reported receiving negativity from their practice colleagues for wanting to sedate a patient for examination or treatment, compared to just 19% of respondents of all experience levels. Again, these survey results demonstrate the obvious dangers of inexperience. Decreasing injuries to early-career veterinarians is critical to keeping them in equine practice. Having mentors promote sedation and adequate restraint could be very important for this cohort. 

A Closer Look at the Trends 

Because the bulk of serious injuries reported in this study occurred during the first five years of practice, it is important to consider why. Perhaps new graduates feel obligated to prove they can “get the job done.”  

If they’ve been around horses all their lives, they might have a degree of overconfidence. They might simply forget that the uncomfortable or painful procedures they perform can elicit fear and aggression in patients. Some of the injured reported they were the one restraining the patient when the injury occurred. While this is understandable if help is not available, it’s no doubt a contributing factor.  

Equine veterinarians with less horse experience might simply lack the ability to “read” horses and can miss subtle signs of an impending “blow up.” Some young veterinarians might feel pressure from their employers to not refuse to work on a horse or might feel guilty if they’re afraid and get into dangerous situations as a result.  

Respondents’ advice on how to stay safe included, “It’s not our job to train badly behaved horses,” and “If the horse is dangerous, walk away.” While early career veterinarians might sometimes put themselves in unsafe positions out of a desire to appear unfazed, with more years of experience they often realize it’s not worth the risk. Veterinarians of all experience levels must advocate for themselves and make safety a priority. 

The industry’s gender shift toward females might also play a part in injury risk. Women pushing for acceptance in an industry previously dominated by men might take chances if clients resist safety measures. 

Don’t Overlook Disability Insurance 

Around 50% of equine veterinarians are in solo practice. This population of vets risks losing clients and essential income unless they return to work swiftly after injury. As a result, returning to work against medical advice seems to be the norm in the profession. While it is important for all veterinarians, disability insurance is essential for the self-employed. If you can save enough money for at least 90 days of living expenses in an emergency fund, consider purchasing a disability policy with a 90-day waiting period. However, most ambulatory veterinarians working alone should pay the premiums for a much shorter waiting period. 

Take-Home Message 

Equine veterinary practice is a physical job that involves large, unpredictable, powerful animals. Some injuries are inevitable, but careful use of sedation, knowledgeable assistants, appropriate restraint methods, and caution can minimize accidents. Always refrain from taking responsibility for training a badly behaved horse, be willing to walk away from danger, and pay close attention to controlling the environment where you are working.  

Related Reading

• Ergonomics for Equine Veterinarians
• Veterinary Wellness Briefs: Practicing While Pregnant
• How Veterinarians Can Use Ergonomics to Reduce Injury Risk

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