Pale Gums in Horses

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Key takeaways

Pale gums are gums that have less color than the healthy salmon pink color typically identified in a horse’s mouth. 

  • Gums can be used as a sign of overall health
  • Pale gums are a symptom of anemia (blood or iron loss), pain, shock, or infection
  • Conditions associated with pale gums include toxicoses, anaplasmosis, equine infectious anemia, gastric ulcers, and leptospirosis
  • Horses with pale gums require urgent veterinary care
  • In cases where pale gums are accompanied by fever, signs of pain, or a rapid heart rate, emergency veterinary attention is warranted
  • Diagnostic tools include physical examination, blood work, urinalysis, and endoscopy
  • Treatment depends on the underlying cause but may include antibiotics, IV fluids, activated charcoal, and blood transfusions
  • Prognosis depends on the underlying cause
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A closer look: Pale Gums in Horses


The gums are a useful tool in caring for a horse because the membranes are thin and the blood is close to the surface. Horses with gums that are paler than usual require veterinary attention. If pale gums are accompanied by fever, signs of pain, or a rapid pulse, emergency veterinary attention is required.

Possible causes


There are many potential causes for pale gums. In general, pale gums are the result of a low volume of red blood cells (anemia), infection, pain, or shock as well as other causes.

Severe dehydration can also lead to shock and can be recognized by the presence of sunken eyes, delayed skin tent, and dry mucous membranes.

Risk factors


The severity of pale gums varies widely depending on the underlying cause.

In some cases, onset is sudden as with internal or external injury. In other cases, onset is gradual, such as with an iron deficiency.

In some cases, the underlying cause is mild and resolves easily with treatment such as with strongyles. In other cases, such as with endotoxemic shock and ionophore toxicosis, the cause is sometimes fatal.

The risk of pale gums is higher for horses that:

  • Have a poor diet
  • Are not drinking sufficient water
  • Have been recently injured
  • Have been grazing in areas where toxic plants grow
  • Have poor immune systems
  • Have eaten medicated feed that is intended for cattle

Testing and diagnosis


Diagnosis aims to identify the underlying cause of pale gums. Diagnostic tools include:

  • Physical examination
  • Blood work
  • Rectal palpation
  • Urinalysis
  • Endoscopy (the use of a camera to see into the horse’s gastrointestinal system)
  • Nasogastric intubation
  • Diagnostic imaging, such as x-ray and ultrasound

Note: nasogastric intubation should only be performed by a veterinarian. There is no safe way to intubate a horse at home.

Treatments depend on the underlying cause, but may include:

  • Antibiotics
  • IV fluids
  • Blood transfusions
  • Activated charcoal or mineral oil in the case of toxicoses
  • Antacids and medications to protect the stomach lining in the case of gastric ulcers
  • Pain relief
  • Anti inflammatory medications
  • Corticosteroids
  • Surgery

Note: always consult a veterinarian before administering medications to horses, including activated charcoal.

Similar symptoms


Gums in healthy horses are usually a strong pink or salmon color. They are typically shiny and slick. Comparing the gum color between horses is less useful than being aware of the changes to an individual horse’s gums, since some healthy horses have naturally paler gums. Horses with yellow, brick red, or blue/purple gums also require veterinary attention.

Associated symptoms


Other symptoms observed with pale gums vary depending on the underlying condition.

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