Red or Spotted Gums (Petechiae or Ecchymosis) in Horses

Key takeaways

Red or spotted gums are mottled or speckled with brown, bright pink, red, or purple spots. 

  • Emergency veterinary attention is required for horses with red or spotted gums 
  • Normal gums are smooth, unirritated, and a single shade of light salmon pink, sometimes with brown patches
  • Red or spotted gums are an indication of one of three issues: failure of the blood to clot properly, excessively leaky blood vessels, or traumatic injury to the vessels
  • Diagnostic tools include physical examination, bloodwork, coagulation time testing, and ultrasound
  • Treatments depend on underlying causes and include anti-inflammatories, antibiotics, and blood transfusions
  • Many of the causes of red or spotted gums are life-threatening and require emergency veterinary attention
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A closer look: Red or Spotted Gums (Petechiae or Ecchymosis) in Horses

Red or spotted gums suggest normal blood clotting has been disrupted. When blood is not fully contained in the vessels, it leaks into the surrounding tissue. If normal blood clotting processes are not functioning properly, leaking blood will continue to enter the tissue, becoming visible in thin, highly vascular tissues, such as the gums.

This symptom has two presentations: petechiae (small dots that look like pinpricks) and ecchymoses (patches that are similar in appearance to bruises). Both types indicate blood is not fully contained within the vessels but the subtle differences between them help guide diagnostic investigation. The presence of one type of spotting versus the other does not indicate the severity of the underlying condition in most cases.

Possible causes

In general, red or spotted gums are an indication that the circulatory system has been disrupted, allowing blood to leak into the tissue. The reasons this might occur include:

  • Blood is failing to clot properly
  • Vessels that deliver blood to the tissues are leaking excessively
  • There has been traumatic injury to the blood vessels

Risk factors

Red or spotted gums in horses is uncommon. Horses with red or spotted gums require emergency veterinary care. Although a few of the possible underlying causes are relatively harmless, most are life-threatening and benefit from prompt diagnosis.

Testing and diagnosis

Horses with red or spotted gums require emergency veterinary attention. Diagnostic tools include:

  • Physical examination
  • Bloodwork
  • Coagulation time testing
  • Ultrasound

Treatment depends on the underlying cause.

Treatments may include:

  • Supportive care
  • Blood transfusions
  • Antibiotics
  • Anti-inflammatories
  • Medications to improve coagulation

Similar symptoms

Red or spotted gums can be mistaken for ulcers in the mouth. In general, petechiae and ecchymoses are smooth and flat, whereas ulcers are depressed in the center and may have raised borders.

Associated symptoms

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