Equine dermatology questionnaire

Equine dermatology questionnaire

Please print and fill out this questionnaire prior to your horse's skin consultation with our vets

Horse’s name:

  1. What is the main skin problem with your horse?
  2. At what age was this condition first noticed?
  3. Have there ever been any previous skin problems?


  1. Have any of the following been observed:















Ear infections






Weight loss


Increased appetite


Hair loss




Weight gain


Increased thirst



  1. Does your horse

Rub at the face


Head shake


Scratch/rub at ears


Bite the limbs


Scratch at the flanks


Bite the stomach area


Roll on the back


Bite at the tail area/anus


Rub against tree/post


Eye discharge




Wheeze or cough




  1. Do the symptoms vary?

If the dermatitis has been present for some time, are the symptoms worse in:

Spring o                         Summer o                        Autumn o                         Winter o

Are there symptoms present all year round?                      Yes  No

If yes, would there be a time of no symptoms?                 Yes  No

What, if anything, causes a worsening of symptoms?


What helps?


  1. Environmental details

Are there any other in-contact animals?                                                Yes  No

If so, how many?             Horses                  Dogs                      Cats                       Rodents               Birds


Do you know of any relatives of this horse that have skin problems?       Yes  No

Does any in-contact human have skin problems?                                              Yes  No

Please estimate how much time your horse spends in the            Stable _____% Paddock _____%

Do you swim your horse?             Yes  No            If so, how often?

And where?   River o                 Dam o                                Beach o             Other o

What type of stable bedding?

What type of paddock?                 Sand o                               Bush o                               Pasture o

If pasture, what type?

Where do you exercise your horse, and how often?

Is your horse rugged? Yes  No   If yes, what type?

How often are rugs cleaned?

Do you wash or dry clean the rugs?

  1. Bathing

Does bathing                     Help o                                                Worsen  o                         Make no difference o

What type of shampoo are you using?

How often do you wash your horse?      Weekly o          Monthly o        Rarely   o          Other o

  1. Insects

What is the current fly/insect repellent for your horse?

How frequently do you use this product?

Is fly/insect repellent used on other in contact animals?

What insects do you see in your horses’ environment?

Mosquitos o                   Flieso                 Ants o                                Cockroaches o                  Moths o

  1. Medication

Do you know what previous medications have been used?

Rinses o             Injections o                     Paste/granules o          Ointments, lotions etc o

What were the names and the dose of any medications? (please list)



Last rinse used (date):                                                                   Last date injection given (date):

Last ointment (date):                                                                     Last ear drop (date):

  1. Diet

What do you normally feed your horses?             Hay o Hard/grain feed o     Grazing only o

If hay – which types?                     Meadow o       Oaten o             Lucerne   o         Other  o

If grain – which types?

If grazing – which types of pasture?

Any supplements? (e.g. vitamins, minerals, fatty acids, glucosamine etc)

What do you give for snacks and treats?

Have you ever fed a special diet?  Yes  No If yes, what diet?

  1. General Health

Have there been any episodes of:





Mucous stools




Increased water intake


Increased appetite


Weight gain


Weight loss










Does your horse have any other illness? If so, please specify illness and prescribed medications:




  1. What do you think could be the cause of the skin problem?