to pump it back up the leg, helping the heart to work against gravity. Pulse The average pulse is 28–45 beats per minute (bpm) in a mature horse, but it can reach more than 250 bpm during maximum exertion. Depending on cardiovascular fitness and the horse's response to exercise, this drops significantly within 15–30 seconds after the horse stops galloping. A two-year-old horse may have a slightly faster pulse, and a 2–4-week-old foal normally has a pulse between 70 and 90 bpm. Heart rate may also increase when the horse is excited, overheated or suffering severe dehydration, has a fever, has an infection or sepsis, has experienced a great deal of blood loss, has advanced heart or lung disease, or is in shock. In these cases, the resting heart rate may be above 80 in an adult animal. When the heart rate is below 20 bpm, the horse may be hypothermic, or have pressure on the brain, heart disease, or collapsed circulation. Determining heart rate Heart rate may be determined with a stethoscope, placed just behind the left elbow of the animal. The pulse may also be felt when taken on an artery close to the skin, most commonly the facial artery located on the lower jaw just behind the cheek. The radial pulse may be taken right behind the back of the knee. The digital pulse is taken on the inside of the pastern, right below the fetlock. It is usually very faint and difficult to find, although certain problems, such as laminitis, will make it quite strong. Blood pressure Although blood pressure may vary greatly between animals, the average blood pressure for a standing horse is 120/70 mmHg. An indirect measurement of blood pressure may be taken with a cuff placed around the middle coccygeal artery at the base of the tail, or above the digital artery. It is usually taken to monitor circulation during surgery. Direct blood pressure measurements, via catheterization of an artery, provide a more accurate measurement, and are preferred for anesthetic monitoring. Gums The gums of the horse can offer good clues to its circulatory health. Another way to see if the circulatory system is running correctly is by pressing a finger on the gum; the pink color should return in 2 seconds. The owner can assess the gums by lifting the upper lip with one hand, while holding the head still (via halter)