In nonfatal cases, most injuries are nervous system-related. The horse may suffer brain damage to the point where it has trouble functioning. Levy says animals electrocuted by lightning seldom have burns on the body, so diagnosis is partly based on proximity to trees or other dead animals nearby. Usually the horse totally collapses in whatever position it was in. When there's no struggle involved, the fact they died so quickly and the report of an electrical storm in the area leads one to consider the possibility of a lightning strike.
Definitive diagnosis is made post-mortem.
One of the things that occurs with lightning strike is that animals will bloat more quickly. Organs in the horse will become distended with gas more rapidly than normal. Usually, we find no burns, but if we do find burns, they frequently will be over the withers, down the legs, or will run down the jugular groove on the side of the neck. Treatment of survivors is done symptomatically. Scoggins sometimes adds corticosteroids to the regimen, and occasionally sedatives for hyperexcitable horses.