I believe that a vast amount of viable space is wasted on horses in this book. While they technically are large animals, they're so vastly different from cattle that they deserve and have their own books which are great.
I think this book isn't very well written and doesn't go into the pathology of diseases very well... at all. I hate the layout, and I think some ideas are just skimmed over or not mentioned at all.
I would not recommend this book, but the problem is there isn't another one out there.

This textbook is, in my experience, the best single medicine reference for large animals. It is designed for the graduate veterinarian and is not easy to read, but contains an immense amount of information (plus references) in a usable format. The index is comprehensive, which is useful as some conditions are discussed by different authors in disparate sections of the text. The text is divided into body systems, then subdivided into equine and ruminant diseases. There are also useful rule-out lists for major clinical signs provided at the beginning of the book. The illustrations and photographs are black-and-white and are largely the same as the previous edition, but this edition contains well-updated text material. Detractors from this text include minimal specific treatment information for some disease processes and the lack of a formulary. It also does not cover swine or camelid species. Nonetheless, I find this book far easier to read and use (with more comprehensive information) than the similar Blood and Radostits text. If you care to invest in several texts instead of a single one, try the Current Veterinary Therapy Equine Practice and Food Animal Practice (very easy to read). However, if you choose these keep in mind that you may need more than one volume of each, as each CVT volume is not comprehensive. My copy of Smith is constantly at hand, and has seen a great deal of use since I purchased it. I recommend this book to any large animal practitioner as a necessary reference.