Does the idea of an oversized horse plus the extra star in the Big Dipper qualify for a Hokuto no Ken tag?
Definitely. Original artwork on Pixiv also had "Death Omen Star" and Kokuoh tagged (by fans).
Though, wouldn't qualify for Kokuoh here, despite those fake horseshoe tracks. We could start a Death Omen Star tag, and I suspect we probably have a few examples that qualify, but someone will have to track them down to tag those.
