Equine Insurance Wynne DiGrassie, DVM, MS, DACT, CVA

To most horse owners equine insurance seems like an unreachable product that costs thousands of dollars a year and the company never pays out. While that may have been the case years ago it certainly is not true now. Most companies have great coverage, will pay out for most advanced treatments, and the cost is reasonable! The largest expense to any insurance premium is the mortality. That is what you value the horse is worth should it die or have to be euthanized. You have to justify what you spent on the horse and any show record or training expenses to increase the value of the horse over the purchase price. For most horse owners it is not that the horse is going to die but it is the large veterinary expenses due to other non-fatal conditions such as lameness and some medical conditions that become costly. Even most colics today can be treated successfully if caught early and the horse can go on to live a successful life.

The medical and surgical coverage portion of the insurance policy is usually anywhere from 250-400/year depending on level of coverage and is the most important part of the policy. You can get up to 10,000/year medical and surgical coverage depending on the value of the horse and that will cover most colic surgeries and medical conditions needing to be treated. All you have to pay is a 250-300 deductable, so for at most 700/incident in a year you can get 10,000 worth of veterinary bills covered which is quite a savings! But don t use your insurance for every little thing because it could be excluded the next year when you renew. For example if your horse has a minor colic bout at a horse show and just needs a dose of Banamine and some mineral oil, don t turn that in unless the condition worsens and the horse needs more extensive treatment. Otherwise this is a red flag and the insurance company may not want to cover the horse for colic next year. Also maintenance joint injections are not covered by insurance companies.

Will insurance companies cover stem cell therapy, MRI, PRP, IRAP For most companies yes! They may have a dollar limit as to how much they cover for each therapy but most insurance companies realize the value of these therapies and will cover them to keep the horse healthy. One thing you do have to realize is that normally you have to pay the veterinarian for the services and then the insurance company will reimburse you. I have seen this take at most two months to get reimbursement depending on the company.

If the value of the horse on death is not what is most important to you but the veterinary coverage is then talk to your insurance company about what is the least value you can have on your horse and still get a good level of medical and surgical coverage. You could possibly get a 12,500 mortality and 8000 medical and surgical for a non-jumping/racing horse for 700/year. I would say that is pretty affordable when you consider the out of pocket expense if your horse gets sick, and if you show you have now increased those odds your horse will get sick or hurt. So shop around and ask questions and find what is best for your horse, but in general equine insurance is an invaluable policy to have so in your time of greatest need you can do that colic surgery you can t afford and save your companion!

My horse recently got a puncture wound on his leg. Should I be worried about tetanus Sara Jensen, DVM

Of all the common species of domestic animals, horses are considered to be the most sensitive to tetanus infection. This means that it requires very little exposure for a horse to become ill. The bacteria that causes tetanus is called Clostridium tetani. It normally lives in the soil in all areas of the world, so it is impossible to eliminate exposure to your horse.

The most common route of infection is via wounds especially to the hoof or lower leg as these areas are easily contaminated by dirt. Puncture wounds provide a great place for the tetanus bacteria to grow because of the lack of oxygen. Surgeries, dental work, uterine infections, or umbilical infections can also serve as potential portals of tetanus infection. As the bacteria grow, they produces several toxins that wreak havoc on the surrounding tissue as well as the entire body. It usually takes about 7-10 days after a horse is infected to begin showing signs associated with tetanus.

Tetanus usually has a gradual onset of signs that are associated with the neurologic system. Early signs include stiffness of the muscles of the head and neck. Eventually, the horse will assume a “sawhorse” stance where the neck and limbs are stretched out and stiff. Often, the third eyelid in the corner of the horse’s eye will protrude unnaturally. This will progress to the horse becoming recumbent with violent muscle spasms.

Tetanus causes death in about 50% of the cases. Treatment can be effective but is long and costly. A much cheaper and effective alternative is simply vaccinating your horse yearly for tetanus. Commonly, tetanus vaccine comes in a combination with Eastern Equine Encephalitis Virus and Western Equine Encephalitis Virus called EWT for short. Sometimes, it comes in other combinations vaccines with rhinopneumonitis or influenza added. Tetanus vaccine can also be purchased as a sole vaccine.

There are two types of tetanus vaccine that may be given. It is very important to understand the difference between the two as they are given in very different situations. The most common type and what you would give the horse for yearly vaccination is termed a tetanus toxoid. The other form of tetanus vaccine is termed a tetanus antitoxin. The antitoxin should only be administered in special situations by a veterinarian when it is believed that a horse has never been vaccinated and has been recently exposed. The antitoxin should be used with much discretion only by a veterinarian as harmful side effects can occur.

It is important to vaccinate for tetanus even before a horse is born. This is accomplished by vaccinating the pregnant mare one month prior to foaling. When the foal nurses the first milk (colostrum), the protective antibodies are transferred to the foal guarding him from infection. Once the foal becomes about 6 months old, it is necessary to vaccinate again for tetanus as the maternal antibodies are decreasing at this time. From there, yearly vaccines are necessary to prevent tetanus. If it has been more than 6 months since vaccination, and the horse is wounded, it may be recommended that the vaccine be boostered.

If your horse is wounded, develops an infection, or undergoes surgery, it is unlikely that tetanus will be an issue if he has been vaccinated within the last year. Always call your vet in these circumstances to determine the most appropriate treatment and whether or not a tetanus booster is indicated.

My horse is a 15-year-old gray thoroughbred mare that has developed some lumps under her tail. Several people have told me that these are melanomas, all gray horses get them, and to just leave them alone. One lump seems to be getting bigger, should I be concerned Sara Jensen, DVM

Melanoma is a type of pigmented tumor that occurs fairly commonly in the horse. There is a predilection for melanomas in gray and white horses of any breed. Horses with other coat colors can develop melanomas, but it is less common. Melanomas tend to occur more commonly in older horses (over 15 years of age), but young horses, even foals, may be affected as well.

Typically melanomas occur in certain sites: under the tail and around the anus; in the throat latch region under the jaw; in lymph nodes; and less commonly, on or around the ears, lips, eyes, and mammary glands. Tumors can also be internal and not visible outwardly. The tumors can vary greatly in size, texture, and appearance. Typically, melanomas grow very slowly. The cause of melanomas, especially in gray horses, remains unknown.

Traditionally, it was believed that most melanomas are benign. This means they stay in one place and do not spread versus malignant which means they have the capacity to spread to other body parts. Usually, melanomas are not treated unless they cause a problem such as inhibiting defecation, swallowing, or causing organ dysfunction.

The idea that melanomas are “no big deal” and do not warrant immediate treatment is being scrutinized more closely. Recent research has shown that all melanomas are, in fact, malignant. Many tumors that start out as pea sized growths can lead to more serious problems that cannot be treated. It may be beneficial to treat these tumors early before they metastasize or grow too large to easily remove.

Biopsy, or taking a piece or the entire tumor to analyze, can be very helpful in many ways. It can verify that the tumor in question is actually a melanoma (other tumors can have a similar appearance.) Biopsy can help determine how aggressive the tumor may become or if it is likely to spread and grow. It can also help the veterinarian determine the most appropriate treatment.

There are many methods for treating melanomas. Some are very aggressive and entail surgically removing the mass, and some are conservative and entail just watching the mass for increases in size. Some methods entail giving oral medications, melanoma vaccines, or injecting chemotherapeutic agents into the tumor. The biopsy results can help your veterinarian determine which method is most appropriate.

It is becoming more evident that being proactive about melanomas early can help avoid devastating effects later. Especially in gray horses, be aware of any new lumps, bumps, or masses in the common melanoma locations. Be sure to report these to your veterinarian for evaluation at your horse’s annual exam!

My horse was diagnosed with a sinus infection about 6 months ago. We have treated with antibiotics two times now, but the smelly discharge from his left nostril keeps coming back. I am so frustrated! Why isn t this going away, and how do we cure it -Sara Jensen, DVM

Anytime you have treated something for that long and seen no improvement, it is time to switch gears. It is important to figure out what the problem is instead of just treating for an infection. Nasal discharge in the horse can have many different causes, and most of them cannot be cured with antibiotics alone.

The first step is to characterize the discharge and determine if it is coming from one or both nostrils. The next step is to determine the character: thin and clear, thick mucus or pus, bloody, smelly, etc. Some thin, clear nasal drainage is normal especially during the colder months. If nasal discharge is coming from both nostrils, it is likely that the problem is coming from the throat or lower airway. If the discharge is coming from one nostril, it is likely that the problem involves only one nasal passage or the sinuses.

In the case above, the discharge is only seen from one nostril, so it sounds like the problem is in the nasal passage or sinus. The next step is to determine what is causing the nasal discharge. The most common cause of smelly, thick discharge is a problem stemming from the upper molars. This may not immediately make sense, but these tooth roots are located in the maxillary sinus. If the tooth root becomes infected, the sinus also becomes infected which leads to a sinus infection. To determine if this is the cause, a simple oral examination with a dental speculum is necessary. Usually the offending tooth or teeth can be identified. If the teeth appear normal on oral examination, x-rays of the tooth roots can help pinpoint which tooth is infected.

Treatment involves extracting the infected tooth or teeth and flushing the sinus thoroughly. This is a good example of a condition that will not be cured with antibiotics alone. The reason for this is that feed and bacteria in the mouth can migrate around the infected tooth into the sinus causing continual infection. Yearly examination and balancing (floating) of the teeth can help prevent this problem.

If a tooth root is not the cause of the nasal discharge, the next step is to perform endoscopy of the nasal passages. This allows the nasal passage and sinus opening to be clearly seen. This diagnostic technique is useful in identifying tumors, masses, cysts, and fungal infections that occur in the horse s upper airway. With these types of problems, endoscopy may not give enough information about how big a mass is or what internal structures it is affecting. MRI and CT can be helpful in providing images of the horse s head in cross-section. MRI and CT are invaluable in surgical planning when a mass or tumor needs to be removed.

It is important to address abnormal nasal discharge as early as possible. In the case above, waiting six months to find the cause of the problem is six months that a tumor or mass could be growing or a tooth root infection could be causing the horse pain. Have your horse s teeth checked at your annual exams and have any abnormal nasal discharge inspected by your veterinarian as soon as possible.

Q: My horse was prescribed Previcox for a chronic condition and I am hearing mixed rumors as to whether it can be used in a USEF or AQHA competition. Can you shed light on this -- Wynne DiGrassie, DVM, MS, DACT, CVA

A: Previcox is the brand name for firocoxib and is the canine chewable tablet. This is a similar product to the equine product Equioxx which is also firocoxib and is an oral paste. Many veterinarians are using Previcox in place of Equioxx due to the price difference between the two on chronic conditions. The problem with this is several fold, first it is illegal according to the AVMA and FDA to prescribe a drug in an off label usage when there is a similar product available for that species. For example we can use some medications in horses that are for cattle because we do not have a similar product labeled for use in horses. This is also how we can get away with using some compounded medications. This is called off-label usage and is acceptable to the FDA. However in this case there is an oral product in horses which is Equioxx so the use of Previcox is not allowed and should not be done. Realistically your veterinarian could be fined or worse lose their license if the issue was pushed.

The reason for this is to protect the horse and horse owner. We do know how Equioxx is metabolized by the horse just not Previcox ; no studies have been done to know if it even truly works. Also if you have noticed the dose in a 100 lb dog is a 227mg pill, but the horse dose is only of that pill. So the horse is definitely more sensitive to the drug and metabolizes it differently then the dog. Also some veterinarians are putting horses on Previcox long term and it has been shown that horses given Equioxx long term (over 60 days) did start seeing some of the same side effects as with phenylbutazone. Therefore a horse should not stay on the drug everyday indefinitely, they could have kidney and colonic ulcer problems. I know of some horse owners that have complained of oral ulcers associated with the Previcox tablets that we have not seen with the Equioxx paste.

The other problem is in the competition horse that uses Previcox . Again since we do not know the rate of metabolism of the pill in the horse we can not predict accurately the drug withdrawal time for competition. It is 12 hours from competition for Equioxx but some horse owners that used that same time period for Previcox did show up positive on a drug test. When I called USEF and talked to them they recommend coming off the Previcox for showing and only show on Equioxx to be safe. You can only use Equioxx for a total of 14 straight days in competition and then the horse needs to come off for a couple days. Also remember you are only allowed one non-steroidal anti-inflammatory (NSAID) during competition now. You can not have your horse on Previcox or Equioxx and think you can bump them with either phenylbutazone (bute), Banamine , ketofen, Surpass , etc. at a show. This is now illegal. In an emergency colic or eye situation a veterinarian can give a shot of Banamine , but the horse must be removed from competition for 24 hours and fill out a medication report.

So to summarize, there is a great product out there for osteoarthritis called Equioxx . It is my favorite for competition horses. If you chose to use Previcox be aware of the long term effects, potential side effects, and the rules for competition. I would hate to see someone win a world/national title only to have it taken away due to a positive drug test!

Q: What is the definition of an “unwanted horse” Wynne DiGrassie, DVM, MS, DACT, CVA

A: An unwanted horse is basically any horse that is not wanted by their current owner for various reasons. It could be they are injured, ill, old, not performing as well as before, or the owner couldn’t afford care anymore. The Unwanted Horse Coalition (UHC) which is a branch under the American Horse Council has been working hard at educating horse owners on responsible horse ownership.

Part of what the UHC strives to do is reduce the number of unwanted horses and find alternative careers for horses before they become unadoptable. However it is a daunting task with the rising number of unwanted horses in the United States and the saturation of horses at rescue/non-profit organizations. These groups are receiving minimal financial support and really need our help. So what can you do to help the problem The first thing you should do is if the horse is not what you need or can afford ask for help! Call your veterinarian, friends, local horse groups, rescue organizations, etc. and ask what your options are!

You can try to sell your horse. There are several local and national publications as well as internet sites and great auction groups that can help you to sell your horse. Adoption is another option whether it is to a rescue group, therapeutic riding organization, or even a school riding program. A lot of these organizations are non-profit and you can get a tax write off for the donation. Some universities around the country have breeding programs that may be looking for quality broodmares for their program. Check out university websites for that information.

Another option is retraining for a different discipline. That has been great for the thoroughbred industry to retrain retired racehorses for different disciplines such as eventing and jumping. Some horses still want to work and be useful but may just not want their current occupation anymore. I am sure there are many people out there that feel the same about their job! Try a different sport or find someone that can teach the horse a different sport like dressage if they don’t want to jump anymore. A lot of people love trail riding for relaxation and pleasure, so if you have a trail safe horse ask your local horse clubs if they know of people looking for a trail horse.

Even though I am a reproductive specialist, I am not a fan of breeding your horse just because he/she can’t do their job anymore. That is part of the reason we got in this situation is indiscriminate breeding! Think before breeding about what are you going to do if the mare has problems with the pregnancy or the foal is born with problems, can you afford to take care of it What if you do not sell the foal as a weanling or yearling as you had hoped, are you prepared to care for that horse until you do find a home or sell it These are all tough economic decisions that people need to think of when starting to breed. Does it make sense for you

Rabies occurs very rarely in horses. Why is it necessary that I vaccinate for it Sara Jensen, DVM

Consider this scenario: A veterinarian is called out to look at a horse that is down and cannot rise on its own. The owner and her children plus some of the neighbors have been trying all day to get the horse up with no success. When the owner is asked when the horse was last vaccinated, it becomes apparent that the horse is way overdue for its yearly vaccines. This instantly creates a much larger problem: these signs can be consistent with rabies, and many people have been potentially exposed. How will the situation be handled Could this have been prevented

There are many effective vaccines for infectious causes of neurologic disease. If a horse is up to date on vaccines, these diseases can be placed much lower on the list of possibilities if a horse begins showing neurologic signs. The most important of these diseases is rabies because it is highly transmissible and fatal to humans if not treated immediately. In the scenario above, the veterinarian is not only faced with decisions regarding the treatment of the horse, but also must consider the well-being of the people involved. This is not an easy situation.

Rabies is a virus transmitted to horses through the saliva of infected wild animals. Usually infection occurs from a bite but can also occur if infected saliva comes in contact with an open wound or mucous membranes. The most common vectors are the fox, skunk, and raccoon. Less commonly dogs and cats can transmit rabies to horses. Horses that are bitten by an infected animal will usually begin to show signs within 2-6 weeks, so bite marks are not necessarily going to be evident when the horse begins to look ill. Once the horse begins showing signs, death usually occurs within 2-4 days.

Signs of rabies can vary widely which makes the disease difficult to diagnose. Often abnormal behavior is noted which can range from dullness and depression to aggression and hypersensitivity. Affected horses may display incoordination, have muscle weakness or tremors, or even become comatose. Other treatable neurologic diseases can cause the same signs, so it is important to have the horse seen by a veterinarian to try to rule out other diseases.

The only way to diagnose rabies is with post mortem (after death) examination of brain tissue. In the scenario above, this puts the veterinarian and owners in a difficult position. They must make a choice to put the horse to sleep and have it tested so that the people involved can immediately get treatment if the horse is positive for rabies. Unfortunately, rabies is not treatable in the horse once it is showing signs.

Rabies is easily and effectively prevented by yearly vaccination of your horse. Rabies vaccine can only be purchased and administered by a veterinarian. Vaccinating dogs and cats on the premises can help reduce the risk of rabies transmission to horses and people. If a horse begins showing neurologic signs (odd behavior, stumbling, muscle twitches, difficulty eating and swallowing, becoming recumbent, etc.), it is a good idea to wear gloves when handling the horse to protect yourself from contact with the saliva. Minimize the number of people that come in contact with the horse and call the vet immediately. Most importantly, keep your horses up to date on their vaccines to avoid scenarios like this one!

Dr. Wynne DiGrassie talks briefly about oral medications and demonstrates giving medication.

 

 

 

Ideally we like to see the placenta passed in less than 3 hours post foaling. Most mares will normally pass the placenta within 2 hours of foaling if there are no complications. There is no good answer as to how long it is in before it causes a problem. I have seen mares that have had a placenta in for 6-8 hours and never have a problem. I have had mares retain the placenta for just 3 hours and have considerable complications. The problem is not only with the retention of the placenta but also with the health of the uterine lining and how well the uterus clears fluids and blood post foaling. The more trauma and difficulty during delivery, there is a greater chance the mare will have post foaling complications whether the placenta is retained or not. The immune system is working hard after a delivery to clean up the uterus from the debris and fluids associated with delivery. However some mares due to uterine conformation can have a harder time clearing the fluids/blood post foaling. The fluids and blood are a great medium for bacteria to develop and lead to a uterine infection. The uterine lining is compromised post foaling and if a bacterial infection does develop in the uterus it usually affects all layers leading to what we call a metritis. It is this septic metritis that causes the mare to become systemically ill. Some of the signs can include: fever, off feed, depression, colicky, abnormal bloodwork, etc... If treatment is not aggressive and started immediately the toxins from the bacteria can cause other more severe problems such as laminitis and organ failure. This is what we worry about the most in these sick post foaling mares.

The role the placenta plays in this cascade is that it acts like a ladder leading the way for the bacteria to enter into the compromised uterus. The bacteria usually come from fecal and environmental contamination. The placenta also continues to traumatize the uterine lining by pulling on the uterus from gravity externally until it is expelled. The placenta also contains blood that is an excellent media for the growth of bacteria. Usually when I see placental retention it sends up a red flag that there is more going on in the uterus. The uterus may be exhausted from a prolonged delivery or trauma and not able to function properly. When the uterus does not function properly it can accumulate fluid and bacteria as stated above.

When you have a mare that has placental retention the first thing you should do is contact your veterinarian. He/She can tell you the next step in treating the problem. Some things that might be done are tie the placenta up to add weight and give oxytocin to help uterine contraction. I do not recommend adding external weight to the placenta. That adds too much tension and excessive trauma to the uterine lining and can lead to removal of only part of the placenta. I will tie the placenta up on itself to add slight weight and get the placenta up out of the bedding. I do recommend oxytocin to help expulsion of the placenta but only under veterinary guidance. Some mares have such an exhausted uterus that either the oxytocin will not work or can lead to a uterine prolapse which is an even bigger emergency. If your mare retains her placenta call your veterinarian and have her seen relatively soon. The vet will probably perform a vaginal examination to make sure there is not any vaginal or uterine tearing and assess uterine health. Your vet will also start the mare on antibiotics and anti-inflammatories as a precaution for a potential metritis. I will also lavage the uterus to get out the excess fluids and blood but that is veterinary specific. If the placenta is expelled before the veterinarian arrives, keep it for examination. Remember even though it may look like the entire placenta is present, tags can be left inside and lead to a metritis as well. The biggest thing to remember is get the vet out and treat aggressively early and have them examine the placenta thoroughly. Early treatment will help keep your mare healthy and prevent any more devastating problems.

Wynne DiGrassie, DVM, MS, Diplomate American College of Theriogenologists

Unfortunately, from the day a horse is born to the day he dies, he is never safe from the wrath of colic. The term colic is used in horses as a general term for abdominal pain. Anything that causes abdominal pain can cause the typical colicky signs such as pawing, rolling, off feed or general depression. In adult horses, we commonly associate gas or spasmodic colic, impactions/obstructions, displaced colon, etc. with these symptoms. Due to their size and diet (milk), foals have the potential to develop different issues that also cause colic. As a foal ages, it is predisposed to different types of colic.

In the first to second day after birth, meconium impactions are very common. Meconium is the type of feces produced in the womb before the foal begins consuming milk. Meconium is typically very dense and sticky and can be difficult for the foal to pass. Foals frequently will appear to strain to defecate but will pass nothing or very little feces. The foal s abdomen may become quite distended. Signs range from slight straining to becoming very painful, going down, thrashing, and rolling. Usually one or more soapy water enemas will resolve the impaction. Very rarely is surgery required.

More rare conditions causing colic in the first day or two following birth are congenital abnormalities. Colonic atresia is an abnormality in which the colon is not completely formed and feces cannot pass through the GI tract. The mating of two overo horses can produce a foal with lethal white syndrome. The result of this syndrome is defective nerve endings in the intestine and feces cannot be propulsed through the GI tract, and there are no treatment options.

In the first to third days a common cause of foal colic is a ruptured bladder. This occurs more frequently in male foals and is thought to be due to trauma during foaling or by lifting the foal from the belly. Foals will appear to be straining to urinate but produce little to no urine. This is a medical emergency as the urine leaking into the abdomen causes potassium levels to rise in the blood. Elevated blood potassium levels can lead to cardiac arrest. Once the foal is stabilized, surgical correction of the bladder tear is necessary.

Enterocolitis causing diarrhea in foals is a common cause of colic at various stages of development. This can be due to bacterial, viral, or parasitic organisms or noninfectious causes such as foal heat diarrhea. Diarrhea in foals should be regarded as an emergency and immediately assessed by a veterinarian. It may be difficult to initially determine the cause of the diarrhea, and foals can deteriorate very quickly and die from dehydration or low blood sugar if they are not appropriately supplemented. Foals that experience diarrhea can have abnormal motility of their intestine which can predispose them to an intussusception. This occurs when intestine slides over itself and gets trapped, similar to how a collapsible telescope folds down.

As in adults, gastric ulcers can be present in foals of varying ages. Usually gastric ulcers occur in foals in a stressful environment such as those that are sick and undergoing treatment in a hospital or those held off milk for any length of time. Unlike adults, these ulcers can also occur in the outflow tract of the stomach into the small intestine. If the ulcers scar down and heal at this location, they have the potential to cause strictures. In addition to typical pawing and rolling, foals will also express signs such as teeth grinding or assuming a position on their back with their legs in the air for extended periods of time.

Older weanlings that are not dewormed appropriately can get an obstruction of their small intestine caused by roundworms. This is easily prevented by routinely performing fecals and using an appropriate deworming schedule as recommended by your veterinarian. Weanlings that live in highly populated pastures with other weanlings are most likely to have problems.

Just as in adult horses, colic in foals must be considered an emergency and treated quickly. Consult your veterinarian before giving medications such as Banamine as it is more likely to cause harmful side effects in foals. Knowing the different causes for colic in foals can help you be more aware and identify potential problems sooner.

The most common reason mares have mild colic signs post partum is from uterine contractions trying to remove the placenta and remaining fluids after foaling. Maiden mares in general that are experiencing this for the first time more commonly react stronger to the uterine contractions then do seasoned broodmares. I always give my post foaling mares oral anti-inflammatories to help discomfort after foaling and decrease the swelling of the vulva and vagina from the trauma of delivery. Some people feel this will prolong expulsion of the placenta but in my hands it has not delayed time to placental expulsion. I feel that if the mare is more comfortable it will make it easier for her to release the placenta.

However other things can cause a mare to show pain that are far more serious and should not be ignored. If you attended the foaling and there was any difficulty in delivery the mare needs to be monitored more closely for complications. A mare that is acting uncomfortable should have a complete physical examination by a veterinarian. A uterine tear will either cause the mare to become painful or depressed. The fluids that are in the uterus are very irritating if invade the abdominal cavity and can cause a devastating septic peritonitis. If it is a large tear the mare will need to be stabilized and then transported for surgical repair of the tear. Very small tears can sometimes close with oxytocin therapy and aggressive treatment of the peritonitis. In either situation the mare is better cared for in a hospital setting and not in the field. Uterine prolapse either partial or complete is more common in draft breeds and after prolonged difficult delivery. For some owners it is difficult to determine that the tissue that is hanging out of the vulva is not just the placenta but also the uterus. This is a true extreme emergency if you see this. The veterinarian needs to come out immediately because the longer the uterus stays out of the vulva the more trauma and shock the mare will endure. While waiting for the vet, it is best to keep the mare quiet and the uterus clean. You can cover it with a trash bag to help keep all the dirt and debris off the tissue. The veterinarian will replace the uterus out in the field but once replaced some of the monitoring and aftercare may best be taken care of at a hospital.

The scariest for me is the uterine artery rupture. Older mares that have had numerous foals are the most likely to have this complication. Over time the uterine artery wall will become stretched out and may become friable. After a difficult delivery that artery may either leak slowly or have a sudden blow out. If your mare becomes violently painful, shocky with a very rapid heart rate but weak pulse and becomes pale this should be on your rule out list. Again this is a true emergency and a veterinarian needs to respond immediately. It is best to keep the mare calm and quiet. I usually take the foal away or at least out of harm since these mares if succumb to a sudden bleed out will become violent and fall down. We do not want the foal to get hurt or any person to become hurt. These mares need to be left at the farm until they are stabilized and should not travel until the clot has formed. Unless a blood transfusion is needed it may be best to leave them at the farm for at least a day because any travel stress or trauma may cause the artery to open up again. The hardest thing about keeping a mare going that had a slow leak/bleed is controlling the pain. This is a very painful process and as they get more uncomfortable and start rolling this is when they reinjure the artery and make it a fatal bleed.

There are several gastrointestinal alterations that can happen post foaling. Most immediately after foaling is usually a small colon tear or cecal rupture. Both of these are life threatening and need to get to a surgical facility as quickly as possible for repair if possible. More commonly seen is the large colon torsion. This can be seen anywhere from immediately post partum to several months later. The large colon has been pushed around for 3-4 months by a heavy, large uterus taking up space. Now that the mare has foaled it is like a party in the abdomen and the large colon can go anywhere including in the wrong place. This is another major emergency where the mare becomes violently painful, shocky and septic as the blood supply is cut off. It is best to get the mare to a surgical facility immediately and the faster they get her on the table the better the outcome. The longer the large colon goes without blood supply the sicker the mare will get and the poorer the prognosis.

So it is best when you see colic signs in your mare to get your veterinarian to come out and take a look at the mare. What may seem minor initially can have a devastating outcome if not identified early.

Strangles is an equine respiratory disease caused by a bacterial organism called Streptococcus equi subspecies equi. The disease is commonly referred to as Strangles due to the severe swelling and abscess formation around the throatlatch area. As is the case with your yearling, initial signs of strangles can be vague and difficult to differentiate from other respiratory diseases. Strangles is a highly contagious disease, and prevention and management of cases on the farm can often be frustrating.

Strangles most commonly affects young horses although adult horses with little previous exposure are also susceptible. Usually the disease is introduced to your herd by the addition of a new horse incubating the disease but not showing signs or a horse that has recently recovered but is still shedding the bacteria from an ongoing infection of the guttural pouches (an enlarged tube that connects the ear to the throat). The bacteria are spread by horses coming in contact with nasal secretions from an infected horse either directly or on blankets, brushes, tack, buckets, etc.

As mentioned above, signs of strangles can initially be vague: clear to thick yellow nasal discharge, high fevers (102-106 F), lymph node enlargement, and anorexia or off feed. Within a day or two these signs progress in severity to large amounts of nasal discharge consisting of thick mucus and pus, severe enlargement of the lymph nodes located around the throatlatch area which may rupture and drain pus, very high fevers, and general depression. Once the lymph node abscesses are opened and drained, the horse will begin to feel better and get well within 7-10 days. Sometimes the disease can take a more complicated course causing systemic signs such as swelling of the lower limbs or abscess formation internally. With the uncomplicated cases, the horse can typically overcome the infection on its own without antibiotic treatment. With more complicated cases, intensive treatment may become needed.

In order to determine if the cause of nasal discharge in your horse is strangles, your vet will need to obtain a sample of the nasal discharge or lymph node abscess. This can then be submitted for culture which takes approximately 3-5 days to get results back. A newer testing method called PCR (polymerase chain reaction) can return results faster and may be more likely to show infection in horses carrying the organism but not showing signs. One or both testing methods can be used, although using both will give fast and most reliable results.

While you are waiting on your veterinarian to get the sample and the results to return, it is important to begin institution of biosecurity measures to reduce the chances of a herd outbreak. This can be done by isolating affected horses into a pasture or barn where healthy horses cannot come in contact with them until they are known to no longer be shedding the bacteria. Rectal temperatures of the healthy horses should be taken 1-2 times daily, and horses with fevers (temperature greater than 101.5 F) should be placed into the isolation area and tested. All communal water tanks on the farm should be disinfected daily using a dilute bleach solution or other disinfectant recommended by your veterinarian. All items (buckets, halters, lead ropes, etc.) used by affected horses should be thoroughly cleaned and disinfected. The horses in the isolation area should be handled last. Personnel handling the infected horses should change clothes and thoroughly wash their hands before handling healthy horses again. A disinfectant foot bath should be placed outside the isolation area to dip feet before walking around the clean areas of the farm.

Vaccinating healthy or sick horses for strangles during an outbreak is not recommended. The reason for this is that vaccinated horses that become infected with strangles have a greater potential of acquiring serious complications that require intensive treatment. Always consult your veterinarian before giving any strangles vaccine to determine if it is appropriate for your horse.

Typically, it takes 2-3 weeks for infected horses to no longer be contagious. Before returning the horse to the general population, your veterinarian may want to obtain another culture or PCR to ensure that your horse is no longer harboring the bacteria. Also, your vet may perform an endoscopy of the guttural pouches, which is a place where the bacteria may continue to multiply and be secreted although the horse appears healthy.

A strangles outbreak can be very devastating and costly, but with quick and appropriate action, widespread infection of your herd can be effectively halted.

Sara Choquette, DVM

Eye issues in horses are a very serious matter and should be considered an emergency. The first thing to do is get the horse out of the sun by either stalling him or placing a mask over the eye (for example a fly mask or anything you have handy). Avoid cleaning the tears and eye boogers from the eye as it will be important for your vet to evaluate the amount and character of the eye discharge. Resist the temptation to use old eye medications you have on hand as they may not be appropriate for the condition your horse has and could possibly make the eye much worse. Next, call your vet to have the eye evaluated.

From the description, it sounds as though your horse has a corneal ulcer. This is a fairly common condition in horses that usually involves an abrasion or cut to the top layer of the eye. Typical signs of an ulcer include squinting, clear or mucoid drainage from the eye, and haziness or irregularity to the cornea. Ulcers can range from very mild to severe depending on the cause of the initial insult. It is also common that these ulcers get infected and typically will not clear up without treatment. As with any wound, infection greatly slows healing time and commonly will make the ulcer worse. This is why fast evaluation and treatment are so important. Horse eyes are very sensitive, and an ulcer can go from easily treatable to very severe with the risk of compromising the horse s vision in the course of a day.

As mentioned above, it is important to resist treating the ulcer yourself with medications leftover from previous eye ailments. Eye medications containing steroids have the potential to make an ulcer more susceptible to infection or cause an already infected ulcer to become much worse. Consult a veterinarian before applying any eye medication.

Treatment regimens for corneal ulcers can be very time consuming and tedious. Since medications get washed out quickly by the horses tears, they must be administered very often. Quite frequently, horses become resistant to having the medications administered directly into the eye. If the treatment regimen requires constant treatment (for example, treatment every 2-4 hours) or the horse resists treatment, a subpalpebral catheter can be placed into the eyelid for ease of administration of medications. This catheter consists of a long tube stretches from the upper or lower eyelid to your horse s mane where the medications are administered. If at any time you are having difficulty administering medications into the eye, a subpalpebral catheter is a great option. Frequent re-evaluation by your veterinarian will help ensure that the eye is healing appropriately and does not warrant more intensive treatment.

Sara Choquette, DVM

Unfortunately, from the day a horse is born to the day he dies, he is never safe from the wrath of colic. The term colic is used in horses as a general term for abdominal pain. Anything that causes abdominal pain can cause the typical colicky signs such as pawing, rolling, off feed or general depression. In adult horses, we commonly associate gas or spasmodic colic, impactions/obstructions, displaced colon, etc. with these symptoms. Due to their size and diet (milk), foals have the potential to develop different issues that also cause colic. As a foal ages, it is predisposed to different types of colic.

In the first to second day after birth, meconium impactions are very common. Meconium is the type of feces produced in the womb before the foal begins consuming milk. Meconium is typically very dense and sticky and can be difficult for the foal to pass. Foals frequently will appear to strain to defecate but will pass nothing or very little feces. The foal s abdomen may become quite distended. Signs range from slight straining to becoming very painful, going down, thrashing, and rolling. Usually one or more soapy water enemas will resolve the impaction. Very rarely is surgery required.

More rare conditions causing colic in the first day or two following birth are congenital abnormalities. Colonic atresia is an abnormality in which the colon is not completely formed and feces cannot pass through the GI tract. The mating of two overo horses can produce a foal with lethal white syndrome. The result of this syndrome is defective nerve endings in the intestine and feces cannot be propulsed through the GI tract, and there are no treatment options.

In the first to third days a common cause of foal colic is a ruptured bladder. This occurs more frequently in male foals and is thought to be due to trauma during foaling or by lifting the foal from the belly. Foals will appear to be straining to urinate but produce little to no urine. This is a medical emergency as the urine leaking into the abdomen causes potassium levels to rise in the blood. Elevated blood potassium levels can lead to cardiac arrest. Once the foal is stabilized, surgical correction of the bladder tear is necessary.

Enterocolitis causing diarrhea in foals is a common cause of colic at various stages of development. This can be due to bacterial, viral, or parasitic organisms or noninfectious causes such as foal heat diarrhea. Diarrhea in foals should be regarded as an emergency and immediately assessed by a veterinarian. It may be difficult to initially determine the cause of the diarrhea, and foals can deteriorate very quickly and die from dehydration or low blood sugar if they are not appropriately supplemented. Foals that experience diarrhea can have abnormal motility of their intestine which can predispose them to an intussusception. This occurs when intestine slides over itself and gets trapped, similar to how a collapsible telescope folds down.

As in adults, gastric ulcers can be present in foals of varying ages. Usually gastric ulcers occur in foals in a stressful environment such as those that are sick and undergoing treatment in a hospital or those held off milk for any length of time. Unlike adults, these ulcers can also occur in the outflow tract of the stomach into the small intestine. If the ulcers scar down and heal at this location, they have the potential to cause strictures. In addition to typical pawing and rolling, foals will also express signs such as teeth grinding or assuming a position on their back with their legs in the air for extended periods of time.

Older weanlings that are not dewormed appropriately can get an obstruction of their small intestine caused by roundworms. This is easily prevented by routinely performing fecals and using an appropriate deworming schedule as recommended by your veterinarian. Weanlings that live in highly populated pastures with other weanlings are most likely to have problems.

Just as in adult horses, colic in foals must be considered an emergency and treated quickly. Consult your veterinarian before giving medications such as Banamine as it is more likely to cause harmful side effects in foals. Knowing the different causes for colic in foals can help you be more aware and identify potential problems sooner.

Sara Choquette, DVM

Ideally we like to see the placenta passed in less than 3 hours post foaling. Most mares will normally pass the placenta within 2 hours of foaling if there are no complications. There is no good answer as to how long it is in before it causes a problem. I have seen mares that have had a placenta in for 6-8 hours and never have a problem. I have had mares retain the placenta for just 3 hours and have considerable complications. The problem is not only with the retention of the placenta but also with the health of the uterine lining and how well the uterus clears fluids and blood post foaling. The more trauma and difficulty during delivery, there is a greater chance the mare will have post foaling complications whether the placenta is retained or not. The immune system is working hard after a delivery to clean up the uterus from the debris and fluids associated with delivery. However some mares due to uterine conformation can have a harder time clearing the fluids/blood post foaling. The fluids and blood are a great medium for bacteria to develop and lead to a uterine infection. The uterine lining is compromised post foaling and if a bacterial infection does develop in the uterus it usually affects all layers leading to what we call a metritis. It is this septic metritis that causes the mare to become systemically ill. Some of the signs can include: fever, off feed, depression, colicky, abnormal bloodwork, etc... If treatment is not aggressive and started immediately the toxins from the bacteria can cause other more severe problems such as laminitis and organ failure. This is what we worry about the most in these sick post foaling mares.

The role the placenta plays in this cascade is that it acts like a ladder leading the way for the bacteria to enter into the compromised uterus. The bacteria usually come from fecal and environmental contamination. The placenta also continues to traumatize the uterine lining by pulling on the uterus from gravity externally until it is expelled. The placenta also contains blood that is an excellent media for the growth of bacteria. Usually when I see placental retention it sends up a red flag that there is more going on in the uterus. The uterus may be exhausted from a prolonged delivery or trauma and not able to function properly. When the uterus does not function properly it can accumulate fluid and bacteria as stated above.

When you have a mare that has placental retention the first thing you should do is contact your veterinarian. He/She can tell you the next step in treating the problem. Some things that might be done are tie the placenta up to add weight and give oxytocin to help uterine contraction. I do not recommend adding external weight to the placenta. That adds too much tension and excessive trauma to the uterine lining and can lead to removal of only part of the placenta. I will tie the placenta up on itself to add slight weight and get the placenta up out of the bedding. I do recommend oxytocin to help expulsion of the placenta but only under veterinary guidance. Some mares have such an exhausted uterus that either the oxytocin will not work or can lead to a uterine prolapse which is an even bigger emergency. If your mare retains her placenta call your veterinarian and have her seen relatively soon. The vet will probably perform a vaginal examination to make sure there is not any vaginal or uterine tearing and assess uterine health. Your vet will also start the mare on antibiotics and anti-inflammatories as a precaution for a potential metritis. I will also lavage the uterus to get out the excess fluids and blood but that is veterinary specific. If the placenta is expelled before the veterinarian arrives, keep it for examination. Remember even though it may look like the entire placenta is present, tags can be left inside and lead to a metritis as well. The biggest thing to remember is get the vet out and treat aggressively early and have them examine the placenta thoroughly. Early treatment will help keep your mare healthy and prevent any more devastating problems.

Wynne DiGrassie, DVM, MS, Diplomate American College of Theriogenologists

Botulism is a disease caused by bacteria (clostridium botulinum) that prefers an environment lacking oxygen (anaerobes). There are three different types but the most common one associated with hay and especially round bales is known as forage poisoning. Horses become infected through consumption of forage containing a preformed toxin from the clostridial bacteria. Forage poisoning is usually associated with decaying vegetative materials or decaying carcasses. The reason round bales are most often associated with Botulism is because the center of the bale usually lacks oxygen and if it gets wet can cause fermentation and molding which makes it an ideal environment for the bacteria grow. Also it is more common to trap dead animals such as small rodents, snakes, etc. in round bales and not notice due to the size of the bale. For both of these reasons a round bale is an ideal environment to set up forage poisoning. Other sources of hay, haylage, and straw can also carry botulism toxins. Botulism toxin is a neurotoxin that acts at the level of the muscle and cause paralysis. Once bound you cannot reverse the effects of the toxin until a new conductor to the muscle is regenerated which can take 4-10 days.

The clinical signs of the disease will depend on the type and amount of toxin consumed. Initial signs of botulism can be seen as eating difficulties and dropping food out of his/her mouth. This can be mistaken as a dental problem but usually if you try to pull out the tongue the horse will not be able to retract the tongue back into the mouth and he/she cannot swallow. This may be the extent of the disease if not a lot of toxin is consumed or the horse can progress to weakness, in coordination, unable to rise, colicky, and finally respiratory distress/failure. If you notice your horse has these signs get your veterinarian to examine your horse immediately time is crucial. Nursing care is the biggest treatment that needs to be done since the horse cannot eat or drink on its own. Intravenous fluid therapy and nasogastric intubation with a slurry of food will help support the horse during the recuperation. There is a blood product that is rich in antibodies against the toxins and will work well at preventing the progression of the signs if caught early. The plasma is expensive but if given early may prevent life threatening progression of the disease.

The best way to prevent the disease is to protect your hay from spoilage and animal contamination. Store your hay inside, make sure it is put up dry and open the round bale before feeding to make sure there are no signs of mold. If you cannot guarantee the safety/quality of the hay then I would vaccinate your horse for the Type B toxin which is the one that usually leads to forage poisoning. If your horse has never seen the vaccine it is a 3 dose series initially several weeks apart and then yearly vaccination in the fall prior to the heaviest stored forage usage. The vaccine is relatively safe and inexpensive compared to treating the disease. If you have questions do not hesitate to contact your veterinarian who can best guide you which way to go!

The best option is to check the mare at 14-16 days post ovulation and check to see if there are two embryonic vesicles. These are the little black round spheres you see on ultrasound pictures. Even if I only see one and I know the mare has double ovulated I will check again the next day just in case the two vesicles are lying right on top of one another making it appear to be only one. If you see two vesicles you have two early options: one is to terminate the whole pregnancy and start over. The other is to crush one of the twins. To crush a twin the veterinarian places forceful pressure on one of the vesicles usually the smaller one. The most common technique for this is to squeeze the vesicle between the ultrasound probe and floor of the pelvis until the embryo has been disrupted. This is usually a simple procedure that does not cause the mare any stress other than the minor discomfort of being palpated. You need to recheck the other vesicle a couple of days later to make sure that pregnancy is safe and again at day 24-30 of pregnancy to ensure there is a fetal heartbeat.

If the twins were not diagnosed until after day 17 it starts to become more difficult to crush the one twin pregnancy due to the shape of the vesicle. If it is found at this point the pregnancy is fixed in location and will not move the rest of the pregnancy. If both embryos are in the same horn you have a chance (up to 85%) for the mare to absorb one of the pregnancies up to day 40-45. If they are in separate horns of the uterus only up to 15% will absorb one of the embryos. You may also restrict the diet of the mare for 2-3 weeks to see if you can cause a nutritional induced absorption of one of the embryos but that usually only works up to 60% of the time.

I would not wait to day 40 for absorption but if you do and they are both still present with heartbeats one option is to terminate both pregnancies with prostaglandins and start over. If you still want to try and salvage one of the embryos, a transvaginal puncture of the embryonic sac can be performed (needle from the vaginal wall into the uterus using ultrasound guidance). This has to be done at a facility with a boarded specialist in theriogenology to make sure the procedure is done safely and correctly. After day 60 of pregnancy you can attempt a transabdominal puncture of the heart of one of the twins (needle through the belly wall and into the heart using ultrasound guidance). Again this has to be done by a theriogenologist. With both of these procedures there are more risks to the mare of infection and possibly leading to disruption and termination of both pregnancies.

You do have options but the easiest and best is to terminate one of the embryos using the crush technique at day 14-16 of pregnancy. Unfortunately letting a mare carry twins is not an option. Most mares either abort both, have stillbirths, or difficult delivery of two small sickly foals.

With the change in seasons from Fall to Winter a few dangers to horses emerge. As pastures begin to become dormant, horses may rely on previously ignored sources of forage, some of which may be toxic. The additional reliance on hay as forage also poses a few toxic threats to horses.

Red maple trees are particularly toxic to horses. Fresh leaves are not a problem for horses, but wilted or dying leaves are toxic. Horses ingest the leaves as leaves or branches fall into their pastures this time of year. Leaves may retain their toxicity for up to 30 days after falling from trees and freezing does not prevent disease. Signs of toxicity usually appear within two days of ingestion and include lethargy, decreased appetite, and severe weakness. The toxic agent in red maple is unknown but it causes damage to hemoglobin molecules and red blood cells such that they cannot efficiently carry oxygen to the body s tissue. These changes often cause reddish-brown colored urine and gum color. Intensive treatment including blood transfusions is required, but despite aggressive treatment many horses may die from severe anemia or kidney damage from the breakdown products of red blood cells. Keeping red maple trees away from horses and keeping pastures free of fallen leaves and branches is the best way to prevent this devastating toxicity.

An increased reliance on hay in the fall and winter comes with its own set of toxic disorders. Alfalfa hay may contain blister beetles that become entrapped in the bales during harvesting. Horses that ingest blister beetles may show signs ranging from lethargy and inappetance to severe gastrointestinal pain, shock and death. Blister beetles contain a toxin called cantharidin which causes cellular dysfunction throughout the body. The gastrointestinal tract and kidneys may be specifically affected and horses may have ulcerations in their mouths that cause them to frequently submerge their mouths in water buckets. Treatment is supportive and many horses die despite aggressive therapy.

Botulism is a disease caused by toxins produced by the bacteria Clostridium botulinum. These bacteria thrive in anaerobic conditions created by decaying plant material or animal carcasses. Round bale hay is often implicated as a source of disease as their size may predispose them to decaying centers and animal carcasses may be easily baled with the hay. However, horses may be exposed to botulism toxin through any feed contaminated with the bacteria or their toxin, or even through contaminated wounds. Signs of disease usually occur within 12 to 24 hours of exposure and are attributable to a flaccid paralysis caused by the toxin. Horses may initially have difficulty eating feed or may be mildly colicy. Thesw signs will progress to weakness, muscle trembling and recumbancy. Death often occurs from paralysis of respiratory muscles making horses unable to breathe. Treatment is usually supportive and may be expensive and unrewarding, as the prognosis is poor once clinical signs develop.

Many other plants are toxic to horses and may cause disease when horses ingest commonly ignored plants as other sources of forage become scarce. Provision of good quality forage during the fall and winter months and removal of toxic plants from pastures may easily prevent the disastrous results of plant toxicities this time of year.

Your veterinarian is correct; he has an increased probability of injuring that tendon. Tendons like other tissues in the body will heal but they need to maintain their elasticity and strength. Tendons have longitudinal aligned collagen fibers. These collagen fibers are arranged into bundles and bind together into a tendon. Tendons are very strong and can withstand repeated stretching without tearing. Tendons act much like a cable that transmits the muscle s force to the bones. Tendons absorb shock and energy like a rubber band. Likea rubber band if it is stretched too far, too fast, too many times it starts to break down. That is a simplistic view of a tendon injury. Scar tissue in the tendon does not stretch like a tendon but it is strong. Re-injures to tendons will often happen around the scar because the tendon can stretch but the scar cannot stretch.

So what can be done about getting your horse back to work Have your veterinarian ultrasound the tendon if they already have not done so recently. This will give them a starting point to see if a treatment works. Many times if the tendon is not healed appropriately we will treat the tendon while we start on physical therapy. A few ways of doing this is with extra corporal high energy shock waves, tendon splitting, check ligament surgery, intra-lesion injections, stem cells, and/or tendon grafts.

Tendons like muscles have to be trained. Tendons adapt to the stresses placed upon them. So if your veterinarian says it is ok to start training then your horse needs to start controlled exercise. I usually have people ride their horses because it is easier to control the horse s movement. For the first week start by walking under saddle for 15 minutes a day on flat firm ground. Avoid deep sand areas and rough uneven ground. The time is increased for 10-15 minutes every week. Each time you get done riding; cool the tendons down with ice boots or cold wraps. After one month it is time to start building strength and endurance. One way is to walk hills. Start climbing an easy gradual slope and then zig - zag down the hill. This is incorporated into the walking regiment. The hill size, duration and speed are then adjusted on a weekly basis. An ultrasound examination should be performed on a monthly basis during the exercise phase to assure that further injury is not taking place. Another way to build strength and endurance is to use a water treadmill and/or swimming. Swimming builds strength to the back and rump area but does not stress the tendons. The water treadmill still puts some stress on the tendons but can build muscle and endurance due to the resistance of the water. It varies with the individual horse which exercise is better for him.
The goal is strength and endurance first before you start jumping. Strong muscles and trained ligaments will help protect the injured area. An ultrasound examination should be performed on the injured tendon before beginning arena work and before you begin to show. When beginning to work in the arena, warm up slowly. Ride the full circle of the arena starting with a walk and build up to a canter over 10 15 minutes. No lounging. Then start with ground poles first and over a period of 3-5 weeks, work up to rails and fences. Keep jumping to a minimum and do not jump every day. Once your horse is fit and jumping short fences without pain or injury, move up to his normal jumps and start showing.
Be patient with the training it takes longer for tendon and ligaments to heal then it does for a bone to heal. Best of Luck and have a great show season!

First, it is time to get your veterinarian involved in the case if he or she is not already involved. Even simple scrapes can seem minor but lead to more unexpected problems later. There is important information you need to give your veterinarian over the phone before he or she arrives on the farm. Is the horse running a fever Is it eating Where is the leg swollen Is it the whole leg or a specific area involved It will help guide the veterinarian what extra equipment may be needed for the visit.
There are several things that may be going on in this leg. Generalized swelling/inflammation of the tissue just below the skin is classified as cellulitis and will need to be treated more aggressively if your current treatment is not working. Examining the horse thoroughly including bloodwork, ultrasonography and radiographs of the swollen area are important at this stage. Take caution tapping a joint or tendon sheath if there is cellulitis in the area to be explored. If the joint or tendon sheath was not already infected pulling bacteria from the cellulitis into a sterile joint/tendon sheath will lead to infection. Swellings involving joints/joint infections are difficult to treat with just systemic antibiotics. They require joint flushes and aggressive intravenous antibiotic therapy. Tendon sheath infections are also difficult to treat on the farm. They also require aggressive flushing of the tendon sheath and intravenous antibiotics.

The swelling may be due to a tendon injury which is why ultrasonography will be helpful to determine if a tendon is damaged. Depending on the tendon involved there are several different treatment options. If a leg is scraped due to a kick there may be bone involvement which may be best evaluated with radiographs. Sequestrums, small pieces of compromised bone, may lead to infections and swelling in the area of the scrapes. Sequestrums and bone infections are best taken care of with surgical intervention if antibiotics alone are not helping. Ultrasonography may also be used to identify if there is a pocket of fluid that may need to be opened and cultured to determine the best antibiotic regime.

First the swelling needs to be reduced and your veterinarian can help guide you how to proceed after examination of the horse. I hope this helps and wish the best for you and your horse.

Infectious respiratory diseases can be costly and serious problems for horse owners and trainers. Gaining knowledge of the pathogenesis of respiratory diseases and implementing measures for prevention can be beneficial to all involved in the horse world. Additionally, diagnosing and treating respiratory infections appropriately as soon as possible may help prevent an individual case from turning into a whole barn outbreak.

Infectious respiratory diseases of horses can be broken down into two categories: those caused by viruses, and those caused by bacteria. Both categories include diseases which can be highly contagious and control measures may be implemented in an attempt to prevent both causes. Some major viral causes of respiratory disease include equine influenza, and equine herpes viruses 1 and 4. While many bacteria are capable of contributing to respiratory disease, many are only able to do so after a virus or other process has first damaged the respiratory tract. One major bacteria that is capable of causing respiratory disease without previous damage is Streptococcus equi equi the causative agent of Strangles.

Equine influenza classically affects young show horses and is spread through respiratory secretions (aerosolized particles, mucus etc). It has a three to five day incubation period and typical clinical signs include fever, lethargy, inappetance, coughing and nasal discharge. The influenza virus damages the lining of the respiratory tract and makes the horse much more susceptible to secondary bacterial infections.

Equine herpes virus types1 and 4 are the major causes of equine rhinotracheitis. Strains of EHV 1 may also cause neurologic disease and abortions. EHV may be spread through respiratory secretions but like other herpes viruses, has the capacity for latency. During latent stages, herpes virus lies dormant within the animal and may then reemerge to cause disease during times of stress or other illness, much like cold sores in people. Typical clinical signs are similar to those of influenza.

Strep. equi (Strangles) is a highly contagious bacterial cause of respiratory disease in horses. It is spread through respiratory secretions and typically causes fever, lethargy, inappetance, nasal discharge and inflamed and abscessed lymph nodes (especially those in the throatlatch area). More complicated cases of strangles may develop lymph node abscessation within the chest or abdomen. Another condition called purpura hemorrhagica which presents as swollen head and limbs, may develop as a result of strangles infection. Some horses may shed the Strep equi bacteria for years after their clinical signs resolve, thus becoming sources of infection to other horses.

Diagnosis of respiratory disease in horses is based on clinical signs, history and specific diagnostic tests. Blood work, nasal swabs for bacterial culture or viral identification, ultrasonographic exam, radiographic exam, and endoscopy are common methods for diagnosing the cause and extent of respiratory disease in horses. Obtaining a diagnosis may help guide treatment and prevention methods in order to minimize the spread of diasease to other horses.

Prevention of infectious respiratory disease involves vaccination and management practices. Vaccination strategies should be based on each individual horse and farm situation and can be best designed in consultation with your veterinarian. As respiratory diseases are easily spread through aerosolized respiratory secretions, quarantine of infected horses will greatly minimize spread. Horses with clinical signs should be separated from other horses by a minimum of 40 feet and equipment (wheelbarrows, shovels, waterbuckets, personnel and clothing) should not be shared between horses. Horses that are newly entering barns or returning from shows should be isolated from other horses for two to three weeks to prevent the spread of respiratory disease before clinical signs are apparent. Disease prevention strategies can be best designed with the input of your veterinarian and should be implemented to minimize the likelihood of widespread disease.

What you have been hearing has become a very hot topic in equine medicine lately. For years, parasite resistance has been a major problem in livestock such that there are parasites that are resistant to every class of dewormers, cannot be killed and are causing death of their hosts. While the situation has not yet become this severe in horses, there is documentation of some parasite resistance to every class of drug, and we must try to prevent further resistance. As we learn more about parasite resistance, we are in the lucky position to be able to change our deworming strategies in order to try to prevent not being able to do anything about it in the future.

No dewormer kills 100% of the parasite burden in the animal to which it is given. After giving drug A, many parasites survive due to resistance to the drug being given. By allowing these resistant parasites to survive, and then deworming with drug B we select for parasites that are resistant to BOTH drug A and B (and other specific drugs within drug A and B s respective classes). Thus, by deworming frequently, with many different drugs, we are only allowing those parasites that are resistant to all of the drugs to survive and multiply in the environment.

The solution to this problem may seem counterintuitive in that it revolves around deworming less frequently in order to allow the non-resistant parasites to dilute out those that are resistant. This strategy works because some horses are more susceptible to parasites than others. The goal is to tailor a deworming strategy to each individual horse based on his or her susceptibility to parasites and parasite burden based on fecal egg counts.

Fecal egg counts involve analyzing a small amount of fresh manure in order to estimate the number of parasite eggs per gram of feces. Typically a fecal egg count of less than 400 eggs per gram of feces does not cause disease in horses. Thus, if fecal egg counts are low, that individual horse may not need to be dewormed at that time. Current thinking is that it may be more beneficial to repeatedly test manure rather than deworm the horse. Additionally, performing fecal egg counts before and after the use of a dewormer gives us what is called a fecal egg count reduction. This measures the effectiveness of that dewormer in that specific horse and allows us to assess parasite resistance. If fecal egg counts are acceptably low after deworming, then repeat egg counts may be performed until they are high enough to justify deworming again. This strategy may significantly decrease the number of horses that need to be dewormed and the frequency with which parasites are exposed to dewormers.

While this strategy sounds good in theory, there are some caveats. Whether parasites are producing eggs in the feces may be dependent upon the season or weather and certain parasites may cause pathology without producing eggs in the feces (encysted strongyles). Additionally managing pastures such that horses have less contact with manure may keep parasite levels low. It is best to discuss individual strategies with your veterinarian.

 

It is important to understand the normal events following the birth of your foal in order to recognize any abnormalities as quickly as possible. Neonatal foals can become very sick, very quickly and it is important to identify possible problems early so that appropriate therapy can be initiated in a timely fashion. Medical treatment of sick foals can be a costly and involved process, but may often be avoided or significantly decreased if problems are recognized and attended to as soon as they arise.

The normal foal should, within the first 15 minutes after birth, make vigorous attempts to stand. It should be successful in doing so within the first 30 to 60 minutes and once up, it should make a deliberate effort to find the mare s udder. Normal foals should latch onto the udder and suckle well within 1 to 4 hours after birth. A normal neonatal foal should nurse vigorously at least once an hour. Nursing properly is the most important task of the foal within the first day of its life. A foal s sole source of immunity to disease within the first few weeks of life is the colostrum it receives from the mare. Even in the cleanest of environments, foals are constantly exposed to bacteria and can develop infections very easily if adequate passive transfer of immunity (colostrum intake) is not achieved. The antibodies that the foal receives in colostrum are large proteins and the foal s intestinal tract can only absorb these proteins within the first 24 hours after birth. Therefore, it is extremely important to make sure that the foal is strong and suckling well within this first day of life. In addition, any supplemental colostrum or commercial product given orally after 24 hours of age will not be helpful.

There are a number of factors that may affect whether the foal receives adequate passive transfer of immunity. First, the mare has to have adequate colostrum for the foal to ingest. Mares may leak colostrum before they foal, or may not produce any at all. Some mares may produce an adequate volume of colostrum, but the concentration of antibodies in it may be inadequate. Checking to see what is actually coming out of the mare is important. Colostrum is a thick, sticky, golden material and should be readily milked from the udder. If you are unable to milk any liquid out of your mare s udder, or if the material is thin and watery, or appears more like milk than colostrum, you should contact your veterinarian. The antibody concentration of colostrum can be measured either directly or indirectly by assessing the density of it. Commercial colostrometers are available, and may be recommended for larger breeding farms in order to assess colostral antibody concentration. The second factor in the foal receiving adequate passive transfer of immunity is its successful ability to find the udder and suck. Numerous medical conditions can cause a foal to be too weak or unable to stand. Additionally, do not assume that if the foal is able to stand that it can find the udder and suck. If you do not see your foal latch onto the udder and suckle well within the first four hours after birth, you should call your veterinarian.

Dipping the umbilicus is an important process in order to prevent infection. The umbilical cord should break on its own during birth and a small amount of bleeding is normal. It is very unusual for a foal to lose an excessive amount of blood from the umbilicus and it should not be clamped, or tied off as this can increase the likelihood of infection. It is recommended that the umbilicus be dipped with a dilute antiseptic solution as soon as possible after birth. One part of 2% chlohexidine (Nolvasan ) solution mixed with three parts of sterile water has been shown to be best at reducing bacterial contamination. This solution can be easily acquired from your veterinarian before foaling. Tincture of iodine is not recommended as this can be very caustic and can increase the likelihood of infection and other umbilical problems. The umbilicus should be dipped 3-4 times per day for the first 2 days after birth. Between dippings it should remain clean and dry and if it appears to be constantly wet, swollen or if it drips when your foal urinates, you should call your veterinarian.

Foals should pass their first manure (meconium) within the first four hours of birth. This manure is often firm and may become impacted in the foal s rectum. The act of suckling stimulates intestinal motility and passage of meconium, colostrum is a natural laxative and most foals pass their meconium without incident. However, many people advocate prophylactic enemas at the time of birth. These should be given before the foal stands and suckles in order to be most effective. Commercial phosphate enemas (Fleet enemas) are best but can be extremely irritating to the lining of the rectum if overused. It is best to administer one enema and if meconium is not produced within the first four hours, call your veterinarian.

All foals should be examined by a veterinarian before 24 hours of age. Your veterinarian will test the foal s blood immunoglobulin (IgG, antibody) concentration in order to determine adequate passive transfer of immunity. He or she will also thoroughly examine the foal to ensure that it is healthy and strong. Nutritional care, routine vaccinations and deworming of both the foal and mare should be discussed at this time in order to determine the ideal health care plan for each individual animal. The importance of early recognition of problems and initiation of appropriate therapy cannot be overemphasized. If you are not sure what is or is not normal, it is best to consult your veterinarian.

 

The foal s first year of life is a stressful time on its developing immune system. Foals are exposed to many infectious diseases in their first year and are surrounded by an environment rich in pathogens. Protecting a foal from infectious disease is a multifaceted process that begins within the first hours of life.

The foal s immune system is incapable of protecting it from infectious disease for the first 6-8 weeks of life. As a result, the young foal relies almost entirely on antibodies and other products produced in the mare s colostrum. The foal must ingest this colostrum within the first 18-24 hours of life, after which time the foal s intestinal tract can no longer absorb the large antibody proteins. In order to improve the concentration of antibodies in the colostrum, mares should be vaccinated against common infectious diseases around 30 days prior to foaling. Owners should discuss with their veterinarian which vaccines might be most important for their specific mares. This improves the chance that the foal will be protected against important infectious diseases within the first months of its life.

As the foal s immune system starts to mature and produce its own antibodies, the antibodies received in the colostrum start to degrade. Most foal vaccination strategies are designed to stimulate the foal to produce its own antibodies so that it can be protected when it loses the immunity received from its dam. The immune system requires multiple exposures to foreign material to develop antibodies, thus multiple vaccine boosters are necessary in most cases.

The American Association of Equine Practicioners has developed vaccination recommendations based on core diseases and risk-based diseases. Core vaccines are those that protect from diseases that are endemic to a region, those with potential public health significance, required by law, virulent/highly infectious, and/or those posing a risk of severe disease. Core vaccines have clearly demonstrated efficacy and safety, and thus exhibit a high enough level of patient benefit and low enough level of risk to justify their use in the majority of patients. (AAEP Vaccination Guidelines, www.aaep.org) Risk based vaccines are those which protect against diseases that may not be great risks for the general horse population, and their use in a program is best assessed through discussion with individual veterinarians. Core vaccinations include those that protect against Eastern and Western Equine Encephalitis, West Nile Virus, tetanus and rabies. Risk-based vaccinations protect against Equine Influenza, Equine Herpes Virus 1 and 4, Botulism, Potomac Horse Fever, Strangles, Equine Viral Arteritis, Anthrax and Rotavirus diarrhea.

Most vaccination recommendations begin at 4-6 months of age (for foals from mares that have been previously vaccinated) and involve a series of 3 boosters, with a 4-6 week interval between the first two boosters and the third being given at 10-12 months of age. Notable exceptions to this schedule include rabies and influenza which may not be effective if given before 6 months of age. Additionally, foals from mares with unknown vaccination history or no pre-foaling vaccination should begin their vaccinations at an earlier age and may require additional boosters. It is best to discuss vaccination schedules with your veterinarian to determine how to best protect your foal.

Equine metabolic syndrome is a condition in horses characterized by insulin resistance, obesity or regional adiposity, and current or previous episodes of laminitis. It may be a genetic condition and certain breeds (Morgans, Paso Finos, ponies) seem to be predisposed to developing the syndrome. The primary concern with the syndrome is the likelihood of the development of laminitis.

Insulin resistance is a condition in horses that is similar to Type 2 diabetes in humans. Glucose is the primary source of energy to cells everywhere in the horse s body. Insulin is responsible for delivering glucose to these cells. In insulin resistant animals, there is enough insulin present but the cells are not responsive to it; they do not listen to the signals from insulin to take up glucose for energy. As a result glucose may build up in the bloodstream.

Equine Protozoal Myeloencephalitis (EPM) is a disease affecting the neurologic system of horses. Sarcocystis neurona, a protozoal parasite, is the most common etiologic agent causing EPM. S. neurona has a complicated life cycle involving multiple species of animals as intermediate hosts, but the only animal that has been shown to be capable of transmitting the disease to horses is the opossum. Horses become infected after consuming opossum feces that have contaminated their feed source. Once inside the horse, the parasite travels to the animal s central nervous system (brain and spinal cord) and replicates. As it travels through and multiplies within the central nervous system it causes damage and inflammation that cause the clinical signs of EPM.

Clinical signs of EPM vary depending on the portion of the central nervous system that is affected. The most common clinical signs include ataxia (incoordination), weakness, and muscle atrophy. If the brain of the horse is affected, horses may have difficulty eating, have a head tilt, or have changes in their mental state or seizures. While a gradual onset of clinical signs is most common, EPM may also present acutely. Due to the wide variety of clinical signs, EPM should be considered as a potential diagnosis for any horse demonstrating neurologic deficits.

Diagnosis of EPM is not black and white. Diagnosis should begin with a thorough neurologic exam by a veterinarian who is experienced in such. Identification of neurologic deficits should be a prerequisite to further testing. As definitive diagnosis of the disease requires identifying the parasite in the central nervous system, the most reliable diagnosis is through post mortem exam. Antemortem diagnostic tests aim to identify the presence of the parasite by examining the presence of antibodies to S. neurona. Antibodies are produced by the horse s immune system in response to exposure to the parasite, and thus horses that have been exposed to S. neurona, but not necessarily infected may have positive serum antibody titers. Some areas of the country, including our own, may have exposure rates of upwards of 60 %. This means that 60% of the horse population may have positive antibody titers without actually being infected. In an attempt to better diagnose the disease, identification of antibodies within the cerebrospinal fluid has been traditionally performed. In theory, positive identification of antibody to S. neurona within the central nervous system would better indicate active disease rather than previous exposure. Problems with this method are that antibodies from the blood (which may be only due to previous exposure) can cross into the cerebrospinal fluid or can contaminate the sample during collection. More recent developments in diagnosis have attempted to identify components of antibodies which correlate better with active disease, than with previous exposure.

Treatment of EPM involves targeting the parasite through drugs such as ponazuril, nitazoxanide , or the combination of pyrimethamine and sulfadiazine, in addition to addressing the inflammation caused by S. neurona. Ponazuril (Marquis) and nitazoxanide (Navigator) are anticoccidials that are given as a paste once a day. Treament duration for these drugs is for a minimum of one month but may be longer depending on the individual horse s response. Treatment with pyrimethamine and sulfadiazine is recommended for at least 4 to 6 months and may cause more side effects with long term use. Additional therapy includes the use of anti-inflammatory drugs, and any supportive care that the horse may need depending on its clinical signs.

To summarize, EPM is a disease which may cause a wide variety of clinical signs in horses, localized to the central nervous system. Diagnosis requires an identification of neurologic deficits and a thorough neurologic exam should be performed by a veterinarian before further testing is pursued. Definitive diagnosis is difficult as many false positive results occur. There a few options for treatment and success depends upon the severity of clinical signs that the horse is demonstrating.

Potomac horse fever is a disease in horses which typically causes fever and diarrhea. It was first recognized along the Potomac River in Maryland in 1979 but has been documented in 43 states, Canada and South America. The disease typically occurs in mid to late summer and frequently (although not always) infects horses near running water (streams or rivers).

The causative agent of Potomac horse fever is Neorickettsia risticii, a bacteria which infects small parasites called trematodes or flukes. Trematodes carrying N. risticii have been identified within multiple species of freshwater snails, thus implicating the snails in the transmission of the disease to horses. Recently, N. risticii DNA has also been identified within freshwater insects including mayflies, caddisflies, damselflies and dragonflies. It is likely that horses become infected after ingesting these aquatic insects.

Horses typically show signs of disease within 1 to 3 weeks after infection. The first clinical signs include lethargy and inappetance with a fever that may come and go. Usually 24 to 48 hours after the onset of fever, horses develop diarrhea which may range from slightly softer manure to profuse watery diarrhea. Approximately 40% of horses develop laminitis as well. Laminitis may progress despite therapy and unfortunately may be the cause of death in many cases of Potomac horse fever. Diagnosis is often based on clinical signs but testing blood and feces for the presence of the bacteria or antibodies against the bacteria aid in diagnosis. Treatment for Potomac horse fever involves antibiotic therapy and most horses respond within 1 to 2 days of initiation of treatment.

Prevention of Potomac horse fever should include control of insect populations. Anecdotal evidence has shown that turning off barn lights (floodlights etc) that attract aquatic insects at night may decrease the incidence of disease. Horses should also have limited access to freshwater streams during the summer if possible. Vaccines are available and while they have shown good efficacy in experimental studies, clinical protection is variable. It is best to discuss prevention with your veterinarian in order to design a program that might best benefit your horse.

Katherine Wilson, DVM, MS, DACVIM
Mountain View Equine Hospital

It is important to understand the normal events following the birth of your foal in order to recognize any abnormalities as quickly as possible. Neonatal foals can become very sick, very quickly and it is important to identify possible problems early so that appropriate therapy can be initiated in a timely fashion. Medical treatment of sick foals can be a costly and involved process, but may often be avoided or significantly decreased if problems are recognized and attended to as soon as they arise.

The normal foal should, within the first 15 minutes after birth, make vigorous attempts to stand. It should be successful in doing so within the first 30 to 60 minutes and once up, it should make a deliberate effort to find the mare s udder. Normal foals should latch onto the udder and suckle well within 1 to 4 hours after birth. A normal neonatal foal should nurse vigorously at least once an hour. Nursing properly is the most important task of the foal within the first day of its life. A foal s sole source of immunity to disease within the first few weeks of life is the colostrum it receives from the mare. Even in the cleanest of environments, foals are constantly exposed to bacteria and can develop infections very easily if adequate passive transfer of immunity (colostrum intake) is not achieved. The antibodies that the foal receives in colostrum are large proteins and the foal s intestinal tract can only absorb these proteins within the first 24 hours after birth. Therefore, it is extremely important to make sure that the foal is strong and suckling well within this first day of life. In addition, any supplemental colostrum or commercial product given orally after 24 hours of age will not be helpful.

There are a number of factors that may affect whether the foal receives adequate passive transfer of immunity. First, the mare has to have adequate colostrum for the foal to ingest. Mares may leak colostrum before they foal, or may not produce any at all. Some mares may produce an adequate volume of colostrum, but the concentration of antibodies in it may be inadequate. Checking to see what is actually coming out of the mare is important. Colostrum is a thick, sticky, golden material and should be readily milked from the udder. If you are unable to milk any liquid out of your mare s udder, or if the material is thin and watery, or appears more like milk than colostrum, you should contact your veterinarian. The antibody concentration of colostrum can be measured either directly or indirectly by assessing the density of it. Commercial colostrometers are available, and may be recommended for larger breeding farms in order to assess colostral antibody concentration. The second factor in the foal receiving adequate passive transfer of immunity is its successful ability to find the udder and suck. Numerous medical conditions can cause a foal to be too weak or unable to stand. Additionally, do not assume that if the foal is able to stand that it can find the udder and suck. If you do not see your foal latch onto the udder and suckle well within the first four hours after birth, you should call your veterinarian.

Dipping the umbilicus is an important process in order to prevent infection. The umbilical cord should break on its own during birth and a small amount of bleeding is normal. It is very unusual for a foal to lose an excessive amount of blood from the umbilicus and it should not be clamped, or tied off as this can increase the likelihood of infection. It is recommended that the umbilicus be dipped with a dilute antiseptic solution as soon as possible after birth. One part of 2% chlohexidine (Nolvasan ) solution mixed with three parts of sterile water has been shown to be best at reducing bacterial contamination. This solution can be easily acquired from your veterinarian before foaling. Tincture of iodine is not recommended as this can be very caustic and can increase the likelihood of infection and other umbilical problems. The umbilicus should be dipped 3-4 times per day for the first 2 days after birth. Between dippings it should remain clean and dry and if it appears to be constantly wet, swollen or if it drips when your foal urinates, you should call your veterinarian.

Foals should pass their first manure (meconium) within the first four hours of birth. This manure is often firm and may become impacted in the foal s rectum. The act of suckling stimulates intestinal motility and passage of meconium, colostrum is a natural laxative and most foals pass their meconium without incident. However, many people advocate prophylactic enemas at the time of birth. These should be given before the foal stands and suckles in order to be most effective. Commercial phosphate enemas (Fleet enemas) are best but can be extremely irritating to the lining of the rectum if overused. It is best to administer one enema and if meconium is not produced within the first four hours, call your veterinarian.

All foals should be examined by a veterinarian at around 24 hours of age. Your veterinarian will test the foal s blood immunoglobulin (IgG, antibody) concentration in order to determine adequate passive transfer of immunity. He or she will also thoroughly examine the foal to ensure that it is healthy and strong. Nutritional care, routine vaccinations and deworming of both the foal and mare should be discussed at this time in order to determine the ideal health care plan for each individual animal. The importance of early recognition of problems and initiation of appropriate therapy cannot be overemphasized. If you are not sure what is or is not normal, it is best to consult your veterinarian.

 

A fair number of older show horse s issues are related to lameness problems such as arthritis and osteoarthritis. If the horse is serviceably sound then this means that the horse is sound enough for the intended use but not completely sound. Maintenance therapy such as joint therapy, anti-inflammatories, as well as other things may be needed to keep the horse at that level of performance. These horses are good to help get a child started in the beginner level as long as there are no general health issues that would prevent the child from riding in their lessons on a regular basis such as advanced COPD that may act up in certain environments. You do not want a horse that is always sick the day of the lesson, because that can become very frustrating for the child and you as a parent. Also you don not want to have a health issue that is going to be detrimental to the longevity of the horse such as cancer, eating problems, neurological problems, etc...

Anytime your horse is faced with an emergent medical condition it can be scary for both you and your horse. The first thing to remember when you find your equine friend in distress or injured is to take a deep breath and evaluate your horse. A simple, quick evaluation includes 3 steps and takes only 5 minutes.

1. Look

Watch your horse in the field and as he comes in. What is his primary problem Is he down or lame Depressed or anxious Is he colicky What signs have you seen

2. Touch

Run your hands over your animal, does he have any new cuts, bumps or sore areas If you find an injury, how deep is the wound

3. Listen

Take the pulse, respiratory rate and temperature of your animal. Does he seem to be having any difficulty breathing

Now when you call your veterinarian you can provide some key information that will help him advise you on how to stabilize your horse until he arrives. Keeping a simple first aid and emergency kit in your barn will assure that you have the tools necessary to follow your veterinarian s instructions until your horse can be seen.

We recommend a medium to large size tackle box to act as your kit. Tackle boxes are easily stored and are portable enough to take along in the trailer. Bright colored boxes are preferred as they are easily seen in an emergency. The box should be stocked as follows at all times.

  • Veterinarian phone numbers

Keep the numbers for your regular veterinarian and a second veterinarian in case your regular veterinarian is unavailable.

  • Owner Information

This is especially important in boarding facilities as veterinarians cannot treat most conditions without direct owner consent.

  • Flashlight and batteries

Most emergencies are noticed in the evening in fading light, and a flashlight is always helpful to evaluate wounds more closely.

  • Halter/ Lead Rope

A spare is always useful.

  • Watch

Good for keeping track of the duration of signs and when to expect the veterinarian. Also, a watch with a second hand is helpful for taking heart rate and respiratory rate.

  • Pen and paper

To keep a record of when you noticed a problem, what you saw, your evaluation, any treatment you have given, etc.

  • Thermometer

Digital thermometers are accurate, durable and beep when the temperature is reached.

  • Stethoscope

Basic stethoscopes are available at most drugstores. If you are unsure where to listen to your horse, ask your regular veterinarian to show you how to use a stethoscope on his next visit.

  • Banamine paste and Phenylbutazone paste or tablets (bute)

These are oral anti-inflammatories that can alleviate pain. They should only be given under the instruction of your veterinarian. They also have a long shelf life when stored properly.

  • Electrolytes

Powdered electrolytes that can be added to water and paste electrolytes are equally acceptable and have a long shelf life if stored properly.

  • Ice pack

Your local drug store should carry room temperature ice packs that become cold when shaken or broken.

  • Towel

To clean and dry your horse if wet or wounded.

  • Leg Bandage (non-adherent pad, roll gauze, quilt/ cotton, vet wrap)

The materials listed can be found at your local drugstore in the first aid aisle and/or at your local tack shop or feed store.

  • Foot Poultice

This can be a premedicated pad, ichthammol, or magna paste. Each can help to alleviate the pain and pressure associated with a hoof abscess.

  • Duct Tape

  • Scissors and/ or a multi-tool

While you are waiting for the veterinarian, try to keep your horse (and yourself) calm. If he is not colicking, give your horse hay to keep his mind occupied. Grooming may also help him relax. If he is colicky he can lie down, but only if he can do so quietly and without rolling.

Finally, you can help your veterinarian in an emergency by providing the proper environment to evaluate your horse. If your horse can walk, bring the horse into a clean, dry, covered, well-lit area. If the horse has an injury, he may require radiographs, and you can help by having a power source handy. The exceptions to moving your horse are if he is down, if he is lame and refuses to walk, or if he has diarrhea. Horses with diarrhea may be contagious to their herd and stable mates and should be isolated until the veterinarian arrives.

Preparation eases the stress associated with an emergency. Routine preventative care, good nutrition, and adequate water intake are key to preventing many emergencies. Please contact your veterinarian to discuss emergency preparation and wellness plans for the upcoming winter months.

 

Equine Herpes Virus-1

Equine rhinopneumonitis virus (EHV-1 or equine abortion virus) is a highly infectious disease that usually affects the respiratory system. Occasionally, the virus may also cause neurological disease. Transmission likely occurs by inhaling infected droplets or ingesting material contaminated by nasal discharges or aborted fetuses. Clinical symptoms may include a fever, difficulty urinating, depression, and stumbling or weakness in the hind limbs. Supportive therapy is often used to treat these cases. In severe cases, horses will be unable to stand; these cases have a very poor prognosis.

Acupuncture is an ancient Chinese method of treating disease through harmonizing the inner energy known as chi. This is accomplished through placing small needles through the skin into what is known as points along a meridian. Each meridian and point is associated with external and internal structures of the body and help heal by reestablishing chi flow throughout the body. Where there is pain there is chi blockage that needs to be relieved. There are different forms of acupuncture and the most common is the dry needle stimulation. However there are other forms used as well which include electro-acupuncture, aqua puncture, moxa sticks, and hemo-acupuncture. When to use each type depends on skill and preference of the acupuncturist. In general I use electro-acupuncture on my chronic arthritis, back pain, and colics. I use moxa when I am dealing with cold induced arthritis to try to warm the points. I use hemo-acupuncture for my immune regulated diseases and severe internal disorders such as Lyme s disease and EPM. I do not use aqua puncture with Vitamin B-12 that often since I use electro-acupuncture for my chronic diseases for which other acupuncturists may use aqua puncture.

When to use acupuncture depends on you and your veterinarian. Acupuncture is one of the complementary therapies that works well in conjunction with other treatments. I think acupuncture works best for chronic back soreness, arthritis, uveitis, laminitis, EPM, diarrhea, and colic. When used in combination with other treatments I have seen reduced hospitalization time and shortened recovery. It is important to remember that acupuncture can kill an animal. If the animal is really old and debilitated acupuncture in the initial stages may be too powerful for the animal. In an extremely sick animal it may push the animal towards death. In pregnant animals you want to avoid very powerful points that may stimulate uterine contractions and lead to abortion. For the most part acupuncture is harmless but these are a few occasions you want to be careful to avoid.

In our clinic we have found that if the horse has a medical colic that can be fixed medically then acupuncture will help fix the colic. If the horse needs surgery acupuncture will only make the horse more painful and help us finalize our decision to go to surgery. I most commonly perform acupuncture on arthritic horses with back soreness. I find that it really helps the horse feel better while we are working on helping the joints. There are so many things acupuncture can help, but remember it is usually done in conjunction with other therapies and should not replace a therapy just merely enhance the therapy.

Best of luck and call if you have more questions!!

 

Summer is upon us. But with the sun, rain, sweat and insects of show season, multiple equine skin diseases also become apparent. The following is a brief summary of summertime skin problems in horses; common clinical signs, causes and treatments.

Rainrot: This common ailment occurs mostly on the back, neck and rump of horses, but can develop anywhere on the body. The classic lesions are scabby areas that may be pulled away with tufts of hair, thus being given the name paint-brush lesions. The lesions are caused by a superficial skin infection due to the bacteria Dermatophilus congolensis. This bacteria thrives in wet conditions and usually (although not always) causes problems after wet weather. Treatment involves softening and removal of the scabs (which may be very painful to the horse), shampooing with a disinfectant shampoo such as betadine. Severe cases may require antibiotic therapy.

Sunburn: Horses suffer from sunburn and require proper sun protection as they are usually exposed to more of the sun s rays than we are! Sunburn is most commonly seen on pink skinned areas such as the nose and eyes, but may occur anywhere and on any color skin. Paint horses may develop reddened skin and lose the hair on white patches with pink skin. Horses with pink muzzles may develop severe and painful scabbing. Treatment involves ointments to soften and soothe the scabs as they heal. Prevention includes sunscreen applied to areas of concern, fly masks designed to cover the nose, and fly sheets to prevent sun exposure of pink areas on paint horses. Severe crusting and ulceration of pink areas may also be symptoms of more serious systemic diseases such as liver disease, drug reaction or ingestion of certain plants and should be examined by a veterinarian.

Scratches: A similar condition to rainrot, scratches is the development of painful scabby areas on the legs. It is associated with standing in wet areas or dew-covered grasses which allow moist skin for bacteria to grow upon. Treatment is similar to rainrot, consisting of softening of scabs and their removal but often necessitates topical corticosteroid and antimicrobial therapy as well.

Atopy: Atopy is the manifestation of environmental allergies as skin lesions. Clinical signs include hives, which may progress to large coalescing swollen areas that are very itchy. Horses may rub these areas on anything they can find to scratch with and may cause hair loss and ulcerated areas. Horses with atopy may be allergic to pollens, dusts or molds in their environment and usually are allergic to multiple things in each of the above categories. Diagnosis may include skin biopsies, certain blood testing and skin testing in order to attempt to isolate which allergens are affecting the horse. Treatment consists of environmental management in order to avoid allergens, corticosteroid and antihistamine therapy. Hyposensitization therapy (allergy shots), as are used in people have been used in horses with varying results. It is best to consult your veterinarian if you suspect your horse may have atopy.

Sweet itch: Sweet itch is caused by hypersensitivity to insect bites, the most common culprit being the biting midge, Culicoides. Clinical signs are usually quite dramatic with severe itching of the mane, tail and belly. Horses frequently spend most of their time finding ways in which to scratch these areas, and usually rub out most of their manes and tails. These areas may also develop secondary bacterial infections due to damage to the skin caused by scratching. Treatment consists of avoidance of insects using long-acting fly repellants, fly sheets and masks, keeping horses stalled during peak insect activity at dawn and dusk, and the use of fans to deter insects in stalls. Severely affected horses often need courses of corticosteroid and antibiotic therapy.

While many skin conditions are mild and easily remedied topically, some may be severe and require diagnostic testing and systemic therapy. It is best to consult your veterinarian before instituting any therapy to ensure the correct diagnosis.

 

Arthritis is defined as the inflammation of a joint or joints. It can be an infliction of many if not all mammals. Inflammation of the joint usually is accompanied by pain, heat, swelling of the joint, excessive synovial fluid, and varying degrees of lameness. The more devastating manifestation of arthritis in horses is degenerative arthritis, degenerative joint disease, or osteoarthritis. Osteoarthritis is defined as arthritis characterized by articular cartilage erosion and/or surrounding bony changes. Arthritis can be caused by many things. Repeated trauma, stress to the joint through training, joint instability, nutritional, infection, etc. The joint is a resilient structure but over time inflammation and cartilage trauma can lower its resilience. Thus, leading to arthritis/osteoarthritis.

Joint anatomy

The joint is made up of bone, articular cartilage, and surrounding soft tissue (ie, ligament, retinaculums, tendons, muscles, and joint capsule).

 

The articular cartilage is principally composed of water, collagens and proteoglycans.

Articular cartilage is responsible for providing a frictionless gliding surface and distributing the load on the joint. The collagen ( mostly Type II) of the cartilage, to put it simplistically, is connected to the subchondral bone and provides a scaffold for proteoglycans to attach. The proteoglycans (aggrecan) are made up of proteins and glycoaminoglycans ( mostly chrondroitin sulfate and keratin sulfate). The aggrecan interacts with hyaluronan to form aggregates. Aggregates attach to the collagen. The aggrecans function is to hold water. With its negative charge it can hold as much as 50 times its weight in water. Water gives the articular cartilage the ability to dissipate load and gives compressive stiffness. Its like flopping onto a water bed, you land flat and then slowly sink in to the bed.

 

Bones give structure and function to the soft tissue. The shape of the joint in many ways determines the way a joint can move. At some joints, the bone ends change shape and become more pliable. This pliability gives the ends of the bones some resistance to loading shock and other every day forces on the joint. The ends of the bone that is mostly associated with the joint is subchondral bone. The articular cartilage attaches to this part of the bone. In very young animals, the subchondral bone will help feed the articular cartilage and chondrocytes( cell that help make the cartilage) by its vessels but in older animals the joint parts are feed through joint fluid.

 

The joint membrane is made of 2 layers, one gives strength and stability to the joint. The other is synovium. Synovium contains mostly 3 different cells A, B, and C. Type A helps clean the joint and synovium up and also produce factors that mediate inflammation in the joint. Type B makes things like collagen and hyaluronan, which are needed to feed and maintain the joint. Type C do a little of both.

Physiology

Early in joint inflammation, the synovium is producing factors that increase inflammation as well as those that decrease inflammation and protect the joint. The chondrocytes are trying to produce more proteoglycans to replace the ones broken down in the cartilage but they may times get broken down faster then they can get produced. This results in cartilage erosion and brake down. Once the cartilage is damaged the subchronal bone starts to get affected. Over a period of time you start to see bone changes. Early in joint inflammation, pain comes from the excessive fluid pressure and inflammation in the synovium. The articular cartilage does not feel pain but the subchondral bone does through nerve endings. So once you have cartilage damage you can have chronic pain, so early detection and treatment is best for long term joint health of your horse.

Some of the early signs of arthritis are lameness off and on, increased fluid in the joints, lame or stiff at the beginning of riding but works it way out, abnormal movement, abnormal stance when resting, not performing like they use too, etc.

 

Joint Pain

Arthritis and osteoarthritis may be the most common cause of lameness in equine athletes but the level of pain does not correlate with the severity of the joint damage. Just because the horse is a little off does not mean that there is not a severe problem with the joint. The problem with using a degree of lameness as a meter for the joint damage is that articular cartilage is devoid of sensory innervation. The cartilage could be eroding slowly over time without pain input until the erosion reaches the subchondral bone. The initial pain of arthritis comes from the nerve endings in the joint capsule and surrounding soft tissue. There are inflammatory factors that increase pain response in the joint capsule but as the length time the joint is inflamed is increased, peri-articular fibrosis can develop. This decreases joint motion and can also cause degeneration of neurons thus, decreasing pain. So decrease range of motion can be a sign of arthritis. If you flex a normal joint the joint pressure increases, with a joint that has increased effusion (fluid) this pressure is increased in not only the joint but may increase the intramedullary pressure (in side the bone where the bone marrow is grown) thus causing pain not only in the joint but can cause pain in the long bones surrounding the joint.

Decrease range of motion as stated previously is a common finding with arthritis and probably caused by a combination of the horse guarding the joint from pain, synovial effusion and edema and peri-articular fibrosis. The pain and synovial effusion and edema is more of an early sign, where as the fibrosis takes time to develop and is considered to be a sign of chronic inflammation.

Joint effusion or increased fluid in the joint, appears as a distention or bulging of the joint pouches. It comes from a leakage of protein into the joint caused from a mismatch between a leaky capillary walls and/or over active synovium with a decreased filtration system (lymphatics). With all of the proteins in the joint more fluid is pulled in to the joint by something called colloidal osmotic pressure. Because of this, joint fluid can be obtained by arthrocentesis (joint tap) to detect inflammation. Inflamed joints can have increased protein, decreased viscosity, color, lower mucin, lower hyaluronan, and higher cell counts but this is very variable from horse to horse. The joint pressure is normally sub-atmospheric with only a thin film of synovial fluid in them, so if you stick a needle the joint and you here air being aspirated. This is not abnormal. With increased joint fluid pressure the chondrocytes and synovial cells can shut down production of nutrients, thus increasing the chance of further cartilage damage.

Nerve blocks and joint blocks can help localize the lameness to a joint or region from the lameness originates but does not tell severity. Sometimes even when we know the joint has a problem, we can not get it to block out . The reason is to lengthy to go into but sometimes we have to do nerve blocks in conjuction with joint blocks.

Some of the later signs of arthritis and/or osteoarthritis may be found with radiographs, nuclear scintigraphy, Magnetic resonance imaging (MRI), ultrasound, and arthroscopy.

Radiographs are great at revealing bony changes but do not detect some small lesions or lesions that just are affecting the cartilage or synovium. Radiographs are important in archiving many inciting inflammatory causes and changes in joint and bony architecture, which is important in cause and treatment. Some of the radiographic finding of osteoarthritis are narrowing of the joint space, subchondral bone mineralizing (sclerosis), joint spurring (osteophyte), subchondral bone lysis (bone being removed), small fractures or fragments, and in advanced stage, joint fusing (ankylosis).

Nuclear scintigraphy uses a radiopharmaceutical (Technetium-99m) that emits gamma rays just like x-rays but only it is injected into the horse and detected on the out side by a gamma camera which is computerized. The radiopharmaceutical can be attached to many different molecules to evaluate things like blood profusion, kidney function, inflammation, lung profusion, liver function, rapid bone repair activity, etc.

The radiopharmaceutical and its molecule (oxidronate or methylene diphosphonate) will go through three phases after injection in the vein of the horse. The first phase is use as a vascular phase to detect blood flow to certain areas but only last about 1-2 minutes. The second phase is soft tissue phase which last about 3-15 minutes and is used to evaluate blood flow to soft tissue. This phase is often used to evaluate the horse for navicular problems, inflame joints,sacroiliac joint problems, etc. The last phase is the bone phase which is taken about 3 or more hours after injection. This phase is used to evaluate bone problems. Most radiation will be emitted from areas of rapid remodeling such as in degenerative joint disease, arthritis, periarticular bone sclerosis, etc. The advantage of using nuclear scintgraphy is that you can image multiple joints and the whole body if needed and is fairly accurate in finding areas of bony and soft tissue problems. The disadvantage is that it lacks specificity of cartilage health, lack of detail which results in other diagnostic to be performed, expense, and the horse has to be quarantined. Scintigraphy is sometimes a useful tool for lameness.

Magnetic resonance imaging (MRI) which detects alternating electrical currents produced from the hydrogen protons found mostly in fat and water. Its advantage is the joint is in a 3-D orientation, detecting water content changes in the cartilage, and with some machines we can find small cartilage lesions. The down fall of MRI is that it is expensive, and it can not detect arthritis before there are changes.

Ultrasound has gained some popularity in visualizing joints. The advantage is that tendons, ligaments, synovial fluid, cartilage, and many other joint changes can be visualized. The disadvantage is limitation of depth and joint structure. Ultrasounds can not look thorough bone.

Arthroscopy is the hallmark of arthritis and joint problem detection. It gives the advantage of seeing synovial inflammation, cartilage damage, early inflammatory changes in the joint, and at the same time flushing the joint fluid the contains large amounts of inflammatory factors. The disadvantage is cost and not every part of the joint can be visualized.

In the near future gene chips and biomarker testing will become more available and cost effective which will detect early mediators of arthritis. This will be a great advantage to help stop arthritis before it becomes a problem.

This is just a brief over view of some of the diagnostics that are routinely used for joint problems in the horse. Next month will be on treatments for arthritis in the horse.

At this moment, treatment for arthritis is geared toward treating inflammation, reducing pain, removing bad cartilage, and protecting the cartilage that is left, or reducing pain until the joint fuses and in some cases, fusing the joint surgically. These goals can be obtained by controlled and planned use of NSAIDS ( non steroidal anti-inflammatory drugs), corticosteroids, hyaluronic acid, polysulfated glycoaminoglycans, other pain controllers, physical therapy, shoeing, herbals, acupuncture, shockwave, and surgery.

The key to arthritis control is to detect it early. Heed the early signs of arthritis. Set up an arthritis prevention plan for your horse with your veterinarian. Although arthritis not totally preventable there are many things that can be done to reduce the changes of your horse s arthritis

 

 

Prevention

The best treatment is always prevention which is difficult to provide in the equine athlete. Even horses in the wild get arthritis mostly in the form of osteochondrosis. In my opinion, prevention of joint problems begin in the selection of the sire and dam even though it is controversial whether or not there is a genetic predisposition to arthritis or osteochondrosis.

Health of the dam is very important to the maturing foal. Nutrition and the time of year the foal is born have been studied and show to be factors in cartilage development. The time of year effect is related to the nutrition of the grass in the pasture and maturity rate of different joints. The nutrition effect includes copper, digestible silica, calcium/phosphorus ratios, proteins amounts and types, etc. which have been found to affect cartilage and bone development. Sick foals that have had septicemia or joint ill may develop arthritis at an early age.

Exercise both in the young weanlings and older horses have been incriminated as a cause for arthritis. Young horses with controlled forced exercise have been shown to develop better cartilage then those just in the fields. This is still under investigation. The flip side to this is that we see more joint problems in horses that are worked at a younger age then those started work when they are mature. This is anecdotal but neither side has been proven to my satisfaction.

Good conformation is important for joint health. Horses with crooked legs , bucked knees , cow hocked , etc. have abnormal stress exerted on ligaments, tendons, and different areas of the joint. This can lead to osteoarthritis over time in the working horse. Weight of the horse may also play a factor on joint stress. Overweight horses over time place a lot more stress on their joints and may predispose themselves to develop arthritis early.

The old saying of no foot, no horse is somewhat true. Feet that are too long or out of balance may have no effect to the horse that is just grazing in the field but when that horse is worked problems may arise. Medial to lateral balance has been studied over and over and found that when the foot is out of balance it puts stress on ligaments and joints further up the leg. Long toes increase the stress of tendons. Also hooves that are too up right and club feet increase stress on the coffin joint, navicular articulations and other joints.

Icing down joints helps reduce inflammation and heat in a joint. It is thought that the cold slows the enzymes that produce inflammation and also has a rebound effect. The rebound effect is that when an area in the body gets really cold it decreases the blood flow to the area but when it warms up it excessively increases blood flow to the area. Icing after strenuous exercise has been shown to reduce joint inflammation.

Other preventatives such as joint supplements containing glucosamine HCL and chondroitin sulfate, manganese, vitamin C, and some containing MSM (methylsulfonylmethane) and other substances have been on the market for many years. Many of these products have varying amounts of these ingredients. Many of them have not complied with FDA ingredient-recognition processes nor does FDA seem to care for the most part. With that said, use only quality reportable products or you may not be get what you pay for. Many of these products make claims of reducing inflammation, protecting cartilage, etc. but it is illegal for any of these products to make claims for treatment of any thing because they are not drugs and have not been approved. There have been many studies involving glucosamine HCL and chondroitin sulfate. There has been conflicting results, some say they do work and help reduce lameness and protect cartilage and some say they do not help. What they do know is that glucosamine HCL works better with chondroitin sulfate then each product alone. All and all, if you feed it and it works with no side effects then use it.

Treatment

NSAIDS are non-steroidal anti-inflammatory drugs which inhibit some component of the enzyme system that converts arachadonic acid into prostaglandins and thromboxanes better know as COX1 (cyclooxygenase) and COX2 inhibitors. Some NSAIDs also claim to be lipoxygenase inhibitors. In short, they are drugs that stop or reduce inflammation by slowing or shutting down the accepted inflammatory cascade called the arachadonic acid cycle thus reducing inflammatory mediators that cause pain, heat, and swelling of the joint and other parts of the body. The complete understanding of the mechanism of action for reducing pain is not yet complete. Reducing inflammatory mediators also reduces the mediators and enzymes that breakdown cartilage. Not all NSAIDS are alike and are there are too many to go over. Each one works differently and anecdotally are used for different aches and pains. They can be given as a prophylactic but are usually used to reduce arthritis and other pains but of the possibility of toxicity, most notably ulcers. These drugs do work well and will be a part of arthritis treatment for many years.

Adequan is the only product that has been approved to be chrondroprotective to be given in the muscle or in the joint (Adequan IA.). This product is a PSGAG (polysulfated glycoaminoglycan) which has been proven to decrease inflammatory mediators in the joint and protect cartilage during an inflammatory insult. This product is now being tested for it s efficacy in protecting the horse against osteochondrosis. For a side note, there are no generic PSGAGs. Those products such as acetyl-D-glucosamine and Chondroprotec (FDA approved as a wound treatment device) are not the same as Adequan and are proven to be less effective.

Oral sodium hyaluronate (HA) has recently common on the market for both treatment and preventative. It has been show in many studies to increase HA levels in the blood. The problem is that they have not been proven to increase HA levels in the joint. Even though research has not been completed on the products efficacy, many people use it for their horse and themselves and have good results.

Intravenous and intra-articular HA are used for treatment and prevention of arthritis. HA is a component of synovial fluid and articular cartilage in normal joints. It is synthesized by the cells of the synovial membrane and of articular cartilage. It provides lubrication, reduces inflammation (controversial), and is part of the structure that makes up cartilage. Given in the vein (Legend ) or in the joint (other brands), it has been shown to reduce lameness and synovitis. Even though given alone into a joint it works by itself, it works better when given with a corticosteroid.

Corticosteroids are drugs that shut down the arachadonic acid cycle completely. Thus it also shuts down some needed mediators the help protect and rebuild things in the body. Used in the proper way they are very useful in decreasing inflammation. Use excessively, they can cause many problems with repair of the body, ulcers, laminitis, etc. It is used in an arthritic joint many times in conjunction with HA but can be used alone.

High energy shockwave is being used more these days to treat arthritis. Shockwaves (too be simplistic) is energy. There are 3 mechanical devices available at this time to produce shockwaves some are good and some are not as good. When the energy passes through tissue and fluids it is released along the way at different tissue interfaces. For example, the shockwave will travel through a fluid with out losing much energy but at an air pocket it will completely release all energy. The shockwave has been shown experimentally and anecdotally to decrease inflammation, increase new blood vessels to the area, and have an analgesic effect (pain killer). More is needed to be learned about shockwave but it is an important tool against arthritis.

When cartilage erosion is evident or suspected, surgery is used. Most notably is arthroscopy for removing cartilage and bone chips in the joint. By removing the chips in the joint you remove some if not all of the source of the inflammation in the joint. At the same time, the joint is washed which will help decreased the inflammatory mediators and let the doctor see the cartilage surface which will help him make a prognosis and a treatment plan. Early intervention helps to lessen the destruction of the joint.

When a joint is so arthritic and other treatments are not working, surgery is the only option. The goal is to make the horse comfortable by fusing the joint and in some cases removing the nerves that go to the joint. There are many surgical procedures but are to in depth for this article. Some of procedures involve LASERS, metal plates, de-nerving, drilling, etc. Talk to your boarded surgeon for details and options.

This article is just a simplistic overview of some preventatives and treatments for arthritis. An in-depth study can be found in many different textbooks and scientific articles. There are thousands of studies that have been done on arthritis and at this time there is no magic bullet to treat or prevent arthritis. Recent research is focusing on early affordable detection of arthritis before it starts. Products such as gene chips, ELISA kits, and genetic typing are currently being researched. With earlier detection and a more precise understanding of what factors and mediators cause arthritis, there will probably be a drug that prevents it in the future.

 

This is a great question that I wish more people would ask. The first thing I like to know from my mare owners is what they are looking for in a stallion (breed, temperament, discipline, marketability, etc.). This question will help you narrow down your search before you dive any deeper. I recommend before settling on one stallion you should go see the stallion, get a video, and/or see his offspring in action. This will only help you determine the attributes this sire may posses and pass on to his offspring. Make sure the stallion you choose compliments your mare s qualities.

Once you have seen the stallion or his offspring and you have decided on a particular stallion next you need to investigate into the breeding fees and contracts. Find out exactly what the stud fee or breeding fee includes. Some places this fee includes the non-refundable booking fee. This is the fee that holds a spot in the stallion s book for you to breed this year. Other stud fees do not include the booking fee and is an extra fee you may not be counting on when budgeting for breeding. Find this out first before signing a contract. Look carefully at the contract for any hidden fees such as chute fees, handling fees, packaging fees, etc. These small fees can add up quickly. A stallion may only have a $500 stud fee but may also have a $250 booking fee, and a $100 chute fee per collection. So your one collection may end up costing you $850 without any vet fees on your end.

Does the stud fee include the first collection and shipment of semen If not this is another fee you need to factor into the total cost of breeding your mare. Most stud fees do include the first collection and shipment but do not assume this is the case with all stallions. Are you breeding with shipped semen If you are then there are another slew of questions that need to be asked if they are not already answered in the contract. What days are the stallions collected for shipment This is important for the timing of when your veterinarian needs to be on the farm to check your mare and order semen. How is the semen shipped Is it overnight via FedEx, UPS, DHL, or is it counter-to-counter through an airport If your closest airport is four hours away and he has to be shipped counter-to-counter for same day delivery you have to determine if you want to make that drive. For overnight shipments I prefer that it is shipped directly to your veterinarian. They normally have regular UPS or FedEx deliver days and can schedule their day better knowing they do not need to come to your farm until the semen arrives at their clinic. How much notice do you need to give the stallion owner prior to ordering semen Most require 24 hours notice so they can make arrangements of how to plan the day and how many containers they need to ship. They can start the paperwork the night before making packaging the day of shipment go a lot smoother.

I do not mind for people to ask me if my stallions ship well and if they have good conception rates. I always recommend you ask this question of your stallion owners, even though you may not always get a straight answer, it will give you a better idea of how easy or difficult the process of breeding your mare may become. If the stallion has a marginal to poor conception rate with overnight semen you may want to request a counter-to-counter shipment or on the farm breeding.

Let us assume you are taking the mare to the farm to be bred for either live cover or AI on the farm. I would visit the farm first before making the final decision. Is it a place you feel comfortable leaving your mare Are their extra fees for the veterinary palpations while she is at the farm Are there extra handling fees What tests/vaccinations does the mare need to have before coming to the farm Will the mare have turnout and is that extra Be specific as to how you want your mare cared for so you can be sure to find out how much those extra things may cost.

These are just a few things to get you started. Carefully look at the contract before signing it and sending in your booking fee. If you do not feel comfortable looking at the contract and formulating questions to ask the stallion owner then find someone who can help. I would recommend a veterinarian that is either boarded in theriogenology (reproduction) or one with a strong special interest in reproduction. We spend our whole spring dealing with mares and stallions and have probably dealt with every situation you may encounter. We can help guide you to make a decision that is best not only for you but also your mare. This is why we are her so use us! Now that you have your stallion lined up watch for an article on preparing your mare for the breeding season this February. Best wishes for a successful and fertile breeding season!

 

There are no clear cut signs of the equine gastric ulcer syndrome (EGUS). Each horse varies in their demonstration of signs of a gastrointestinal problem due to their inherent differences in pain thresholds. Horses with a high tolerance to pain may not show any obvious outward signs of EGUS. Horses with either severe EGUS or mild EGUS with a low tolerance to pain may demonstrate more outward signs of colic. Some common mild signs of general gastrointestinal problems include: depression, off feed, decrease in performance level, dull hair coat, weight loss, grinding their teeth, playing in their water bucket, flipping their lip, acting interested in food but not eating, or signs of colic after eating. Moderate to severe signs can also include pawing, stretching, looking at their sides, rolling, kicking at their abdomen, as well as others not listed.

A good general physical examination by your veterinarian is the best way to start in figuring out what is going on with your horse. There are many diagnostics that can be performed to rule out gastrointestinal problems. Currently the only way to confirm EGUS is with gastroendoscopy. This is where a long flexible endoscope is passed into the stomach to visualize the stomach lining and look for areas of irritation/ulceration. If you suspect your horse is unthrifty due to gastric ulceration contact your veterinarian and they can guide you to your best diagnostic course of action.

There are many different treatment options for EGUS. These treatments focus on either coating/buffering the stomach from the acids that are being secreted or decreasing acid production through altering the acid pump mechanisms. The treatment of choice depends on severity of the condition and cost. For mild, intermittent cases or where cost is a concern simple use of generic antacids may be helpful if given before a meal and at least 4-6 times a day, however the dose for a horse can be quite high (150 -200 ml/treatment). Sucralfate is used frequently in preventing stress induced ulceration in neonates but is controversial in the adult horse. Either ranitidine or cimetidine can be used as the middle of the road treatment. They are more expensive than antacids but can be administered as few as three times a day orally. The top treatment is still omeprazole (GastroGard, Merial, Ltd.). It is more expensive but is administered as a paste once a day. Complementary treatment options can include several herbal preparations and homeopathic agents such as Nux vomica, licorice, peppermint, etc. Be careful with the use of herbals in competition horses. Some of the herbals may be prohibited by your breed organization during competition. Be sure to check on this before starting any complementary treatment.

These are just a few of the pharmaceutical treatment options available out in the market. Let us not forget that dietary changes are crucial not only for treatment but also for prevention of EGUS. Horses are constant grazers and use this form of eating as a way to produce more bicarbonate in their saliva to help buffer the stomach. Therefore feeding horses small amounts of roughage multiple times a day is ideal for horses susceptible to EGUS. Also decreasing the carbohydrates in the grains and switching to higher fat feeds may be helpful. Calcium as in alfalfa helps to protect the stomach and some veterinarians may recommend feeding your horse a grass/alfalfa mix as your source of roughage. Again the information listed above just scratches the surface of EGUS. For more information on any of the treatments listed above or others not mentioned contact your local veterinarian. Your veterinarian can guide you as to what is the best course of action for the treatment of EGUS in your horse.

 

Many fractures can be fixed today that could not be repaired 5 -6 years ago. I don t know what kind of tibial fracture your horse had but if it was in an adult horse it was probably a fracture that was comminuted and compound (in many pieces and broken through the skin.) The tibia in an adult horse is a very strong bone and in order to fracture the bone it takes a lot of energy and thus leads to the explosion of the bone into many pieces. Horses have to stand up immediately after a fracture repair and if the bone can not withstand the weight of the horse then the fracture repair fails.

Long bone fractures (cannon, radius, tibia, and femur) in adult horses, even in a simple fracture, are very difficult to repair because the implants are not strong enough to hold the stresses the horse puts on the legs. With new technology in implants and improved techniques more fractures are able to be repaired. Just a few years ago and even now, most fracture repair devices are developed for people and small animals and not for horses. It appears that Barbaro s fracture configuration was one that has a chance of repair and potential successful outcome. They also were using a new type of implant and a pool recovery system. With all this and a wonderful surgery team they were able to repair the fracture and get him back on his feet.

Many fractures can be repaired. Foals fractures usually can be repaired because they are light and can usually bear weight on just 3 legs if needed. Adult horses that bear weight on 3 legs tend to break down in the opposite limb, i.e. laminitis, suspensory tears, hoof abscesses, etc. Adult horse fractures that involve the bones from the carpus and hock down and skull bones can usually be repaired depending on the fracture configuration.

Prognosis for fracture repair depends upon joint involvement, the horse s attitude, type of fracture, further secondary complications, and what is the horse s expected usability. The best thing to do when your horse fractures a bone is to call your veterinarian immediately and keep your horse quiet . Also you can consult your boarded surgeon of choice if you have more questions.

 

Scott Reiners, DVM, Diplomate American College of Veterinary Surgeons

Mountain View Equine Hospital

It sounds like your horse may have a condition call upward fixation of the patella. In some horses the patella gets stuck and it can not get unlocked. The patella is part of the stifle and it locks over top of the medial trochlear ridge of the femur or the inside part of the stifle. This is part of a mechanism that enables the horse to lock up its hind legs and sleep standing up. Some times this mechanism does not function properly in the hindlimbs. Some of the causes are too straight of stifles, weak quadriceps, muscle spasms, joint inflammation.

Many treatments are available to treat this problem. The most conservative approach is some analgesics and controlled exercise that will build strength in the quadriceps muscles. This is reserved for horses that only mildly lock-up and are not too painful to work. Some exercise programs may consist of water trendmill work, hill climbing, and more. Sometimes the joints are too inflamed for analgesics alone, so the stifles may need to be injected with anti-inflammatory drugs. Internal blistering to the medial patellar ligaments and/or quadriceps muscles is another treatment method. This method consists of injecting strong iodine mixed with an oil and then injected in the area of the medial patellar ligaments which causes the area to form scar tissue. The formation of scar tissue causes a thickening to the medial patellar ligament and making it thicker and possibly short so that it can not lock-up. The down side to this method is that it can cause abscesses to form and can be painful.

Another method that I have been using is the standing medial patellar ligament splitting. This method of treatment can be used for both severe and mild cases of locking stifles. It consists of inserting a needle into the ligament several times in certain places to cause the ligament to get thicker and possibly shorter. The down side to the treatment is that sometimes it has to be done twice. It is very affective with very little complications when done properly. I prefer this method of treatment.

The last treatment option is to cut the medial patellar ligament. This alleviates the stifle locking problem completely by letting the patella not being able to lock up. The down side to this treatment is that it causes a big lump of scar tissue on the inside of the leg, some horse can not sleep standing up, and it can cause further joint problems in about a 100% of the cases. This method should be reserved until after other methods of treatment have failed.

Many times radiographs need to be taken in order to determine which treatments are needed to repair the problem. Sometimes arthroscopy is indicated if there are signs of joint lesions.

The first step to alleviating the problem is to consult with your veterinarian. Early repair is usually a faster recovery.

 

There are two forms of shockwaves that are routinely used for treatment of horses, dogs and humans, extracorporeal shock wave and radial shock wave. Extracorporeal shock waves are pressure waves generated outside the body that can be focused at a specific site within the body. There are a few different ways of producing these waves. One of the most used methods is the use of piezoelectric crystals that are arranged in a cup or funnel form. The crystals are energized with a pulse of energy. The crystals then expand and create a positive pressure wave which is several times that of atmospheric pressure and then a negative pressure wave. These waves are created in nanoseconds. The radial shock wave is created by a projectile mechanism to stimulate a pressure wave much like a hammer hitting the top of an anvil and the energy is transmitted to the bottom. The pressure waves produced in this fashion are transmitted through tissue radially and the energy is released at the surface and decreases strength as it travels through the tissue.

Pressure waves travel through fluid and soft tissue and release energy at areas of different impedance. For instance, at a ligament or bone the energy travels through the ligament and bounces off the bone which can cause expansion of the soft tissue. If a pressure wave travels through soft tissue and hits air like in the intestines, it causes the full release of energy into the air/soft tissue interface and can injure the intestine. Almost like a mini explosion.

What does the pressure waves do to the tissue There are several ongoing studies to find that out but what we do know is that it decreases pain, increases new blood vessels in the area, stimulates healing of both bone and soft tissue, fractures kidney stones, and decreases agents that cause inflammation. It was once thought that it caused micro fractures in bones but this has been shown not to be true. It is used in humans for blasting apart kidney stones with some success but it is questionable if it will break apart calcifications in the soft tissue of the horse.

What do we use shock waves for in the horse We use shock wave therapy for tendon and ligament injuries, arthritis, heel bruises, heel pain, navicular syndrome, calcification deposits, back pain, bursitis, synovitis and to stimulate acupuncture points just to name a few things. Mostly we use it to decrease pain, swelling and to stimulate healing. We also use it in dogs with hip arthritis, stifle arthritis, back problems, and to help stimulate non-union fractures.

There is a wide array of uses for shock wave and treatment protocols are still being worked out. Most treatments are done with 2000 shocks and 3-4 treatments. Treatment intervals are about 14 to 21 days apart. The healing of an injury is not immediately seen but the analgesic effects can be seen in a very short time after treatment.

This is just a brief look at shock wave therapy. If you have any questions or concerns, you can contact your veterinarian or us at Mountain View Equine Hospital.

 

Unfortunately not every type of abortion will show signs of an impending problem. But before we get into that let s first talk about things that may cause a mare to abort and then we can review signs of a pending abortion, treatments and future prevention to help you prepare for future pregnancies.

There are lots of things that can cause a mare to abort that may not involve a reproductive problem. Any stressor to the mare such as hauling, new horses in the environment, poor nutrition, etc. may compromise the health of the fetus. The mare will usually hang on to the fetus until the last possible minute, sacrificing her own body condition for the developing foal but that is not always the case. If the mare becomes ill from another reason such as colic, laminitis, pneumonia, as well as others this can also cause significant stress to the fetus and abortion. You may or may not see signs of impending abortion in these situations. Herpes virus is usually the number one cause of infectious abortion in the mare. The mare will not usually show signs until one visualizes a fresh fetus in the stall. Upon investigating the abortion, there is usually a history of new horses, young horses, or sick horses in the recent past on this same farm. The pregnant mare once exposed to the Herpes virus if not protected through vaccination may abort. Bacterial and fungal uterine infections (placentitis) are usually the next most common cause of abortion. Placentitis will almost always give you a sign that something is wrong prior to abortion. These signs will be discussed below.

How do you know there is a problem with your mare Of course if your mare is severely underweight one should worry about a potential loss of the pregnancy as the fetus undergoes rapid development in late pregnancy. If the mare has been sick or if she undergone surgery recently one should also be more concerned with the health of the pregnancy. Some other more specific signs of a problem are colic signs, off feed, fever, vulvar discharge, and early lactation (bagging up). Any or all of these signs should send up a red flag to have your mare examined by a veterinarian to make sure the fetus is healthy. During examination of your mare, your veterinarian may run tests to ensure the mare and fetus are healthy. These tests may include bloodwork on the mare, transrectal ultrasound measuring placental thickness, transabdominal ultrasound to determine fetal heart rate, and estrone sulfate levels to assess fetal health. It is always better to examine the mare as soon as you suspect a problem rather than wait until it is too late to save the pregnancy.

If you do identify a problem what can you do to help maintain the pregnancy First thing you need to do is isolate the mare from other pregnant mares. If this mare has a potentially infectious disease you want to minimize your other mares exposure. Usually the other mares have already been exposed to the disease but I feel it is still better to be on the safe side. If your mare is underweight, slowly start increasing her ration to a higher quality diet especially during the rapid fetal growth phase the last three months of the pregnancy. If I am worried about a bacterial/fungal placentitis, I usually start the mare on an antibiotic/antifungal that is safe for the fetus and crosses the placental barrier. Progesterone therapy may also help maintain a pregnancy. If the placenta is compromised it may not be producing enough progesterone to keep the mare pregnant. These mares may benefit from supplemental administration of progesterone. Any time a pregnant mare is stressed for any reason, I like to place them on progesterone just in case the uterine health becomes compromised. There are other drugs you can also use to help increase blood flow to the uterus if the placenta is compromised and keep the uterus quiet. It is best to get your veterinarian involved or contact a reproductive specialist prior to starting any treatment protocol.

How do you prevent problems in future pregnancies Sometimes you can t but here are a few things to keep in mind. Always keep a close eye on your mare s weight. As soon as she begins losing weight you need to add in good quality hay and/or grain. Good farm hygiene is a must! It is best to keep pregnant mares away from your transient/moving population of horses and the young stock. These are the ones that will expose the mares to viral infections that may lead to abortion. Remember we (humans) are the biggest vectors for spreading disease. I think it is best to feed your broodmares first prior to feeding everyone else in the herd to prevent exposure and keep your pregnant mares in a field by themselves. If your mare has had problems in the past, prior to breeding again you may want to perform a complete breeding soundness examination to make sure the uterine health is sufficient to maintain a pregnancy. During the pregnancy have the mare routinely checked with serial ultrasound and hormonal panels to ensure fetal well-being.

Abortion can be devastating emotionally and economically to an owner. Trying to be prepared through prevention and knowing the signs are the first steps in the right direction! My sympathies for your loss and I wish you the best of luck with your future breeding program!

Wynne DiGrassie, DVM, MS, Diplomate ACT, CVA