Everything You Need To Know About Tetanus

Everything You Need To Know About Tetanus

Tuesdays with Tony

A little housekeeping before we get started on Tetanus: don’t forget about my Paddocks & Pastures Seminar on April 19th @ 6:00pm. Join me, the docs, and the Alachua County Extension Office to learn all you ever wanted to know about grass! The talk will be held right here at Springhill Equine, and as always, admission is FREE!

   Now for this week’s enlightening blog. Continuing my trend of why we vaccinate horses for things, I decided to talk to you all about Tetanus today!

What is Tetanus?

   Tetanus is a neurotoxin caused by the bacteria Clostridium tetani, which lives in the soil pretty much everywhere. Clostridium tetani likes to form spores that are very resistant to heat, drying, chemicals, and fire-breathing dragons. Ok, I got a little carried away there… but seriously, this bacteria can survive for years in the environment. More bad news: it is particularly common in horse manure. You know where you can find plenty of that? On horse farms!
    Tetanus becomes a problem when it enters the body, usually through a wound or surgical incision. It is a myth that tetanus comes from sharp metal objects… it’s just that sharp metal objects tend to cause wounds which serve as a perfect entry point for this bacteria.
   Once the organism enters the body, it begins to multiply *evil cat laugh*. Clostridium tetani loves anaerobic (oxygen-poor) environments, like the inside of a wound. The tetanus toxin travels through the bloodstream and binds to nerve endings at neuromuscular junctions. The toxin signals the muscle to contract, and the muscle gets locked in the contracted position.

What does Tetanus look like?

Sawhorse stance tetanus    What this looks like is a horse with all 4 limbs stiffened (often called a “sawhorse” stance), a tight or locked jaw, and the third eyelid flashing across from the corner of the eye. The horse may be lying down with all 4 limbs extended, unable to stand. Eventually the tetanus toxin binds to the muscles used to breathe, leading to death.
    In short, Tetanus looks very scary. Horses usually begin exhibiting signs within 24 hours of infection. The disease can progress over days to weeks, but is over 50% fatal. In order to survive tetanus, a horse must be rapidly treated with tetanus antitoxin, and managed with intensive supportive care (read: $expensive$). Even with treatment, horses often have long-lasting deficits from the tetanus infection.
   If you suspect your horse may have tetanus, call your veterinarian immediately. Better yet, you should call your vet any time your horse suffers a wound that breaks the skin.

Is my horse at risk? 

   If your horse’s hooves ever touch the ground, then yes, he is at risk. If your horse lives on a horse farm full of tetanus-laden horse manure, then he is definitely at risk. If your horse lives on a horse farm, goes outside, and has access to sharp objects he could potentially cut himself on (this basically describes every horse I’ve ever met, and this cat has met a lot of horses), then he is at high risk for being exposed to tetanus at some point in his life.
   In fact, as a human you are also at a pretty high risk of contracting tetanus. This risk is increased if you spend time outside and at the barn, which most of our clients do with most of their free time. If you are a human, you probably received a series of tetanus vaccines as a child. Even so, you will probably receive a tetanus booster vaccine if you have a serious wound and have not been recently vaccinated against tetanus.
    “But Tony,” you may ask, “humans only need a tetanus booster like once every 5 years. Why do horses need boosters every 6 months?” Well, there are the high-risk factors discussed above (living outside in the dirt, having manure that is naturally full of tetanus). Then there is also the fact that nobody has ever studied exactly how long the protection of a tetanus vaccine lasts in horses. If you have a spare million dollars sitting around, you are welcome to fund such a study. Until then, I’m going to continue to err on the side of caution and recommend you vaccinate your horse once every 6 months.

How can I prevent Tetanus?

   I thought you would never ask! Conveniently, there is a simple, inexpensive vaccine that is very effective at preventing tetanus in horses. Our docs recommended the vaccine twice a year in case your horse suffers a puncture wound or laceration. If we perform a surgery (such as castration) we will want to make sure your horse has been vaccinated against tetanus within the last 6 months. Reminder: that’s not because the docs dip their scalpel blades in Clostridium tetani before your horse’s surgery. It’s because cuts, even clean surgical ones, create a route for this bacteria that lives all around us to get inside the body.
    When it comes to tetanus, an ounce of prevention is worth a pound of cure. Since the disease is often fatal, and treatment is very difficult, we feel strongly that it is well worth a $20 vaccine. For this reason, many of the combination vaccines we give include tetanus. Tetanus is the “T” in “EWT-WN” (Eastern/Western Encephalitis/Tetanus/West Nile) and “EWTR-WN” (Eastern/Western Encephalitis/Tetanus/Rhino virus/West Nile) vaccines. It just so happens that these other vaccines are also recommended every 6 months, so why not lump them all into one poke? If that’s not your style, and this post has inspired you, we do stock the plain Tetanus vaccine at the clinic as well.
    So let’s all remember to call Shannon or MJ at the office to check when our horses are due for a tetanus booster, mmkay? Now I think I’ll go walk through some lovely tetanus-laden horse manure, and roll in some tetanus-flavored dirt! While I’m doing that, why don’t you scroll down a bit and subscribe? I’ll let you take a selfie with me at the next seminar if you do.
Until next week,
      -Tony

Tuesdays with Tony is the official blog of Tony the Office Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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The Curse Of Knowledge

The Curse Of Knowledge

Tuesdays with Tony

My humans have been worrying about the future a lot this week. The weather people say it’s going to get cold (no one seems to remember how often they’re wrong), and with cold weather comes colicky horses. That got me thinking, so this week I asked Kayla, Nancy, Beth, and MJ what they worry about more now that they’ve worked here and seen all the things horses really can do to themselves. After all, they see hundreds of horse problems every year, so they have plenty to worry about with their own horses. We call that the Curse of Knowledge. Here’s their Top 5 list.

#1 Eye ulcers

Maybe you’ve had the Docs come out and put some of that fluorescent green dye in the eye. Then they tell you to use a few ointments 4 times per day, give some Bute or Banamine, and they come back out to check it again in a few days. Lots of eyes heal perfectly well this way. The ones that don’t, however, are the ones my team worries about. My minions have all had the joy of treating ulcers in eyes. They say what makes this one Number 1 on their list is that everything can be done absolutely perfectly, and things can still go bad. These ulcers are also very expensive and extremely time consuming. Treatment very quickly goes into the thousands of dollars, and is a minimum of 4 weeks. My minions also agree eye problems are a great reason to have major medical insurance on your horse!

#2 Very specific lacerations

Last year we had a weanling come in with a very small cut over her hock. She was an extremely well-bred barrel horse. Turns out that small cut went into the hock joint. It looked like no big deal, but because of the location, it was life-threatening. That’s right: life-threatening. Wounds in joints can very easily lead to infections in joints, and infections in joints are extremely difficult to clear in horses. Luckily, with about $5,000 in treatments, my Docs were able to get this one cleared up. MJ was horrified at how small the wound was, how easy it was to overlook, and how bad it all could have ended up. She says she’ll never take a wound for granted again! We all know horses are incredibly fragile, but MJ was amazed to see it action. Also, yet another reason to have major medical insurance on these crazy horses.

#3 Colic

This one had to be on the list. However, my minions said they view colic very differently than they did before working here. All colics used to scare them. Now it’s the colics that don’t respond quickly to drugs. Then they go into full on panic. You see, most colics get some sedation and a little pain relief, a whole lot of water and electrolytes, and off they go. It’s the ones that get painful again very quickly that scare my minions. Too often those are surgical colics. Even if they aren’t surgical, they do require lots of fluids, pain meds, and care. These colics are always touch and go for a bit. And yet another reason to insure horses!

PS on this one: coastal hay is the number one cause of colics. You can feed coastal to your horse, but please, please, please also feed some alfalfa or peanut hay!!

#4 Tendon Injuries

You pick up the trot one day and something doesn’t feel quite right. You wait a day or two and try again: still not right. My Docs come out and do a lameness evaluation, put some novocaine in different parts of the leg until the lameness goes away, and then do an ultrasound. You know you should be worried when the Doc gets “that look” on her face. She tells you it’s a proximal suspensory tear. Why do my minions fear this diagnosis so much? They know it’s a minimum of 6 months of rehab work before we even know if things are going to be back to normal. They know with some of these small tendons and ligaments (like the oblique sesamoidean) that it is nearly impossible to get the horses back to normal. They also know that the best shot for healing comes with extremely diligent physical therapy work, and most people don’t do so well at that part.

#5 Lay Tooth Floaters

I saved this one for last, but it should probably be higher on the list. There are lots of people out there who will “do your horse’s teeth” for not a lot of money. You get what you pay for. Unfortunately you also often get much, much less than you pay for. My minions have seen broken teeth, missed tumors, infections caused or made worse, and, simply put, really bad floats done. Even worse, many lay floaters sedate horses which is AGAINST THE LAW. My Docs went to school for a really long time to know all the things that can go wrong when they sedate a horse. They drive around with a truck full of stuff to manage problems if things do go wrong. My Docs have the knowledge to understand how that little thing they see can be an indicator of BIG problems. I can’t be any clearer: Lay floaters are not a good answer for your horse’s health. Dentistry should be done with bright lights, sedation, a speculum, and a doctor.

Want to know how to keep your horse safe in a scary world? Communicate! My Docs and minions are here to help you. Send pictures, call, email in questions. From abscesses to zoonoses, they’ve got you covered. Now I’m headed for a long winter’s nap.

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Tuesdays with Tony – Laceration Care

Tuesdays with Tony – Laceration Care

   In my many years of observing horses, I’ve noticed that they have a strong affinity for sharp objects. Is it some sort of magnetic force? Do they have little aliens inside their heads telling them to stick their leg through that rusty bush hog? Someone really needs to do some research on this topic. All I know is that horses love sharp things, and they love rubbing their bodies up against them, especially after-hours and on weekends.

Is this an emergency?

   If in doubt, whenever your horse has a cut that has broken the skin, yes it is an emergency. Some things that make it more of an emergency include location (over a joint, tendon, or vital structure), bleeding (think puddles rather than drops), and duration (did this happen 5 minutes ago, or last week). Remember, all of our docs text message, and they generally will not charge you for reviewing photos of your horse’s questionable wound to decide whether or not it needs to be seen immediately.

Does this need stitches?

   The answer to this question is not always black-and-white. It depends somewhat on your goals for the horse, your budget, and the level of aftercare you are able to provide. Oftentimes it is not a question of whether or not the wound will heal without sutures, but rather how pretty it will look in the end, and how long it will take. If you want the most cosmetic outcome for your horse, and the shortest healing time, then yes it needs stitches. But if you would like the least expensive option, you only want the horse to be a pasture ornament, and you have unlimited time to spend on cleaning and bandaging the wound, then you can probably get away without suturing. I will say, though, that skin makes an excellent band-aid, and any time it can be preserved, our docs like to give it a fighting chance.

What’s next?

    So, your horse’s wound is all stitched up and looking wonderful. Game over, right? Not quite. Your horse may need some antibiotics, as well as daily cleaning, to prevent the wound from becoming infected. You also may need to implement some extra fly control around the wound, as bugs really love that seeping blood and serum. Usually our docs use sutures that will dissolve on their own over time. However, if your horse manages to rip the stitches out in less than a week, let us know right away.
   The good news is that most lacerations heal amazingly well if treated quickly and properly. If you own a horse, chances are you will become familiar with their natural affinity for sharp things, if you haven’t already. Luckily you have my staff close at hand to help you when the time comes!
  Until next time!
        -Tony
Tuesdays with Tony – Wound Care

Tuesdays with Tony – Wound Care

Wound Care

The Shock and Awe Phase

You walk out to feed in the morning and are confronted with what you are sure is your horse’s leg hanging off a bloody stump. Go ahead and freak out for 30-60 seconds. It’s OK. We all do it. Now calmly catch your horse and walk over to the water hose. Begin hosing the wound and continue to hose it for at least 15 minutes. If possible, call Springhill Equine (I’m even going to give you the phone number right here: 352-472-1620 and the emergency line number in case it’s a weekend or after hours: 352-474-5007 ) while you are hosing. Even better, email or text a picture of the wounds to my Docs, and then call. If you can’t call while hosing, hose first, then call. My minions have a saying: dilution is the solution to pollution. Basically, the water dilutes out germs, dirt, and general nastiness.  

The ‘Take Deep Breaths, it will be OK’ Phase

Springhill's Tuesday with TonyOnce you have hosed the wound for 15 minutes or so, put your horse somewhere quiet. We want them calm until one of my awesome Docs can get there. Do not apply any lotion, potion, or goop, no matter how many people tell you how great it works! It doesn’t matter that it worked great on that injury your great aunt’s cousin’s friend had. Each wound is different, and my Docs are the best people to decide which goop will be the best goop.

Your horse is likely in pain at this point. We know you want to do something about that pain, but please wait to hear what my Docs have to say! They will direct you about which pain medication to use, and how much. Generally bute, Banamine, and Equioxx are the go-to choices to start with, but your horse’s medical history and the wound severity and location can change those choices. Once they assess the wounds, they will likely add some stronger drugs to help with pain.  

Let the Healing Begin!

OK, you’ve hosed the wounds really well, a super awesome Springhill Equine veterinarian has taken care of your horse: now what? Less truly is more! Once again, I know you really, really, really want to put that super cool stuff in the blue bottle, or green tub, or white bottle on the wound. Vern down at the feed store said his friend’s niece’s cousin used it and it worked great. I promise you it didn’t and it won’t. Horses really, really want to heal wounds. They do it despite all the stuff we do to the wound, but if you want it to heal the fastest and the best, you need two things: pressure and moisture.  

You can apply pressure the expensive, difficult way: non-stick pad to wound, gauze, elastikon, followed by a quilt or cotton, more gauze, and more elastikon or vetwrap. Or you can go with the easy way: Sox for Horses. My Docs spent a long time doing it the hard way. Now they do it the easy way! You may remember Coby, who fell through the trailer floor. My Docs began using Sox on that horse, and haven’t looked back. Your choice. As a typical cat, I pick easy every time.  

Moisture can be applied many different ways, but I find they use plain old triple antibiotic ointment the most. For some wounds they will use a burn cream called silver sulfadiazene, but for most they tell you to go buy out CVS’s supply of triple antibiotic. In a few weeks, my Docs may adjust the topical ointment to add some steroid, but early on, simple is better.

So your plan: Cold hose for 10-15 minutes daily, apply triple antibiotic to wounds, replace sock.

The Real Story from The Top Cat

There are tons of pictures of amazing wounds that healed fantastic thanks to some lotion, potion, or goop. The truth is, horses heal despite all these products, not because of them. The most important parts of wound care are your diligent care and communication! If you aren’t sure about something, call the Doc! They eat, breathe, and sleep this stuff, and they are happy to talk you through your situation so that your horse gets the right care the first time.

Tuesdays with Tony – Injury Prevention

Tuesdays with Tony – Injury Prevention

Whenever a horse comes into the clinic with an injury, it reminds me how glad I am to be a cat. Horses don’t have nine lives like cats do, so you’d think that they would be a little more careful! They are also not as smart as cats, at least in my opinion. You are welcome to disagree, but I will point out that I’ve never scratched my eyelid off (knock on wood)!

I’ve been running the clinic here at Springhill Equine long enough to see some trends develop, and I thought that a good way to start the New Year would be to share some of my insights with you, my loyal fans. There are things that make all your horses unique, and then there are things that make them all similar. The similarities are what we’ll look at today.

Some things are preventable, and some things are not. For example, you can’t prevent your horse from rolling and jamming his foot through the fence; that’s just something that a lot of horses do. You also can’t prevent your horse from being a complete jerk, and getting kicked by one of his pasture mates as a result. Sometimes those things just happen, and we do our best to patch them up when they do.

Other injuries are a little more preventable. Horses are going to develop itches on a pretty regular basis, whether it’s on their eye, or ear, or chest. You can’t control the itch, but you can limit what they have to scratch it on. Things like barbed wire, old rusted-out car bodies, nails sticking out of posts and walls, broken gates with sharp edges, ancient farming implements, broken buckets, and all other sorts of things can be removed from the horse’s pasture, paddock, and stall. Even if the horse has been grazing around it for years without a problem, it only takes one instant in time to produce a dramatic injury. I see it all the time.

I’ve watched the docs sew a lot of eyelids back on, and remove a lot of them that couldn’t be salvaged. A lot of those come off while they were scratching on gate latches, metal feed/water bucket handles, nails, and barbed wire. I recommend doing an inspection of every space that your horse has access to at least once every few months. Things change, nails work their way out of boards, the horse sharpens the edges of things she scratches on constantly, they break a bucket or a board, and so on. Basically, if you wouldn’t want a two-year-old kid messing with it for safety reasons, you probably don’t want your horse messing with it, either.

Replacing that strand of barbed wire on the top of your fence with an electric wire is a really good idea. Barbed wire is a great thing for a horse to scratch on, and they will abuse it until it abuses them. New barbed wire is dangerous because that’s when it is the sharpest. Old barbed wire is dangerous because it’s rusty. The cost of replacing it? About the same as a weekend emergency visit from your veterinarian.

barbed-wire-pic

Speaking of fences, keeping your fence up and in good repair is another great way to prevent injuries. Some of the more serious injuries the docs see happen when the horse gets into a place that it’s not supposed to be. Remember Coby, the horse that managed to get inside the old horse trailer and then fell through the floor? He’s not the only one that’s managed to get into trouble. Just this past weekend, Dr. Lacher saw a horse that got through the fence and got her leg trapped in some stuff on the other side of it, and did some serious trauma to the muscle, nerves and veins. She’s going to be recovering in a stall for months as a result of it. It happens on a regular basis, and for most horse owners, it’s the first time something like that ever happened.

So, take my advice (it’s really good advice, as it’s coming from a cat): learn from the experiences of others. You don’t have to learn everything the hard way! Clean up your horse’s area, and inspect it on a regular basis. Don’t assume that it’s fine now because it was fine last year. Be proactive about safety, instead of reactive. As my grandcat always said: an ounce of prevention is worth a pound of cure!

Tuesdays with Tony – A Tale of Three Lacerations

Tuesdays with Tony – A Tale of Three Lacerations

Quick shout out to all the UF Vet students, our Docs, and our amazing Clinic staff for an awesome Castration Clinic 2016.  The world got nine new geldings on Saturday, and a whole bunch of vet students learned how to make more geldings.  Of course, the highlight of everyone’s day was getting to see me.  I supervised the entire event very closely, especially lunch.  Now on to the rest of this week’s peek into my life.

You already heard about all the colics Dr. Lacher saw over Thanksgiving.  Now you will get to hear about the lacerations.  As far as I can tell, horses like to seek out any and all sharp things to cut themselves on.  Sometimes they do such a good job the humans are left scratching their heads trying to determine what exactly the horse cut themselves on this time.  Dr. Lacher’s Thanksgiving weekend consisted of an eyelid laceration split on the hook of a feed bucket, an ankle laceration done on a fence, and a shoulder laceration cut on who knows what (the horse wouldn’t tell).

Everyone who sees a cut of any size is certain there will be stitches.  Well this wise cat is here to tell you not all wounds can be sutured, some shouldn’t be sutured, and some get stitches even when the Docs know they won’t stay in very long!  In the case of Thanksgiving weekend it was stitches for the eyelid laceration, no stitches for the ankle, and stitches that were going to pull apart on the shoulder.  The eye is obvious: there was a cut and stitches were placed.  The wound will heal and all will be right with the world.  The ankle was a little different.  First, the skin was basically shaved off.  It was super thin!  Using a needle through the skin would have caused it to tear.  Instead Dr. Lacher just cut it off.  After she cut it off, she bandaged it with some Sox for Horses material.  If you don’t know about Sox for Horses, I’m going to assume you have been hiding under some sort of rock or (and this better not be the case) you don’t read my blog very often.  Use the Google thingy or ask one of my minions to tell you about Coby.  Last, but not least, the shoulder cut.  Dr. Lacher stitched the skin flap across but warned the owners it probably wouldn’t stay longer than about five days.  So why did she suture it anyway?  She’s a pretty smart cookie so I’m guessing she had a good reason….Turns out those skin flaps help the wound heal.  For every day the skin flap is across the wound you gain 5 healing days.   This means even if the skin flap stays for 3 days, you’ve shortened healing by 2 weeks!  See I told you she was smart.

The wounds are now stitched or not stitched.  What comes next?  This is where it gets difficult for you humans.  Do Less Stuff.  That’s right, adopt the strategy of cats the world over: watch the world go by and do very little about it.  As I was looking through a catalog Stephanie had open on the desk recently I noticed no less than 4,386 wound lotions, potions, and creams.  Do you know how many our Docs use? Four, and mostly just two of those.  What do they use a whole lot of? Water from a hose.

Wound care is simple.  Keep the wound clean and moist, and sometimes because horses like to get a little too excited about healing, beat back the granulation tissue, also known as proud flesh.  That’s it.  Keep it clean with water, lots and lots of water. Then apply triple antibiotic or Vaseline to the wound to keep it moist.  These products do double duty since they protect the wound itself from dirt while keeping it moist.  If the Docs see a particularly nasty wound, they will recommend silver sulfadiazine (SSD).  SSD has really strong nasty stuff killing properties, while being super gentle on wounds.  And finally, proud flesh is put in its place by hydrocortisone.  So all told we just spent about $20 on wound care stuff.  No pretty blue bottles with very dilute bleach.  Yes, that really all that’s in those pretty blue bottles.  No expensive state of the art wound gel.  Vaseline and water will cure most of what your horse has done to himself.

Sometimes, particularly if a wound is on the legs, our Docs recommend bandaging.  Sure the leg will do great with just a water and Vaseline but the dreaded proud flesh likes to become a problem below the hock and knees.  Three words: Sox For Horses.  Once again use the Google thing or talk with my minions and they will get you hooked up.  These are absolutely the cat’s meow when it comes to bandages.  Also they are easy, relatively cheap, and reusable.  From my limited experience, these three things never go together with horses.

Signing off this week with a reminder to sign up for our 2017 Wellness Plan by January 1st.  One colic owner and one laceration owner over Thanksgiving weekend saved $100 each on their unplanned Dr. Lacher visit.  How you ask?  Our Wellness Plans include NO emergency fees.  You are as crazy as the Labrador from down the street if you don’t sign up.

 

tony-with-suture