If you have been following the Springhill Equine Facebook page, and I know you have, you have probably seen the post about a couple of horses who took the opportunity this weekend to injure themselves.  For some reason I think horses are feeling a bit restless with all this stay at home, self-quarantine, social distancing stuff. I have heard about several horses who have wounded themselves in one way or another since the start of all of this.  I guess they must be experiencing stable fever. Don’t worry, you all will be back on the trails, headed to shows, and barrel races soon. In the meantime, let’s talk about what to do when your horse is the one experiencing stable fever and finds a way to injure himself.

So, you’ve been inside all day watching Netflix and you finally decide to spend some time outside with your horse only to find your horse has an open wound on his leg, or neck, or face, or really, just about anywhere.  Oh, no! Now what do you do? Well, I know you all have downloaded the Medici App already, so you grab your phone and get ahold of one of my docs through Medici.  They will look at the wound and determine if it needs to be seen.

Initial Treatment

My docs will probably tell you to go ahead and start running cold water over the wound. Remember, dilution is the solution to pollution. They will instruct you not to go exploring the wound. Vital structures may lay just below the surface and any type of probing may disrupt those structures leading to a life-threatening emergency for your horse. Depending on the injury, they may recommend moving your horse to his stall or a clean environment. However, sometimes it is best to not move your horse at all until my docs can assess the situation. This is why we love using telemedicine with Medici! My docs can really see the problem at hand in real time and get you the best advice for your horse before they even get there.

If it’s possible, my docs may recommend getting your horse a dose of bute or banamine to help with any swelling that is inevitably going to occur. Now that you have performed the critical steps in your horse’s wound care, sit tight and wait for the doc to arrive. I have heard this is the hardest part of all. I have no trouble sitting around all day waiting for dinner, so I am not sure what is so hard.

The Exam

Now that my doc has arrived, they will assess the situation.  The first thing they will do is ensure that your horse is safe. They ask themselves several questions, including how much blood has been lost, is the horse in shock, how long ago does it appear the injury has happened, are there any other injuries that need to be addressed, etc.

From here, they will likely sedate your horse. An injured horse is unpredictable, and sedation is best and safest for all involved.  While your horse is getting sleepy, they will gather supplies. Scrub, clippers, syringes, needles, medications, surgical instruments, suture and drains. Your horse is going to have a funny haircut for a few weeks as they heal, since my docs are going to clip an area surrounding the wound. This allows them to clean the affect area better and to visualize any hidden cuts/scrapes that may need addressed.

Once your horse has his new -do, they will scrub the area thoroughly to make sure there are not contaminants. Next comes the blocking of the skin. They will use lidocaine so your horse cannot feel the area while they manipulate it and get an idea of the extent of injuries. They will assess nerve and blood vessel damage as well as muscle, tendon and ligament damage. Next comes suturing. Any excess tissue that will prevent proper healing is removed. Oftentimes, several layers of suture are required to put a wound back together. Occasionally, if there is a lot of open space under the skin, a drain may be placed. Drains help to prevent fluid from accumulating and developing an infection. Once the skin is sutured closed, they will clean up the affected area and apply topical ointment to the wound.

Doctor’s Orders

When my docs are finished putting your horse back together, they will leave you with very specific instructions on how to manage your horse’s wound. They will go back to what we said in the beginning: dilution is the solution to pollution. You and your horse are going to be spending some quality time together with the water hose. This shouldn’t be a problem for you since you’re stuck at home anyway. Ten to twenty minutes of cold hosing twice a day doesn’t seem like much, but when you’re having to put your Netflix on pause, you may change your mind.

This is going to be the best therapy for your horse. Not only will cold hosing keep the wound clean, it will decrease inflammation and swelling. Hope you stocked up on antibacterial hand soap, because you’re going to need it.  Once a day you are going to have to wash the affected area with a mild soap. After the wound is clean and dry, apply a triple antibiotic ointment such as Neosporin to the wound. I am a big fan of Kinetic Vet, IBH salve for these kind of things. For one, it keeps the bugs off, 2, it has antiseptic properties, and 3, it just smells really yummy.

Depending on the location of the wound, where your horse lives, and how dirty the wound was to start, doc may start your horse on antibiotics. However, antibiotics are not always required and can sometimes be detrimental to your horse’s wellbeing. For the first few days post-injury, you can bet on administering some kind of anti-inflammatory medication to your horse. This will help will swelling and keep your horse more comfortable during the healing process.

Finally, and probably the most important part of your horse’s recovery, is you. Doc will instruct you to monitor the wound for any heat, redness, or discharge. If you notice any of these signs, call my clinic immediately and they will get you in touch with one the docs. You can also go through the Medici App to get the docs directly. Sutures come out in 14 – 21 days and then its smooth sailing from there.

Seeing your horse hurt is never easy and always scary.  Wounds take time to heal and can be frustrating at times, but just remember, we are only a phone call away and are always happy to help answer any questions you may have.

Until next week, stay safe, keep your distance, and go hug your horse!

~Tony

P.S. I have heard the humans talking about our Facebook Live seminar this month on Thursday, April 16th and they are talking about prizes? Be sure to keep an eye on our facebook page for that. Until then, looking for more great horse information? Don’t forget about our podcast. Click here to listen.

What Your Horse Does All Day

I’ve heard from the cat version of the dark web that some of you are suddenly home way, way too much during the day. I hear some virus is responsible. Let me tell you, the cats aren’t happy about it, and we’d like things to go back the way they were very soon. Those of you at home have also been watching your horses a lot more. You’re noticing things you’ve never noticed before. This week I’m going to help you determine if those behaviors you’re suddenly aware of after watching your horse for 8 hours while pretending to work from home are worth a call to one of my Docs, or if it’s no big deal.

Sleeping

I’m going to let you in on a little secret: us pets, small and large, spend a large portion of our time sleeping. In the wild, your horse would have to spend a large portion of the day trying to eat enough crappy, tough, dry grass to meet their nutritional needs. You have given them at least two square meals daily of delectable, nutritious concentrates, along with plenty of hay. While that hay is dried grass, it is of delicious varieties which were specially cultivated, and fertilized to provide optimum nutrition to the equine athlete. All that means your horse can spend most of the day sleeping under the thoughtfully provided fans, in their comfy stall, or in that perfect wallow they’ve made in the sandy area.
By now you’ve spent several days, at the very least, watching your horse’s patterns. As long as nap time happens around the same time every day, and involves snoozing either in sternal (the fancy word for sitting-up sleeping), or lateral (the fancy word for laying flat out) recumbency (the fancy word for laying down), then things are good. You may continue to “work” from home.
You will also notice normal nap time involves sleeping, then waking up, then moving on about one’s day. This is true for cats as well. If your horse is getting up, laying back down, getting up, laying down, and never truly sleeping, or getting on about their other daily chores, then it’s definitely time to call my Docs. Even better, send a video of the behavior to them via Medici. See last week’s blog if you have no idea what I’m talking about when I say Medici.
Repeated rolling, without a good shake upon standing, is also a reason to call the Docs. As is laying around at inappropriate times and locations. You may have noticed your horse is particular not only about what time naps occur, but also where. Changes to these behaviors are often early signs of colic. Definitely a reason to call the Docs!!

Standing around

Since you humans have provided all a horse could want, you may also notice them standing around an awful lot of the time. Much like napping, this often has a prefered location, especially if your horse is in a stall. While pretending to attend that Zoom meeting, you may be watching the camera on your horse. Take this opportunity to really notice how they stand around. Horses just hanging out will generally have one hind foot resting, with the opposite front foot popped forward a little bit. This keeps them stable, but allows that hind leg to really rest. Most horses will have a preferred hind resting leg, but will also switch legs periodically. There’s no hard and fast number here, but if your horse is constantly (think every few minutes) switching up the resting hind leg, there’s a good chance they have some level of lameness or soreness going on somewhere from the low back to the hind feet. If the opposite front foot is pushed more than about 6” in front of the other front foot, there’s a very good possibility that foot hurts.
Other clues to look for that can indicate pain, are resting against a wall, and piling footing underneath their feet. Horses will rest an entire side against a wall, or push their hips into a wall to help hold themselves up. A huge indicator of painful feet is stacked bedding underneath a portion of the foot. The most common way my Docs see this is pushing bedding into a hill that the horse then props their heels up on. By doing this, your horse has created their very own wedge shoe!

Eating, Drinking, Pooping, Peeing

These are the first four questions I often hear when my Docs are evaluating sick horses. Are they eating normally? Drinking the same amount? More? Less? Pooping as usual? And how’s that urine? Same color? Opacity? Quantity? These seemingly simple questions are huge clues about your horse’s basic well being. Now is the time to get a really good handle on how your horse normally goes about these normal daily tasks. Is the hay all scarfed down quickly? Or is your horse more of a savor-every-morsel kinda guy? How about drinking? A few visits to the water trough for a deep drink? Or more of a drive by sipper every time a cloud passes the sun? Get a handle on the details of the Big Four Questions, and you will be able to spot health concerns for your horse way, way before they become a big problem.

Many of you humans are looking at this stay-at-home thing all wrong. It’s not isolation, it’s a chance to understand a day in the life of your animals on an unprecedented level. This information can help you pick up on subtle clues about lameness, GI health, and more! As the official cat representative, I do ask that you keep these deep observational dives to the non-feline species. We cats would prefer to nap in peace!

Until next week,
~Tony

PS ~Looking for fun things to do while keeping your distance? Springhill Equine has a ton of videos on our YouTube channel. Catch up on all those seminars you’ve missed. Our website has every blog yours truly has ever written. You can get sucked down a rabbit hole of information there. Need more? Check out Springhill Equine’s podcast: Straight From The Horse Doctor’s Mouth. And maintain your distance!!

Tuesdays with Tony

You may have noticed (or not, if you’re oblivious to the racehorse world like me) that some major bad players were recently indicted by the FBI. That’s right, the Federales were involved. I am above these things you humans call laws, except when it comes to Rabies shots, but I understand some pretty big laws were broken. More importantly, horses were hurt, and potentially even died because of what happened. I will let you humans sort out the law side of things, but I wanted to chat about science, ethics, and supplements.

What do you want for your horse?

The trainers involved in this indictment obviously don’t want the best for their horses, but what do you want for your horse? I’m okay with saying we pushed hard for the championship. If I wasn’t a cat who’s only motivation is finding the ideal sleeping spot, I’d probably want to push hard for the championship too! You all know horses. You know they understand the game, and many of them like to do what you humans ask of them. Some of them don’t, but that’s a whole different blog topic. However, at the end of the day, it’s up to the humans to understand where the line is between pushing and breaking, and what’s more important: the win, or the horse. I’m not a young kitten, I do understand that the line is in different places for different people. Think about where the line is for you, and your horse. 

What’s in it?

One of the products involved in the FBI raids has an ingredient list that reads as: an innovative formulation consisting of amino acids derived from Ovine Placental Extract. SGF 1000 RMR is manufactured and purified through a patented low temperature process that involves homogenization, fractionation and ultra-filtration of the ovine placental extract suspended in a sterile liquid.

As stated earlier, I’m no kitten, but I am a wise cat. I’ve done my time on the front counter listening to my Docs. That is a bunch of big, sciency sounding words that don’t mean a thing. And nowhere do they have the unabridged version of what’s supposed to happen when they put it in a cold blender, then run it through an expensive strainer. Tony’s Take Home: Be very wary of a company that won’t give you a good answer to 1. The science behind their process, 2. What’s actually in the stuff they’re selling you for what I’m sure is a decent amount of money. This applies to every single thing you humans buy for your horses. From grain, to hay, to probiotics, to saddles, tack, bits, and ANYTHING called a supplement.

There is one particularly overpriced, but very pretty, supplement on the market that is 90% flax seed (!) plus some vitamins and minerals. You can give your horse a pound of flax seed daily, and a pound of a good ration balancer and have the EXACT same thing for about 1/10th the price. Anyway, you and/or my Docs should have a very clear understanding of what’s in any product you are putting in or on your horse. 

What does it do?

In the case of this supplement, it did a lot, and there were statements made like “it doesn’t test,” and “there’s no test for it.” Those seem like red flags to me. Many of these drugs are illegal because, not only do they cause profound performance enhancement, but they also have pretty awful side effects. Mother Nature has done what can be done with the available materials. Racehorses already perform at the edge of what their engineering is capable of. Giving them performance enhancers will only cause the engineering to fail.

That’s exactly what’s suspected in one horse, X Y Jet. One of the nasty side effects is the potential for a heart attack. Well guess who died of a heart attack? That’s right, X Y Jet. Imagine if your tiny human was on that horse when that happened rounding the third barrel and heading for home. I promise you, it’s not a good outcome. Things that promise to vastly improve Mother Nature come with a very, very high price. 

On the other side of the spectrum (and way more common) is the drug that promises to make your barrel horse run faster, your jumper jump higher, and your western pleasure horse to lope slower. Guess what? It very likely doesn’t do ANY of those things! The only thing this type of product, supplement, boot, saddle pad, widget, or thingy is good at is separating your money from your person. Horses are pretty good at that all on their own. You don’t need snake oil to help you. 

Know what makes your horse run faster, jump higher, or lope slower? Good training, hard work, and natural ability. If things aren’t going the way you want, here’s some simple rules:

1. Have my Docs talk with you, watch your horse perform, and do a lameness evaluation
2. Check your tack
3. Check yourself.

I’m not a big fan of rules, but they are important occasionally. So follow the rules, avoid the FBI, and have a happy, healthy horse at the end of the day. 

Until next week,

~Tony

P.S. Looking for more knowledge in the world of horses? Head on over to our podcast page for an abundance of useful knowledge. To get there, just click here. 

Very few things around here are uttered with the same hateful tone as the word sarcoid. My Docs do NOT like this tumor. They feel the same way about sarcoids, as I do about cold, rainy days. I’m lucky. The sun will come out tomorrow. The sarcoid may not go away tomorrow, or the next day, or the year after. Let me share a little Tony wisdom with you about this pesky, not quite cancer, but definitely a tumor, growth that horses get, and veterinarians hate. 

What is it??

Putting on my overly dramatic professorial voice here: sarcoids are a neoplasm of fibroblast cells occurring at the level of the skin in anything equine, to include horses, donkeys, zebras, and all the crazy horse, donkey, zebra crosses that also exist. Now back to regular sarcastic Tony. This means it’s a tumor caused by the cells that give tissue toughness. Blast is science’s way of saying cell, and fibro is what these cells make. They make that tough fiber that keeps skin from tearing, tendons from ripping apart, lungs able to expand without breaking. You get the idea. Neoplasm technically means cancer, but the only good news about sarcoids is they don’t metastasize. That means little bits don’t break off to go form new tumors elsewhere on the body. If you see a horse with multiple sarcoids, each one of those is its own separate little hell creation, not a spawn. 

Why? Oh, Why does my horse have Sarcoids?

It’s a reasonable question for so many of the things horses do, and get. It’s a reasonable question here too, but, as usual, the answer is complicated. There’s a cow wart virus called Bovine Papilloma Virus (BPV) that’s associated with many (but not all) sarcoids. That seems reasonable. I can see how horse skin could be like, eww get this cow wart virus out of here, and make something that looks like the warty, knobby, crusty thing sarcoids tend to look like. However, there’s some of these tumors that don’t have BPV associated with them. Being honest here, it’s a big old “they don’t know”. Here’s another big however: flies are implicated in the spread of BPV to uninfected horses! Need more reasons to have good fly control?? (I’ve written a few great blogs on this along with Dr. Erika Machtinger, known as The Other Erika around here, and there’s a podcast about it over at Straight From the Horse Doctor’s Mouth) One way doctors and scientists have determined flies are involved is the general location for sarcoids in the same areas flies like to hang out on horses. Scientists have also isolated way more BPV-carrying flies around horses with sarcoids than they have around non-sarcoidy horses. In other words, manage your flies. There is also (well, likely, anyway) a genetic predisposition to get more, and worse sarcoids, but this is so far beyond clear that my best answer is wait for more work on this topic. 

The many faces of Sarcoids

This is where the fun starts. Sarcoids can have many, many different appearances, and the approach my Docs take will depend on what that appearance is. Sometimes they can’t even be sure it’s a sarcoid, based on appearance, so they do a biopsy. That biopsy has to go to one of a few equine skin specialists because sarcoids love to look like other things, even when being evaluated under a microscope! 

So what are the sarcoid appearance options? Well there’s occult, verrucose, nodular, fibroblastic, mixed (my personal favorite), and malignant. Very often my Docs will take a wait-and-see approach to the occult and verrucose variety. These sarcoids are known to stay exactly as they are for years and years. They are also known to react poorly to negative stimuli, much like cats. Occult and verrucose also like to play together. They will even combine in one lesion. These guys can usually be described as flat for the most part. Don’t worry, I’ve included pictures for you. 

Nodular are, not surprisingly, nobby, and have intact skin covering them. Fibroblastic are nobby, but with gnarly, warty, not intact skin covering them. Mixed are, well, mixes of the types. And finally, malignant. These guys are super aggressive, spreading, ugly, and very, very invasive. They like to grow on the sides of the face, the groin, and the elbows. 

Pictures

These pictures were rather shamelessly borrowed from one of  Dr. Knottenbelt’s excellent lectures on this topic at the recent American Association of Equine Practitioner’s meeting. 

Die Sarcoid! Die!

Let’s talk about treatments. An important “rule” when it comes to treatments must be discussed here. When there are a whole lot of “treatments” available for a condition, it means science doesn’t have a good handle on the best treatment. It also means a whole lot of those “treatments” don’t do a darn thing, so you best check with one of my Docs before dropping a bunch of money on Dr. Google’s latest trend in sarcoid treatment, only to find out it’s nothing more than repackaged toothpaste. That’s a real example by the way. 

For my Docs, treatments are generally two pronged in some way. Prong one involves removing as much of the tumor as possible. These include surgically removing it, freezing it, heating it, lasering it off, and sometimes even radiation. You know typical evil villain type stuff. Prong two involves getting after the remaining cells with chemicals. This is chemotherapy. There are topical and injectable versions. Choices here are based on location, type of sarcoid, and your horse’s willingness to let you do what needs done. There are also some really great, but very expensive options such as radiation therapy, brachytherapy, and photodynamic light therapy. These are only available at a few specialty hospitals around the world, but offer great ways to kill sarcoid cells in some very sensitive areas like around the eye. 

There’s no way around it, sarcoids suck. Control your flies, and ask my Docs about lumps and bumps early is my very best cat advice.

Until next week,

~Tony

PS – If you would like to learn more about this topic, the humans just did a great podcast on this topic. Click here to learn more.

Show season is in full swing and my docs have been super busy getting your horses ready to perform their very best. Now that you and your horse have been competing for a few weeks, it might be time to have them looked at again. When your horse is competing, they are under a significant amount of stress; their normal routine is altered, they are being ridden multiple times a day, and they’re pouring their hearts into their work for you. Competitions can take a toll on your horse. Thank goodness there aren’t cat shows, that seems like way too much work for this cat.

Now that you’ve been competing for a few weeks, maybe you’ve started to notice your horse is just a tad late with his lead change, or he isn’t quite jumping the same as he was at the start of season, or that push off the last barrel just isn’t quite as strong. You’ve heard competitors talking about joint injections and how they have improved their horse’s performance and you’re thinking, maybe it’s time for my horse to get his joints injected.  Joint injections are not without their risks, so luckily for you, I am here to talk about the pros, the cons and everything in between on joint injections.

The Exam

You think your horse needs some joints injections, so you schedule an appointment with one of my docs. Before my docs go all willy-nilly injecting joints, they will require a lameness examination. You’re probably thinking, but my horse isn’t lame, he’s just not as good as he usually is.  And you’re probably right, your horse probably isn’t lame, but a full lameness examination will allow for my docs to determine if your horse even needs injections and if they do, which joints should be injected.  They put their expert hands on your horse and feel their muscles, their joints, and their tendons and ligaments to determine where the source of pain might be. They watch your horse move at the walk and trot on different terrains and in different directions.  They may even perform some joint flexions. Based on their examination they can then determine if your horse needs joint injections or if further diagnostics are necessary.

Diagnostics

After a thorough lameness examination is performed, diagnostics such as radiographs and/or ultrasound may be recommended. If my docs recommend radiographs, they may be looking for hoof abnormalities such as toe length, coffin bone angles, or navicular changes. They will also assess the radiographs for evidence of arthritis which can lead to inflammation and decreased performance.  Ultrasound can be used to assess tendons and ligaments for inflammation, small tears, or other areas of concern. My docs can also use ultrasound to assess joints capsules for inflammation, infection, and arthritis.  While radiographs and ultrasound may not be necessary to treat your horse, they are extremely useful to locate precise areas of concern.

The Injections

Now that a lameness examination and diagnostic imaging have been completed, my docs can determine if your horse needs injections and what joints need to be injected.  They will also determine what will be best to inject your horse’s joints with.  There are several different options for joint injections including steroids, hyaluronic acid, and platelet rich plasma (PRP).  Steroids help to decrease inflammation in joints. Hyaluronic acid can be used to help lubricate the joint. Platelet rich plasma brings a large number of growth factors to the joint which helps to stimulate production of repair tissue. Depending on your horse’s lameness exam, my docs will decide which medication or combination of medications to inject into your horse’s joint(s). My docs choose which product, and how much, very, very carefully. Steroids cost less in dollars, but can cost way more in side effects. For instance, steroids injected into joints can cause laminitis, even if the joint is really far from the feet. This side effect is particularly worrisome if your horse’s weight tends towards the pudgy like mine. Steroids also don’t heal the joint at all. They do reduce inflammation, but they also bring calcium to the soft tissues around the joint. Calcium in your very soft, flexible joint capsule is, shall we say, less than ideal, and it hurts. This side effect often happens after repeated steroid injections, and can be a cause for retirement. Platelet rich plasma and hyaluronic acid don’t carry these concerns, but every time a needle is placed in a joint there is a very small amount of damage done. That damage needs to be less than that being caused by the inflammation present.

Joint injections are considered an invasive procedure.  My docs take special care when performing joint injections which includes sedating your horse as well as sterile preparation of the injection site.  Prior to injecting, my docs will have their technician place a twitch on your horse’s upper lip. They tell me that the placement of the twitch actually helps to release endorphins and helps relax your horse. Maybe so, but I sure don’t want to find out if that is true. I’ll keep my lips to myself thank you very much. While your horse’s joints are being prepared for injection, my docs will pull up the medication for the joint in a sterile fashion. They also may add in a small amount of antibiotic to help reduce the risk of joint infections.  Often times they will administer a dose of bute to help decrease the inflammation that is a result of the injection.  Finally, they will leave you with specific instructions for your horse going forward, including stall rest the day of injection, usually turn out the day following injection, and then light work for a few days. They will also instruct you to monitor your horse for any pain, swelling, redness, or lameness in that limb that was injected.  They will tell you to call us immediately if you notice any of those signs.

The goal after joint injections is to decrease the inflammation in the joints to help your horse return to peak performance.  However, joint injections cannot and should not be performed any time your horse has a decrease in performance.  Instead, joint injections should be accompanied by physical therapy and a strict exercise program to boost your horse’s fitness level and keep your horse sound longer.

Physical Therapy

My clinic is a one-stop-shop for all your horse’s needs.  If my docs recommend physical therapy, I can offer that as well. We have the functional electrical stimulation (FES) which we use to help retrain your horse’s muscles to work in the correct way. It helps to relieve muscle spasms, treats muscle atrophy, and overall strength of your horse’s muscles.  We also have two very new offerings coming your way in Spring 2020: Springhill Equine is excited to offer acupuncture and spinal manipulation (chiropractic) treatments for your horse! Get excited, I know I am! I think I could use some acupuncture. You know, sleeping all day results in some very sore muscles for this old cat.

If you think your horse might have some performance issues, give me a call at the clinic and I will get you scheduled for a lameness workup. My docs can answer your questions and help you make the best choices for your horse, both for today and down the road.

Until next week,

~Tony

P.S. If you want to learn more about joint injections, my docs did a podcast on this topic a while back. They go very in-depth, which I don’t really have the energy for, but if you want to advance a few knowledge levels on joints, that’s the podcast for you. Click here, and scroll down the list until you get to the one called Joint Injections. You can listen to it right from your phone or computer.