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EPM 101

EPM 101

Mar 6, 2023 | EPM

Tuesdays with Tony

What is EPM?

EPM stands for Equine Protozoal Myeloencephalitis. Breaking this down into normal person-speak instead of doctor-speak, it means a small organism called a protozoa gets in the brain and/or spinal cord and causes inflammation. There are two protozoa commonly associated with EPM. These are called Sarcocystis neurona and Neospora hughesi. These little buggers are just about everywhere in the environment. They use a variety of small mammals and birds to mature until they are ready to head to a opossum, who then poops out eggs of S. neurona and N. hughesi so that those same small animals can eat them and get infected again. Most of the time the goal is to not overly affect the animals involved while carrying out your life cycle. This keeps your hosts happy, and able to continue being a good place for you to live. 

Enter horses, because horses are often bad at life. On rare occasions in horses, the organism gets into the brain or spinal cord. This also happens with diseases like Eastern Equine Encephalitis, and West Nile Virus. They aren’t supposed to get into the central nervous system. When they do, they can’t replicate like they’re supposed to, which means they can’t complete that great circle of life. The important thing to know is that this happens in less than 1% of horses exposed to EPM. Read that again: Less than 1% of exposed horses!

What Does an EPM Horse Look Like?

My Docs talk to lots and lots of people who are sure their horse has EPM because of behavior changes, or poor performance, or lameness, or any of a million different things. What EPM horses most commonly look like is muscle loss in one spot. Because EPM most commonly affects a spot in the spinal cord, it stops the signal coming from the brain to a muscle. That signal also tells the muscle to stay all muscley and pumped up. When the signal stops, the muscle goes away, or atrophies. 

For EPM horses, this occurs in one particular area, and only on one side. If you think about it, that makes sense. The organism won’t line itself up perfectly on the centerline of the spinal cord and cause even muscle loss on both sides. If it is affecting a big enough area to hit both sides of the body, it will be way worse on one side than the other. This is a hallmark of EPM horses. They are never symmetrical. Almost always, only one side of the body is affected. In the rare case both sides are affected, one side will be way worse than the other. 

This means the first clue for my Docs is a sudden area of muscle loss. Some horses aren’t as obvious, and may present with subtle neurological signs like tripping, or sudden difficulty turning one direction or the other. Again, my Docs are going to look for areas of muscle wasting associated with these signs. They’re also going to do a very thorough lameness and neurologic exam. EPM horses will display neurological symptoms as opposed to lameness symptoms. This can sometimes take a lot of pushing, pulling, walking in weird ways, and putting horses in odd positions to determine. Luckily, my Docs are persistent.

Springhill Equine Veterinary Clinic

Testing for EPM

Here is where the really sticky widget comes in. Conclusive testing for EPM simply can’t be done by blood test, and here’s why: if the blood test is positive, it just means your horse has been exposed to EPM, it doesn’t mean it’s in their brain or spine. If the blood test is negative, it means your horse hasn’t been exposed. In many areas of the United States, it is highly, highly unlikely your horse has not been exposed to EPM. The organism is everywhere. 

“But Tony,” you say. “Does this mean there isn’t a conclusive test?” Never fear, testing can be done. But: it does require a spinal tap. This can be done as a standing procedure in 99.9% of horses. And yes, it does have to be a spinal tap. You see, the fluid around the brain and spine is special. It has huge barriers to entry from the rest of the body. You may have heard of the blood-brain barrier. That’s what I’m talking about. This means the test is only positive if the organism is actually in the brain or spinal cord. Exposure to the organism in the usual fashion won’t cause high levels in the spinal fluid. So: a spinal tap is the only way to be sure of your results.

Is it Treatable?

The short answer is yes. Very nearly all the time is the longer answer. For most horses, a diagnosis of EPM means a round of drugs to kill the protozoa. They get a strong version for at least 30 days, followed by a weaker version for several months. Marquis and Protazil are the most common drugs used for that first 30 days. Both do a great job of really hitting the protozoa hard. From there, the follow-up medication is used to actually kill the little buggers. This plan works great for most horses. 

Here’s the deal for any horse with a neurologic disease: we can only improve them one grade from their worst grade. The grades are numbered 0-5. Numbers 0-2 can usually be ridden. This means if my Docs give your horse a score of 4, they will likely improve to a 3 with the very best in therapy, AND a good response from the horse’s own immune system, which means they will be a danger to ride. This is why I said they respond nearly all the time. Sometimes the organism gets into a very, very bad spot, and/or the body responds with a big huge inflammation response, and a whole lot of damage is done in a very short amount of time. These are the worst case EPM scenarios that no veterinarian or horse owner wants to deal with. 

But My Horse Felt Better with Drugs!

Time for a giant cat pet peeve. My Docs hear this All.The.Time. My horse got better while on EPM treatment. Yep, they sure did. Every one of the medications used to treat EPM have what is known as anabolic effects. That means they work like those steroids the pro-athletes aren’t supposed to take. They aren’t as strong as the big, bad steroid injections, but they still have moderate effects. Of course your horse feels better! They were getting juiced! This my horse felt better statement is often followed by, they felt worse when they came off EPM meds, so they must have it. Now you know the real reason they felt better, and the real reason they felt worse when they stopped medication. It had nothing to do with EPM.

The moral of my tale this week is that EPM, as a cause of neurological symptoms, is not all that common. If your horse is having neurologic signs or poor performance issues, the best place to start is a good thorough physical exam, followed by a good thorough lameness exam. This gives my Docs the best chance to recommend diagnostics to determine the real underlying cause. Once they know the true problem, they can target treatments and rehab protocols to help you and your horse get back to doing what you love. If you want to see what a neuro exam is like, check out this amazing video my docs made for you!

Until next week,

~Tony

P.S. If you liked that neuro exam video, there’s more where that came from! Check out my YouTube Channel for dozens and dozens of videos, as well as seminars, how-to tutorials, ASMR videos, and more!

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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Acupuncture

Acupuncture

Feb 27, 2023 | Acupuncture

Tuesdays with Tony

Did you know that two of my Springhill docs are trained to use acupuncture to treat your horses? Acupuncture may seem mysterious to some of you. Not to me though. I’m a cat and I know everything, so let me explain.

Acupuncture is the insertion of needles into specific points in the body to cause a healing response. It’s been used to treat humans and animals in China for thousands of years, and now is used all around the world. Acupuncture is used to treat a wide variety of illnesses, and positive results have been shown in many clinical research studies. Each of those acupuncture points has a specific effect when it’s stimulated by the needle. Scientific studies have shown that most acupuncture points are located in regions where there is a nerve plexus and higher electrical conductivity than the surrounding tissue.

Springhill Equine Veterinary Clinic

In traditional Chinese medicine, the acupuncture points are connected by pathways in the body called meridians. These pathways create an energy flow throughout the body that maintains overall health. This energy is called Qi (pronounced chee). When the flow is disrupted, disease can occur. By stimulating certain acupuncture points, the energy flow can be restored.

In Western terms, acupuncture stimulates the nervous system, releasing chemicals into the muscles, spinal cord, and brain. These biochemical effects stimulate the body’s natural healing abilities. They can increase blood circulation, relieve muscle spasm, and release pain-controlling endorphins. The National Institute of Health consensus statement concluded that there was compelling evidence of acupuncture’s ability to control multiple ailments in people, including osteoarthritis and musculoskeletal pain, asthma, nausea, and headaches.

So while Eastern and Western traditions may use their own terms for these concepts, they’re really not all that different. Not so mysterious after all, right?

The Exam

Acupuncture diagnosis and treatment is very individualized to the patient. In addition to their usual veterinary examination, my docs will employ a few additional diagnostic techniques. In Chinese medicine, personality type can predispose an animal to certain illnesses or injuries. When my doc comes out to see your horse, she will ask questions to determine which personality your horse leans towards, and this is taken into consideration when she is choosing a treatment.

The Personality Types:

Wood: Wood personalities are confident, they are competitive, can sometimes be aggressive, and are often dominant. Many of our best show horses are wood personalities since they thrive on competition.

Fire: Fire personalities want to be the center of attention; they are friendly and playful but often sensitive. These kinds of horses are the ones that are always getting into something, these are the mischievous ones who open stall doors and let all their friends out, too.

Earth: Earth personalities are mellow, easy going, friendly, slow moving, and tolerant.

Metal: Metal personalities are rather aloof, independent, and like rules and order.

Water: Water personalities are timid and shy. They may be nervous and tend to react based on their fear.

After my doc determines your horse’s personality type, she will assess his tongue.  Based on the color, texture, and moisture of the tongue, she can gain clues on what organ systems are affected and if there is a deficiency or stagnation in the energy flow. She will then feel your horse’s pulses, which will help her narrow down where the abnormality is coming from. Next comes the scan. My docs will apply pressure with an instrument to assess each meridian or channel where energy flows. She will watch your horse carefully for his reaction to certain acupuncture points or entire channels. For example, there are certain points that indicate hock pain or stomach ulcers. My doc will score each reaction then put all the pieces together to make a diagnosis.

Springhill Equine Veterinary Clinic

Treatment

Now that we have a diagnosis, treatment can begin. Based on your horse’s personality and diagnosis, my doc will perform the treatment that will best suit your horse on that day. You’re probably most familiar with the idea of thin needles placed in specific acupuncture points, but there are several other types of treatment that may also be used. Electro-acupuncture involves sending a light electric current through wires connected to the needles in your horse to increase the stimulation of the points. Moxibustion involves burning dried mugwort over specific points to encourage the movement of energy and relieve stagnation. Vitamin B12 can also be injected directly into acupuncture points for a long-term stimulation of the point that will last days after treatment.

Follow-up

After your horse’s initial examination and treatment, my doc will recommend follow up treatments. During these treatments, she will perform the same examination done at the initial visit to determine where your horse has improved, where there have been changes, and what needs to be addressed now. Usually, it takes 3-4 treatments 1-2 weeks apart to fully treat an ailment. In other words, acupuncture requires commitment.

How Can Acupuncture Help Your Horse?

My doc’s preferred way to practice is to incorporate both Western medicine and acupuncture together to achieve the best results for your horse. They use acupuncture to assist in the treatment of musculoskeletal problems such as arthritis, tendon/ligament injuries, and sore backs. Acupuncture can also be used to treat respiratory issues such as asthma or heaves, anhidrosis (non-sweaters), and anxiety problems. It can stimulate appetite, soothe some types of colic, and reduce diarrhea. Using acupuncture, my doc may be able to decrease the amount of medication necessary to treat your horse.

Acupuncture doesn’t cure every condition, but there are many applications where it can improve your horse’s quality of life and facilitate healing!

If you want to schedule an appointment for your horse’s initial acupuncture treatment, call my minions today. And make sure you tell them I deserve a treat for all my hard work around here.

Until next week,

~ Tony

P.S. Do you know how many videos I’ve got on my YouTube Channel? It’s a LOT! You can binge watch my videos and become a horse healthcare expert. Not on my level, of course, but on a high level for a human. Just click the link to check it out, and make sure you subscribe. I put up new content all the time, and you don’t want to miss out. You’re welcome.

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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Equine Senior Care and Considerations

Equine Senior Care and Considerations

Feb 20, 2023 | Seniors

Tuesdays with Tony

As a cat, I have 9 lives, and am therefore perpetually young, despite my many years of experience. Don’t question me on this. Horses, though… . After many seasons of showing, trail riding, or general riding, you eventually find that your horse has reached the age of retirement and is entering his golden senior years. This can be different for each individual animal, but in general, we consider a horse as a “senior” around 15 to 20 years and older. Senior care is important and can often be overlooked (cats would never allow this, of course). Our senior horses have general maintenance requirements that are very similar to our younger horses that are still in work. Additionally, there are some special considerations when it comes to nutrition, diseases, and cases of chronic lameness. 

Vaccines

In my [not-humble cat] opinion, one of the most important aspects of senior care is to continue the general maintenance that was part of their routine health care. This would include continuing to booster the core vaccines (Eastern Encephalitis, Western Encephalitis, Tetanus, West Nile and Rabies). This is important because horses are constantly exposed to these diseases through mosquitoes, the soil, or other animals, in the case of rabies. Therefore, even if they have been vaccinated their entire life, that does not mean that once they hit their senior years that they no longer need to be boosted. 

Deworming

Similarly, deworming based on fecal analysis is just as important, if not more so, in elderly horses that may have secondary conditions impacting their immune system. These issues make them more susceptible to intestinal parasites. They might have been able to fend them off when they were young, but getting old is rough. I like to deny my geriatric status, but it does make everything a little harder. Cushings (PPID) is just one common senior disease that makes it easier for parasites to flourish. This can mean even if your horse was a low shedder in their younger days, they may not retain that status. The only way to know for sure is at least yearly fecal egg counts. 

Springhill Equine Veterinary Clinic

No Hoof, No Horse

We should never forget about podiatry care for the senior horse. Not only can they have conditions impacting their feet, but chronic conditions of the tendons and arthritis of the joints can be exacerbated if their feet are overgrown or imbalanced. Have you heard of the saying, “no hoof, no horse?” That applies at all stages of life! 

Condition

Another general consideration for our senior horses is to monitor their hair coat and body condition in the extreme times of the year, when it is excessively hot or cold. Horses that are underweight, or those that are not growing a thick coat, may need to be blanketed in cooler weather, especially if there is limited shelter available. Conversely, if your horse is over-conditioned, or fat, or has a thick hair coat, they may be prone to overheating in the summer. These horses may need to be clipped, given additional shade, and in some cases even stalled with a fan. We’ll discuss some disease conditions in seniors that may predispose them to these sensitivities. 

Nutrition

As with all life stages, nutrition plays an important role in the health of your animal. Luckily, many companies, such as Purina, Nutrena, Triple Crown, and Seminole, among others, formulate complete feed products for senior animals. Complete feeds include chopped roughage, which is important for horses that can’t chew grass or hay well enough anymore. If your senior horse is unable to chew and digest ordinary feed properly, the senior feeds can be fed at higher rates to act as a complete diet for your horse. It’s important to read the quantity of feed recommended on these, as it’s much higher than non-complete feeds, and you can accidently starve your horse by under-feeding them on senior. Complete feeds are often needed with older horses because they may have worn out the life of their teeth. 

Dentistry

Horses are fairly unique with regards to their dentistry because they have hypsodont teeth. This means that their adult teeth gradually erupt throughout their life and get worn down as they age. This is why veterinarians “float” or file down the teeth in certain areas that can get sharp from this wearing-down process as they age. In their late 20’s and early 30’s the horse may completely erupt the end of some of their molars and this may limit their ability to chew and digest hay and forage properly. 

Some horses can also develop a condition that affects their incisors called Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH). It can be a painful condition that we can diagnose based on exam and dental radiographs, signifying the importance of continued yearly dental exams on our older horses. 

Disease Vulnerability

There are a few diseases that we monitor as a horse ages. Some of these diseases are more breed-specific than others. The major endocrine condition that we think of with older horses is Cushing’s Syndrome, also known as Pituitary Pars Intermedia Dysfunction (PPID), which causes increased levels of a hormone called ACTH. Some of the clinical signs of Cushings often include loss of topline musculature, long, thick hairs sticking out of their coat (hirsutism) and chronic laminitis. 

Other conditions that can occur in older horses include Equine Asthma, previously known as Heaves, which is often triggered by allergens. Horses can present with coughing and increased respirations. There is also Uveitis, which is inflammation in the eye that can lead to blindness. A more well-known term for this condition is moon blindness. Finally, previous injuries or the impact of a previous athletic career can result in managing chronic lamenesses and long-term pain management. 

Some medications that can help manage these conditions include Equioxx or bute. Some injuries may need to be managed with joint injections, such as Arthramid or PRP-type products. In any case, having your veterinarian help create long-term strategies for pain management is essential in maintaining an older horse’s quality of life.

Springhill Equine Veterinary Clinic 

Golden Golden Years

Overall, once our horses reach their senior years, they still require some extra love and attention that your equine veterinarian is happy to provide. The key takeaway from this information should be that age is not a disease, it is just a number! We are lucky to have many advances in equine veterinary medicine care that are allowing our horses to live longer than previously expected. With diligent care, we can make our horses’ senior years some of their best years. 

Ask my minions about the Senior Add-on to your Wellness Plan at your next visit! Our Senior Wellness add-on includes routine bloodwork, testing for Cushings (PPID), and foot x-rays. There’s no better way to make sure your Super Senior is monitored for early signs of little problems so they don’t become big problems. This wise cat is on the feline equivalent, which you can also ask about, as we have a wonderful small-animal veterinarian now. I highly recommend it. Tasty treats for us patients come with those blood draws!

Until next week,

~Tony

P.S. If you haven’t subscribed to this blog yet, be a good human and scroll down to the big purple box. You can do it! There, that’s a good human. Just put your email address in there, and I’ll email you my blog every week. That way you don’t miss out on any of my cat wisdoms. You’re welcome.

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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Floating Teeth: Equine Dental Care

Floating Teeth: Equine Dental Care

Feb 13, 2023 | Dentals

Tuesdays with Tony

I, being the hard working feline that I am, am often hand fed by my humans and do not often have to think about the use of my teeth. Your horse, however, requires roughage (hay, grass, other gross green things) in their diet which they generally need to use their teeth for. Today we are going to talk about equine dentistry and the effects it has on your horse’s well-being. 

If you’re a reader of this blog, I know you care deeply for your equine friends. You have your veterinarian out on a regular basis, vaccinate for the things they recommend, and only deworm based on fecal egg counts as directed by your veterinarian. So, who’s floating your horse’s teeth?

If it’s not also your veterinarian, keep reading. Oh–and even if it is–you should still read the rest of my blog.

What Do We Do to Horse Teeth During a “Dental”

Horse teeth are designed to grow continuously throughout the horse’s life. As the horse chews, they wear down their teeth. When the mouth is balanced, the teeth wear down in a relatively even way. Once imbalances start though, they only get worse as the grinding action occurs every day. Horses can develop imbalances–things like malocclusions, sharp enamel points, and hooks–for a variety of reasons, and yes they do develop these things “in the wild” too. Some imbalances are relatively minor and don’t prevent the horse from eating, but some cause severe oral pain and make your herbivorous friend taste blood in their mouth. 

So, when my docs go in there with their special tools, what they are doing is correcting those imbalances. My docs use tools called “power floats” which make the dentals quicker and put less strain on their overworked backs, but you may see your veterinarian use tools called “hand floats” which basically just look like metal rasps. And that is where the term “floating a horse’s teeth” comes from–just the name of the tool used! The floats are designed to be used in specific ways to safely grind down the high or sharp points on various surfaces of the teeth in order to bring things closer to being balanced. It is very possible to “over float” however, which is why a dental speculum and bright light are absolutely vital to the dental–and you can’t use those effectively without the magic word: sedation!

Sedation can only be used and administered by or under direct supervision of a veterinarian. There are lay people who claim to float horse teeth out there who use sedation but this cat knows they went under the table to get it–and that spot is reserved for me. So, sedation is used by my docs to make the horses a bit more calm and amenable to the whole process. It is a very light sedation that keeps them standing and aware, but also allows the doctor and technician to be safe while the speculum goes into the mouth and holds it open for the dental exam. 

The dental exam is one of the most vital parts of the entire procedure and is definitely not being performed by lay people claiming to be able to float teeth. The dental exam involves both visual and tactile assessment of every tooth in the horse’s mouth. The docs look for missing teeth, sharp points, oral ulcerations, tumors, extra teeth, you name it they want to find and document it. Just like doing a physical exam for vaccines helps your veterinarian know what is normal for your horse so they can more easily spot abnormal, doing dental exams every year allows them to track progression of any imbalances or abnormalities your particular horse has.

How Often Should Dentals Happen?

For most horses, my docs recommend a dental exam and float once per year. Exams should start within the first few years of life and often there are already mild sharp points that my docs take down quickly with their power float. Starting dentals early helps find any issues your horse was born with so they can be managed over time. It also helps young horses get used to the sedation of the speculum and the noise of the float in their mouth, which will make them better patients for the next visit.

Regular dental work by a veterinarian can help prevent pain and discomfort, improve chewing ability so they get more out of each piece of food, and can even improve behavior and comfort while working. Sometimes my docs will recommend twice yearly dental work for young horses with pre-set imbalances so we can set them up for success in later life, and very often my docs will recommend twice yearly dental care for older horses who teeth are starting to “expire.” 

Don’t worry, I’m not going to go Tim Burton on you, by expire I just mean teeth that are so worn down they are not very effective at grinding anymore. If a horse lives long enough, this will happen, and it takes a skilled hand to manage the teeth around that one, especially the one directly across the mouth from it. Remember how I said at the beginning that the teeth are designed to grow for the entire life? Well, if one expires, the one opposite on it on the upper or lower jaw will often keep growing, and growing, and growing…

For horses that don’t get regular veterinary dental care, this leads to the sensation of having a giant pillar in their mouth that they can’t quite chew around, and will often make them less likely to eat. If my docs meet an older horse who isn’t keeping weight on or isn’t eating well, one of their first steps will be a dental exam and likely floating the teeth!

Take Home Points

What this cat wants you to know is this: all of your horses should have dental care performed with sedation by their veterinarian at least once per year. 

It doesn’t matter what a lay person tells you about how “skilled” or “specialized” they are in equine dentistry, they are not qualified to appropriately manage your horse’s teeth.

A horse’s teeth are vital to their digestion of nutrients. Most horses eat hay or grass as the majority of their diet. This is known as roughage because the plant fibers need to be broken down by the grinding action of the teeth. This is why older horses that have expired teeth should switch to a complete or “senior” feed. Senior feeds have the roughage component in them already ground down, essentially doing the work of the teeth prior to entering the horse’s mouth! 

Well, I hope that gives you some perspective on equine dentistry. If you have any follow up questions my docs are always happy to answer, just give the clinic a call or talk to them at your horse’s next wellness appointment!

Until next week,

~Tony

P.S. Be a good human and scroll down to the purple box and subscribe to my blog. Don’t rely on Facebook to let you know when a new one is out. My subscribers get it right in their email inbox, and a day earlier than everyone else! Go ahead, just scroll down a little further. Good human. You can do it!

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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Subtle Lameness

Subtle Lameness

Feb 6, 2023 | Lameness

Tuesdays with Tony

Ah, the subtle lameness. This is often a source of medical mystery for my Docs. For me, it’s like a good Netflix drama. Is the problem even what you think it is? One minute you’re sure it’s the left rear leg, but it turns out it’s really the neck, and sometimes it isn’t even a lameness! It’s a neurologic issue, or even a muscle disorder. I tell you, it’s high suspense around here! How do my Docs even begin to unravel the mystery? Read on while I drop some cat wisdom on you.

Start at the Beginning

Everyone always wants lameness exams to start with trotting, or riding, or something where they can show off the lame part. My Docs never start here. It’s even more important with the vague lameness. They start by talking with you about what’s going on. The story is often long, complicated, and can have some subtle plot points. 

It may be that it all started with a day where Flicka didn’t feel quite right. From there, some days have been good, maybe some bad. There could be a buck when turning left and picking up the canter. There could be a skip when coming down to a trot from the canter. All those little clues help my Docs begin to formulate an idea. That idea is just that, an idea. It’s likely to change as more information is added, but it’s the starting point of what’s really going on. Much like that Netflix show, there may be some false clues in here, but without exploring them all, my Docs often can’t know what’s real and what’s not. 

Hands On

We’re still not going to run the horse around. The next step is a full cat scan… er, human scan. I’m generally very involved from a supervisory standpoint for this part. My Docs will poke, prod, flex, extend, and turn all your horse’s parts while standing still. 

Each Doc goes through this a little differently, but the general idea is to get their hands on every part of your horse, and to move those parts through their normal range of motion while standing still. This is often very telling about where horses are stiff, sore, or generally reactive. Excellent clues are gained from this section of the exam. Those ideas from earlier are expanded upon, modified, and sometimes changed all together. 

Finally, We Move

Once there has been time spent on history, and hands laid upon the horse, then we head out to see how they move. Generally, my Docs start on grass footing. They watch the horse walk away from them, towards them, and from the side. They will often watch, and then video. Then they do the same at the trot. Depending on how that goes, next may come flexions, or heading to a hard surface to see what happens there, or some circles in both directions. 

Springhill Equine Veterinary Clinic

Different problems show up in different places. Some things don’t like hard surfaces, some don’t like soft, some don’t like to be on the inside of a circle, and some object strongly to being on the outside of the circle. Especially with a subtle lameness, my Docs are going to run through a lot of scenarios. They are also going to video a lot of those scenarios and watch them in slow motion. Slow motion can really highlight an area that isn’t moving normally. Turns out those phones are good for something more than Facebook! 

A Cautionary Tale of Flexions

Flexions are a let’s stress this area and see what happens kind of test. They are far from perfect, but they can sometimes point to an area that hurts when it’s bent, held, and then asked to move. However, flexions can lie in all sorts of ways. Occasionally, there’s a well-performing horse with no issues that trots off like it has a broken leg when flexed. More often there are lame horses that trot off exactly the same when flexed. Flexions add information to the mystery; they don’t solve it!

Springhill Equine Veterinary Clinic

Even More Moving

With a subtle lameness, my Docs will often have you ask the horse to perform their normal job. My Docs will watch the horse go through their paces. They nearly always video this part, especially if faster gaits or quick turns are involved. Even my Docs are only human, and videos help them see the subtle changes going on. For many of these not-so-obvious lamenesses, it takes until this step to really fully complete that inkling of an idea that happened way back at talking to you about history. 

Next Steps

Depending on all the previous steps, the next step can be a variety of things: blocking, radiographs, or ultrasound. Blocking involves numbing an area to see if the problem stops. There are obvious issues with this system. Sometimes you have what we call an unblockable area. Many back and pelvis issues fall under these categories. The other issue is some horses really change the way they move when some part of their body is numb. Last week we had one that held his leg up in the air because his foot was blocked. Very, very difficult to continue a lameness like that! There was nothing to do but wait for the block to wear off and try a different plan. Ah horses. 

Some areas my Docs image before they block if they are suspicious. Proximal suspensories often fall in this category. To block them, you have to put liquid where the ultrasound then looks, which makes it look like you have a really, really bad suspensory issue when it might just be your block. Some areas, like backs, don’t always respond great to blocks so x-rays or ultrasound may be the next step. 

Next, Next Steps

After narrowing down their ideas to a primary problem, my Docs will work on a plan to address that primary issue. This may involve injections, rehab therapy, spinal manipulation, acupuncture, a change in tack, or any of a number of things. Often there is a combo pack of things that need to be done to help these horses. Rarely is it a let me give your horse this magic injection (or pill) and all will be fixed! 

Subtle lamenesses can be frustrating. Making sure you have reasonable expectations for the process, and knowing the results often require a lot of work can help everyone arrive at the best answer for the horse. Unlike Law & Order, the perpetrator isn’t always found in 47 minutes. Sometimes it can be an 8-episode series, and there’s no binge watching allowed. We hope for a 2-3 episode max series to solve the mystery, but horses have their own ideas about what’s entertainment.

One thing I didn’t mention was the rider. An unbalanced rider can make it difficult for the horse to do all the things. That’s a whole different blog, and may require some professional help for the rider (physical therapist to figure out your body, mental therapist to help you accept that you’re not perfect, etc). My humans just released a podcast episode about that very topic called Unbalanced Riders, so make sure you’re subscribed to the show, or head over to the Podcast Page of my website to listen in!

Until next week,

~Tony

P.S. Be a good human and scroll down to the purple box and subscribe to my blog. Don’t rely on Facebook to let you know when a new one is out. My subscribers get it right in their email inbox, and a day earlier than everyone else! Go ahead, just scroll down a little further. Good human. You can do it!

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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Types of Colic

Types of Colic

Jan 30, 2023 | Colic

Tuesdays with Tony

While a rose is a rose is a rose, a colic is not a colic is not a colic! The old saying implies that when all is said and done, a thing is what it is, but colic in horses isn’t really just one thing. Colic is a catch-all term for abdominal pain, but a number of issues might be going on in that dark mysterious place that is your horse’s belly. While the outward signs can look similar (rolling, pawing, lack of interest in food, etc.) it takes some detective work in my doc’s examination to determine the cause of your horse’s colic.

Depending on what the actual problem is, the treatment can be very different. It can be confusing to horse owners that the remedy that worked on their horse before isn’t the right choice for the colic they’re dealing with now. I’ve written several blogs filled with my cat wisdom on how to prevent colic, but today let’s talk about the different kinds of colic so you can have a better understanding of what my doc is describing if a colic happens.

There are a few broad categories of colic – non-strangulating obstructions, strangulating obstructions, inflammatory conditions, and “other stuff” that doesn’t really fit into those other categories. There are about 100 feet of intestine in your horse’s belly, so unfortunately there’s a lot that can go wrong. I won’t describe every possible abdominal problem your horse could think up, because frankly we’d be here all day and I have a clinic to supervise!

Non-Strangulating Obstructions

This is the largest category of colic my docs see. In these types of obstructions, something is blocking the passage of feed material through the GI tract. Because the blood supply to the gut isn’t cut off (aka strangled), the intestinal tissue isn’t badly damaged (at least not immediately). Non-strangulating colic can often be managed medically, meaning that with appropriate care such as pain medications, oral or intravenous fluids, and laxatives, many can get better without surgery.

The type of non-strangulating obstruction you’re probably most familiar with is a feed impaction. It’s basically constipation. Food gets lodged somewhere in the GI tract – frequently the large colon or a part of the small intestine called the ileum. We see impactions a lot when the horse isn’t drinking enough water and gets dehydrated, when he’s not chewing his feed well, or with certain types of feed (cough-cough coastal hay cough) Most of the time, if my docs can rehydrate your horse and soften the impaction, she can get him un-impacted and feeling better.

Also very common are large colon displacements. The not-so-brilliant design of the horse GI tract includes a 12-foot-long large colon that basically has a single attachment point to the upper body wall. Why is that a problem? Because it allows the colon to move around the abdomen. Sometimes the colon turns in such a way that it kinks off the passage of feed material and gas or gets trapped against other organs. We call this a right dorsal displacement or a left dorsal displacement (aka nephrosplenic entrapment), depending on what direction the colon has moved. Some of these can be treated medically, but sometimes the colon will fill up with food and gas and get really wedged. It can get bad enough that the gut becomes damaged, and the horse won’t survive without surgery.

Springhill Equine Veterinary Clinic

Other kinds of non-strangulating obstructions include sand impactions, which is ingested sand that accumulates in the large colon, and enteroliths, which are mineral stones that develop in the colon and grow large enough to cause a blockage. Enteroliths can require surgery to remove if they get large enough to cause a problem. Young horses that aren’t dewormed properly can even develop an obstruction made of ascarid parasites.

Strangulating Obstructions

Thankfully, strangulating obstructions aren’t as common as the non-strangulating types, but when they do happen, you have to move fast to save the horse’s life. These colics occur when part of the GI tract gets twisted or trapped in a way that cuts off the blood supply to the gut. Strangulating colics are much more serious and always require surgery to treat.

Signs of pain often come on quite suddenly and can be quite severe, with a very high heart rate and violent rolling. It’s usually difficult or impossible to control the horse’s pain with medications. The bowel begins to die quickly once the blood supply is cut off, so there’s no time to lose and your horse will need to be on his way into surgery quickly. Yet another reason to contact your vet immediately if your horse is showing signs of colic.

There are several types of strangulating colic. A “volvulus” of the large or small intestine occurs when the piece of bowel twists on its own axis and tightens down. Because of the long attachments and the ability of the bowel to move around the abdomen, volvulus can occur as an “accident” for no known reason. Large colon volvulus also tends to occur in broodmares shortly after foaling.

Another common strangulating lesion, especially in older horses in their later teens and 20’s, is a lipoma. A lipoma is a benign fatty tumor growing from the mesentery (the tissue that connects the intestine). The lipoma itself isn’t the problem, it’s the fact that the lipoma grows suspended from a thin rope of tissue like a stalk. Lipomas can exist in the abdomen for years without causing an issue, but if they get wrapped around the intestine, they will quickly cause the tissue to die. The treatment is surgical removal of the dead intestine and suturing the healthy ends of intestine together.

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Entrapment colic occurs when small intestine gets stuck in a place where it’s not supposed to be. Epiploic foramen entrapment is when the intestine wiggles itself into a narrow opening between organs in the front of the abdomen, called the epiploic foramen. The foramen is a normal part of the horse’s anatomy, but the intestine isn’t meant to get in there. Another way entrapments happen is through an abnormal tear in the mesentery (a mesenteric rent) or in the gastrosplenic ligament. In both cases, there is an abnormal opening where there isn’t supposed to be one, and the intestine finds its way in there and gets stuck.

An intussusception is a weird type of colic where a piece of intestine telescopes inside the adjacent intestine and gets stuck. It’s an infrequent cause of colic and tends to affect young horses. Eventually, like all strangulations, the blood supply is cut off and the bowel starts to die.

The prognosis for a strangulating colic depends on how long the colic has been going on, how much intestine is involved, and how quickly the horse is operated on. While strangulating colics are invariably very serious situations, if treatment is performed fast, many will make it through surgery and be discharged home.

Inflammatory

Inflammatory colics are usually caused by infection by bacteria, viruses, or mold. Sometimes it’s possible to find the specific microorganism causing the problem, like salmonella or clostridium, but frequently the exact cause can’t be identified. Inflammatory colics can involve the large colon (colitis), small intestine (enteritis), or the peritoneal space inside the abdomen that contains the organs (peritonitis). Unlike most of the other types of colic we’ve discussed, inflammatory colics may have a fever.

They can all range from relatively mild to extremely severe. The inflammation of the colon in a colitis case usually results in diarrhea. Enteritis causes inflammation of the small intestine and a painful fluid backup in the stomach and small intestine. Peritonitis cases might show obvious colic signs, or just depression and a lack of appetite. Depending on what kind of inflammatory colic you’re dealing with, the treatment might be intravenous fluids, antibiotics, decompression of the stomach by nasogastric tube, or lavage of the peritoneal space. Prognosis depends on the amount of inflammation and how sick the horse is.

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Other Stuff

There are a few other types of colic that don’t fit easily into one of the categories above. And it’s not that they’re uncommon! Gas colic, sometimes called spasmodic colic, is one of the most common causes of abdominal pain in horses. Gas buildup in the intestine can be caused by changes in diet or activity level, though many times a specific reason can’t be identified. While many gas colics will feel better once the gas moves through, it’s possible for an untreated gas colic to progress into a more serious colon displacement or twist.

Gastric ulcers, or sores in the lining of the horse’s stomach, don’t always show obvious outward signs – they may just have poor body condition, lack of appetite, or attitude changes. More serious cases can show colic signs like laying down and grinding their teeth. They can affect any horse at any age, but they’re most likely to occur in athletes like race or show horses.

As you can see, there are a whole bunch of different ways your horse can colic! It’s not possible to tell the type of colic just by looking at it, so make sure to get my docs involved right away. That’s why they go to school for years and years!

I’m going to give you a Pro Tip from a cat in the know: I see people who are trying to avoid spending $500 on a vet bill when their horse is showing signs of colic, so they try to wait it out. The first few hours that the horse is sick is when it’s the cheapest and easiest to treat him. After that, it gets more expensive, and the chances of a good outcome drop significantly, because most of these things we’ve talked about get worse if left alone, not better. So do your horse (and your wallet) a favor and call sooner rather than later.

Until next week,

~ Tony

P.S. Now that I’ve whetted your appetite with some serious horse knowledge, you should listen to an episode of Straight from the Horse Doctor’s Mouth, which is my podcast. Well, I have people that do that stuff, just to be clear, but I still claim it. Dr. Lacher is willing to spend way more time talking about this than I am (hey, a cat’s got to sleep, and eat, and there’s only so many hours in the day). She has several very in-depth episodes on colic that will really clog your brain up with next-level facts. You can check it out over on the Podcast Page, or subscribe on Apple Podcasts, Spotify, or wherever you get your podcasts.          

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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Crate Training Dogs

Crate Training Dogs

Jan 23, 2023 | Crate Training

Tuesdays with Tony

This one’s for the dogs. The unsophisticated, stinky, dogs. While no cat can be tamed, of course, dogs often need to be contained to prevent messes or not-so-smart choices. I know, it’s embarrassing, right? Dogs. But we should talk it out anyway, just so that we’re all on the same page with best practices.

What is Crate Training?

Crate training can be an effective way to housetrain your dog and teach them to be comfortable in their crate. Positive reinforcement is a great way to train dogs and puppies as it involves rewarding them for good behavior and basically ignoring the unwanted behaviors. There are a variety of different types of crates, so I’m sure you can find one that will work in your home. Here are some of the categories:

  1. Wire crates: Wire crates are one of the most popular types of crates. They are made of metal wire and usually have a removable plastic or metal pan at the bottom. They come in different sizes and often have a removable divider to make it easier to adjust the size of the crate as your puppy grows. They have good ventilation and are probably the simplest and most accessible to start with, and they are also easy to clean.
  2. Plastic crates: Plastic crates are another popular choice. They are made of hard plastic and usually have a removable plastic or metal pan at the bottom. They are lightweight, durable, and easy to clean. They are suitable for travel, as they are easy to fold and store. These aren’t the best idea if your dog is an aggressive chewer, as they can potentially chew and eat the plastic.
  3. Soft-sided crates: Soft-sided crates are made of fabric and mesh and are lightweight and portable. They often have a steel or aluminum frame for support. They are suitable for small dogs and for travel as they are easy to fold and store. They are not as durable as the wire or plastic crates. These should not be used for crate training but can be used once the dog is acclimatized to the concept.
  4. Wooden crates: Wooden crates are made of wood and are suitable for indoor use. They are not as durable as the wire or plastic crates and are not easy to clean. They are usually heavy and not suitable for travel. These are often the most aesthetically pleasing, and also the most expensive.
  5. Outdoor crates: Outdoor crates are made of heavy-duty materials such as metal wire or plastic, and they are designed to be used outside. If they are weather-resistant and have good ventilation, they can be useful for dogs that spend a lot of time outside. It is vital that they always have free access to water if they are outside and that they are not left outside in extreme conditions.

Springhill Equine Veterinary Clinic

Making the Right Choice

It’s important to consider the size and behavior of your dog when choosing a crate. You should select a crate that is just large enough for your dog to stand up, turn around and lay down comfortably, initially. This specific sizing makes the initial crate training much easier. Once your dog is comfortable in the crate, you can try getting them a larger one, so they have more space, especially if you’re leaving them for the work day.

How Do You Do It?

So, how’s a human supposed to convince your new puppy or adult dog to go into a cage and stay there? Start by introducing your dog to the crate gradually. Place treats and toys inside the crate and let them explore it on their own. The goal is to make the crate a happy place to be. Once they are comfortable inside, you can start closing the door as you sit next to it. Ideally, they shouldn’t even notice the first few times because they’re so enthralled with whatever interesting thing you’ve put inside. This should happen the first day or two you bring your dog home.

This isn’t a new puppy blog, but I will say new puppies are going to cry at night pretty much no matter what (again, embarrassing). Some people choose to put them in their new crate next to their bed, others choose to put them in a pen, bathroom, or other safe space that is not the crate for their first few nights. Wherever you put them should be contained and fully puppy-proofed. That will be a future blog topic in itself, I’m sure. I hear Dr. Speziok talk about it to her clients every day, so it must be important. But enough on that for now. What was I saying? Ah, yes, crate training.

Springhill Equine Veterinary Clinic

Gradually increase the amount of time you leave your dog in the crate, and always, always reward them with a treat when they go in. Avoid making a big fuss when you put your dog in the crate or when you let them out. This can create anxiety for your dog and make the process more difficult.

This is an important point that you humans sometimes have a hard time grasping: Crates are not to be used for punishment. Really, punishment is never a good training tool. You can use the crate when your dog needs to be removed from a situation AFTER they’ve gotten used to the crate and associate positive things with it, but it should always be a positive, happy experience to go into the crate. Some of the big brain humans that study animal behavior feel that many dogs think of their crate as a sort of “den.” They consider it their home within the home, and some will be seen to bring toys, bones, or food inside.

Why Crate Train?

A properly sized, properly conditioned crate provides dogs with a safe, private place that is all their own. It allows you to focus on that new Top Gun movie or on sniping in Fortnite (if you don’t know what that means, it’s similar to playing Bingo). It creates independence for both the dog and you and gives them a place to settle. Probably most importantly, for your carpets, at least, it massively improves housetraining success.

While I, as a self-respecting litter box user, have never had to wear a leash, Dr. Speziok always recommends new puppies be kept on a leash or in their crate for the first few weeks they are with you so you can make sure they always make it outside to eliminate. Rewarding good behavior is significantly better than trying to “punish” bad behavior after the fact, mostly because it doesn’t work. Yelling or rubbing a dog’s nose in their mess only makes them fear you, and makes them more likely to hide from you to eliminate in the home. If you become a scary person, they will not be willing to be vulnerable around you, even outside on the leash. This is one of the biggest mistakes that new dog owners make.

What if I Adopt An Adult Dog That’s Already Housetrained?

Every animal in your home should be comfortable going into a crate, cage, or pen of some sort in case of emergency. Yes, this includes cats, though we only acquiesce to that indignity in dire situations. And it’s exactly those dire situations that I’m talking about when I say emergency. For those of us in the southeast US, we know that hurricanes are a major worry during certain parts of the year. At any point, you humans could decide you need to leave your home, city, or even state, and you need to be able to take your animals with you, or at the very least get them to a safe weather-proof shelter. This will, unfortunately, necessitate them going into a crate.

So, even if your dog doesn’t need to be crated while you’re away at work, or at night, you should still go through the exercise of crate training them. Family emergencies, vacations, vet visits, emergency room visits, a tornado removing your roof; the reasons your pet might need to go in a crate on short notice are endless.

Try to take crate training slow and be patient with yourself, other members of your household, and your dog. Be consistent and positive and eventually your dog will be comfortable in their crate. Every dog is different, and some are more difficult (read: obstinate [pronounced: cat-like]) to train than others. Don’t be afraid to find a dog trainer in your area to help you out. Dr. Speziok also recommends two channels on the YouTube: Zak George Dog Training and Kikopup. Just click the highlighted link to visit them.

Oh, also… don’t tell the dogs I told you about this.

Until next week,

~ Tony

P.S. Speaking of YouTube Channels, make sure you subscribe to mine! Just click on that highlighted bit. It’s filled with great videos that will teach you way more about horses (and goats, and other things) than I’m willing to spend the time writing about. If you aren’t watching them, you’re missing out!

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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OCD in Horses

OCD in Horses

Jan 16, 2023 | OCD

Tuesdays with Tony

Today, I’m going to be talking about OCD in horses, but it does not involve horses that are obsessive about keeping things neat and tidy! That’s a problem that only you humans have. Osteochondritis dissecans, or osteochondrosis is a developmental disease in horses (and other species, including humans) that is often abbreviated as “OCD”. The lesions caused by this disease are important to know as a horse owner because they can cause varying degrees of joint effusion and lameness in the horse.

They can also play a significant role in the pre-purchase exam. Even in young horses, my veterinarians often suggest radiographs. You may be thinking, he’s too young for arthritis and has no known history of an injury, so I don’t need x-rays, doc! However, OCD can be present in horses as young as 5-6 months old. At this young age, they may not be showing obvious signs of having a lesion. Having the knowledge of these types of lesions on your pre-purchase exam can help guide you in future care and treatment of that particular horse.

Now for a little semantics. We commonly use the abbreviation “OCD”, or the term Osteochondritis dissecans, as an all-encompassing term for this type of developmental condition. However, there are two terms that describe different stages of the condition.  Osteochondritis dissecans is technically when there is a flap, chip or some degree of separation from the joint surface. These are often referred to as “bone chips.”  These flaps or chips can cause inflammation and pain in the joint, which contributes to lameness. This is typically occurring later in the disease process. On the other hand, the term osteochondrosis is used when there is incomplete hardening of the bone, but there is no separation. In the horse, the most common joints that are affected are the hock, fetlock and stifle.

Springhill Equine Veterinary Clinic

OCD is a complex disease because the cause of the lesions is multifactorial. There is evidence that genetics, nutrition, and exercise play a role in the development of OCD. Genetically, there are some breeds and lineages that are predisposed to OCD in certain joints. Currently, we don’t know of a specific gene involved. Nutritionally, the most influential component is the ratio of calcium to phosphorus that is being fed, especially to a growing weanling. Exercise tends to play a modifying role in the condition. That means that younger horses that were stall rested or exercised infrequently have a higher incidence of OCD compared to those that are in a consistent exercise schedule. That makes me really glad to be a cat.

Now that you know what OCD is and what causes it, you’re probably interested in knowing how my docs can determine if your horse has it. Luckily, taking a radiograph (what you humans call an x-ray) can help us find most types of lesions. They’re sometimes inclined to take the x-ray because your horse may be showing the clinical sign of effusion. In some cases, ultrasound can also be used to identify the lesion.

There are several different treatment options, but the most common is arthroscopic removal, especially if there is a flap or a chip. Medical management could include injections with steroid or hyaluronic acid medications, or systemic non-steroidal anti-inflammatories (bute, banamine, equioxx) to help reduce inflammation. In general, arthroscopic removal leads to the best prognosis and return to athletic ability and soundness, but these results can vary depending on the location and joint.

Well, there you have it. OCD is a great reason to get a pre-purchase exam done on your next horse. And if you want to know more than I’m willing to write (hey, a cat’s gotta take a nap!) you should check out the podcast my humans did on this topic. It’s very informative.

Until next week,
~Tony

P.S. Are you watching my YouTube videos? There’s a LOT of really good stuff on my YouTube Channel. If you’re not binge watching it, I don’t even know what to say. 

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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Proud Flesh Management

Proud Flesh Management

Jan 9, 2023 | Proud Flesh

Tuesdays with Tony

Did you know that horses only sleep about 3 hours a day? I’m pretty sure they spend the other 21 hours thinking of ways to hurt themselves. Cats, being far superior to horses, sleep 21 hours a day and think about eating the other 3 hours, which is a much better use of time, in my [not humble] opinion. But I digress.

If you’re caring for a horse, you’ll certainly have to deal with a wound at some point. While many wounds can be straightforward to manage, injuries to the lower limbs are especially prone to complications. One way the healing process might go awry is by the development of “Proud Flesh” (more officially called exuberant granulation tissue) – a pink, bumpy tissue that bulges from the wound. Once proud flesh occurs, it’s difficult for the skin to grow together and cover the wound. What results is a chronic wound that just won’t finish healing. Very frustrating!

What Is It?

To understand what proud flesh is, let’s briefly talk about how normal wound healing works. There are four steps: In simple terms, they are:
• Clotting
• Inflammation
• Rebuilding of tissue (proliferation)
• Remodeling into mature tissue

As part of the proliferative phase, the wound fills in with granulation tissue to provide a base for the new skin to grow in on. You’ve probably seen granulation before – it’s pink and bumpy and looks a bit like cauliflower or cobblestone. It’s a normal part of wound repair and is eventually replaced by mature tissue when the wound is healed. Once the new skin cells migrate in from the edges and cover the wound, the signal for the body to make granulation tissue is switched off. When all goes right, these steps proceed in an organized way.

Springhill Equine Veterinary Clinic

Sometimes this process doesn’t work like it’s supposed to, leading to abnormal wound healing and the production of way more granulation tissue than needed. That’s when we call it “exuberant” or use the term proud flesh. For a variety of reasons, the proliferative phase of wound healing isn’t properly limited, and a bulging mass of granulation tissue grows out of the wound, preventing the skin edges from being able to come together.

Horses, being the problematic critters they are, are more prone to proud flesh than other species. Several factors promote excessive granulation tissue – contamination or infection of the wound, motion in the tissues, poor blood supply, a foreign body or necrotic tissue, and chemicals applied to the wound. These things can slow or halt the normal progression of wound healing and the body gets stuck in the “must produce granulation tissue!” stage.

Most of the time, proud flesh is a problem that occurs on the lower limbs. Being near the ground, the lower limbs are particularly prone to contamination with dirt or manure. The skin is naturally under more tension than higher up on the body and a lot of motion occurs over the joints as the horse moves. This causes cracks in the healing tissue, so inflammation persists, and more granulation tissue forms. When proud flesh occurs in other areas of the body, there is usually a specific reason, such as a foreign body in the wound.

How To Prevent It?

Because persistent inflammation and infection are contributors to proud flesh formation, it’s important to make sure the wound is clean, healthy, and properly managed from the beginning.  Have my doc examine the wound when it first occurs, don’t wait until it looks nasty. She’ll clean the wound appropriately and remove any foreign material, bone fragments, or dead tissue. Depending on the wound, she may recommend trimming damaged tissue or closing it with sutures.

Once the wound is prepared, my doc will recommend the appropriate ointment and bandaging technique for your horse’s specific injury. There are a lot of wound products sold over the counter that actually backfire on well-meaning owners and slow down wound healing, so be careful what you reach for! (Pro Tip – if it’s bright purple or fluorescent yellow, don’t put it on your horse’s wound. And no powders, ever!)

Good products to keep in your first aid kit are triple antibiotic ointment, Silver Sulfadiazine cream and medical grade honey. These dressings are antibacterial but also gentle and keep the wound moist, which is important for healing. Harsh chemicals or repeatedly washing and scrubbing a wound can damage the delicate new skin cells trying to grow and cause proud flesh to form. Don’t kill them with kindness!

Bandaging of a wound is decided on a case-by-case basis. The benefits of bandaging include reducing contamination and limiting movement of the healing tissue. However, some studies have shown that heavy bandaging can encourage proud flesh by limiting oxygen to the wound. The type of bandage can have an effect, so my doc may recommend one kind for the first few days and then switch to a different one as the wound progresses. Depending on the location, she may recommend resting your horse in a stall or small paddock to limit his movement and the stress on the wound edges.

How Do We Treat It?

Sometimes, despite your best efforts, proud flesh happens. Horses do love to make it! My doc will examine the wound for causes of lingering infection or inflammation. She may need to take x-rays or do an ultrasound to look for bone fragments or a foreign body. Antibiotics may be needed to control infection. Because there can be other growths that look similar to proud flesh, such as summer sores, sarcoids, or certain cancers, my doc may recommend a biopsy to be sure it’s definitely just proud flesh.

If the proud flesh is minor, appropriate wound care and topical creams may be sufficient to resolve it. A wound cream with a steroid can help to reduce the inflammatory response and turn off the signal to produce granulation tissue. Steroids aren’t a panacea though and should only be used once my doc has checked out the wound, because if there is infection present, steroids can make it worse.

The most effective treatment for significant proud flesh is to trim excessive tissue surgically. Because the proud flesh is taller than the surrounding skin edges, it forms a mountain that the new skin cells can’t climb over. The goal of surgical debridement is pretty simple – the proud flesh is cut back to just below the level of the surrounding skin edges. If the wound has been present for a while, the skin margins may be unhealthy and require a little trimming as well to create a fresh edge that is ready to heal. Proud flesh bleeds a lot, since it’s full of tiny blood vessels, but since it doesn’t have nerve endings, trimming it isn’t painful for the horse. Usually, the procedure can be done on a standing horse with just a little sedation. General anesthesia is rarely required, and my docs often don’t even need to numb the area unless they need to trim unhealthy skin.

Afterwards, the new skin can continue growing inward from the edges. This process may need to be repeated a few times, depending on the size of the wound. If the wound is so large that the skin can’t easily grow over it, your horse might be a candidate for skin grafts. Small pieces of healthy skin are taken from another area (often the top of his neck under the mane) and plugged into the granulation tissue of the wound. The little islands of skin grow where they are inserted and speed up the rate of healing.

So when your horses gets a wound, work with my doc to treat it correctly from the beginning. Early intervention and good management are always the keys to quick and successful wound treatment. Now that’s something you can be proud of!

Until next week,

~ Tony

P.S. If you aren’t subscribed to my blog yet, be a good human and scroll down to the purple box. It’s right below this, you can do it. Good human. You don’t want to rely on social media to get my blog to you, as it’s nearly as unreliable as dogs are. Just put your email address in the purple box, and I’ll send my blog right to you every week. I know, I make it so easy for you! You’re welcome.

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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Coronary Band Dystrophy

Coronary Band Dystrophy

Jan 2, 2023 | Coronary band dystrophy

Tuesdays with Tony

Today we’re going to talk about what’s going on when your horse’s coronary bands look weird. I’m going for a specific weird today, not just any old weird. Read on to learn more about Coronary Band Dystrophy, and autoimmune disorders in general.

What Does Coronary Band Dystrophy Look Like?

This is an issue my Docs can spot from a mile away. The hair at the coronary band sticks straight out so it’s parallel to the ground. The hoof wall is rough, with multiple horizontal ridges, and it has a dry, cracked appearance. Check out the arrows on my graphic to better see what I’m talking about. Horizontal ridges appear during laminitic episodes as well, but they are larger, and more distinct than those seen with coronary band dystrophy. The hoof wall itself also doesn’t get quite as roughened, dry, and crackly with laminitis. 

Springhill Equine Veterinary Clinic

The sole of the foot is often affected as well. The frog is particularly prone to thrush, and shedding excessively. All of this can contribute to cracks so deep the horse bleeds, kind of like you humans in the winter with your hands. I don’t like scritches from those rough hands!  If your horse has coronary band dystrophy you may also want to check out the chestnuts. Some horses get similar cracking and splitting there as well. 

Coronary band dystrophy is often going on for a while before it’s spotted. You humans, understandably, chalk it up to wet hair, dirt on the hoof, wet conditions, thrush, you name it. It’s very easy to overlook, especially in the early stages. 

If you’ve got a great relationship with your veterinarian, and see them twice yearly for routine care, this may be noticed early. In that case, a biopsy of the coronary band can be used to identify the problem. This is a simple procedure where a small amount of tissue is removed and sent to a lab. There, it’s examined under a microscope to look for particular cells. These cells indicate the immune system is attacking the skin. If the symptoms are mild enough to require a biopsy to identify the problem, treatment will be easy and rewarding. Pat yourself on the back for being a good owner! 

Okay, But What Is It?

Coronary Band Dystrophy is a type of a syndrome called Pemphigus. Pemphigus is a group of autoimmune disorders where the body decides skin is bad. This seems like a horrible idea, but sometimes there’s no convincing the immune system it’s wrong. Autoimmune disorders are weird like that. They occur when the immune system suddenly begins to see what is normally considered “self” as “not self.” They can happen in many different ways, and can be extremely difficult to treat. No one knows why the immune system suddenly turns on the body, and no one knows how to get it to go back to normal.

What To Do

Luckily for horses, coronary band dystrophy can usually be managed readily. Much like normal feet, they should be kept clean and dry. This is really hard in Florida during the summer, but honestly, it’s hard for everyone, everywhere. From there, regular application of a steroid cream to the coronary band helps get the immune system to calm down. This also works on the chestnuts if they’re affected. 

Steroids are a blessing and a curse. They shut the immune system down when it’s being hyperactive, but they also keep the immune system from doing its very important job of keeping the body safe from invaders. The advantage with coronary band dystrophy is the steroids can be applied topically right where they are needed. This shuts the immune system down there, but not body wide. In that regard, this isn’t such a bad syndrome in the realm of bad things that can happen. 

Coronary band dystrophy is a lesson in noticing the small things and talking with my Docs about those concerns. As official caretaker and treat supplier, you humans do know your horses. If you see something that concerns you, bring it up with my Docs. This is best done by sending an email into the clinic at vets@springhillequine.com with your concerns and a picture of the issue. You humans are good at doubting yourselves sometimes. As a cat, I find this a difficult concept, but let this week’s blog be a life lesson as well as a horse lesson. You’re welcome.

Until next week,

~Tony

P.S. If you’re new to this whole horse ownership thing, there’s a lot you need to learn from this cat. You can read my Blogs, watch videos on my YouTube Channel, listen to my Podcast, and read my books. Naturally, I’ve delegated the production of some of these things to my minions, but I make sure they do a good job providing you with all the horse knowledge they can. Why would I do all this for free, you ask? Because Springhill Equine Veterinary Clinic’s mission is to make the world a better place for horses (and dogs and cats and goats and sheep). This is what I do. Well, this, and take naps. Lots of naps. That’s a requirement if you’re a cat.

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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