Sometimes it feels like time is standing still. Other times it feels like I close my eyes for a split second and we are already into the next month of 2021. On days when time flies, I am reminded that every day, I grow another day older. While I still feel great most days and I am certainly young at heart, there are days I can feel my age. I imagine it is much the same for aging horses. 

 Many of you own senior horses. Most of you have owned your older guys since they were youngsters. You’ve been taking care of their every need day in and day out throughout their whole lives. You’ve raised them from frisky 2 year-olds through their naughty teenage years and now some of them are well into their older years. At each life stage horses require different nutrition, different hoof care, and different veterinary care. You’ve been through the early years and middle age, so let’s talk about what your horse needs now in their golden years.

 Lucky for you all, I have established the best team of veterinarians, technicians and office staff to provide you with a wealth of knowledge about caring for you senior horse. I always place emphasis on preventative veterinary care for your horses, hence my Wellness Plans.  Preventative care is the best way to be ahead of any potential problems or illnesses that might arise.

 Dental Care

One of the most important aspects of veterinary care in the old horse is the dental examination. As horses age, they develop dental changes. These changes include tooth loss, gingival loss, infection, and fracture. Senior horses are prone to a common and painful condition known as Equine Ondontoclastic Tooth Resorption and Hypercementosis, aka EOTRH (or as I like to refer to it as, “the letters”). EOTRH is a type of autoimmune disease in which the horse’s body recognizes their own teeth as foreign material. When this occurs, your horse’s tooth roots are attacked and reabsorbed by their body. Your horse will also lay down bone-like material around their teeth to help stabilize them. The entire process is incredibly painful and unfortunately, there isn’t much that can be done to prevent the process from happening. The only treatment for EOTRH is to remove the horse’s teeth.  Tooth removal just sounds so painful, why would humans even consider this? But from what I understand, removal is significantly less painful than leaving the teeth in.

 Any dental issues can result in health problems like weight loss, sinus infections, and oral ulceration. Having my docs assess your horse for any oral or dental issues at least once a year is imperative to their overall health. Similarly, if my docs notice any problem areas, they may recommend additional visits throughout the year to address these issues and prevent further problems from developing.

 Vaccinations and Coggins

You’ve kept you horse’s vaccinations, Coggins, and deworming up-to-date throughout his whole life. For the love of cats, please don’t stop now! Older horse’s immune systems are more delicate, making them more prone to disease. My docs recommend twice yearly vaccinations against mosquito-born diseases such as EEE and WN and annual vaccination against rabies.

 Your horse is an old pasture potato now, but please keep his Coggins up-to-date. For one, if anyone from the state stops by to check on your farm, they will require to see a negative Coggins for all horses on the farm. If you don’t have them you risk being fined and/or quarantined. Not to mention, if any unforeseen circumstances occur where you may have to move your horse (hurricane, flood, illness, injury), you’ll need to have a negative Coggins on hand before you put your horse in a trailer. So save yourself a lot of hassle and keep your horse up-to-date!

 Blood Work

As horses age, my docs suggest yearly blood work. It is always a good idea to have a baseline of a normal complete blood cell count and serum biochemistry. If your horse develops an illness there will often be changes to blood work. Having a baseline normal to compare to is incredibly helpful to my docs. Blood work will also allow my docs to recognize any minor changes that may be suggestive of underlying illness. Similarly, a yearly ACTH for an older horse is always a good idea. ACTH tests for Pituitary Pars Intermedia Dysfunction (PPID) or Cushings. PPID can predispose your horse to laminitis. It lowers your horse’s immune response to disease and puts them at risk for illness. Annual testing allows my docs to diagnose PPID early on and get your horse on medication to help manage the disease.

 Hoof Care

I know you’ve heard me say it before, but I’m going to say it again: No hoof, no horse. I don’t care how young or old your horse is, he has to have 4 solid feet under him.  As we discussed, older horses may be prone to laminitis. This is why I recommend annual radiographs of your horse’s front feet. Radiographs are one of the best tools we have that allow the docs to rule out any changes to your horse’s feet that could cause them pain or lameness. Not only can radiographs show changes to your horse’s feet, they allow my docs to collaborate with your farrier to make adjustments as necessary to prevent any problems down the line. And as you know, an ounce of prevention is worth a pound of cure.

 Nutrition

As we all age, our nutrition needs also change.  My nutritional requirements have most certainly changed over the years. I would love to eat sweets and carbs all day but with my diabetes I have to be very mindful of what I eat every day.  As your horse ages, he also will have changes in nutritional requirements. Inevitably, an older horse will have dental problems. Dental issues can make it difficult for your horse to chew his feed properly. This makes it difficult for him to digest his feed thoroughly. When he doesn’t digest appropriately, he is not getting everything he needs from his food.

 It can become nearly impossible for older horses to eat hay and grass. Because of this, it’s necessary to ensure older horse receive everything they need from their grain.  Complete feeds such as senior feeds are ideal for the older horse. A complete feed incorporates forage into it so an older horse who can’t eat hay or grass will still meet their daily forage requirements. Similarly, forages such as soaked alfalfa pellets, alfalfa cubes or beat pulp can be added to the older horse’s diet to increase water and caloric intake.

 Older horses, like older cats and older people, require a bit more attention and care. Veterinary care for your older horse is essential and may increase your horse’s life expectancy.  We love pasture potatoes around here, and love to watch them grow well into their senior years while living their best life. A little TLC will take them a long way.

Until next week,

~Tony

P.S. – As you know, my minions work tirelessly on their podcasts, so take a few minutes and check them out here. They have a wonderful talk on senior horses. Also, we have a Facebook Live event coming up on Thursday Feb. 25th at 6:00 PM on fecals & deworming. Be sure to join us!

It’s February. For other parts of the country that means snowstorms, bitter cold, and all the finest winter has to offer. For Florida, it means some cold days, and some 75 degree days, and maybe some really cold days. I hate really cold days. It detracts from my strict property assessment schedule, and leaves me uncomfortable even while sunning in the middle of the driveway watching the humans drive around me. That’s right, don’t expect me to move. I know, get to the point. Here in Florida, February is the ideal time to get started on growing grass. I have listened to more than my fair share of Pasture Management Seminars. Between that and being a cat, I’m an expert. 

What kind of soil do you have?

This is the biggest reason you should start thinking about your grass now.  Soil testing will tell you what you need to do to make your ground a place grass wants to grow. Even though Florida is strong on sunshine and water, it’s often really weak on other things plants need to grow like nitrogen, and a neutral soil pH. Much like everything in life, there’s the right way to soil test, and all the other ways. The best way is to start by evaluating your property. If you’ve got a whole lot of acres, the chances are you have a few different soil types. 

Test similar soils together, and estimate how much property you have of each type so you will know how much fertilizer of each kind you’ll need. To do that soil test, you could grab a handful of soil and call it a day. This would be the wrong way to soil test. Instead, take a shovel and a wheelbarrow and start wandering your property. Every 50-100 feet or so take the vegetation away to expose the soil underneath, and put about half a shovelful in your wheelbarrow. Carry on until you’ve sampled your whole place. Now mix thoroughly. Then mix again just to be safe. Next, take a few handfuls of that soil, spread them out on newspaper and let them dry. Once dry, use the envelope you got from the soil testing lab that your fertilizer company or local County Extension Agent told you about, and send your soil off for testing. 

County Extension

Middle of the blog aside here: Call your County Extension Office!!!! These people know all kinds of useful things, and your tax dollars pay for them, so use them! From how to grow grass, to managing pests, to gardening, to managing home finances, seriously knowledgeable people. Call them. And now back to our regularly scheduled blog.

Fertilizing

Now you know what to get for your fields. It will be important to talk with your fertilizer company about the best time for actually fertilizing. Here in Florida, it’s generally before the rains start in June. Now that’s tricky timing, isn’t it? Put fertilizer out, but not too soon since it will just burn up, but not too late or it will all wash away into our poor overtaxed aquifer in one torrential rain and then the springs and your pasture will both be in trouble. Anyway, watch the weather and talk with the fertilizer companies about timing. Or look into cover crop options that may work to help get nutrients into the soil without using chemical fertilizers. 

The hardest part about cover crops is that they cover stuff. I’m not being a smart alec. Okay, I am, but really it’s that these crops generally cover the soil underneath while they’re doing their thing. This means grass isn’t growing, and horses may not be enthralled with eating the cover crop instead. Consider cover crops if you’ve got an area you aren’t using for a while.

Grass

Finally, grass. The thing we’ve all been waiting for. Talk to your County Extension Agent and your fertilizer supplier about when and how to best plant grass. There are different options depending on a number of different factors including how many horses you’ll have per acre, if this is a new pasture, or if you’re looking to help an older pasture get back to happy. There are some really great grass seed options that have all kinds of great things for Florida including drought resistance, and longer growing seasons. While you’re talking grass, you can talk about rye grass as a winter add-on.

Keep that grass happy!

Now that you’ve got grass, keep your grass. Horses are hard on their pastures! Horses are just plain hard on everything, if I’m being an honest cat. Designing your pasture to allow rotation in 2-4 week intervals will allow your pastures a break from all those thundering hooves and ripping teeth. Bonus: this is also good for breaking parasite life cycles. This can be as complex as multiple fenced pasture areas, or as simple as a hot wire that divides your pasture. If you go the hot wire route, I recommend tape. It’s easier for the horses to see, and make sure it’s HOT. Horses do tend to respect electricity! Giving grass as little as two weeks to recover will keep it growing better and longer. 

Now you know all you need to be the envy of the neighborhood. However, if you want more, we’ve got pasture management seminars on our YouTube channel, and you can always call your County Extension agent if you didn’t catch it the first two times I told you. Grass can be a tricky bugger, unless it’s a sidewalk where you absolutely do not want grass to grow. Doing a little work can go a long way to ensuring your spoiled horse has all of it they desire. More grass also means less hay, which means lower feed bill, for an added bonus. 

Until next week,

~Tony

P.S. Can’t get enough of me? I’ve got years of blogs at SpringhillEquine.com on any topic you can imagine. Had enough of me? Check out the podcast by my humans called Straight From the Horse Doctor’s Mouth anywhere you get podcasts. It’s got somewhere around 70 episodes of awesome free veterinary knowledge for your listening pleasure.

Tuesdays with Tony – Tendinitis

Around my clinic, horse legs sure do hold a lot of fascination for my docs. They spend a whole lotta time looking at them and talking about them. I have to admit, it is kind of amazing that those big ol’ horse bodies have such spindly legs, and they don’t even seem to rest them 23 hours a day like I do.

Horses evolved with the bulk of their muscles in the upper part of their limbs, in order to reduce the weight of their lower legs and make them more efficient for locomotion. Put simply, horses are fast because they have long, skinny legs, and a lot of muscle up top. (This is why we don’t race hippos). Because of their anatomical construction, the tendons in a horse’s lower legs are long and carry large weight bearing forces. The tendons are used to store energy to propel the horse through his next stride and they also act as a shock absorber for the limb. Those long tendons that make your horse awesome for running away from predators (lions, wolves, or plastic bags) also makes him great at the stuff you want to do with him, like racing and jumping. But surprise, surprise, their design also makes them prone to injury.

The basics

Tendons and ligaments are made of pretty similar material, the main difference being that a tendon attaches a muscle to a bone and acts to move that bone, while a ligament attaches a bone to a bone (usually) and works to maintain bones in alignment and keep the joint stable. There are a whole bunch of tendons and ligaments in the horse, but there are some that we talk about frequently, because they are easy to observe, and among the most commonly injured – specifically, the flexor tendons and ligaments on the back of the lower leg. The big 4 in that area are the superficial digital flexor tendon (SDFT), the deep digital flexor tendon (DDFT), the check (accessory) ligament of the DDFT, and the suspensory ligament. In some places where a tendon changes direction over a joint, the tendon is enclosed in a fluid-filled tendon sheath. Think about a tendon sheath like a water balloon wrapped around the tendon that allows it to glide smoothly over a bony point.  If you have an injury to a tendon, it’s called tendinitis. Injury to a ligament is called desmitis. Unlike muscles, tendons and ligaments don’t have a very good blood supply, which can be an important difference when injuries occur.

How injuries occur

Injury can happen as a sudden overload of a previously normal tendon, such as might happen if your horse takes one bad step. An injury like this often happens during exercise. The chances are increased if the horse is unfit for the job he’s being asked to do, but even a fit horse can be injured if he is fatigued and not protecting himself properly or if he is ridden on poor footing. Another contributing factor is having long toes and low heels, which places extra stress on the tendons on the back of the leg. Injury can range from a minor tearing of the tendon fibers to a complete rupture.

Frequently though, an injury doesn’t just come out of nowhere but is actually the result of cumulative damage that progressively weakens the tendon. There may not be much clinically evident inflammation, but small amounts of damage are occurring without being noticed, and the body isn’t able to keep up with repairing it. The tendon eventually becomes weak enough for a significant injury to occur. Tendons tend to be injured in this kind of progressive, degenerative way, while ligaments are more likely to be injured in the sudden overload way.

 What you might notice

This will depend on how bad the injury is. The basic signs of a tendon injury are heat, swelling, and pain around the area of the injury. Because of the inflammation, the injured leg will feel warmer than the uninjured one and the tendon may feel thicker. When you squeeze the tendon, the horse may flinch or try to pull his leg away. If there is bad enough damage to the superficial digital flexor tendon, you may see a thickening giving the leg a “bowed” appearance if you look at the leg from the side. This is the origin of the term “bowed tendon” you have probably heard.

If there is only minor damage, you might only see a mild lameness. You may not even notice it when the horse is walking, and it only becomes evident at the trot. In a severe injury, the horse may be unable to bear weight on the limb at all.

 How will my doc diagnose an injury?

While heat, pain, or swelling may help to make a diagnosis, subtle tendon and ligament injuries may not have obvious localizing signs and may need to be identified by performing a lameness examination with nerve blocks. Extensive injuries also need to be evaluated to see what structures are involved and how bad the damage is. Once my doc has this info, she can recommend the appropriate treatment.

My doc has a super cool ultrasound to allow her to see the tendon and ligament fibers within your horse’s leg. She can do this at my clinic or right at your farm! The ultrasound can show which tendon or ligament is injured and how far within that structure the injury extends. She uses her ultrasound to measure the size of the injury, to recommend therapy, and to monitor healing. It’s also very useful to follow the injury over time to determine when the horse is ready to resume an exercise program. It’s suuuuper important to use a controlled exercise program when your horse goes back to work, to avoid re-injury.

Treatments

The old acronym for how to treat a tendon or ligament injury is taken from human medicine – R.I.C.E.. That is, Rest, Ice, Compression, and Elevation. Good luck convincing your horse on the elevation part, but the first 3 still apply. Rest will mean a period of restricted activity. Whether that means stall rest or paddock rest, and for how long, depends on the injury and the stage of healing. My doc will figure that one out for you. Ice means cold therapy, which is often cold hosing (or cooled wraps if you’re fancy). This is usually employed in the early parts of the injury while there is a lot of inflammation. Compression means bandaging, used to support the area and keep swelling down. (For a tutorial on how to apply a stable bandage, see my previous blog.) My doc may also prescribe an anti-inflammatory medication to reduce swelling and pain.

Those are the old standbys, and while they are still useful, the problem is that tendon and ligament just aren’t tissues that naturally heal well (unlike bone). They tend to heal with scar tissue instead of well organized, elastic tissue like the original. So the healed tendon is weaker and prone to re-injury.

Nowadays, my doc has some pretty cool tools to help improve the quality of the healing. Even better, they use materials from your horse’s own body to do it! I’m talking about a field called regenerative medicine, and specifically, Platelet Rich Plasma and Stem cells. The idea behind these things is that they improve the way the tendon or ligament heals so there is less scar tissue and less risk of re-injury.

Platelet-Rich Plasma (PRP) is taken from your horse’s own blood. Blood contains platelets, which are the cell fragments that form blood clots when an injury occurs. The cool thing about platelets is that they are little bags of molecules called growth factors. So my doc can take some blood, and process it to get the platelets in a super-concentrated form. She then injects the PRP right into the injured part of your horse’s tendon where the growth factors get to work stimulating regeneration of your horse’s tendon/ligament fibers. We use a lot of PRP at Springhill Equine, because it works really well and is a bit more economical than stem cells.

Stem cells are cells with the ability to turn into many types of tissue, according to what signals they receive. They are also collected right from your horse. My doc can take them from either bone marrow or fat and then send them to a lab to be cultured up to a high number. The lab then sends them back and my doc will inject them into the injured tendon. Similar to PRP, the stem cell injection also has growth factors. Those stem cells, now sitting in the tendon, will get the signal to become tendon cells, so the repair will have more quality material and less scar tissue than if it were left to heal by itself. Modern medicine is pretty cool, huh?

There are a few other therapies used to treat tendon and ligament injuries in certain circumstances, such as extracorporeal shock wave therapy, laser therapy, or even surgery in certain circumstances. My docs have done a lot of training in this stuff, so they’ll know what to recommend if your horse gets injured. Give them a call if you have any questions, I’m sure they would looove to talk to you about those fascinating horse tendons. As for me, I’m ready to rest my own legs and take a nap now.

Until next week,

Tony

P.S. Looking for more information on Tendinitis? Look no further than our podcast page, Straight from the Horse Doctor’s Mouth. Did you know that Dr. Lacher & Justin have a weekly podcast. It’s filled with tons of useful knowledge. Be sure to chek it out.

Have you guys heard about the new World Equestrian Center in Ocala? I hear it’s just incredible! The stalls are fit for a king, possibly even a very entitled cat. The arenas are impeccably groomed with world-class footing. The entire grounds are utterly perfect, or so I have been told by just about everyone who walks through the clinic doors. My very own Dr. Lacher had the pleasure of competing there this past weekend and she reports nothing but amazing things about the facility, staff and overall wondrous and magical place that is the World Equestrian Center. I can only guess it to be the equestrian’s Disney Land, as it sure sounds magical.

 Hearing how wonderful the World Equestrian Center is got me thinking about what type of events they can have there and how diverse of a facility it must be. Of course they host Hunter/Jumper events, but what else? They also will be holding dressage events, three-day-eventing, polo, breed-type events, and a lot of other things. I thought back to my recent blogs about lameness and it got me wondering about what kind of footing would be so universal to be able to facilitate all things equestrian. Digging deeper, I pondered, what kind of footing would be best for rehabilitating the lame horse? As it turns out, there’s a lot to know just about the ground you ride your horses on.

 A Footing Overview

In general, the basics for footing for all disciplines are the same.  A firm base with a top layer that provides a little give without breaking away when your horse pushes. Whether turning a barrel, jumping a stadium jump, bounding over a table in a cross-country course or performing an elegance piaffe in dressage, a weak base that gives to pressure sets you and your horse up for dangerous situations and potential injury. A base that is “sticky” can cause your horse to feel stuck and exacerbate their movement, leading to soft tissue injuries. Similarly, a “loose footing” will not provide support to your horse’s feet and legs which puts undo stress on their tendons and ligaments, leading to injury.

 Arthritis

There is such thing as a surface that is too hard. Imagine galloping across an arena that’s as hard as concrete. The concussion on the joints of 1000+lb horse creates inflammation in their joints, causes micro injury and can potentiate the development of arthritis. Not to mention how slippery that might be! Add in a horse that has shoes on and wow, the concussive forces are increased exponentially. A carriage horse whose main job is on asphalt is probably very much prone to the development of joint inflammation and arthritis. I have been told they make special driving shoes for those big guys which help absorb some of the shock when they are working. One of my minions who has carriage horses explained to me that they do not work their horses on hard surfaces for more than an hour or so at a time, which definitely allows them to have longer careers.

 Should you find yourself in a situation where you are riding on hard footing, I suggest packing your horse’s feet at the end of the day with products such as magic cushion or animalintex poultice.  This will help draw the sting out and make your already-spoiled horse feel like a million bucks.

 Soft Tissue Injuries

As I have already mentioned, loose, deep, or sticky footing can place your horse at risk for soft tissue injuries such as suspensory tears or tendon strains. That being said, certain disciplines require a little bit of a looser top surface to their arenas. Reining horses, for example, require a looser footing so they can obtain those awe-inspiring sliding stops. On the other hand, a grand prix jumper would really want to avoid deeper footing. If the footing gave way underneath as they are propelling themselves over 5’ high fences, it could lead to injury. Similarly, landing from a jump on soft footing puts more strain on your horse’s tendons, ligaments, and joints resulting in inflammation and injury. 

 Unfortunately, you can’t always ride in places like the World Equestrian Center. That means you and your horse may be presented with surfaces that are not what you would consider ideal. If you do find yourself in a situation where the footing is not ideal, don’t be afraid to withdraw from the competition. Your horse’s legs aren’t worth risking. Trust me, my docs don’t want to have to tell you your horse needs 6-12 months off to heal an injury.

 At the end of the day, I always recommend standing wraps for a horse who has worked hard and will be stalled overnight. A nice poultice or liniment under the standing bandage will make you feel better and your horse will probably appreciate it as well. However, if you plan to turn your horse out at the end of the day or weekend, forego the wrapping. Standing wraps can get wet, twist, and slip which can also lead to injury.  If you are unsure about any bandaging for your horse just call my docs, they will be happy to answer any questions.

 Laminitis

Yes, I am saying it, the unspoken word: LAMINITIS.  Every horse owner’s worst nightmare. The good news is laminitis, if caught and addressed early on, is not always the death sentence that you assume.  I have many a-blogs about laminitis and would love to discuss it further, but this blog is about footing. How does footing apply to laminitis, you ask? Well, that is a wonderful question.

 Almost always, if your horse has been diagnosed with laminitis, my docs are going to recommend confinement to a stall. The caveat with stall confinement is they’re going to recommend very deep, soft, sand footing in the stall. The deep, soft, sand allows for your horse to move and stand in a way that the footing moves under them and becomes a naturally balanced surface where they can obtain the most comfort.  A stall with rubber mats and deep shavings can provide a similar dynamic, however, it is not exactly the same and the results of your horse’s comfort may vary. 

 If you do not have the ability to stall your horse, the next best option would be a small paddock or round pen with loose footing in which your horse can find his comfort spot.  The key to laminitis is to help your horse find where he is most comfortable, and once that’s achieved, inflammation in the feet reduces and healing can start to occur. A soft surface alone probably won’t resolve laminitis, of course. It takes a dedicated team: your veterinarian, your farrier, and you to give your horse the best chance of recovery. If you have a barn cat, that could help, too, so there’s always someone in charge.

 While not every facility can have the best footing in the world, you, being the diligent, caring, overprotective horse owner that you are, can play a huge role in reducing injury. Horse owners are the most observant group of people in the world, which means you will know when the riding surface is not ideal. But just because it may not be perfect doesn’t mean you can’t ride, it just means you need to be aware of the situation and be smart about what you ask your horse to do. 

 Should you find yourself in a situation where your horse has come up lame or sore, don’t fret, me and my docs are here for you. We can get to the root of the problem, maybe perform some acupuncture or spinal manipulation, and get you and your horse back to the arena without missing a beat.  

 Until next week,

~Tony

 P.S. If you want to learn more about these soft tissue injuries, my humans have a variety of podcasts where they really get into the mechanics of it. You can find them all for free right here on my website, over on the Podcast Page. And if you are a Patron of the podcast, they even have videos on all kinds of cool things like rehab exercises, building core strength to prevent injury, and more.

I see a whole lot of things from the front porch here at Springhill Equine. I hear a lot of things, too. One of the more common things I hear is “My horse has a sore back.” Seems simple and straightforward. The back is sore. Fix where it’s sore. Alas, these are horses we speak of, so nothing is simple. Back soreness ranks up there with how the Hadron Super Collider works: pretty complicated. So, let’s talk backs: How my Docs evaluate a back-sore horse, why it’s very often not the back, and what the treatment options are.

It hurts when you push here

Whew! The ways in which back-sore horses present themselves can be the subject for an entire textbook, but I’ll be generous and give you the short version. Cats can be generous, occasionally. The two most common ways my Docs get presented a back-sore horse are: 1) obvious pain when you push on the back somewhere, and 2) bucking. The bucking almost always involves cantering or loping in some way. 

This isn’t the only way back-sore horses present though! From poor performance, to an obvious lameness in one leg, back soreness can show up in a whole lot of ways. This is why my Docs always talk to you humans before and during their exam. They’re like Sherlock Holmes: looking for clues to the cause of the crime. It’s also why my Docs evaluate the entire horse during a lameness exam, and why they may ask for videos of your horse doing it’s job, and why they may want to see all your tack on your horse. It can be a complicated task figuring out if back pain is a saddle, pad, or even rider issue, or if it’s a horse issue. 

Why it Hurts

Okay, let’s talk about why horse’s backs hurt. 

• Tack fit. Notice I didn’t just say saddle. It’s really important to evaluate how your tack fits your horse. Get help from a saddle fitter if needed, change things up to see if your horse has preferences, and evaluate all the tack, not just your saddle. 
• Sore front feet. Number One reason horses get sore backs is sore front feet. This can be due to things as varied as navicular problems to poor foot balance. If your horse’s front feet are sore, they’re going to carry themselves weird, and that’s going to cause back pain. Pro Cat Tip: it works the same in people. If your back hurts, ask a physical therapist to point out how crooked you are. 
• Sore back legs. Number Two reason. Put number one and number two together and you have around 90% of the causes of sore backs. That says something about leg lameness and backs! Hocks get blamed for this a lot, but any hind limb lameness can lead to back pain for the same reasons any forelimb lameness can: when your legs hurt, you walk weird and that messes up your back, even if you’re a quadruped.
• Actual sore backs. Yes, this does happen. I’m not here to tell you it’s only an Urban Legend on par with walking colics (just don’t, please don’t walk your colics). There are things that can go wrong with the back to cause back pain. The most common one is affectionately called kissing spines. This happens when the big fins off the top of the spine touch each other. This causes them to rub up against each other as your horse moves, and that hurts. These horses are almost always worse when ridden, because adding a human and some tack makes the back sink which leads to more intense “kissing.” There are some other issues in the back as well, including arthritis and low back pain, usually around the sacroiliac joint. 
• Sore necks. This one is sort of just an extension of the back, but hey, gotta include all the parts. These horses usually have trouble turning their heads side-to-side, and their back pain is present, but not horrendous. Managing the neck issue usually fixes the back issues.
• Miscellaneous. Ah, my favorite category. It’s a category made for cats. I included this one because lots of things can contribute to back pain so it’s important to evaluate the entire horse (even the teeth!) when there’s back pain. 

What to do

The first step to managing back pain is figuring out the real cause. That’s a simple sentence that does little to capture how difficult this can sometimes be. For example, a horse comes in with back pain. On evaluation, there’s some hock pain going on. My Docs inject the hocks, and give you some exercises. Two weeks later the back pain isn’t better, but when my Docs check your horse, the hock pain is gone. This happens all the time, and is usually pretty quickly remedied by helping the back figure out it’s new normal. My Docs have a number of ways to do this including FES (Functional Electrical Stimulation), spinal manipulation (chiropractic), and acupuncture. It very much depends on each horse’s symptoms to decide which one of these is the correct answer, and sometimes it’s all three. Have I mentioned Spa Day? I’m mentioning it now. This is the greatest gift ever for the hard working horse. It’s an FES session, acupuncture, and spinal manipulation all at one great price. Seriously, what horse wouldn’t want this??

I sort of hit step two up there in step one, but step two is helping the body get back to normal. This is done through a combination of rehab exercises, and therapies like acupuncture and spinal manipulation. The back is whack so we gotta help it get unwhack. Just like in human PT, this will often involve exercises for you, the human, to do with your horse. Common ones are shoulder-in, walking over poles, and backing uphill (finding a hill is sometimes the hardest part). These exercises typically evolve into a base set of things your horse needs to work on forever. Just like you humans are better with a left or right paw, horses are stronger on one side or the other. Helping them build even strength will help avoid lamenesses and back pain. 

Step three is believing in your feelings. No, I’m not getting all mushy on you. I’m saying believe yourself when you feel something isn’t right with your horse. Back pain, in particular, can cause very subtle signs. If your horse is doing something new and different, call my Docs for a conversation. Heck, shoot a video. You humans all have those things you call a phone but only use for pictures and videos anyway. Sometimes watching a video really helps you see what’s going on.

Back pain can be a real pain in the, well, you know where. With a solid team approach, you and your horse can get back to great rides in no time!

Until next week,
~Tony

P.S. My docs talk about this stuff on their podcast a lot. And to take it a step further, they’ve created videos on some of the exercises I was talking about for Official Patrons of the podcast. That’s a pretty sweet perk! If you aren’t listening to the podcast, you’re missing out on some great horse doctor knowledge. There’s a lot to know about your horse, and you can find it over on the Podcast Page. It’s what all the cool cats are listening to these days!

One of the great things about being a cat is that I am admired for simply being. I lay around, I eat, I survey my clinic. My servants would never dream of asking me to fetch things or jump over things. As a cat, I am above that nonsense. But as for the horses that come to my clinic, their people often want them do things. Ridiculous things, like running circles around huge cans of cat food, jumping over sticks they could just as easily have gone around, or prancing around a big litter box with letters on it. It all seems very unnecessary, but you ought to hear the moaning people do if their horse is lame and can’t do those things.

 One of the most common things my docs do at Springhill Equine is lameness exams, so let’s talk about what may happen if you bring your horse in for lameness. There are several parts to a lameness exam that help my doc figure out the problem, and you might see my doc doing some or all of these things to check out your horse out. Some types of lameness are more obvious and won’t require all the steps, but for a more subtle lameness, each of them can be a piece in the puzzle to find the source of the problem.

 Motion exam

If you drive by my clinic, you will often see horses being trotted up and down the grass outside the clinic while my docs watch them. This is the Springhill technicians’ favorite part of the day. They love the healthy exercise, especially at noon in July and August.

 So what does it look like when a horse is lame? It can be an obvious limp in a forelimb lameness. Your horse may not want to bear weight on the leg or may have a pronounced “head bob” when he walks or trots. For a forelimb lameness, think “down on sound” – meaning the head bobs downwards when the sound (non-lame) leg hits the ground. So if the head bobs down when the left front foot hits the ground, the lameness is on the right front leg. For a mild lameness, there may not be a super obvious head bob, especially when he’s moving on a straight line. My doc will also listen to the sound of his footfalls – a lame horse will land softer on the foot that hurts, as he shifts his weight to avoid pain.

 Hindlimb lameness is evaluated differently than forelimb lameness. It may look like a “hip hike”, toe dragging, or a shortened stride on the lame hindlimb. It can also just manifest as problems picking up or keeping the canter leads, lack of impulsion, or even “crow hopping” or bucking.  Don’t worry if you aren’t sure, that’s what my doc is for. If you’re feeling like something doesn’t seem right, just call my doc.

 Some lameness is more subtle than others. If your horse is quite sore, my doc may just need to see him walk and may not need him to trot. For most lameness cases though, the horse is evaluated at the trot, because the symmetrical nature of the normal trot gait makes abnormalities more apparent. Sometimes my doc will ask to see a horse canter to check out how the hind end moves. She will want to see the horse move on a straight line and may want to see him moving in a circle (such as on a longe line) to see how positioning his limbs on the inside or outside of the circle will affect his lameness. Different types of lameness may look worse on soft vs hard ground, so my doc may ask her tech to jog your horse on the asphalt driveway instead or the grass to check out the difference.

 Here’s one thing I want you to understand – horses don’t lie about lameness. Their brains don’t work that way. Your horse isn’t “faking” a lameness when you ride him just because he doesn’t look as lame when you see him cantering in the field. He isn’t capable of that. Some things, like the additional weight of carrying a rider, or the specific motions he is asked to do under saddle, just make a lameness more apparent. So if you notice lameness when you ride, just schedule a lameness exam with my doc instead of thinking your horse is being tricksy.

 Physical exam

My doc will do an exam to look and feel for abnormalities in the horse’s body. She will look at his conformation and muscle symmetry. She will check out his posture to see if he stands squarely, since abnormal stance can give clues to the areas of discomfort. His hooves and shoes will also be evaluated carefully – I’m sure you have heard the saying “No hoof, no horse” – the angles and health of the hooves are critically important to soundness. My doc will feel your horse’s limbs for heat or swelling and evaluate his tendons for thickening or pain. She’ll feel the limb pulses to look for areas of inflammation. The joints will be palpated for swelling and taken through their range of motion. The exam will often include an evaluation of the back muscles for tension or sensitivity, especially with a hind end lameness.

 Hoof testers

You may see my doc use a big metal instrument to squeeze your horse’s hoof. That instrument is called a hoof tester and it checks for sensitivity when pressure is applied to certain areas of the hoof. My doc’s knowledge of the anatomy inside the hoof helps her to determine what pain in a certain spot means. Sensitivity in one area may indicate laminitis, whereas another spot may signify a problem with the navicular apparatus. Hooftesters can be used to locate the position of a hoof abscess so my vet can open it up to drain.

 Flexion tests

You may see my doc holding up your horse’s leg for 30 or 45 seconds and then asking him to immediately trot off – that’s a flexion test. The purpose of a flexion test is to accentuate pain that may be coming from a joint, in order to localize the part of the leg that is bothering your horse or to look for a subtle problem that isn’t immediately apparent. Specific joints are flexed in turn to check the response to that area. If your horse has an arthritic hock, for example, flexing the hock for 45 seconds may make him trot off more lame than he was without the flexion. That can help my doc determine the part of the leg that needs treatment. Flexion tests aren’t always a black or white answer, but they can be a useful puzzle piece in some cases. My doc uses her experience to know the appropriate position, time, and pressure for a flexion test, since it’s possible to get an inaccurate assessment if you flex the joint too hard or for too long. It’s also useful for her to flex the same joint on both the left and right sides to compare how the horse responds.

 Nerve or joint blocks

Have you ever gone to the dentist and had a shot to make your tooth numb for a filling? That’s basically the same thing as a nerve block my doc may use during a lameness exam. When my doc “blocks out” an area on your horse’s leg, she is temporarily numbing it to see if that region is the source of the pain. If the correct spot is numbed, your horse won’t look lame anymore since he won’t feel the pain. Unless there is an obvious abnormal finding on her physical exam, my doc will inject a numbing agent into specific anatomical areas until she finds the one that takes away the lameness. Nerve blocks are an injection to directly numb a nerve and the area it supplies feeling to, while joint blocks will inject the numbing agent right into a joint, which is a sterile procedure. Nerve blocks only lasts a couple of hours though, so don’t confuse them for a permanent treatment, they are just a way of finding where the problem is so it can receive the appropriate therapy. 

 Imaging

Once my doc has determined which leg your horse is sore on and which part of the leg is the problem, she will often recommend imaging to get a look at what’s going on inside. This is most often an X-ray (radiograph) or ultrasound. Generally speaking, X-rays look at bone and ultrasound looks at soft tissues such as tendons. Occasionally, advanced imaging such as CT or MRI is needed, but the majority of cases can be diagnosed with the imaging equipment at my clinic. Once a specific diagnosis is made, my doc can recommend the best treatment to get your horse sound and back doing those silly things you want to do with him!

Until next week,

 ~Tony

 P.S. Looking for more information on lameness exams? I bet you can find at least one if not a few podcasts on lameness. Check out our podcast here. You can also search back through my old Tuesdays with Tony to see what wise words I have shared in the past.