My Docs have a lot of ways they keep up with the latest and greatest things in medicine. One way is plain old talking. They talk with other veterinarians, they talk to horse people, heck, they’ll talk to anyone! Another way is on the internet. I’m convinced the internet was created by and for cats, so it must be a good thing. My Docs use it to talk with other docs about the crazy things horses do and how to care for them, and to attend formal continuing education (CE) on something called Zoom. (I thought this was what happens when I get excited and run for 4-5 steps, but it was explained to me that it’s sort of a meeting room for humans.) 

Anyway, my Docs have been doing a bunch of CE on this Zoom thing for the past 18 months. They say it’s been a great way to learn about things, but it lacks the fun of real life CE. Recently that changed! First Dr. Abbott went to a really cool CE all about finding the hard-to-find causes of lameness. She came back with some great tips, tricks, and complaints about how Colorado does winter. Just this past week, Dr. Lacher came back from the national equine practitioners conference in Nashville. She also had complaints about how Nashville does winter, but more importantly, she sat down with me to talk about some cool wound care stuff!

Bacteria and Biofilm

Holy horses and their wounds! If there’s a way to injure themselves, horses are going to find it. For the most part, they are then going to try very hard to heal it. Healing is a horse superpower. If that superpower seems to be struggling, there’s a good chance biofilm, one of bacteria’s superpowers, is to blame. Biofilm is this gooey, nasty covering bacteria create to keep themselves safe from antibiotics and the immune system. If they can’t get to the bacteria, they can’t kill them! When wounds on horses aren’t healing, biofilm has to go on the list of suspects. What’s a Doc to do? Debride, debride, debride, and some other stuff. Never fear, I’m going to cover the debride part, but first, let’s talk about some other stuff. 

The trick to getting rid of biofilm is to not also destroy the baby cells trying to heal the wound. There are some nifty things that help with this. Silver sulfadiazene has previously been thought of as the miracle cure for all as far as my Docs are concerned. Turns out, it also breaks down biofilm! That stuff really is amazing. There’s also a bandage with some stuff called, wait for it, it’s a mouthful, polyhexamethylene biguanide impregnated right in the bandage. This stuff does a great job keeping biofilm knocked back to manageable levels. Other things that worked well were topical antibiotics (after debriding, which, as stated, I promise I’ll talk about) and platelet rich plasma (PRP). But the most important thing to start with is……

Debriding

Docs need fancy words for things. Debriding just means taking away unnecessary tissue. For horse wounds in particular, this often means way, way too much granulation tissue. It’s part of their attempt at super healing which sometimes goes awry. Anyway. It can also mean removing dead tissue, dirt, and other debris. The most common way any of you humans debride a wound is with a water hose. You are always allowed to do this method unless there’s a whole lot of active bleeding. Tiny aside: if there’s lots of bleeding, wrap the wound with a whole lot of bandage material, call my Docs, have horse move as little as possible. Back to our story. 

If a wound is really nasty, as horses are known to do, there are all kinds of cool bandage materials and techniques that can help remove the unwanted bits, and biofilm, and get your horse back on the healing track. Honey and wet gauze were a few of the things talked about. The trick to debriding is knowing when to stop the debriding. Too much debriding will keep a wound from healing. Basically, don’t decide you’ve read all my cat wisdom and now know all there is to know and can go it alone. Nope. You need a whole lot of learning to know when to stop and when to keep going, and how to pick the right product for each different type of wound. 

On to bandaging!

There are some pretty cool products out there to help with the biofilm and debriding side of things, but what about bandaging? Bandaging helps keep swelling out of legs, provides coverage for wounds, can be part of the debriding process, and can contain things that reduce biofilm. Basically, bandaging is important. 

Regular readers (you have subscribed to my blog, right?!?) have heard me talk about Sox for Horses. These things are pretty darn cool. The silver woven into the materials works on the biofilm, the material helps with debriding, and they help provide compression to the wound. And they’re washable/reusable! 

However, sometimes you’ve got a leg or a spot that just doesn’t cooperate. May I (not-so-humbly) suggest you check out Equine Sleeves? These things are brand new to the horse world, and they’re pretty cool. They can be used on places as tricky as a hock. They can be stacked, or trimmed, used alone, or with things underneath them to help. Using Sox or Equine Sleeves with products that help debride and manage biofilm can help get those wounds back to healing quickly, and using fewer dollars. Sounds good to this cat! And these are also washable and reusable.

You know I talk about wounds on horses a lot. It’s because horses can’t resist an opportunity to hurt themselves. There’s really cool work out there to help my Docs do the best job they can to help your horse heal fast. I’m always amazed at the new, fun things my Docs learn about, whether it’s on the internet or in-person, and it gives me new, exciting information to share with you! So, make sure you scroll down and subscribe so you don’t miss out on any of my feline wisdoms.

Until next week,

~Tony

P.S. If you haven’t been over to my YouTube Channel recently, you’re missing out! The humans have been very busy making videos during the pandemic. If you like my blog, you’ll love their videos! Tell them I sent you.

This seems like an appropriate week-after-Thanksgiving topic. I know I indulged in way too much turkey over the long weekend. I also know my Docs see lots and lots and lots of horses who have hit the hay bale a little too hard for too long with not enough time spent working out. Whether you’re a cat, a human, or a horse, excess weight puts you at risk for all kinds of badness. Just ask this diabetic cat. Luckily, in the realm of poor design decisions that is the modern day horse, the pancreas wasn’t one of those bad choices. This means horses, unlike cats, don’t get diabetes. Don’t worry, they still get bad things from excess weight. Read on to learn more!

A Brief Overview

I have plenty of blogs regarding fat horses and donkeys and what happens, so I’m going to do the quick version here. I know you will then go search out the depths of my shared knowledge to learn even more. Overweight horses get what’s known as insulin resistance rather than diabetes. In normal diabetes, the pancreas stops making insulin. For horses, the cells stick their metaphorical fingers in their metaphorical ears and say, “Nope insulin, I can’t hear you no matter how loud you yell.” This causes the cells to be unable to take in glucose which means bad things happen. This also causes high glucose in the blood which makes the pancreas kick out even more insulin. No one ever said it all made sense, just that it’s what happens. 

While bad things are happening to the cells from no glucose, other cells are saying, “Oh boy! We’ve got all this insulin around. We need to do stuff!” It’s that doing of stuff that causes most of the side effects of insulin resistance. Again, go to the search bar above to find all the in-depth blogs I have put my heart and soul into to get quality information to you humans.

Calories In

Moving on to correcting the problem. It’s a pretty simple equation: calories in<calories out. Simple does not always mean easy! 

My Docs always start with a diet evaluation. Just like in you humans, high sugar is bad. Making sure your horse’s diet is based on good quality roughage with just enough concentrate added is often enough to cause weight loss. This is not permission to throw Flicka an all-you-can-eat buffet of alfalfa hay! Looking at options for roughage like Teff and Coastal hays, then mixing in some alfalfa or peanut to keep that persnickety GI tract happy are likely better options. 

Going even further on keeping the aforementioned persnickety GI tract happy, slow feed hay bags (and even putting your slow feed hay bag in another slow feed hay bag) can help Flicka eat hay all day long while not actually getting that much to eat. The key is using that large brain you humans have to out-think your horse. The best way to make sure your precious pony is getting the correct amount of roughage is to weigh it out so they are only eating 10% of their body weight daily. Okay, roughage managed. 

Moving on to concentrates. Less is more! For the average easy keeper, all that’s needed is a ration balancer. These are protein, vitamin, and mineral concentrates that minimize the calories while getting your horse all the nutrition they need. For most horses who, let’s be honest, are either lawn ornaments, or only get slightly more work than this cat, this is all they need. Good quality forage set up in a way that they will take a while to eat it, and a small amount (usually 1 pound per day for most brands) of a ration balancer. 

Calories Out

I’m going to be honest with you humans. After all, it’s what I do. You are really, really, really bad at this part. “Calories out” means exercise. Yes, exercise. I find it to be awful as well! I’m going to start with the number one excuse I hear: time. Well you’re in luck! Fifteen minutes of walking and light jogging three times per week. Three.Times.Per.Week. You can do that! And that’s all it takes to minimize the effects of those extra pounds. I’m not at weight loss yet. This low level of exercise, though, will get glucose and insulin back at least speaking with each other. Start here!

Moving on to the tougher versions of calories out. The easy version of decreasing calories and increasing work does great on most of the equids my Docs see. However, if your horse is too lame due to laminitis, or is a pony or donkey, some special considerations need to be taken. For the lame horse, it’s a matter of reducing those calories as much as possible. This means weighing hay and concentrates so they only get what is absolutely required. It also means knowing what’s in your roughage by having a hay analysis done. An equine nutritionist can really help here to design the best diet. 

My Docs will often add thyroid hormone supplementation to kick the metabolism into a higher gear as well. This can be used in the short term to help bump up weight loss on horses who can’t exercise. I want to be 100% clear that these horses don’t have a thyroid problem. My Docs are simply using a bit of a crutch to help get things going the way they need to go. As your horse gets more comfortable, work on ways to add in some walking. Any bit of exercise, under strict supervision from the Docs, will help! 

Donkeys, ponies, and miniature horses love to break the rules of weight loss. This is because all three of these were designed to live under some really harsh conditions. Their metabolism can run all day long on minimal calories. That means we can kick them into hyperlipidemia if we try to drop the calories too fast. Hyperlipidemia means too much fat in the blood. It occurs because the liver recognizes a sudden drop in calories, and aggressively recruits fat stores. The recruitment and processing doesn’t always align quite right and that extra fat ends up running around in the blood until the liver can get to it. Except that extra fat running around causes all kinds of systems to go haywire. 

These are sick, sick equids. I highly recommend avoiding this if at all possible. Avoiding it means increasing exercise slowly over 2-3 weeks so the system doesn’t experience a shock in calorie need. It also means slowly reducing calories in the diet over that same 2-3 week period so there isn’t a shock in calories provided. In the realm of things that are weird about horse-type critters, one of the diet adjustments will be increasing calories from fat. This doesn’t mean a willy-nilly adding of fat. It means look at the overall calories needed in the diet and work to replace some of those calories with fat, instead of carbs and proteins. This is not something you should do based on some time spent with Google. This is definitely something you should call my Docs for. They will likely bring in an equine nutritionist as well. These diets can be some of the trickiest to formulate, and regular monitoring will be important!

Being overweight can be difficult. I’ve been dealing with it my whole life! Having a plan and a support team is crucial. My Docs are here to help you with both sides of that equation. Give them a call to set up your horse’s Couch to 5k plan today!

Until next week,

~Tony

P.S. My docs did a podcast interview with Dr. Vineyard, the senior equine nutritionist at Purina. If you want to learn more about nutrition, that’s a great place to start. You can find it over on the Podcast Page of my website. And, as I mentioned earlier, I have a bunch of other blogs on this stuff as well. Now you just have to decide if you want to read or listen. Decisions, decisions.

I was hanging out on the counter the other day when a client came in asking about Pigeon Fever. My ears perked up at the thought of chasing pigeons, but it turns out this conversation had nothing to do with birds. Pigeon Fever is a syndrome caused by a very specific bacterium, Corynebacterium pseudotuberculosis, which leads to abscesses. This bacteria hasn’t been a big problem for Floridians since it prefers dry weather but lately it’s decided hot and humid isn’t so bad!

What is Pigeon Fever?

Let’s start with a little bit of learnin’. Pigeon Fever, or Dryland Distemper, is a relatively common problem in the hot, dry regions of our desert southwest. For reasons the experts don’t really understand, the organism has been marching its way across the country to wetter regions. C. pseudotuberculosis is perfectly content to live in soil until drought conditions occur. At that time it seems to begin looking beyond the ground for somewhere to live and reproduce. The bacteria is readily spread by common insects like the stable fly, and infects horses through any small wound.

Diagnosing

The most common appearance of Pigeon Fever is a large swelling of the chest, so the horse looks like a pigeon. While the chest is the most common location, Pigeon Fever can cause swellings anywhere. Upon further examination, the swellings turn out to be large abscesses.  Another, less frequent problem, is what’s known as ulcerative lymphangitis. This is a big, swollen, oozing infection of the leg. Even rarer is an invasion of the internal organs such as the kidney and liver by the organism.

Treatment

Once my Docs have decided that a C. pseudotuberculosis abscess is likely to be the problem, they will start treatment by draining the abscess and flushing the area. The tricky part is any pus that hits the ground can contaminate the entire area, so all pus must be contained and disposed of properly. My Docs try to open them on concrete so bleach can be applied to the area. 

Opened and regularly-flushed abscesses generally heal rapidly with minimal scarring. However, Ulcerative Lymphangitis can be very difficult to treat. These horses are placed on aggressive antibiotic therapy with both injectable antibiotics and highly concentrated therapy into veins in the affected leg. The leg is kept bandaged to help reduce swelling, absorb drainage, and keep antimicrobial ointments in place. Unfortunately, chronic scarring of the leg and repeated infections are often leftover effects of this form of the disease. Infection of the internal organs is treated with rest and aggressive antibiotics with a full recovery the usual outcome.

Prevention

Prevention is aimed at controlling insects in the stable area and making sure any wounds are regularly addressed. The very bottom of the abdomen is a common area for us to see insect bites leading to open skin and excellent entrance sites for many diseases. Equishield IBH salve is the best way my Docs have found to prevent this problem. Several groups are working on a vaccine, but so far they have had no luck.  

I know we were all hoping Pigeon Fever would stay out West, but it seems to be here to stay in Florida. If you notice a swelling, and it’s not going down after a day or two, call my Docs. They’ll get you all fixed up!

Until Next week, 

~Tony

P.S. Note to the social calendar: I expect to see all my loyal readers this coming Saturday, November 20th, from 10am-1pm at Springhill Equine for our Annual Open House. It’s sure to be a good time, and it’s a great opportunity to meet me in all my feline glory.

As a horse person, you are probably familiar with your horse’s guttural pouches, although you may not be familiar with what they are and the issues they can cause for your horse. For those of you who don’t know, let’s first discuss exactly what it is. Bear with me; as the most superior species, cats do not have guttural pouches, so I had to do a bit of research to determine what this structure is all about.

As I’ve always suspected, horses are indeed just full of hot air, as can be explained via their guttural pouches, which are, in fact, sacs of air. They’re on either side of the head just below their ears, and are an expansion of the eustachian tube which is the structure that prevents air and fluid from building up within the ear. A horse’s guttural pouch can hold up to an entire mug of coffee per pouch!

Within the pouches are some very vital structures including veins, arteries and nerves, covered by just a thin membrane. As you can imagine, when there is a problem with the guttural pouches those vital structures are at an increased risk for damage. Damage to these structures can lead to difficulty swallowing, breathing, facial expression and head posture problems. The most familiar problem is Strangles. However, there are other issues that can affect the guttural pouches, including guttural pouch mycosis, guttural pouch tympany, and temporohyoid osteoarthropathy. I know, it’s a mouthful, even for me.

Guttural Pouch Empyema

When I hear the word empyema, my mind immediately goes to food, and I think of empanadas. While empyema seems like a pretty fun word to say, and we all know I really love thinking about food, what it stands for is not fun or delicious. Empyema is the fancy doctor-word for a pocket of pus. Most commonly, empyema of the guttural pouches is caused by a bacterial infection. One such bacterial infection that can affect the guttural pouches is streptococcus equi equi, otherwise known as Strangles. The pus caused by the bacteria forms in guttural pouch and can drain through the eustachian tube into nasal passages and nostrils. Accompanying thick, mucoid nasal discharge are clinical signs including fever, depression and swelling under the jaw.

However, unlike other guttural pouch diseases, guttural pouch empyema does not usually affect the vital structures. As the name Strangles implies, the swelling under the horse’s jaw can become so enlarged and painful that the horse can have difficulty breathing to the point of respiratory distress. Rarely, the pus that forms in the guttural pouches fails to drain and can precipitate into hard balls called chondroids. As with all other balls associated with animals, these balls must be removed surgically. If they go undetected, horses can be silent shedders of the bacteria and spread Strangles without their owners knowing it.

Treatment for Strangles is supportive and includes anti-inflammatories, antibiotics and, rarely, surgical drainage of the guttural pouches. Strangles is one of the biggest reasons to never share water buckets, troughs, feed buckets, etc with horses you do not know.

Guttural Pouch Mycosis

Man, fungus really does like to cause problems for horses, from eyes to wounds to their guttural pouches. No matter the form, fungus is one of the most difficult and potentially deadly organisms that horses are up against. When a horse’s guttural pouch(es) becomes infected with a fungal organism, it attaches itself to the top of the guttural pouch, going undetected. Once attached there, it eats its way through the thin lining and attacks the nerves and arteries. Since the fungi go undetected and do not fill the guttural pouch like empyema does, clinical symptoms occur very rapidly and can be dramatic.

One of the most common symptoms of guttural pouch mycosis is bleeding from the nostrils. It can range from a trickle to profuse bleeding, which can quickly result in the horse’s death. If the fungal organism affects the nerves in the guttural pouches, mild to severe symptoms may occur. Mild symptoms typically resolve, however, severe symptoms can lead to respiratory distress, trouble swallowing, and other life-threatening problems that are nearly impossible to recover from. And I thought diabetes was a pain to deal with!

Guttural Pouch Tympany 

As if horses were not already poorly designed, they can also develop a congenital problem associated with their guttural pouches called guttural pouch tympany. This affects foals very shortly after birth. Their guttural pouches fill with air that’s unable to escape. Oftentimes they can look like adorable little chipmunks (well, BIG little chipmunks). Usually, guttural pouch tympany does not cause major issues, but it can occasionally lead to difficulty swallowing and breathing. The only way to correct this problem is with surgical intervention. Of course, it can never be an easy fix with horses. They always have to make things as difficult as they can.

Temporohyoid Osteoarthropathy 

Ear infections are the actual worst thing ever. I know, because I have them all the time. One thing horses do right: they do not usually get ear infections. Yes, I said usually. As we all know, there are always those 1 or 2 horses out there that like to break the rules. On the rare occasion that a horse develops an ear infection, it may end up affecting the middle ear. As we have already discussed, the ear and the guttural pouches are interlinked therefore, a middle ear infection can affect structure close to the guttural pouches.

The stylohyoid bone forms a joint called the temporohyoid joint, which can be visualized along the roof of the guttural pouch. If the middle ear infection progresses, it can lead to infection of the temporohyoid joint and stylohyoid bone. Once infected, the joint and bone become thickened and brittle and can eventually fracture with movement. As the fractures heal, boney changes occur, callus of the bones form, and arthritis can develop. Callus formation and enlargement of the joint and bone can impinge on the nerves within the area. The most commonly affected nerve is the facial nerve, which affects facial expression.

If the facial nerve becomes damaged, it can lead to a droopy ear, droopy eyelid, and/or droopy muzzle on the affected side. More severe damage can even result in a head tilt and incoordination. Antibiotics are the go-to choice of treatment for a mild infection. More severe infections result in removal of a portion of the stylohyoid bone which allows the tongue to continue to function normally but alleviates the pressure on the facial nerve. Without intervention, it is possible that damage to the facial nerve may not fully resolve, and the symptoms associated with facial nerve paralysis may persist even after treatment.

As can be seen, problems with guttural pouches are far more than Strangles, and require quick recognition by the owner and swift treatment by your veterinarian. There are other diseases and problems that can be associated with the guttural pouches beyond what I have discussed, however, they are rare. If you think your horse may be having an issue that is associated with their guttural pouch(es) please contact your veterinarian as soon as possible.

Until next week, stay warm and pet the cat!

~Tony

P.S. There is a Meet Tony event coming up! Well, the humans are calling it Open House here at the Clinic on November 20^th, but it’s mostly about me. Mark your calendar, and come hang out with me from 10am to 1pm. There will be raffles prizes, drawings, and I’m even giving away a free Wellness Plan! I mean, what more could it take for you to come scratch my ears and give me a treat?

Hey, kits! This week I’m going to fulfill a reader request (yes, I can read) and frequent topic of quandary around here: fecal water syndrome. Before you accuse me of coming up with fancy names for diarrhea, let me assure you, fecal water syndrome is different. These horses have normal, formed manure, along with poop-colored water, and both are expelled at the same time. That lovely brown watery substance then sticks to the tail and hindlimbs to create as much work as possible for you, the human caretaker. So without further adieu, let’s talk watery poop!

What is it??

“Differential defecation of solid and liquid phases” is how it was described in a research paper from 2020. Seems an appropriate description! That’s exactly what these horses do; they poop normal solid apples, along with brown colored water. Very different from diarrhea. Some horses also show some signs of painful defecation as well. This is often demonstrated by picking up and replacing alternating hind limbs. You humans would probably call it ‘the peepee dance’ in a 4-year-old child. However, many horses show no signs of pain, in general, or discomfort of any sort. These horses are similar only in the fact that they both have excess fecal water.

Who gets it?

The study mentioned above found the syndrome in all colors, breeds, ages, and sexes of horses. Older geldings with bad teeth were slightly overrepresented. However, in most horse studies where age is a factor, older geldings are also overrepresented (small rabbit hole here!). It is generally thought that this occurs because geldings are more likely to be well loved older horses due to their good behavior (like me!).

I feel this should be a warning to all chestnut mares out there. It also likely reflects that mares and stallions may be used for breeding, and this is generally linked to increased health problems at younger ages. This study was looking at haylage consumption in particular, but in the process found that horses of all kinds of different sorts of feeding regimes were susceptible to fecal water syndrome. 

So what’s going on in there?

Great question! Most smart humans agree, they don’t know (which is why they asked The Cat). There’s almost certainly some disruption of the normal bacteria, viruses, and fungi in the GI tract. Yep, that’s right – the normal GI tract has all those icky-sounding things. But why this disruption happens is the $64,000 question. Current best thoughts among smart humans like my Docs are:

1. A GI tract that can’t handle long stem forage (probably a significant factor in the senior horse that’s got bad teeth)
2. A GI tract that doesn’t like grain
3. An inflammatory response in the GI tract (think allergies here)
4. A general revolt by the good bugs in the gut with a takeover by the bad guys

So you can see it’s a complex question with a lot of potential answers. One thing I did find interesting in my research for this week’s blog, is that horses with fecal water syndrome also have a higher reported incidence of colic than normal horses. 

Treatments!

Surely, I jest. If no one knows why this happens, how can even smart humans like my Docs treat them? Well, treatment is aimed at making the GI tract happy. But how??? Let’s start with basic guidelines. With any treatment, time is needed. This means patience, which is not something you humans do well. It’s not easy, but it usually starts with diet changes, and having patience.

My Docs start by evaluating the diet and then, depending on their findings, either increasing hay, or getting rid of it altogether. I realize this sounds drastic, but poopy water causing stinky, icky tails and hind legs calls for drastic measures! This diet change will be tried for at least 3 weeks. Along with diet changes, a good probiotic that contains Saccharomyces boulardii is added in. If no improvement occurs, then the next step is usually anti-inflammatories in the form of low doses of steroids like dexamethasone. These work by telling the gut immune system to calm down, stop being so dramatic, and let everything settle. A typical course of treatment would start with a higher dose, then taper down. 

Finally, if diet changes and anti-inflammatories don’t work, my Docs pull out an antibiotic called metronidazole. This antibiotic is used to kill a group of bacteria called anaerobes. The most common bad guys in the GI tract (human and horse) are anaerobes. Metronidazole has a slightly different use here than the wholesale destruction of bacteria antibiotics usually perform. Here, metronidazole is used to decrease the numbers of anaerobes and try to set up a better environment for the happy bugs. This means lower doses, or tapering doses may be used which is way, way different than the way antibiotics are normally prescribed. 

Sometimes one or more of these combined treatments helps, sometimes not. If these treatments fail, my Docs generally recommend allergy testing or limited source diets to see if an allergic cause can be narrowed down. They may also bring in an equine nutritionist to evaluate all kinds of things like fiber and starch content of the diet, and to help formulate a balanced diet if limited ingredients are going to be tried. My Docs may also try something called fecal transfaunation. This involves taking the manure of a normal healthy horse, mixing it with water, and giving it via NG tube to a horse with fecal water syndrome. Like all treatments for fecal water syndrome, sometimes it works, sometimes it doesn’t.

Besides the endless tail and leg washing, fecal water syndrome is a giant pain in the behind (literally!!!). With a lot of patience and some experimenting with feed sources, good probiotics, and maybe some pharmaceuticals, my Docs can work with you to get your horse back to normal. Now, be a good human and scroll down a bit and subscribe to my blog, if you haven’t already!

Until next week,

~Tony

P.S. If you want to take a really deep dive into fecal water syndrome, my docs did a podcast on this very topic! Just hop over to the Podcast Page and scroll down through the list until you see it. I’m sure you’ll see