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Below is a list of frequently asked questions with answers.
 
 

QUESTION:
What service(s) does The Atlanta Equine Clinic provide to the horse community?

ANSWER:
The Atlanta Equine Clinic was designed to provide specialty equine service to the southeast horse community. Our practice is limited to the following cases:

  • Prepurchase Evaluations

  • Lameness Evaluations and Treatment

  • Medicine

  • Surgery

The Atlanta Equine Clinic does not provide:

  • Primary care: Vaccinations, Coggins, Dental Care, Health Certificates, etc.

  • Reproductive Services

  • Primary Emergency Services

Of course, The Atlanta Equine Clinic continues to assume the responsibility of providing quality service to you and your horses, and will contact a local veterinarian in your area to perform primary services if needed. Please call our office for specific recommendations.

QUESTION:
I see a lot of horses getting their hocks injected. Some horses get theirs injected every few months. Is this healthy?

ANSWER:
Distal tarsitis, often referred to as "bone spavin", is the most common cause of clinical lameness associated with the tarsus (or "hock") in horses. Distal tarsitis is an osteoarthritis and periostitis (inflammation) of the distal intertarsal, tarsometatarsal, and occasionally the proximal intertarsal joints. Distal tarsitis is a clinical diagnosis.

In other words, demonstration of pain in distal tarsal joints is diagnostic. Pain is demonstrated upon clinical examination, lameness characteristics, response to Churchill's Hock testing, hock flexion, and response to intra-articular anesthesia. Radiographs are frequently used to assess the presence and severity of distal tarsitis. It is important to note, however, that joint inflammation (arthritis) is invisible on a radiograph (which provides only structural information). Since the tarsus is a low-motion area, radiographic changes and the presence of distal tarsitis do not always correlate.

The low-motion nature of the distal tarsal joints also allows veterinarians to be very aggressive regarding treatment, which usually involves intra-articular (joint) injections. Typically, a combination of steroids and hyaluronan is used. Although the excessive use of steroids can be harmful to joints, the lack of movement within the distal tarsal joints presents little risk in regard to future function and performance. In fact, horses that are refractory to distal tarsal injections may be candidates for chemical fusion, which eliminates the joints altogether and produces soundness.

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QUESTION:
My horse is a "cryptorchid". What does this mean?

ANSWER:
Literally, cryptorchidism means "hidden testicle". Abnormal location of the testicle occurs when one or both of the testicles fail to descend completely from the fetal position behind each kidney through their respective inguinal canals into the scrotum. An abdominal cryptorchid has testicle(s) within the abdominal cavity. A horse with testicle(s) in the inguinal canal is called an inguinal cryptorchid or "high flanker". Since cryptorchidism is heritable, cryptorchid horses are considered genetically unsound. For this reason, registration of cryptorchid horses is disallowed by many breed associations.

Cryptorchid castration requires general anesthesia and is therefore more involved than routine castration. The procedure, however, is relatively simple. By using the inguinal extension of the gubernaculum, the testicle can be retrieved without having to dilate the inguinal canal and increase the potential for herniation of bowel into the scrotum. Aftercare consists of one week of stall rest prior to resuming exercise. Surgery costs $800-$1200. If you are interested in learning more about cryptorchidism or would like to view cryptorchid surgery (live), please give us a call. The Atlanta Equine Clinic performs cryptorchid castration on a weekly basis.

QUESTION:
How do I know when I need to send a horse with colic to a hospital versus treating it at the farm?

ANSWER:
Before answering your question, let’s first review what the term "colic" means. The term "colic" refers to abdominal pain. Of course, abdominal pain can be a result of many things including kidney disease, peritonitis, and estrus (in mares). In horses, we typically use the term colic to describe pain associated with intestinal obstruction and/or distension. Obstruction can occur subsequent to impaction, displacement, torsion (twisting), entrapment, strangulation, and/or incarceration (trapping) of intestine(s). Regardless of the cause of obstruction, the inability of ingesta to move at a normal rate results in excessive gas production and fluid accumulation. This in turn causes intestinal distension and pain (colic).

In some cases of severe obstruction, vascular occlusion can occur. Consequently, a portion of intestine does not receive an adequate supply of blood (and therefore not enough oxygen and nutrients). Endotoxins are absorbed through compromised bowel wall into the bloodstream. Since this condition (called endotoxemia) is life-threatening, surgery is indicated to prevent/treat decreased blood flow and compromise of affected bowel.

Endotoxemia usually manifests as increased heart rate, compromised mucous membrane color, and/or moderate to severe persistent pain. The presence of any of these symptoms justifies sending your horse to a surgical hospital, particularly if your horse has been refractory to conservative treatment.

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QUESTION:
My horse has a clubbed foot. Should I do anything about this?

ANSWER:
A foot that is taller and more contracted than its contralateral counterpart is commonly referred to as "clubbed". By definition, a clubbed foot has more than the appropriate amount of heel length; the extra heel results in a broken-forward distal limb axis. A foot becomes clubbed as a result of excessive tension on the deep digital flexor tendon (DDFT). The DDFT arises from the DDF muscle behind the radius and courses all the way down the back of the limb to insert on the underside of the third phalanx (P3). Excessive tension on the DDF tendon can cause several things, including excessive pressure on the navicular bone, mechanical rotation of the third phalanx, pedal osteitis, and delamination of the hoof wall ("white line" disease). Treatment options for excessive DDF tension include corrective shoeing, massage therapy, acupuncture, and/or surgery.

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QUESTION:
What is all this about West Nile Virus? Should I be worried?

ANSWER:
The West Nile Virus is an arthropod-borne virus similar to the viruses that cause Western and Eastern Equine Encephalitis (EEE). Encephalitis cases are seen in the warm months of the year when the primary vector, the mosquito, is present. EEE occurs each year in Florida, occasionally in southern Georgia, and rarely north of Atlanta. The West Nile Virus was first identified in the US in New England in 1999. It has gradually spread over the east coast and was recently identified in the South, including Georgia. The pathogenesis: birds are the usual host for West Nile, it is spread from bird to bird via the intermediate host, the mosquito. Humans, horses, and perhaps other mammals are dead-end hosts, infected via the bite of an infected mosquito, and cannot transmit the virus to others. Not every individual who contracts the virus will become seriously ill. Most will have subclinical infections or develop mild symptoms such as fever, malaise, body aches, etc. similar to other viral infections. Development of neurologic signs such as severe depression, circling, seizures, etc. occurs in a small percentage of cases; some of these cases will ultimately be fatal.

A vaccine for horses currently exists and is recommended by most veterinarians on a biannual basis. Mosquito control is the most important preventive measure for all species, however. Spraying, removing free-standing water, stall confinement during mosquito feeding times, etc. are highly encouraged.

QUESTION:
My horse has been lame for over 2 years. Nobody can seem to find out what the problem is. Any suggestions?

ANSWER:
Lameness is by far the most common cause of inadequate performance in the horse. The majority of horses currently in training have experienced lameness at one time or another. Accurate diagnosis of lameness requires a comprehensive understanding of equine anatomy and a methodical approach to examination. Causes of lameness can be divided into two categories: primary causes and secondary causes. Primary causes represent abnormalities that did not occur as a result of another problem. Foot abscesses, acute fractures, soft tissue injury (e.g. from trauma) and some forms of arthritis are common primary causes of lameness. Secondary causes of lameness are present as a consequence of one or more other problems. Laminitis, stress fractures, and soft tissue inflammation (e.g. myositis or desmitis) are common examples of secondary causes of lameness. They occur as a result of the horse’s compensating for a primary cause of pain. Although treating secondary causes of lameness often improves the horse’s performance, they will recur and lameness will persist as long as the primary cause(s) of lameness goes untreated. It therefore behooves both the horse and client to accurately diagnose the primary problem(s) as soon as possible. Once the primary lameness is eliminated, all secondary problems should disappear.

A complete understanding of the horse’s anatomy, conformation, gait, and intended use(s) are essential in determining an accurate diagnosis. A proper lameness examination should include 1) conformation evaluation, 2) passive lameness evaluation, and 3) active lameness evaluation. Performing a lameness examination is much like putting a jigsaw puzzle together. There is always 1 piece that makes everything else fit!

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QUESTION:
My horse is a chronic cribber. I have tried everything, but nothing seems to work. Any ideas?

ANSWER:
Cribbing is a common vice in which horses grasp a solid object with their upper incisors, contract ventral neck muscles and arch their necks, retract their larynx and pull backward. Horses that swallow air during this maneuver are called "wind suckers". Cribbing is considered an unsoundness, causing excessive wear on the incisors and enlargement of ventral neck muscles. Horses with aerophagia may exhibit weight loss, unthriftiness, poor performance, digestive disturbances, and flatulence.

Cribbing can be corrected in many cases through surgical intervention, especially when nonsurgical management is unsuccessful. Surgery involves partial removal of two muscles and resection of a nerve that supplies a third muscle. Consequently, "wind sucking" becomes impossible for the horse. The Atlanta Equine Clinic has experienced very good success in treating cribbers through surgical intervention. To find out more, please call the office.

QUESTION:
I have heard a lot about "shock wave therapy" lately. What is this and what does it do?

ANSWER:
Extracorporeal High-Energy Shockwave Therapy (ESWT) is a new treatment methodology that is currently gaining popularity in the world of performance horse medicine. ESWT was first developed for humans as a treatment for the disintegration of kidney stones. Subsequently, it was recognized that ESWT might have applications in orthopedics as well. High-intensity waves apply mechanical pressure and tension on tissues. These forces stimulate osteogenesis (new bone formation) and removal of excessive osseous tissue (calcification). The effects of shock waves occur in regions where tissue density changes, such as bone/ tendon or bone/ ligament interfaces. Therefore, it has shown promise in treating such conditions as stress fractures, navicular disease, distal tarsitis, suspensory desmitis, ligament and tendon fibrosis and/or ossification, etc. Preliminary research shows better quality healing and improved recovery rates.

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QUESTION:
My horse has been diagnosed with "degenerative joint disease". What does this mean?

ANSWER:
Degenerative joint disease (DJD) is a common cause of decreased performance in equine athletes. Lack of performance often precedes overt lameness and/or radiographic changes. The degenerative cycle is initiated as a result of joint instability. Instability may occur pursuant to trauma/injury, damage to the supporting soft tissue structures of the joint (ligaments), and overuse. Inflammation of the joint's synovial membrane (a condition called synovitis) occurs secondary to joint instability. The presence of inflammatory cells within the synovial membrane results in 1) increase in hydrostatic pressure within the joint and 2) release of catabolic enzymes (lysozymes) and other chemical mediators into the joint. The increased hydrostatic pressure results in the influx of fluid into the joint, distension of the joint capsule, and pain (the joint’s nerve endings are within the joint capsule). The enzymes released into the joint degrade hyaluronan (the molecule that gives synovial fluid its thick and slippery characteristics) as well as the articular (cartilage) surface. Erosion of the cartilage surface results in loss of articular congruency, which in turn causes increased joint instability. And the cycle begins.

Since we are limited in our ability to enhance joint stability in the horse, we rely on medications designed to reduce inflammation and enhance/normalize synovial (joint) environments in the face of instability. These medications are referred to as "arthrotherapy", and include both systemic (e.g. Adequan®, Legend®, Bute) and local (HA, steroids) forms.

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QUESTION:
Why does my horse "slap" one of his back feet on the ground at a walk?

ANSWER:
The slapping of the back foot is often referred to as "goose stepping". This characteristic gait abnormality is specific for fibrotic or ossifying myopathy of one or more of the hamstring muscles on the back of the pelvic limb, which include the semitendinosis, semimembranosis, and biceps femoris groups. The semitendinosis muscles is most commonly affected. Pelvic limb myopathies are most frequently observed in Quarter Horses, due to the type of work they perform.

Normally, the hamstring muscles move independently of each other and are able to stretch very easily when the limb is extended cranially (out in front). However, trauma in the form of muscle strain/tearing (resulting from hyperextension of the pelvic limb) or reaction to intramuscular injection results in the development of scar (fibrotic) tissue within the muscle(s). The scar tissue organizes, matures, and contracts, creating a "rope-like" band where there was once normal pliable muscle tissue. The lack of elasticity of the scar tissue causes the pelvic limb to be pulled caudally (backward) before the full length of the stride is reached. The foot "slaps" the ground as a consequence.

Fortunately, this problem is very easy to treat, and carries a good prognosis. Treatment involves a minor surgical procedure that is performed with the horse standing/sedated and the area locally anesthetized. Scar tissue is transected through a 1-to-2-inch incision along the back of the leg. Most horses can return to normal work after 3-4 weeks.

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QUESTION:
I have a horse with a “clubbed” foot. My vet wants me to further increase the angle of the foot to reduce tension on the deep digital flexor (DDF) tendon, which he says is too tight. Won’t the tendon tighten up even more and make the problem worse if we do this?

ANSWER:
The angle of the LF pastern and foot, the contracted heels, and the evidence of wall delamination (i.e. the dished dorsal wall) all suggest that he has too much tension in his DDF tendon (i.e. it is too “tight”). It seems that alleviating the tension on the tendon by raising his heels with the wedged pad would only allow it to contract further (become even tighter), whereas stretching it by imposing greater tension (i.e. dropping the heels) would normalize it's length and tension.

Although this makes perfect sense, it is extremely difficult to achieve in older horses. We find that some horses develop contactural deformity(ies) in one or both thoracic deep flexor muscles/ tendons when they reach their mid to late teens. Although we are not sure as to the cause, it does appear to be a progressive problem.

One farrier and I have worked on another horse with a similar problem. We cut both proximal and distal check ligaments which allowed us to drop the heel and reestablish a normal distal limb axis. However, within 18 months of surgery the same issues were remanifesting as a result of persistent excessive flexor tendon contraction.

Generally, dropping the heel and increasing the tension on the DDF tendon in older horses does not effectively stretch/ lengthen the tendon. Rather, it accentuates the problems occurring as a result of excessive DDF tension: laminitis, navicular inflammation, dorsal wall delamination, contracted heels, DDF tendinitis, etc. We would expect that lowering your horse’s heels would do the same.

We do recommend massage therapy of the flexor tendons in an attempt to discourage further contraction. Although we're still not certain as to it's effectiveness, it can only help.


QUESTION:
My horse has swelling around all four fetlock joints. When I asked my trainer about it, she told me that they were “windpuffs”. What are “windpuffs”?

ANSWER:
Windpuffs is a term that denotes synovial effusion (i.e. extra fluid) within the fetlock joint and/or digital flexor sheath. It can occur in the front legs, the back legs, or both. Extra fluid results in a soft fluctuant swelling behind and just above the fetlock joint. It is more common in older horses, but can occur at any age.

Although the digital flexor sheath and fetlock joint are in close proximity with one another, effusion in one structure can be identified by its specific location. Swelling behind the suspensory ligament branches is consistent with digital flexor sheath effusion. Swelling in front of the suspensory branches suggests fetlock joint effusion.

In the vast majority of cases, the swelling is a result of extra fluid within the palmar (front leg) or plantar (back leg) digital sheath rather than the fetlock joint. The plantar digital sheath acts as a sleeve that houses the superficial and deep digital flexor tendons as they course around the back of the fetlock joint. Normally, a very small amount of synovial fluid is present within the sheath to provide lubrication to the tendons as they slide around the back of the joint.

Excessive fluid within the sheath develops in response to increased hydrostatic pressure which in turn occurs due to the presence of inflammatory cells (inflammation) within the sheath. The synovium can become inflamed for a variety of reasons such as flexor tendonitis, trauma to the synovial membrane, infection, etc. In most cases, however, the source of the inflammation is undetermined.

Although plantar digital effusion can cause clinical lameness, this is rare except in severe cases (e.g. infection or tendon damage). Therefore, the problem is considered primarily cosmetic in nature. Consequently, most horses are left untreated.

Treatment options include intrasynovial injection (steroids/ hyalronan) or surgical debridement. Injection usually dramatically reduces the size of the swelling, although recurrence is very common and usually expected. Surgical manipulation can result in the formation of scar tissue within the sheath, which in turn can cause adhesion formation and lameness. Therefore, this strategy is reserved for only the most severe of cases.

Learn More About Windpuffs


QUESTION:
I have a 2-year-old colt that I’m trying to teach to load on a trailer. Someone told me Acepromazine was the best drug to use for this sort of thing. How much should I give him?

ANSWER:
Acepromazine is contraindicated in intact males (i.e. colts and stallions) due to chance that paraphimosis (a permanently dropped penis) might result. Although this complication was associated with a former preparation of the tranquilizer (not currently formulated), it is still recommend that Acepromazine not be administered to colts or stallions in any form. This complication has not been observed in geldings.

We would recommend using something else, such as Xylazine (Rompun), to lightly sedate your colt prior to loading. Please consult your veterinarian regarding dosage and administration.



QUESTION:
Do any of the vets at your clinic perform the newer surgery of "splitting" the patellar ligament for horses with the upward patellar fixation problem rather than blistering it?

ANSWER:
Yes, we do perform the "splitting" technique to address upward patellar fixation. As you may know, the technique involves splitting or separating the ligament fibers within the medial (inside) and middle distal patellar ligaments. This creates defects within the ligament which fills in with scar tissue. As the scar tissue matures and organizes, it contracts, thereby shortening the ligament and repositioning the patella (or kneecap).

In our hands, however, we have had the most success performing a technique that combines the splitting and blistering strategies. Rather than split the fibers with a scalpel blade, we simply split them using an 18-gauge 1.5" needle. Consequently, no external (skin) incision is required. As we remove the needle from between the ligament fibers we infuse a small amount (or trail) of counterirritant (usually 2% iodine in almond oil). This stimulates the developing scar tissue to contract even further than it would on its own.

We have been performing the procedure for over 20 years with very good success.

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QUESTION:
With a younger horse, how long should I wait to see if IUPF is something he will "grow out of"....before deciding to have the surgery done? I want to try all other options before surgery, but I also don't
want to wait too long. As I mentioned in my previous email...my horse is a two year old and he is showing mild signs of upward patellar fixation...his leg appears to be "catching" at times...I first noticed it when I started picking up his back hooves to clean them out...it's like his foot is stuck, then it springs up all the sudden...and I also notice it periodically when he is turning in a tight circle...I am waiting until he is 3 or 4 years old to put him under saddle, but I do pony him off my other horses and he doesn't have any problem when being ponied.

ANSWER:
We usually try to avoid doing anything aggressive in regard to IUPF treatment in this breed until they are 5 years of age. I realize that this is very easy for me to say, as I'm not responsible for feeding and riding him for the next 2.5 years.
The problem is VERY common in 2-year-old horses, because it is during this period that they tend to be most downhill in regard to conformation. The pelvic (back) limbs grow more quickly then the thoracic (front) limbs which results in a downhill topline conformation. This conformation, in turn, puts the medial femoral trochlear ridge of the femur (the "hook") in closer proximity to the distal patellar ligaments. Therefore, upward fixation or "catching" is more likely to occur.
I would visually assess the horse on a flat firm surface and determine the orientation of the topline. Is the rump higher than the withers? If so, the horse is very likely to grow out of this problem within the next 2.5 years. If the topline is level (or uphill), then it is less likely to resolve with maturity in our opinion.
If we decide to wait to perform aggressive treatment (such as surgery), we might suggest some conservative treatment in the meantime. This would consist of corrective shoeing and fitness training (hill work). We would be happy to provide you with a Fitness Training Schedule and/or Farrier Prescription at your request.

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QUESTION:
My mare is constantly back sore. I have the chiropractor out to treat her at least once monthly. The treatment helps, although her back soreness inevitably recurs within a few weeks. I should also mention that her hocks are sore and I have been considering getting them treated (injected). Any thoughts?

ANSWER:
In our opinion, back soreness is an extremely common (and expected) consequence of pelvic limb (hind limb) lameness. Just about every horse we evaluate for lameness in the rear limbs is sore in the back. Typically, it is the thoracolumbar back (the area just behind the saddle) that gets sore first. Resolving the horse's lameness issue(s) usually resolves the back soreness as well.

Our responsibility as your veterinarian is to identify and successfully treat the primary source of pain/ lameness. In this case we might find that soreness in the hocks is the primary problem. Presuming we do our job well and successful eliminate hock pain, we would expect your mare’s back comfort to improve concurrently.



QUESTION:
My horse has been diagnosed with "locking stifles". My veterinarian recommended estrogen injections to treat this problem. Does this work?

ANSWER:
In some cases, we elect to treat horses exhibiting clinical signs of intermittent upward patellar fixation (IUPF) with estrogen. As you know, estrogen is a naturally-occurring hormone that is present in all horses (both male and female).

Estrogen used to treat IUPF comes in two synthetic preparations: Estrone (water soluble) and Estradiol Cypionate (oil-based). In my opinion, the latter (Estradiol Cypionate) works better and lasts longer (since it is oil-based and is resorbed by the body more slowly). Furthermore, it runs about half the price of its water-soluble counterpart.

Since both medications consist of a naturally-occurring hormone, neither are testable at shows or events.

This form of therapy is currently being used widely by veterinarians treating IUPF based on the idea that estrogen (as a hormone) increases the tension of all of the ligaments in the horse (collateral ligaments, cruciate ligaments, distal patellar ligaments, etc.). By increasing the tone of the distal patellar ligaments, we can presumably reposition the patella (kneecap) to an area where it is less likely to inadvertently interfere with stifle function.

At The Atlanta Equine Clinic, we have not been very impressed with the physiologic ability of estrogen to "tighten" the ligaments. In our experience, most horses treated for IUPF with little or no behavioral component exhibit only marginal response to estrogen therapy.

However, we do often utilize estrogen as a treatment strategy for IUPF, particularly when there is a considerable behavioral component to the problem.

IUPF is generally very frustrating to the horses, represented by frequent bucking, bolting, spinning, kicking, etc. Since estrogen is also a very competent behavior-modificator, we recommend it for horses that exhibit behavioral problems (anxiety, nervousness) or resistance (such as with IUPF). It seems to help the horses to "relax" and work through the problem more efficiently and safely.

In short, if your horse is exhibiting behavioral resistance we would recommend estrogen administration. If not, then we might consider alternate forms of therapy.

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QUESTION:
I have a 22-year-old Appaloosa gelding that is not wanting to shed out this spring. My vet thinks that he has Cushing’s disease and that we need to test him by performing a Dexamethasone Suppression Test. Does your clinic do that sort of thing?

ANSWER:
We would be happy to test your horse for Cushing's disease. However, we might wait until this summer (i.e. May or later). In older horses, blood flow to the feet may already be compromised in the spring months (March-April) due to the increase in carbohydrate (fructans) concentration in the grass. Performing a Dexamethasone Suppression Test (for Cushing's) involves administering a steroid and evaluating the pituitary gland’s response to the drug. Since steroids also have a negative effect on bloodflow to the feet, performing the Dexamethasone suppression test while your horse is ingesting spring grass may increase the risk for laminitis (founder).



QUESTION:
My friend showed me a "triangle" on my horse’s neck and said that this was the best place to give intramuscular (IM) injections. My horse tends to get sore from neck injections. Is there another place I can give the shots?

ANSWER:
Most people select the neck area to administer intramuscular injections due to convenience and safety (i.e. unlikely to get kicked). However, the muscles in the neck may not have as much bloodflow (i.e. may not be as well perfused) when compared to some of the other muscles in the body.

Furthermore, adverse reactions (i.e. swelling and/or abscessation) that sometimes occur pursuant to intramuscular injections can result in severe neck stiffness and in some cases neurologic signs (due to the close proximity of the cervical vertebral column/ spinal cord to the neck musculature).

For this reason, The Atlanta Equine Clinic generally recommends that you select another muscle to administer medications that consist of 2cc or more in volume. To view our recommended intramuscular injection sites, click HERE.



QUESTION:
I have a small boarding facility and a few boarders. Due to the lack of stalls, I have one horse that gets the use of my indoor arena at nights. We put his hay on mats for him to eat, but I still worry about him inhaling too much sand as he forages throughout the night. I have checked his feces for sand and find small amounts of it at this point.

My questions are:

What is the best sand colic remedy for this? I have been told that Metamucil (a human product) would be good to give the horse, but I'm not sure this is correct. If it is, how much would I give the horse? All of my horses are on a dirt lot during the day and get fed hay three times daily in it.

Is it possible for them to get a type of sand colic from inhaling too much dirt as well? Any suggestions? They are dewormed every 8 weeks alternating from an ivermectin to a strongid and then Quest once a year. Is there anything else I should be doing?

ANSWER:
Sand colic is common in regions where grass turnout is limited. Horses are very good at sifting out small morsels of food from the dirt but they may accumulate sand in their gut over time. The horses most at risk are the ones fed on the sand and in small lots with sparse grass. The horse pulls up small tufts of grass with the roots and sand attached. We believe that any sand found in the manure is abnormal, but have heard the general rule of thumb that three teaspoons is normal and three tablespoons is abnormal. We like to treat sand colic with a psyllium product called Advantage by Animal Healthcare Products. We find that the horses will eat this product dry on top of their regular ration. The sand "sticks" to the psyllium in the GI tract and is "carried" out with the product as it passes through. Treatment dosing consists of three tablespoons for three days on and three days off for a month and a preventative dose of once weekly. We tell our clients to remember PSYLLIUM SATURDAY.



QUESTION:
My husband and I operate a small horse boarding facility and our "claim to fame" is the quality care client horses receive. What is your preferred annual deworming schedule? I include an all inclusive worming program in my boarding price.

ANSWER:
Any deworming schedule should be customized depending on the age and turnover of the horses and the manure removal system. The goal of paste deworming is to prevent environmental contamination. The time interval from deworming to reshedding is variable depending on the environment. Any new horse introduced to your stable should be dewormed immediately. Ivermectin is generally satisfactory in most cases. However, if the deworming history is unknown/ questionable then we recommend administering a Panacur Powerpac (5 consecutive days of Panacur) due to the slower kill rate and increased safety. Subsequently, we recommend administering a dose of Ivermectin 2 weeks later.

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QUESTION:
My question concerns 'Arena/Round Pen Footing' .
My clients frequently ask what is the best footing for round pens or arenas. I have seen a variety of different sands used from extremely coarse, almost fine gravel, to a local fine beach sand. The extremely coarse sand, to me, seems far too rough and likely to cause irritation around the coronary band. What would you suggest as the best footing?

ANSWER:
Horses will fatigue more quickly in deep footing when compared to firm footing. Course sand tends to pack more easily and horses find it less tiring, although firm footing can be harder on the joints. Sand particles reveal different shapes when viewed microscopically: Deep soft sand has round particles and hard-packing sand has angular particles. Our preference is a base of course sand or stone dust that gives a firm consistent purchase for the horses foot topped with a thin layer of soft sand to allow some cushion and glide. Inspect the hoof prints and check for breakover of two to three inches of the toe into the footing. This will vary with moisture conditions, but the best footing is a mixture that provides ample support and reasonable breakover.



QUESTION:
I have a five-year-old Thoroughbred gelding that is confined to a stall due to a recent injury. Do you have suggestions for keeping him mentally sound while laid up for multiple weeks? He is usually turned out all day and is not particularly fond of his stall. We are feeding sweet feed twice daily and free-choice hay. Any suggestions would be appreciated.

ANSWER:
Short of recommending tranquilizers/ calming agents, etc., we might suggest changing his diet somewhat. Energy comes in two basic forms when it comes to feed: CARBOHYDRATE (sugars) and FAT. Carbohydrates provide horses with readily-available energy. Horses on a high-carbohydrate diet tend to be more hyperactive. The primary source of carbohydrate for horses is sweet feed and grains. Alfalfa hay is also somewhat high in carbohydrates.
Fat, on the other hand, is generally stored after consumption. It is later broken down into sugar as energy is required, but does not make energy readily available to the horse. Therefore, decreasing the carbohydrate/ starch percentage of the diet and increasing fat while maintaining a comparable caloric intake may prove beneficial.



QUESTION:
My horse has a new stablemate. They are both geldings. The new horse is a 3-year-old and he urinates on his hay (and then won't eat it, of course) and my horse, which is eight years old has now acquired the habit. Why do they do this? Is there any way to correct it?

ANSWER:
Geldings don't like to get splashed when they urinate. Make sure there is adequate bedding in the center of the stall to absorb the urine and place the hay in a corner. If they are doing this outside, it might be territory-marking behavior. A dominant gelding will urinate over the spot where another horse has urinated. Try another location for the hay pile.



QUESTION:
We board at a barn that offers lessons and has around 50 horses on site. Many of the horses are put together in pastures, these horses run out of the barn to their pasture where the gates are put up. At the end of the day the gate is dropped and those same horses run back into the barn where they are met and put into correct stalls. My question: is this a safe practice for a boarding facility?

ANSWER:
This is never a safe practice. Horses catch hips and shoulders cutting turns and squeezing through doors. They also kick at each other in competition. There is little opportunity to teach good manners while leading in and turning out each day. Horse boarding is generally a very low profit situation so if more labor intensive practices such as leading horses to and from turnout are requested, you may have to pay higher board.



QUESTION:
My horse was recently diagnosed with "OCD" in his fetlock. What is OCD?

ANSWER:
OCD is an abbreviation for "Osteochondrosis Dissecans".  It is one of the 5 primary manifestations of developmental orthopaedic disease (DOD) in the horse.

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QUESTION:
I own an 8-year-old draft gelding that has been lame in the right front for over 8 months. My vet came out and looked at the horse, but I was skeptical of the diagnosis that she gave me. She said it was the sidebones. I know I am not a vet, but if it were the sidebones then there would have been more improvement when the heels were blocked. And the research I have done shows that it is fairly common in drafts unless I am incorrect. What do you think?

ANSWER:
That is correct; sidebones are more common in draft breeds. As you know, "sidebones" is a layman's term for ossification (mineralization) of the collateral cartilages of the third phalanx (P3). Normally, these structures are composed of cartilage (only) and have soft-tissue density (i.e. are invisible) on radiographic images (x-rays).
The cartilages become radiographically visible as they begin to ossify and take on the density of bone. Since these structures do not communicate with a joint or critical soft tissues structures, sidebones are typically not implicated as the cause of lameness (unless they are infected... a condition called "quittor"). Although the sidebones may not be a cause of lameness, their presence suggests that there is chronic irritation/ inflammation associated with that area of the foot. If the tissue environment was normal there would be no reason for the cartilages to ossify. Horse with navicular inflammation, chronic bruising of the heels, coffin joint synovitis or pedal osteitis, for example, often have ossification of the P3 collateral cartilages.



QUESTION:
My horse recently tore his suspensory ligament. My vet told me to keep the horse in a stall for 2 months, but he is going crazy. Can I turn him out in a small paddock instead of keeping him in a stall?

ANSWER:
The answer to this question depends entirely on the nature of the lesion within the suspensory ligament. The location, size, and degree of the lesion are best evaluated using diagnostic ultrasound.

A defect is created within the damaged portion of the suspensory ligament when it tears. The defect is initially filled in with blood/ serum and eventually with scar tissue. The scar tissue (put simply) consists of collagen fibers.

Without applied stress to the tissues, the collagen fibers are laid down in a random pattern. Consequently, the scar tissue that develops is not very functional. Mild but consistent stress to the tissues encourages alignment of the collagen fibers as they are being laid down. The fibers will tend to orient themselves in the direction of the applied stress. The result is scar tissue that mimics normal tissue in appearance and function.

Therefore, we at The Atlanta Equine Clinic recommend handwalking almost immediately for at least 10-15 minutes twice daily. There is really no limit to the amount of time of handwalking, since this activity is not considered intense enough to cause further strain/ damage to the ligament fibers (except in severe cases). The result is well-aligned collagen fibers which comprise more functional scar tissue.

Regardless of the percentage of damaged fibers in the ligament, we must consider the phases of ligament healing. It takes about 90 days (3 months) for the scar tissue to develop, mature, and organize. It will take another 7-9 months (i.e. 10-12 months from the time of injury) for the scar tissue to obtain its maximum strength, which is not as strong as the original ligament tissue.

Treatment methodologies (such as ESWT/ shock wave therapy) are designed to shorten the healing time for certain injuries. The size, location, and severity of the injury will dictate the amount of rest/ time off that will be required for adequate healing.

Please consult your veterinarian regarding the nature of the lesion and the recommended amount of rest. We generally do not recommend small paddock turnout for this type of injury unless the horse is dangerous to himself and/or others while confined to a stall. Following a period of rest, exercise should resume in gradual fashion so as not to injure newly developed scar tissue.

Changing the horse's feed may make his stall confinement more tolerable.

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QUESTION:
My mare has been lame behind for about a month. I think that she has sore hocks. She has had them injected in the past and it has really helped. When my vet came out, he said that her stifles were "catching" and that her hocks were fine. But she is doing the same thing she did the last time her hocks were bothering her. How can I tell which problem is making her lame?

ANSWER:
We might try the "BUTE TEST". This test is designed to differentiate between pain- and/or inflammatory-mediated problems (such as distal tarsitis/ sore hocks) and biomechanical or non-painful problems (such as intermittent upward patellar fixation or "catching" of the stifle). To see the "BUTE TEST" protocol, click HERE.



QUESTION:
My farrier said my horse has "thrush". What exactly is this?

ANSWER:
Thrush represents an infection within the space between the heel bulbs and frog sulci of the foot. Infectious agents can include bacteria or fungi, both of which are ever-present in the equine foot’s environment. Infection occurs within the dark, warm, moist and enclosed space created by contraction of the heels. So, in reality, infection (thrush) of the area can be considered secondary to the presence of the space. Therefore, we are treating a secondary problem when we treat the infection associated with thrush.

Treating the primary problem would involve eliminating the tight space altogether. This is accomplished by spreading the heels further apart, which is usually easier than it sounds.

In cases in which heel contraction is secondary to chronic underloading on the heels (as may occur with navicular inflammation, excessive flexor tendon tension, upper limb pain, etc.), then successfully treating the source of pain can result in increased loading and spreading of the heels.

If the horse can tolerate frog pressure, then applying weightbearing force to the frog (through various techniques including pads, heart bar shoes, pour-in products, etc.) can also prove beneficial. Heel springs are also used although considered by many farriers to be overly-aggressive.

In many cases of heel contraction, a primary cause cannot be isolated and we have to rely on topical and/or systemic treatment of the secondary infection.

Systemic therapy (such as oral or injectable antibiotics or antifungals) is generally reserved for severe cases. In most cases, antiinflammatory therapy (such as Phenylbutazone) is also not necessary unless lameness is present.

Topical treatments are designed to kill bacteria and fungi as well as attempt to "dry out" associated tissues. Our favorite product is manufactured by "VET’S COMPLETE®" and is called "Thrush Eliminator and Sole Toughener".

We have created a THRUSH TREATMENT TUTORIAL for you HERE.

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QUESTION:
My pastures were just fertilized with chicken manure. Will this cause my horses to founder?

ANSWER:
The chicken fertilizer itself doesn't contain anything that directly causes founder (laminitis).

However, the nitrogen content in the fertilizer accelerates initial growth of new grass. Therefore, there is a greater amount of new (infant) grass that becomes available at one time. This infant grass has a high concentration of fructans (a type of carbohydrate). The horses love this stuff because it is so sweet. The fructans can cause peripheral vasoconstriction (altered blood flow to the feet), thereby inducing laminitis.

To reduce the risk of any of the horses developing laminitis, we would recommend:
1) Limiting their weight (don't let them get too fat) and
2) Limiting their access to the pasture from the middle of March to the middle of May (2 months): 2-4 hours turnout per day during this time period.

Find a BETTER way to fertilize your pastures HERE.



QUESTION:
My horse makes a "popping" sound when he walks. Do you know what that is? Will he go lame from it?

ANSWER:
The "popping" and "snapping" as your describe is likely a result of synovial fluid moving from one aspect of the joint to another. The sound is created via the friction of the fluid moving across the synovial surface (cartilage).

The sound(s) generally suggest that there is an excessive amount of fluid within the joint(s). It is not uncommon for younger horses to produce this sound, as they often have slightly more fluid in the joints in comparison to older horses. In older horses, excessive fluid might indicate synovitis (inflammation) within the joint(s).

Administering systemic arthrotherapy (e.g. Adequan or equivalent) might help to normalize the synovial (joint) environment(s) thereby reducing the amount of fluid. Frequently, the popping sounds disappear following initiation of arthrotherapy(ies).

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QUESTION:
I own a 12-year-old Warmblood named Will. I am scheduled to have his coffin joints injected next week. I don’t like to idea of injections, and certainly don’t like the thought of using steroids. Would you recommend just using HA?

ANSWER:
You could certainly eliminate steroid from the recipe (i.e. only use HA). However, the HA (hyaluronan) alone would very likely not give Will enough anti-inflammatory effect to produce soundness.

Although steroids can certainly have deleterious effects in the joint, we should consider the whole picture:
1) Let's say we don't infuse steroid into the joint. The inflammatory cells will persist in the joint. As a result, the following consequences will occur:
a) The presence of the inflammatory cells within the joint will increase the hydrostatic pressure within the joint causing the influx of fluid. Increased synovial fluid in the joint (called effusion) results in stretching of the joint capsule (which houses nerve endings) and pain. So Will's lameness will persist.
b) The inflammatory cells release degradative enzymes (called lysozymes) and other chemical mediators that break down hyaluronan (HA) within the synovial fluid. The fluid becomes very thin and watery, thereby losing its ability to protect the cartilage. Consequently, we get erosion of the cartilage which in turn results in increased joint instability, inflammation, and so on.

In other words, persistent inflammation is not healthy for a joint!

2) Let's say we infuse steroid into the joints. The presence of steroid will reduce inflammation within the synovial environment. As a result, the hydrostatic pressure will decrease, fluid will leave, the joint will decompress, and Will will be more comfortable. Furthermore, there will be less degradation within the joint due to the absence of the inflammatory enzymes and mediators. Therefore, in one sense, steroids are helping us to IMPROVE synovial integrity.

On the other hand steroids also result in breakdown of HA which, as we previously discussed, is chondroprotective (protects the cartilage). Therefore, we must weigh both sides. The factors that determine if intraarticular injection using steroid is indicated include:

1) How important is the integrity of this joint in regard to the soundness of the horse? Is it a high-motion joint? Is it a high-weightbearing joint? In this case we are dealing with the coffin joint. The coffin joint is not characteristically very high-motion and therefore is not considered as important as a very high-motion joint (the fetlock joint, for example). It is considered more important than very low-motion joints (e.g. the distal hock joints). The coffin joint moves enough and bears enough weight that suggests we need to think about whether or not steroids are indicated.

2) How much inflammation is present?

Inflammatory changes can eventually become irreversible. This leads to greater joint disease and further inflammation. The deleterious effects of inflammation may outweigh those that occur pursuant to steroid injection. In many cases of coffin joint disease, intraarticular steroids are HEALTHIER for the joint than a lack of steroids. In other words, the benefit of steroids outweighs the deleterious side effects.

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QUESTION:
I have two horses for you to see next week. One requires surgery (cryptorchid castration) and the other needs his stifles blistered. Your receptionist told me that you could not perform both procedures at the same time. Why not?

ANSWER:
We ALWAYS try to perform surgery (of most types) first thing in the morning. Cryptorchid castration requires general anesthesia, so the horse will require some time to wake up and feel back to normal following the procedure. Sometimes surgery takes longer than planned, and we don’t want to worry about impending darkness or time constraints. The most important reason, however, is that a morning procedure allows the owner to adequately monitor the horse throughout the day. We wouldn’t want to finish the surgery at night and leave the horse unattended for the first several postoperative hours while we go to bed!

The blistering procedure can result in a considerable amount of discomfort for the horse. The degree of discomfort usually peaks at about 12-18 hours post-treatment. If we perform the procedure at night, the horse will be experiencing the majority of the pain during the next day. We can easily monitor and attend to the horse during this time. If we perform the procedure in the morning, the horse will be miserable in the middle of the night when most of us are fast asleep.



QUESTION:
My horse really dips in his back when I run my fingers along each side of his spinal column behind the saddle area. What makes his back so sore?

ANSWER:
This is a good question, and one that is asked very often. We as horse owners should realize that ventroflexion ("dipping") of the back is a NORMAL neurologic reflex that occurs in response to digital pressure along either side of the spinal column. The reflex is most pronounced when the thoracolumbar aspect of the back (the area between the back of the saddle and the pelvis) is manipulated.

Here are the possible responses that you might observe during palpation/ manipulation of your horse’s back:
1) The horse’s back bends and moves away from your fingers, but he/she doesn’t seem to care. The horse is relatively uninterested in what you’re doing. This is considered a NORMAL response.
2) The horse’s back bends in response to your finger pressure, their ears pin, they swish the tail, move their entire body away from you, and/or kick out at you. We would consider this horse to have a MODERATELY SORE back.
3) The horse’s back doesn’t move at all in response to your digital pressure. One of two things are happening:
a) Either this horse doesn’t feel your pressure (due to excessive fat, incorrect location of the pressure, or he/she is an extremely friendly horse), or
b) The horse is EXTREMELY SORE and resisting the reflex in order not to experience pain.

In our experience, the horses with the most painful backs do not elicit a response to digital palpation of the thoracolumbar back.



QUESTION:
My 3-year-old Thoroughbred gelding ("Buddy") recently "bowed" his right front deep flexor tendon. My vet told me to take him out of work for a year. Why so long?

ANSWER:
When a horse strains or "bows" a tendon or ligament, they compromise a percentage of the fibers that make up that structure. In some cases, they only compromise 5% of the fibers. This means that 95% of the fibers are still intact. In other cases, 95% of the fibers are torn, leaving only 5% of normal tissue.

Regardless of the percentage of torn fibers, scar tissue that develops will take 10-12 months to gain maximum strength. The maximum strength of the scar tissue is never as strong as the original tissue.

In a case in which only 5% of the fibers are torn, the horse is at decreased risk of reinjury since most of the structure is still healthy and strong. Therefore, a rest period of only a few weeks may be satisfactory prior to resuming exercise.

I suspect that Buddy has a high percentage of damaged fibers, thus warranting the entire year out-of-work. Since he will be relying primarily on scar tissue to perform the functions of his deep digital flexor tendon, we will want to make sure it is as strong as possible before he resumes work.



 
 


THE ATLANTA EQUINE CLINIC: 1665 Ward Road, Hoschton, Georgia 30548 - ph. 678-867-2577

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