Month: March 2018
Whether it’s for an Olympic hopeful or a reliable trail horse, Palm Beach Equine Clinic has more than 30 years of proven success keeping horses healthy and happy while working to extend their performance careers. In addition to innovative veterinary services that utilize advanced diagnostic tools and surgical equipment, Palm Beach Equine Clinic also offers alternative therapies to optimize health and increase the longevity of the horse’s performance career.
Veterinary chiropractic manipulation, acupuncture, and Chinese herbal medicine are three alternatives to standard medical treatments offered at Palm Beach Equine Clinic. While all of Palm Beach Equine Clinic veterinarians are versed in the many aspects of equine medicine, several of the doctors have studied extensively in alternative therapies. Dr. Natalia Novoa treats horses with chiropractic manipulation and acupuncture, and Dr. Janet Greenfield-Davis focuses on acupuncture treatment and uses Chinese herbal medicine to bring out the best in her patients.
Alternative Therapies for a Competitve Edge
“The line between success and failure is very thin for performance horses, and a lot of these alternative therapies can be very useful in giving the horse that little bit more,” explained Palm Beach Equine Clinic’s Dr. Richard Wheeler. “Chiropractic and acupuncture are just two of the alternative therapies that we offer. They are both conjunctive therapies that can keep horses comfortable, happy and performing well.
“Both chiropractic manipulation and acupuncture can get the horse moving and feeling better, and help to maintain some minor chronic problems that they may have, therefore avoiding more invasive treatments,” Dr. Wheeler continued. “For neck or back pain, once we diagnose a problem, we may treat it and then follow up with a program of alternative therapies. These therapies are used with the aim of keeping the horse supple and moving with ease and helping the musculature to work correctly. We work with the trainers to optimize muscle development so that we can fix the problem and keep the horse moving forward and performing at their top level.”
Alternative Therapy: Equine Acupuncture
Fellow Palm Beach Equine Clinic veterinarian, Dr. Janet Greenfield-Davis is skilled in acupuncture and herbal medicine. Acupuncture is a form of treatment used in both traditional and classical Chinese medicine. It is based on the principle that there are energetic pathways, or channels, throughout the body that influence associated internal organs and structures. Energy from these pathways surfaces at various points on the body, identified as acupuncture points. Extremely fine gauge needles are inserted at selected points, stimulating these points and thereby activating the body’s natural healing abilities.
“We offer acupuncture, chiropractic and herbal medicine as an alternative or adjunct therapy to your current veterinary protocol,” Dr. Greenfield-Davis explained. “With acupuncture, we stimulate particular points that can relieve pain, increase endorphins, calm, and improve health and body function in horses. These specific points have a high capacity of nerve endings, lymphatic vessels, and blood vessels, as well as hormone stimulation.”
Clinical trials indicate that acupuncture may be an effective adjunct therapy for musculoskeletal problems such as muscle soreness, back pain, disc problems, osteoarthritis, and degenerative joint disease. Acupuncture may help neurological disorders such as laryngeal hemiplegia, and facial and radial nerve paralysis. It can help with gastrointestinal disorders including diarrhea, gastric ulcers, colic, and impaction. Acupuncture may also help with respiratory diseases, metabolic and endocrine diseases, and other chronic conditions, such as anhidrosis, heaves, asthma, cough, uveitis, and behavioral problems.
Alternative Therapy: Veterinary Chiropractic Manipulations
Alternative therapies such as acupuncture and chiropractic manipulation are increasingly popular amongst sport horse owners, and Palm Beach Equine Clinic’s Dr. Natalia Novoa offers both forms of treatment.
“Chiropractic adjustment is an excellent complementary modality that can be used for diagnosis, treatment, and prevention of selected neuromusculoskeletal disorders,” Dr. Novoa explained. “The practice of chiropractic focuses on the relationship between structure (primary spinal column) and function (coordinated by the nervous system) to restore it. The goal is to treat soft tissue injuries or articular dysfunction to optimize health through manual therapy and to detect and treat abnormalities and alleviate pain.”
Veterinary chiropractic manipulation is thought to optimize equine health by restoring the normal joint motion, reversing mild pathology, and helping to slow the progression of degenerative joint and spine disease. Over the years, this therapy has become a valuable adjunct for competition horses.
Chiropractic manipulation is also a great treatment option for horses that suffer neck and back pain, nerve damage, poor performance, behavioral problems, muscle spasms, localized or regional joint stiffness, unexplained lameness, gait abnormalities asymmetry/muscle imbalance/atrophy, injuries resulting from falls, trauma (such as slips, getting cast in the stall, or missteps), or poor fitting equipment.
“I identify the restricted movement or subluxations by manipulating and evaluating the joint mobilization. Then I restore the joint motion with an adjustment, which is a manually controlled force applied to a specific joint,” Dr. Novoa said of the process. Chiropractic and acupuncture therapies are complementary treatments for lameness problems and other issues. They are alternative methods and do not replace conventional veterinary medicine or surgery, but can be very useful in maintaining top performance levels in your horse.
“There has been an increase of interest in non-traditional therapy, and Palm Beach Equine Clinic is aware of its great value, so we provide the services to allow our horses to reach maximum performance potential and overall health,” Dr. Novoa concluded.
As sport horses become faster and stronger, veterinary medicine is often challenged to break barriers to provide the best in diagnostic and maintenance care. Palm Beach Equine Clinic is consistently on the forefront of those advances and employs a team of veterinarians equipped with the latest developments in regenerative medicine.
Two resources that have become increasingly popular to treat equine injuries are Platelet Rich Plasma (PRP) and Interleukin-1 Receptor Antagonist Protein (IRAP) to encourage regeneration of injured or degenerative tissue. Managing joint diseases and injuries using these methods is ground-breaking, but logical at their core. They essentially use naturally-occurring proteins, cells, and other natural bodily processes. Regenerative therapies put the horse’s own biological mechanisms to work stimulating healing without the use of steroids or other drugs.
What is PRP?
Platelets are among the very first cells to accumulate at an injured site, making them very important when simulating the repair process. Platelets contain granules filled with growth factors (the elements that aid in healing) and stimulate specified tissue to heal at an increased rate. To treat a horse with PRP, the veterinarians at PBEC are able to take a sample of the horse’s blood and concentrate the platelets in a high-speed centrifuge onsite. The harvest and processing procedure takes approximately 30 minutes before the concentrated platelet rich sample is injected back into the horse at the specific area of injury using sterile techniques and guided by ultrasound.
PBEC’s Board-Certified Staff Surgeon, Dr. Weston Davis, explained PRP use in more detail: “We harvest a large quantity of blood, anywhere from 60 to180 milliliters, and we process that to concentrate the segment that is very rich in platelets. We get a high concentration of platelets – we are hoping for five to eight times the concentration that you would get from normal blood. Then we take that platelet-rich extract and inject it back into an injured area to encourage a more robust healing response. Whenever you have an injury, platelets are one of the first cells that get there. They will aggregate, clump, and de-granulate. They release these granules, which are very rich in growth factors, and signal the body to start the healing process.”
What is IRAP?
IRAP is used to treat equine athletes that are susceptible to musculoskeletal injuries and osteoarthritis or degenerative joint disease. Joint trauma results in the release of inflammatory mediators such as Interleukin-1 (IL-1). IRAP uses a horse’s own anti-inflammatory protein found within the blood to counteract the destructive effects of IL-1 to slow the process of osteoarthritis. The process works by binding to the IL-1 receptors in the joint and blocking the continuation of damage and inflammation.
“We often see joint damage in sport horses because of the nature of their work, but we try to avoid overuse of steroids in joints because steroids can have long term effects on cartilage,” said PBEC veterinarian Dr. Samantha Miles. “This is a way we can manage joint disease and stop inflammation without having to consistently use steroids every time. Some of our clients will maintain their horses on IRAP alone for joint injections.”
The goal to better serve sports horses that continue to improve athletically is the driving force behind the development of even more developed and precise techniques used in regenerative medicine. And, at PBEC, the work to break new ground is never finished.
“I believe we are learning more about these technologies with more advanced science behind what they do and how they do it,” said Miles. “These treatments are natural, drug-free, and competition safe, and necessity drives the need for regenerative therapies in the sport horse world.”
Breeding the Modern Way
Palm Beach Equine Clinic’s Own Dr. Katie Atwood Discusses a 21st Century Take on Equine Reproduction
The process of breeding sport horses is ever-changing. Whether in an effort to produce the healthiest, most talented foals, to prolong the competition career of a mare, or make the most of a stallion’s longevity, reproductive science in horses has come a long way from the days of the traditional breeding shed.
Dr. Katie Atwood joined Palm Beach Equine Clinic, based in Wellington, FL, in June and brought her passion for reproductive work with her to the winter equestrian capital of the world.
“I like the creating of life,” said Dr. Atwood, who is a Florida native and University of Florida graduate and currently pursuing steps to become a board-certified reproductive specialist. “Equine medicine is intriguing, but you’re dealing with sick, unhealthy animals. With reproduction, I am working with healthy animals and making their babies, which I love!”
Embryo Transfer
The most popular wave of advancement that has hit the horse sport industry over the past several years is the process of embryo transfer.
How it works:
- A donor mare and stallion, who hold the genetics of the future foal, are bred.
- At seven or eight days of pregnancy, the embryo is flushed out.
- A catheter is placed through the vagina and cervix, and an inflatable cuff on the catheter provides a fluid-tight seal.
- A lavage fluid with surfactin (added to reduce the “stickiness” of the embryo and allow it to be extracted easily) passes down through a tubing system into the uterine lumen. As the fluid swirls throughout the lumen and drains back out through gravity, it collects the embryo, which is swept back out. The fluid and embryo pass out through the tubing system into and through an embryonic filter.
- When the embryo is identified under microscope, it is removed into a more enriched medium until the time of transfer.
- The embryo is shipped to a recipient farm where a young and healthy surrogate mare of decent size receives the embryo. That mare carries the foal to term, but it is genetically created from the donor mare and stallion.
While the process is fascinating, some may wonder why it’s necessary. According to Dr. Atwood, it relieves much of the concern owners have about breeding their sport horse mares.
“The gestation period for a horse is 11 months, so you’re only getting one foal per year when you breed traditionally,” she said. “This allows a mare to produce multiple foals per year, but it also allows that mare to remain in competition. This process can be done on younger mares with no interruptions to their competition and training schedules.”
Horses are now being bred at an ideal reproductive age while they are still in training, which is made even more valuable by the fact that advances in equine science has prolonged the longevity of horses. While 16 or 17 was once the age of an older horse, now it’s commonly seen as the age when horses are winning in the show ring. Thanks to embryo transfer, these horses can enjoy longer, healthy careers and still produce the talent of the future.
Dr. Atwood has seen embryo transfers become popular in dressage and polo, but she has begun to see it span all disciplines, saying, “At the start of the season, I had one farm and a few mares, but now it has quickly grown to several farms with multiple mares at each. It is really taking off because people now realize it does not remove their mares from competition.”
The process not only keeps mares competing, but it allows stallions to cross continents. Frozen fertilized embryos from working polo ponies in the U.S. are now being shipped to Argentina where they are carried by mares and then trained by some of the best polo trainers in the world. On the flip side, semen can also be frozen and shipped to the U.S.
“Stallions are collected, the semen is placed with an extender and high nutrient base so the sperm has something to use for energy, and then cooled slowly until it is frozen in liquid nitrogen,” said Dr. Atwood. “Once frozen, it is theoretically good forever. Last year, I bred a mare with 1991 semen and she was successfully pregnant!”
What’s Next at Palm Beach Equine Clinic
Palm Beach Equine Clinic underwent significant facility renovations over the last year, which included improvements to their onsite breeding shed. Now covered from the heat and inclement weather like an indoor arena, the shed boasts a hydraulic phantom mare.
“We can raise a lower our phantom with the push of a button so it can be the appropriate for the stallion,” said Dr. Atwood. “Previously, we had to bring a tractor in to raise and lower the phantom.”
Additionally, Palm Beach Equine Clinic recently incorporated the use of a SCA® CASA (computer assisted sperm analyzer) system into their reproduction work. An excellent way to improve quality control of a stallion’s sperm, the system evaluates sperm motility (velocity and type of movement), concentration (sperm count), morphology (sperm shape), DNA fragmentation (counting of fragmented sperm), vitality (live and dead count) and acrosome reaction, which is what ultimately allows the sperm to penetrate the egg.
From onsite experience to computer technology, Palm Beach Equine Clinic offers Dr. Atwood the opportunity to be at the forefront of equine reproduction, a place she has always strived to be.
“I wanted to come into a practice that had a developed program in place, but what is even more important to me is mentoring and teaching my technicians and clients about reproduction,” she said. “It is so important to make sure these techniques are shared and promoted for the continued success of veterinarians, owners, and most of all horses.”