Cold Fronts: Effects on the Horses of Wellington

Each year, many people relocate to Wellington for the winter show season. This allows escape from the brutal winters in the northern US, Canada, and Europe. However, cold-fronts do periodically pass through South Florida. Horses who have acclimated to the warm temperatures of Wellington and the surrounding areas are at risk when the cold weather arrives.

Most horses are very resilient, but when there are rapid changes in temperature, they can be susceptible.  Any change of 20 degrees or more from typical should prompt consideration of ways to minimize risk.

  • Blanketing horses when there is a 20+ degree temperature change over a period of 24 hours or less will keep them more comfortable and likely to maintain normal water intake
  • Take care when using heaters to ensure air quality remains clear, and that no dust or hay chaff will be burnt in unused heaters.  Ensure adequate ventilation – carbon monoxide is colorless and odorless!

Many horses will refuse to drink cold water. This can lead to firmer fecal material and impactions which cause signs of colic, or abdominal discomfort.

There are several different methods owners may use to encourage their horses to drink water when the temperature drops:

  • Keeping access to hot water in the barn and topping off the water buckets with hot water to help keep the water at a warmer temperature
  • Adding a second water bucket with salt, electrolyte, or Gatorade added can help horses feel thirsty which in turn increases water intake
  • Soak hay with warm water and feed a sloppy, warm mash

As always, call your veterinarian to discuss management strategies to minimize risk for your horses. The vets and staff at Palm Beach Equine are here to help any time.

Internal Medicine at Palm Beach Equine

Equine internal medicine by definition is focused on treating diseases of the internal systems of the horse, but for Board Certified Large Animal Internist Dr. Peter Heidmann, DVM, MPH, it boils down to an analytical way of thinking and approaching any equine health concerns.

“What you’ll see on the American College of Veterinary Internal Medicine (ACVIM) website is an emphasis on organ systems and organ system problems – respiratory disease, gastrointestinal disease, and neurologic disease being three of the most prevalent,” said Dr. Heidmann, who is both a part of the team at Palm Beach Equine Clinic (PBEC) and the owner and hospital director of Montana Equine Clinic & Surgical Center. “What it really entails is a way of analyzing problems specific to the organ systems. It can be all over the map, and that’s part of what makes the specialty so fun and interesting.”

Dr. Peter Heidmann (right).

Since the winter of 2016, Dr. Heidmann has brought his analytical approach to PBEC for the Winter Equestrian Festival (WEF) seasons, and he returns this winter to again add his skill-set to an already impressive line-up of talented veterinarians and specialists.

“Palm Beach Equine is well-equipped for these types of cases. We now have Dr. Heidmann, who is an internal medicine specialist; we have an amazing staff, and we have top-notch facilities providing great care,” said Dr. Jordan Lewis, who has been a part of the PBEC staff for more than 12 years and has dedicated several of her years at PBEC to hospitalized, internal medicine cases. “We have three U.S. Department of Agriculture (USDA) approved isolation stalls; our main hospital is brand new, and we have ten stalls equipped for ICU patients. We have a whole team that works together, including Dr. Heidmann as an internist, three boarded surgeons, a boarded radiologist, and access to other specialists.”

Dr. Jordan Lewis

Among the most common internal medicine cases that require the attention of the PBEC team of veterinarians are those horses with gastrointestinal (GI) problems.

“When it comes to GI issues, I usually see horses in two buckets or categories,” explained Dr. Heidmann. “Bucket number one are the horses that may need to go to colic surgery and the horses that just had colic surgery. The other bucket is horses with intestinal infections, often colitis in which they have heavy diarrhea. All of the treatments for colitis kind of boil down to the same thing: replacing their ongoing losses and letting the intestine heal itself. It doesn’t matter if it’s colostrum or salmonella or Potomac Horse Fever or any other kind of infection.”

Colitis case receiving fluids.

What each of those types of colitis cases also have in common is the need for the aforementioned isolation stalls. These USDA approved stalls can also become necessary in the second most common type of internal medicine cases seen at PBEC: respiratory diseases.

“Isolation is important for any infectious disease, and the two big ones that are the most common are colitis and respiratory problems – things like influenza,” explained Dr. Heidmann. “If there were ever to be an influenza outbreak, we have the ability to isolate horses in their own air supply. They’re breathing fresh air. You can have them just a stall or two away from each other, but they’re breathing their own air; it’s not cross-contaminated. That’s something extremely important we’re able to offer.”

Veterinarians exploring inside a patient with a scope.

The third most frequently seen disease pertaining to internal medicine are those of the neurological system, an area in which PBEC has recently become even better equipped to offer correct diagnosis and treatment options.

“We have an incredible ability to do advanced imaging and diagnostics on neurologic conditions,” said Dr. Heidmann. “Most vets even in the field can do neck x-rays, but we can do neck x-rays with contrast, so myelograms. More importantly, with the new standing CT, we can do CT scans of the head and neck, and CTs of the head and neck with contrast, so basically, a CT myelogram. It really ups our ability to diagnosis a condition.”

With the acquisition of a new standing CT scanner, PBEC is able to locate problems on not only the top or bottom of a horse’s neck, but also on the sides of the neck – an area previously inaccessible to view even from myelograms under anesthesia.

“Being able to go around and around with the CT, allows us to see things that are not just up and down, but it allows us to see things that are left and right on an image. It ups our ability to diagnosis problems substantially,” said Dr. Heidmann. “That’s part of the satisfaction of the job that I do. It’s not just ‘here is my experience. Here is what I guess is going on.’ I use that, but then I have at my fingertips all of these options for diagnostics and tests. We can confirm our clinical suspicions and then do treatment based on that.”

Meet PBEC Internal Medicine Specialist Dr. Peter Heidmann

One of the characteristics that is repeatedly praised and recognized as one of Palm Beach Equine Clinic’s greatest strengths is the great pool of talented professionals from all specialties that make up the clinic’s large team. In 2016, Dr. Peter Heidmann, DVM, MPH, began working with PBEC for the winter season, and this year, the accomplished internal medicine specialist is returning to work with PBEC for the duration of the 2018 winter season.

Dr. Heidmann graduated from Tufts University with his veterinary degree in 2000 before beginning a one-year internship in equine medicine and surgery at Arizona Equine, followed by a one-year surgical fellowship at Oregon State University, followed by a residency for internal medicine at the University of California, Davis, which he completed from 2002 to 2005. In 2005, Dr. Heidmann joined a private equine practice in Montana, and today he is the owner and hospital director of Montana Equine. 

Q: What prompted you to pursue equine veterinary medicine in particular?

I knew I wanted to be a vet for a long time, but I didn’t know that I wanted to practice more individually focused medicine until I was going through vet school. It wasn’t until my fourth year, where you’re actually starting to work with patients, that I made that realization. I started moving in that direction, and I had some faculty that saw the same for me and encouraged me to do the horse stuff.  I always loved working with horses, but up until that time, I thought my background was too agricultural to do high-end sport horse work.  But their encouragement helped me realize that wasn’t true.   Then, I decided as a result of that realization and thought process, that I wanted to do an internship and residency to become specialized in internal medicine.

Q: What led you to Montana, and how has your role and practice evolved from when you started there in 2015 to today where you’re now the owner and hospital director of Montana Equine?

When I finished my residency at Davis in 2005, I wanted to be in the west. I wanted to be somewhere where there was nobody with my skill set – meaning internal medicine. I wanted to be in a small mountain town basically. Somewhere that I could practice the kind of medicine that I was trained to do but not in big metropolis. So, I narrowed it down to a practice in New Mexico and a practice in Montana. I went to work for a practice in Bozeman, MT, in July of 2005 and six months later my predecessor, Dr. Dave Catlin, passed away in a car crash. It was really sad. He had three kids, left a widow, and it was his dream to start an equine only specialty vet hospital, which he had done in 1999.

When he died, the conventional wisdom around Bozeman was, ‘Well this can’t be done. Dave had a dream, and it’s not a realizable dream now. There aren’t enough people here. Montana residents won’t understand specialized medicine and they won’t pay for it.’ I was faced with this proposition of leaving the practice after just arriving there, but I knew that was where I really wanted to be. I basically picked up the pieces of Dr. Catlin’s practice and formed Montana Equine in February of 2006.

Now we have a 7,500 square foot hospital with a surgery site at Bozeman, and I have a partner there, an associate, and two interns. We have two satellite locations: an ambulatory-only satellite in Helena, MT, and have nearly completed satellite clinic building in Billings, MT, which is the largest community in Montana.

Dr. Heidmann participated as one of the founding veterinarians in Montana State University’s bioregions program to Mongolia in 2014.

Q: You began working with PBEC during the 2016 Winter Equestrian Festival (WEF) season, but you’re out in Montana and have your own practice there. How did that relationship come about, and what does it look like today?

There are various aspects to that. We’re very quiet in Montana from basically Thanksgiving through March, and it’s not really my personality to sit around. That’s one aspect, and another is from a business perspective, it allows me to bring more vets on and keep them year-round. A third element is the desire to do more high-end medicine, and a fourth element that led me to Wellington, is my wife, Allison, who is a professional jumper rider. Two years ago, during the winter of 2015, Allison had a girlfriend who had just had a baby and asked Allison to run her business for her here at WEF. I thought that was an interesting idea and started talking to PBEC and found that there might be a need for a internal medicine specialist in their group. So that’s when I started coming. At that point, I was in Wellington for four or five days and then home for ten days, back and forth and back and forth. Then last year, I was more of a week here and a week at home. We had our first child, so Allison and Oliver, who was brand new then, were here straight through, but I went back home to Montana as well. The need is there and the relationship is great. So, this year, I’m in Wellington full-time for the WEF.

Q: What do you enjoy most about having the opportunity to practice with PBEC?

It’s a huge group of people, so there are a lot of personalities. When you have a lot of different personalities, you have a lot of different perspectives on treatments, and that’s interesting and fun. It means that every year when I’m here, it’s pretty dynamic. Back in Bozeman, I have a great team, but I’m the leader of the team. I’m the oldest and the most experienced. That’s good, and that’s not to say that those guys don’t definitely come with new ideas, but being here, there are so many ways of doing things that I end up picking up new tricks or new ideas even though I’ve been practicing for most of two decades. So here at PBEC, I’m picking up new strategies and new techniques separate from new stuff coming out in the world – just different ways of doing things, and different experienced veterinarians to bounce ideas off of. That’s really refreshing and stimulating.

From a vet’s perspective, with the Wellington demographic there is sometimes less of a limitation on budget and expense, so we’re really able to set that factor and worry aside and instead focus solely on what is best for the patient. The limitation isn’t financial; the limitation is just medicine and what we are able to do, which is exciting and allows us to see great results.

Q: Have you had any favorite cases or standout moments during your time with PBEC thus far?

I won’t name any in particular, but what I really enjoy are the challenging medical cases, the internal medicine cases that tend to be really sick and that you’re able to fix. The most common ones that we see are probably sickness after colic surgery, horses with really bad diarrhea, so colitis cases, followed by foals. Those cases generally all have a lot of things going on in a lot of different organ systems. So, there are a lot of factors to balance. Internal medicine people like me are kind of inherently nerdy, and we really get into what’s happening with the acid base status, and electrolytes, and blood gases, and fluid volumes, and other technical aspects of sick horse medicine.

Q: What do you enjoy doing outside of work?

In South Florida, we’re basically working all the time this time of year, so not as much here except trying to get exercise and be fit. I like to ride a bike or go for a run. At home, the Gallatin Valley – which is where Bozeman is – is surrounded all around by mountains. The valley floor at Bozeman is at about 5,000 feet, and the peaks are at 8,500, so you can do a lot of really serious hiking. Our son is only 18 months old, but he loves it. I’ve had dogs in the past where their whole personality changes when you get out of town, and that’s what Oliver is like too. It’s almost like his whole face is a different face when he’s out there.

PBEC Success Story: Beatrix

Any horse owner’s worst nightmare is realized when their mount begins to show the dreaded signs of colic. For Jody Stoudenmier, a Wellington, FL, resident and avid dressage rider and horse owner, she knows the symptoms all too well.

Stoudenmier owns an 11-year-old American-bred Dutch Warmblood mare that joined her string at the end of 2016 and has competed through the Intermediate II level. Sidelined by a suspensory injury last year, Beatrix was prescribed stall rest to aid in her recovery by Dr. Robert Scott of Scott Equine Services based in Ft. Lauderdale, FL. An unfortunate but common side effect of the necessary stall rest was colic. Beatrix suffered from six bouts of colic that were resolved without surgery when Dr. Scott referred Stoudenmier and Beatrix to Palm Beach Equine Clinic (PBEC).

“She is such a wonderful mare; a nice mover, very athletic, sweet, sensitive, and easy to handle in the barn,” said Stoudenmier of the mare that regularly competes at the Adequan Global Dressage Festival in Wellington, FL, during the winter season. “When she was recovering from her injury we tried everything to prevent her from colicking – diet, medications, hand walking – but, nothing seemed to be working.”

It was then that PBEC’s own board-certified surgeon, Dr. Weston Davis, suggested a laparoscopic surgical approach.

“Her colic had never progressed so far that we needed to do surgery before,” explained Stoudenmier. “But, at that point, I was open to anything! After speaking with Dr. Davis, I immediately had a positive feeling about it.”

Beatrix ready to return to work. Photo courtesy of Jody Stoudenmier

The procedure that Dr. Davis suggested was an endoscopic ablation of nephrosplenic space. In layman’s terms, as a result of Beatrix’s colic, her colon was essentially getting caught or entrapped over the nephrosplenic ligament, which connects the left kidney to the spleen. When the colon is entrapped in this position, its contents cannot move through it and the colon becomes distended, causing the horse considerable pain, and the inevitable colic.

Dr. Davis’ solution was to close or perform an ablation of the nephrosplenic space to prevent further entrapment. The procedure can be conducted endoscopically where the horse does not have to be anesthetized, but undergoes a standing surgery with sedation and local anesthesia. A small incision is made in the left flank and the laparoscope is inserted through a smaller incision close by. The nephrosplenic space is then sutured closed so that the trough that forms the space between the kidney and spleen is obliterated and can no longer entrap the colon.

On October 9, 2017, Beatrix underwent a successful ablation of the nephrosplenic space at the hands of Dr. Davis.

“In the past, I have had several horses undergo surgery where they had to be anesthetized and it was very difficult to get them standing again after surgery,” said Stoudenmier. “We did not have that worry with Beatrix and the approach absolutely made a difference in her recovery.”

Beatrix remained at PBEC for a week and a half after surgery to jump-start her recovery before returning home to Stoudenmier, who has managed her post-surgery care with the help of both Dr. Davis and Dr. Scott.

“Dr. Davis was absolutely wonderful to work with,” said Stoudenmier of her experience at PBEC. “He listened to my concerns, was patient, and kept his mind open.”

Dr. Davis paid a visit to Beatrix in mid-November to perform an ultrasound and together with Dr. Scott approved the mare to return to work. Stoudenmier has begun to introduce trot work into Beatrix’s routine and is optimistically expecting a full recovery, saying, “She looks super and everything looks good for the next two months. My goal by the end of the season is to get her back in the show ring!”

Meet PBEC Veterinarian Dr. Natalia Novoa

Dr. Natalia Novoa was born in Nashville, TN, and raised in Colombia, where she graduated from the University of La Salle. Upon returning to the United States, Novoa validated her degree in both the U.S. and Canada and received her chiropractic adjustments qualifications in Kansas and studied acupuncture in Florida. Novoa joined the Palm Beach Equine Clinic (PBEC) team for a short period in 2000, before spending several years following the hunter/jumper horse show circuit in Canada, Colorado, and Ocala, FL. She then re-joined the PBEC staff in 2011, and, with her veterinary license in Florida, Kentucky, North Carolina, and Canada, Novoa has been a valued member of their team ever since.

Photo by Erin Gilmore

Q: How did you decide that you wanted to pursue veterinary medicine?
I have enjoyed having animals in my life since I was very young, but what was key to me deciding to pursue veterinary medicine was having a farm where I was able to gain skills and real world experience that would prove handy down the road. I was able to practice with real medical cases and acquire knowledge in operational management, and it was an introduction to the lifestyle, because it requires patience, hard work, commitment, determination, and accountability. It was a valuable opportunity to work hands on in the environment with the veterinarian of my farm, absorbing, assimilating, and getting familiarized with the vet skills that were the building blocks for my future. He made me realize that veterinary medicine would fit me perfectly. That helped me set the foundation for my career, and since then, I didn’t have to look any further!

Q: What led you to PBEC?
I think of it like this: if I want to become the best at what I do then I have to work with the best, and I picked PBEC. They say, “Leadership is not about a title or designation. It’s about impact, influences, and inspiration.” Palm Beach Equine assumes the leadership role, chases the latest trends, and evolves continuously. In addition, we have a great team of skilled vets and staff who try to expand their vision and abilities to achieve success.  

I have to say I have had a great seven horse show seasons with Palm Beach Equine, and I’m looking forward to an eighth one. When you are doing what you love and you are working with great horses, time flies.

Q: What is your primary area of focus?
I focus on sports medicine and lameness, combining conventional medicine with alternative medicine; this includes chiropractic adjustments, acupuncture, and herbal therapy. To me those are great alternative tools for diagnosis and treatment. I have to say, they help you to look at a horse or a dog in a different way, and you have more tools and options. Regardless of the case – lameness, pain management, internal medicine, etc. – I have different choices to achieve results in those situations.

I perform chiropractic adjustments, acupuncture therapy, and laser treatments to small animals as well. Most horse people have dogs, so I’m able to take care of their companions too.

Q: What is a typical day like for you at PBEC?
It’s a busy agenda every day with continuous juggling. I’m usually dealing with lameness (involving diagnosis and treatment), doing pre-purchase exams, chiropractic adjustments, acupuncture therapies on horses and dogs, performing laser treatments, and at the end of the day, doing paperwork. Depending on the day, I could be doing FEI treatments, vet shift at the horse show, donating vet work at Vinceremos Therapeutic Riding Center, or dealing with an emergency. We’re a very mobile practice able to go from farm to farm and horse show to horse show (Kentucky; Tryon, NC; Ocala, FL), so I’m moving around a lot.

Q: What is your favorite part of the job?
There are so many aspects that I enjoy: working outdoors, closely with animals on a daily basis, and diagnosing and dealing with different issues to overcome problems; the privilege of working as a team with the clients and trainers and creating a great, close relationship with them; the connection with the animals and how they show you how grateful they are, and being able to see the improved outcome. There’s great satisfaction in successfully applying my knowledge and skills to a make a difference in someone’s life.

Q: Have you had any standout, favorite moments since beginning to work at PBEC?
When I had double success treating a ‘mystery’ case of a horse in which the owner was losing hope because other treatments were not showing good outcomes, and also treating her dog that was crying and unable to get in the car. The animals and owners were both happy and thankful. “For it is in giving that we receive” – having a positive impact on someone is correlated with high levels of overall job satisfaction.

Q: What do you enjoy doing outside of work?
I enjoy traveling with my daughter, Lola, and visiting my parents and siblings that live in different countries. I also love dancing to Latin music, running, playing tennis and squash. I’m a pretty competitive squash player, so I welcome any challengers!

Palm Beach Equine Clinic Provides the Best in Emergency Colic Care

Fear of colic is in the back of many horse owners’ minds, but with the expert care of Palm Beach Equine Clinic, owners can rest easy knowing that they have some of the world’s best surgeons and veterinarians at their disposal in the event of an emergency.

Characterized by abdominal pain or problems with the gastrointestinal tract, colic is something that often arises unexpectedly and from many different origins. Spoiled feed, abrupt changes in feed, parasite infestation, sand ingestion, lack of water consumption, and even excess stress or changes in the weather are among the numerous causes generally related to colic.


Whatever the cause may be, the most important step any owner can take is to recognize the symptoms as early as possible and immediately call their veterinarian. Pawing, rolling, looking at abdomen, sweating, loss of interest in food and water, and absence of gut sounds in any of the four quadrants are some of the telltale signs of colic development. Unfortunately, colic can be fatal, but the proper knowledge and care may save your horse’s life. The sooner your veterinarian gets involved in treatment, the better your horse’s chance of survival.

In the event of an emergency, the veterinarians and surgeons of Palm Beach Equine Clinic are available 24/7 to offer the very best care for your equine partner. PBEC is renowned for its referral full-service surgical center and intensive care hospital located in the heart of Wellington, Florida. Board-Certified surgeons, primary care veterinarians, and skilled hospital technicians are scheduled 24 hours a day, 365 days a year to treat, monitor, and care for critical cases. With world-class veterinarians and a full staff of highly trained technicians, both clients and patients of PBEC are in the best hands possible.

Palm Beach Equine Clinic offers the latest in technology as the surgical techniques are less invasive and result in faster recovery times for your horse. The surgical team leader, Dr. Robert Brusie, is a nationally renowned, Board-Certified surgeon. Dr. Brusie’s surgical specialties include orthopedic, arthroscopic, and emergency cases. Dr. Brusie has been the head surgeon with PBEC for the past 20 years.

“In the last ten years, colic surgery has come a long, remarkable way,” Dr. Brusie stated. “With our clients, if the horse needs to go to surgery, we get an approximately 95% success rate. We attribute that to the client’s excellent care of their horses, as well as their knowledge to contact us immediately. That being said, colic surgery is always the last resort. We try to help all horses improve medically first.”

Palm Beach Equine’s surgical suite and staff is prepared to handle all types of emergencies, day and night. The large team of more than 30 veterinarians includes three Board-Certified Surgeons who rotate on-call duties so every day is covered. This aids Palm Beach Equine veterinarians and all of Southeast Florida with the ability to treat their emergencies requiring surgical assistance as quickly as possible. The state-of-the-art intensive care hospital is equipped with top-of-the-line medical equipment, including digital video cameras for the clinicians to easily monitor their patients from any location, at any time.

For more information on the Palm Beach Equine Clinic facility or in case of an emergency, please call (561) 793-1599 to contact an on-call veterinarian.

Meet Dr. Meredith Hustler

Dr. Meredith Hustler is one of the newest additions to Palm Beach Equine Clinic, having joined the team in June of 2017. Originally hailing from New Jersey, Hustler completed her undergraduate degree in Equine Science at Centenary College while simultaneously riding as a member of their Intercollegiate Horse Shows Association (IHSA) team. Hustler then graduated from the Ross University School of Veterinary Medicine in 2016. Learn more about Hustler here:

 

What is your background with horses?
Both of my parents are ministers, so I come from a non-horse family, but I begged my mom for riding lessons as a kid. From there, I got involved in the show jumping community in the Ocean Grove, NJ, area where I was growing up. I stayed in the show jumping world up until I became a veterinarian. I worked as a rider and an FEI groom for various professionals, including about seven years with Gabriella Salick, a show jumper from the West Coast. With Gabby, I had the opportunity to take care of her horses at World Cup Finals, the Olympic trials, Spruce Meadows, and top horse shows all over the country. She really taught me how to be a good horseman too, which I think has been really invaluable to me now as a veterinarian.

How did you then decide to pursue veterinary medicine?
I’ve always been quite interested in science, as well as the horse. I’ve always loved animals, and I wanted to be able to help horses, as well as the professionals and owners, involved in the industry. You do that as a groom and rider to some extent, but it’s different being a veterinarian. I’ve always felt like it was my mission in life to help horses and the people involved with them, especially in this capacity.

What led you to Palm Beach Equine Clinic?

I knew Dr. Richard Wheeler and Dr. Bryan Dubynsky and knew of Palm Beach Equine from my involvement in show jumping, so when it came time to do an externship when I was in vet school, I did it at Palm Beach Equine. Then, while I was extern-ing, I applied for the clinic’s internship position, and I got the internship position. Then, during my internship, they offered me an associate position. I got the externship, and I was able to make my way up from there. During the externship, I remember thinking, ‘I really want to intern here,’ and then when I was interning, I was thinking ‘I don’t really want to leave.’ I love the practice. I like the demographic of the horses that we get to work on, the people that are involved, and the sense of community. You’re surrounded by colleagues that you can work with; you can always ‘phone a friend.’ It’s a really inviting and helpful atmosphere to learn and work in.

What is your favorite part of the job?

I mentioned the demographic of the horses that we’re working on – the caliber of them is really just incredible, and getting to work on the horses that we do is such a privilege. Outside of that, I focus a lot on lameness, alternative therapies, internal medicine, and I’m acupuncture certified, which I really enjoy. I’m a big advocate of acupuncture as a non-invasive way for the horse’s body to heal itself, as well as a nice addition to other kinds of treatments to promote overall well-being and health.

Outside of work, what do you enjoy?
I’m married to a great guy named Samuel, and we spend a lot of time outdoors and with our three dogs. We’re big beach people, and we love the ocean, paddle-boarding, yoga, hiking, biking – just getting out and enjoying being outside.

Meet PBEC Veterinary Dr. Michael Myhre

Dr. Michael Myhre was born to be a veterinarian. In 1978 his father, Dr. Grant Myhre, developed a referral practice, Myhre Equine Clinic in Rochester, NH. After working alongside his father since middle school, Michael, who hails from Milton, NH, believes he was always destined to be a veterinarian. Michael graduated from Cornell University College of Veterinary Medicine based in Ithaca, NY, in 2016, and he joined the Palm Beach Equine Clinic (PBEC) team thereafter as their surgical resident to work under the direction of Dr. Robert Brusie, Dr. Jorge Gomez, and Dr. Weston Davis.

Learn more about Dr. Myhre:

What is your background with horses?

I grew up in my father’s practice. He would bring me along to see outpatients and cut colics at 2 a.m. When I was in high school and college, I would work there during the summers as a technician. I kept learning from him and when it was time to decide what I would do, I applied to vet school.

We had some lesson horses at home and taught some therapeutic riding, so I rode on the trails occasionally, but I knew I was always supposed to be a veterinarian.

Where did you complete your undergraduate degree?

I attended Ithaca College in New York and studied computer science. It is a pretty unusual undergraduate degree for a veterinarian, but I did not want to go the traditional route of getting a biology degree. Computer technology is now involved in a lot of veterinary medicine – so much of what we do is going through computers, so it is an asset to have that degree.

I still took all the biology and chemistry classes at the same time, and I finished in three years. At that point, I applied to Cornell University and was accepted.

What led you to Palm Beach Equine Clinic (PBEC)?

I came here because it is the best residency program in the country. I have a big case load and get to work on the best horses in the world. I started on July 1 and what I like the most is the diversity in cases. We have seen hunters, jumpers, dressage horses, and race horses. I have done everything from condylar fracture repairs to MRIs, nuclear scintigraphy, x-rays, and even colic surgery on a miniature horse. PBEC stays at the forefront of technology with a new standing surgery pit, standing MRI machine, and paperless medical records.

What goals do you have for your veterinary career?

After my three-year residency at PBEC, I plan to move back to New Hampshire and work at my father’s practice.

What can we find you doing when you’re not working?

I am pretty much always working, but my girlfriend is a neurology resident in Manhattan, so I try to visit her as much as I can, or I take advantage of living in Florida and go swimming.

Name one thing most people wouldn’t know about you? 

I rowed for the Ithaca College crew team and while I was in vet school, I was an assistant coach for the Cornell University team.

 

Understanding the Equine Neck With Dr. Richard Wheeler

In the past, when a horse’s gait has felt off or lacking in its usual impulsion, it was often assumed to be an issue of lameness. Now however, thanks to the improved diagnostics readily available at the Palm Beach Equine Clinic (PBEC) and other top clinics around the world, veterinarians are able to more accurately pinpoint the problem area. Perhaps surprisingly, it’s not always in the legs or hooves. With increasing frequency, the horse’s neck is being diagnosed as the root of the issue.

The Anatomy of a Neck and What Can Go Wrong

In order to understand the problems that can arise in association with the horse’s neck, it’s important to first understand the anatomy.

The neck is composed of seven cervical vertebrae running from the head to the thorax, named C1 through C7, and each articulating with each other. The primary purposes of the neck are to move the head and to protect and transport the spinal cord and nerves, which run through the middle of the vertebrae.

Such a major role as the protection of the nerves and spinal cord can also come with some major risks and complications, with clinical signs of these problems generally presenting themselves either neurologically, as neck pain, or as lameness in the front legs. These more specific symptoms may include:

  • Ataxia or clumsiness – Ataxia is defined as the “lack of control of bodily movements”. In the case of an ataxic horse, you may begin to notice staggering, sudden loss of balance, or even an inability to remain upright. Ataxia is generally an indicator of a neurological condition or damage to the spinal cord itself, caused by either developmental issues, trauma, or an infectious disease such as equine protozoal myeloencephalitis (EPM). Such neurological cases can often be the most debilitating.
  • Lameness – You can think of the spinal cord and the nerves in the neck like an interstate, with the spinal cord itself acting as the major highway. As you are “driving” along the interstate, every so often there are little exits, which is where the other nerves come out. Should there be any impingement on the interstate or spinal cord itself, you’re likely looking at more severe complications – much like an accident on the highway. Should there be impingement on the nerves coming off of the spinal cord, it will more likely present itself like an accident a little way off an exit – not affecting the interstate itself, but possibly causing problems that spread elsewhere. That is where we see lameness issues arise.

This can be more difficult to pin down, but can often be due to pressure on the smaller nerves that pass through the openings in the vertebrae and supply the front legs. Arthritis of the articular facet joints of the vertebrae is another common reason for lameness, as anytime these joints become arthritic or inflamed, it can easily translate to the forelimbs.

  • Neck Pain – This will often go hand-in-hand with lameness, as factors such as arthritis of the articular facet joints can lead to both symptoms. Other possible reasons for neck pain include trauma or inflammatory diseases.

Diagnosing the Problem

Neck problems, particularly those related to lameness, are generally diagnosed through a process of exclusion, first performing nerve blocks to or ruling out lower regions of the horse’s body. Palpation of the neck, testing of the neck’s movement, and full neurological exams may also be performed in addition to a full lameness exam, depending on the horse’s symptoms.

Once other regions of the horse are ruled out as the location of the problem, veterinarians are now able to use diagnostic images such as radiographs, nuclear scintigraphy and standing CT scans to specifically locate problems in the neck like never before.

In years past, those diagnostic resources were left for last-ditch cases when veterinarians really could not pinpoint any other problems. Today, with the advent of more modern technology, better radiographs, better ultrasound machines, and the more advanced imaging of nuclear scintigraphy and CT scans, veterinarians are able to readily utilize advanced diagnostics to save time and money, and to find the root of the problem more quickly and accurately.

The neck is one of the areas that has most clearly benefited from the progression in advanced imaging. While neck problems have likely been prevalent for some time, veterinarians are now finding those diagnoses more common, as they are able to more accurately locate the issue – particularly at clinics like Palm Beach Equine Clinic. Often these issues will go undiscovered or undiagnosed in the field, but they can be identified at PBEC, thanks to the readily available imaging tools.

As an example, if arthritic factors are suspected, nuclear scintigraphy can be used to look for areas of increased bone turnover. On the resulting bone scan, veterinarians are looking for areas where there is an increased calcium uptake because the bone is actively remodeling. These areas will appear darker on the scan and are generally a good indicator of a boney injury or arthritis, with the darker “hot spots” often appearing above the articular facet joints.

Also new and groundbreaking for the diagnosis of equine neck problems is the use of a Computerized Tomography or CT scan, with the ability to scan a standing horse with light sedation on the near horizon which will be available at the clinic this upcoming winter season.

Treatment

Once a solid diagnosis is arrived upon, the proper treatment protocols can be prescribed. Depending on the root of the problem, possible treatments may include shockwave therapy, regenerative therapies such as interleukin-1 receptor antagonist protein (IRAP) therapy or platelet-rich plasma (PRP) therapy, or one of the most common treatments, injections of the facet joints.

In the case of facet joint injections, veterinarians at PBEC are able to medicate under ultrasound guidance, guiding a needle into the joints and delivering corticosteroids or similar medication. Surgery is also an option as a final approach to severe complications.

In milder cases, treatments may also just call for increased time off, chiropractic treatments, or the administration of non-steroidal anti-inflammatory (NSAID) medications.

If you suspect any issues with your horse’s neck, contact Palm Beach Equine Clinic any time by calling (561) 793-1599 to schedule an appointment.

 

Success Story: Freeman

In January 2016, the Pine Hollow team noticed something seemed off just before driving out of the Winter Equestrian Festival (WEF) with their horses. Stopping to check the horses before continuing off the showgrounds, Pine Hollow discovered Freeman, a promising and successful Dutch Warmblood, had swung his hind leg over the back of the trailer. Freeman’s stifle had ended up squarely on one of the hooks used to secure the back door, lodging the hook into his stifle and into the femoropatellar joint.

Recognizing the extreme peril facing Freeman, Pine Hollow immediately called for help from Palm Beach Equine Clinic (PBEC), the official veterinarians of WEF.

“It took tremendous effort, creative thinking, and exceptional teamwork to free Freeman from the hook impaling his leg,” said David Blake, Pine Hollow’s internationally acclaimed rider and trainer. “PBEC sent several of their top vets to help us rescue Freeman. The team of vets is truly great.”

Thanks in very large part to the help and determination of the vets, Pine Hollow and PBEC were able to free Freeman from the trailer door.

From there, Freeman was transported to the nearby Palm Beach Equine Clinic, where he spent a few days trying to recover before it was agreed to pursue arthroscopic surgery on his femoropatellar joint.

“To be honest, it wasn’t looking good at all for the first day or so Freeman was there,” said Blake. “The joint was so severely damaged we didn’t know if it could be fixed. Our only chance of fixing the joint was surgery, so we agreed we would try everything possible.”

Dr. Weston Davis performed the surgery, after which Freeman remained in PBEC’s care while he regained use of the leg.

“The team did a fantastic job there and kept Freeman until he was ready to begin long-term rehab with James Keogh,” said Blake.

When Freeman was finally ready to return home to Pine Hollow, Blake hoped at best Freeman would eventually be able to do light work and perform at a low level.

12/07/2017 ; Tryon NC ; Tryon Summer VII ; 50, FREEMAN, DAVID BLAKE ; 1m40 ; Sportfot

Freeman, however, continued to defy all the odds. Following the successful arthroscopic surgery and a very gradual return to work, Freeman is not only doing ‘little stuff,’ but has returned to jumping at the 1.40m level. On Saturday, August 27, at the Tryon International Equestrian Center, he jumped his first grand prix since the injury.

“He definitely defied all odds and expectations and came back to his level!” said Blake. “Regina Daniels, who works for me, did all the rehab riding with him, and she did a great job. She took him from walking and hand-walking, right back up to jumping little jumps. Regina spent a long time doing it, about a year, which I think was the key. When Freeman came back to me, we continued to build him up slowly back to the level he was at before.”

Throughout his recovery and gradual return to work, Freeman was carefully and routinely monitored by the Palm Beach Equine team including Dr. Weston Davis and Dr. Richard Wheeler. The vets evaluated Freeman every couple of months and took periodic x-rays to assess if, or by how much, he was improving and what might be the appropriate level of work at the time for the gelding.

“It was important to make sure that we weren’t pushing anything too soon,” explained Blake. “What was really incredible to see develop and return over time was his muscle. After the injury, the muscle of his whole left side was like looking at a different horse from his right side. Now you look at him or stand behind him, and you wouldn’t even pick a side.

“I think he wanted to come back, because his recovery has truly been remarkable,” concluded Blake. “Touch wood, it’s been a pretty quiet injury. I think the horse knows he was lucky. I can feel it. Funny, when he came back he was almost a different horse in his personality a little bit. I can feel that he’s appreciative to be home, and he knows he’s lucky. He’s really trying to do everything that he can now to be good. I think he’s found a new respect for life.”