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Year: 2017

Meet PBEC Internal Medicine Specialist Dr. Peter Heidmann

Dr. Peter Heidmann Palm Beach Equine Clinic Veterinarian

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

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. Peter Heidmann, DVM, MPH Palm Beach Equine Clinic
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 Palm Beach Equine Clinic 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 Palm Beach Equine Clinic and found that there might be a need for an 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 Palm Beach Equine Clinic?

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 Palm Beach Equine Clinic, 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 Palm Beach Equine Clinic 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, electrolytes, blood gases, fluid volumes, and other technical aspects of horse medicine.

Q: What do you enjoy doing outside of work?

While in South Florida, we’re basically working all the time, 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.

Palm Beach Equine Clinic 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, she knows the symptoms all too well.

Beatrix success story palm beach equine clinic colic surgery
Beatrix looking happy and fully recovered from her surgery.

Patient History

Stoudenmier owns an 11-year-old American-bred Dutch Warmblood mare that joined her string of horses 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.

“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 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 Palm Beach Equine Clinic’s 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.”

Dr. Davis’ Surgical Procedure

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. Weston Davis surgery palm beach equine clinic

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.”

Post-Surgery Care and Recovery

Beatrix remained at Palm Beach Equine Clinic 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 Palm Beach Equine Clinic. “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 Navoa
Palm Beach Equine Clinic Veterinarian Dr. Natalia Navoa

Dr. Natalia Novoa was born in Nashville, TN, and raised in Colombia, where she graduated from the University of La SalleUpon 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.

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 seven great 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.

Palm-Beach-Equine-Clinic-Acupuncture-Alternative-Medicine-Therapy-Natalia-Novoa-1

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.

Colic 101

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.

Colic Symptoms

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 abdominal 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.

Dr. Weston Davis surgery palm beach equine clinic

Emergency Colic Care

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. Palm Beach Equine Clinic 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 available 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 Palm Beach Equine Clinic are in the best hands possible.

Surgical Capabilities

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 40 veterinarians includes three Board-Certified Surgeons who rotate on-call duties so every day is covered. This aids Palm Beach Equine Clinic 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.

Meet Palm Beach Equine Clinic’s Dr. Robert Brusie

Need Emergency Colic Care?

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 Mitchell Hustler

Dr. Meredith Mitchell Hustler Palm Beach Equine Clinic Veterinarian
Dr. Meredith Mitchell Hustler

Dr. Meredith Mitchell 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.

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 showjumping community in the Ocean Grove, NJ, area where I was growing up. I stayed in the showjumping 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 showjumper 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 showjumping, 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 demographics 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 demographics 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 Surgical Resident Dr. Michael Myhre

Dr. Michael Myhre Palm Beach Equine Clinic Veterinarian Surgeon

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, Dr. Myhre, who hails from Milton, NH, believes he was always destined to be a veterinarian. Dr. Myhre graduated from Cornell University College of Veterinary Medicine based in Ithaca, NY, in 2016, and he joined Palm Beach Equine Clinic thereafter as a surgical resident to work under the direction of board-certifed surgeons Dr. Robert Brusie, Dr. Jorge Gomez, and Dr. Weston Davis.

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.

Dr. Michael Myhre Palm Beach Equine Clinic Veterinarian Surgeon

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?

I came here because it is the best residency program in the country. I have a big caseload 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 racehorses. I have done everything from condylar fracture repairs to MRIs, nuclear scintigraphy, x-rays, and even colic surgery on a miniature horse. Palm Beach Equine Clinic 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 Palm Beach Equine Clinic, I plan to move back to New Hampshire and work at my father’s practice.

Michael Myhre surgery palm beach equine clinic standing

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.

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.

Emergency Veterinary Care

Recognizing the extreme peril facing Freeman, Pine Hollow immediately called for help from Palm Beach Equine Clinic, 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. “Palm Beach Equine Clinic 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 Palm Beach Equine Clinic were able to free Freeman from the trailer door.

At the Equine Hospital

From there, Freeman was transported to the nearby Equine Hospital, where he spent a few days recovering 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 Palm Beach Equine Clinic
Dr. Weston Davis of Palm Beach Equine Clinic.

Dr. Weston Davis performed the surgery, after which Freeman remained in Palm Beach Equine Clinic’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.

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 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 the Equine 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.

A Link Between Neck Issues and Lameness

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 Palm Beach Equine Clinic 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 Palm Beach Equine Clinic 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: Rescue Pony Amazing Grace

On the morning of December 30, 2015, Laurie Waggoner, director of rescue operations and founder of the South Florida SPCA, got a call that she gets all too often. Agriculture patrol had received reports of three emaciated horses in Miami Gardens, FL, that needed immediate care. Waggoner took action and hooked up her truck and trailer to make the drive to pick up the three horses. When she arrived, she found an Arabian and a Quarter Horse, both severely underweight, and a pony she estimated to be two years old laying in the mud, too weak and malnourished to even stand.

Amazing Grace South Florida SPCA Rescue Pony Palm Beach Equine Clinic

The pony, who was quickly named Amazing Grace or “Grace” had been down for more than 24 hours. Despite Waggoner’s best efforts, her team was unable to get Grace on her feet and decided the most humane option was to end Grace’s suffering. Calls went out to local veterinarians, but were met with a slow response the day before New Year’s Eve. While they waited for a veterinarian to become available, Waggoner and her team rolled Grace onto a blanket and carried her onto a trailer to make the trip back to the South Florida SPCA.

“When we pulled her off the trailer, she immediately started grazing,” said Waggoner. “The vet was on the way to euthanize her, but I saw that there was fight still left in her. We were able to pick her up and she stood with help. She was not ready to go.” Grace was made comfortable in a stall at the South Florida SPCA and stood with assistance over the next day. But, on the second day, she was no longer willing or able to make an effort to stand.

treatment veterinarian Amazing Grace South Florida SPCA Rescue Pony Palm Beach Equine Clinic

“I knew we were going to need help, but it was a holiday and locally everything was closed,” said Waggoner. “I called Palm Beach Equine Clinic (PBEC) and they told me to bring her right in.” Grace arrived at PBEC on New Year’s Day and was greeted by a team of veterinarians led by Dr. Scott Swerdlin, president of PBEC. She was treated for extreme starvation and neglect, which included constant blood work to monitor organ function, the administration of fluids, several meals of senior feed and alfalfa each day, and a lot of compassion from PBEC veterinarians.

Watch Amazing Grace’s Full Story

“She spent eight days at PBEC and returned to the South Florida SPCA ranch with the same will to live,” said Waggoner. “Five days later, I came out in the morning and she was standing on her own.” Grace was completely rehabbed in four months and put up for adoption at the end of 2016. On December 31, 2016, one year after she was found on the brink of death, Grace made her way across the U.S.-Canadian border to her new home at Sherwood Farm in St. Catharines, Ontario, with adopter Marilyn Lee.

show pony Amazing Grace South Florida SPCA Rescue Pony Palm Beach Equine Clinic

“I knew she would need special handling to give her the chance to succeed, which we were fully prepared to do,” said Lee, who also adopted a Thoroughbred from the South Florida SPCA in 2012. “I saw her current photo on South Florida SPCA’s Facebook page and thought, ‘Now there is a lovely pony’. Then I saw the photo of her laying in the dirt, and that was that.” One of Lee’s young riders, Abby Banis, had also learned of Grace’s story on social media and was waiting for the pony in the early morning hours the day she arrived at Sherwood Farm.

The two have been inseparable ever since. Grace’s training began immediately under the direction of Lee’s daughter, Robin Hannah-Carlton. Impressed by the pony’s love for jumping, Lee made plans to start showing Grace. The rescue pony won a reserve championship in the pony hunter division at the very first show she competed in with Banis in the irons.

Today, Grace is happy and healthy with the care of Lee and her staff, and the love of a little girl. The South Florida SPCA operates under the motto, “Your next champion just might be a rescue”, and for Grace, nothing could be closer to the truth.

Meet Palm Beach Equine Clinic Veterinarian Dr. Katie Atwood

This month, Palm Beach Equine Clinic welcomed a new face to their team. Dr. Katie Atwood, hails from Jacksonville, FL, and attended veterinary school at the University of Florida, making her return to south Florida from Lexington, KY, a special homecoming.

Palm Beach Equine Clinic Veterinarian Dr. Katie Atwood
Palm Beach Equine Clinic Veterinarian Dr. Katie Atwood

What brought you to Palm Beach Equine Clinic?

I grew up in Florida, so I wanted to be closer to family and the ocean! But, I was also looking for an opportunity to grow and become a better veterinarian. This is a difficult industry to get into, but it is especially difficult to find the right practices. This is a chance for me to work with some of the best doctors in the country.

What would you say is your specialty at Palm Beach Equine Clinic? 

In addition to general, preventative and sport medicine, I will be focusing on Palm Beach Equine Clinic’s reproductive work. I did an internship and a fellowship in reproduction and realized that it is what I am most interested in. I will be working on breeding mares, performing frozen and fresh semen inseminations, as well as breeding management and embryo flushes for transfers to recipient mares.

What inspired you to be a veterinarian?

When I was a little kid we had a trail behind our house that was really popular and I would sit on the back wall and watch everybody ride by on their horses. We do not have any other veterinarians in my family, but when I was five years old I realized that I wanted to work with animals. During my undergraduate studies in Animal Science at Berry College in Rome, GA, a professor named Dr. Martin Goldberg really pushed me to pursue veterinary school.

I wake up every morning so excited to go to work and if I don’t come home exhausted and filthy then I have done something wrong. It is an “every minute of every day” commitment, but very rewarding.

When you aren’t working, where can we find you?

I like to spend as much time as possible in the water. I can usually be found swimming, diving or paddleboarding at the beach and spending time by the pool

What advice would you give to someone considering pursuing veterinary school?

Do it! It will be the most difficult time of your life, but if you have a passion for it, it will be so rewarding. Dedication is so important; take advantage of every wet lab you can, go to any conference that is available, and take advantage of opportunities to meet new people and gain mentors. Who wouldn’t want to do what they love for a living?

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

I am a pretty open book at this point. But, when I retire, my fiancé Mackenzie and I want to sail around the world!

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