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Month: February 2020

Back From The Brink

Dr. Santiago Demierre Gives Peachy a Second Chance


When two-year-old Quarter Horse filly Peachy decided to jump out of her paddock for a night-time stroll this past November, she got herself into some creative “young horse” trouble. After tipping over a garbage can containing bailing wire, she became entangled in the wire and her attempts to kick free resulted in the wire penetrating the wall of her right hind hoof and looped through the sole. The more the filly kicked, the deeper the wire went until it pierced the opposite side of the hoof wall and protruded out the other side.

The first call owner Corey Chilcutt made was to the clinic, and on-call veterinarian Dr. Santiago Demierre responded immediately.

Palm Beach Equine Clinic veterinarian Dr. Santiago Demierre

Not So Peachy Anymore


peachy santiago demierre palm beach equine clinic success story puncture
The wire penetrating the wall of Peachy’s right hind hoof and looped through the sole.

“When I arrived, the two ends of wire that looped over the horse’s back had been cut down so it was only the wire penetrating the hoof,” said Dr. Demierre. “She was stressed and in a great deal of pain. I sedated the horse and blocked the foot so she would not feel any more pain.”

Once Peachy, who is in training to run barrels in Loxahatchee, FL, was comfortable, Dr. Demierre utilized portable radiograph technology to obtain x-ray images of the right hind foot and evaluate the injury. The images revealed that it was safe to remove the wire, and after disinfecting the area, Dr. Demierre removed the wire through the injury site.

peachy santiago demierre palm beach equine clinic success story puncture radiography wire
Dr. Demierre utilized portable radiograph technology to obtain x-ray images of the right hind foot and evaluate the injury.

“There were no fractures or synovial structures involved, but I did see on the radiograph that the coffin bone was compromised,” said Dr. Demierre. “There was a suspicious line through the coffin bone that could have led to chronic lameness, so the prognosis for performance was reserved. The prognosis for survival was very positive, and I told the owner there was a 50/50 chance she would return to training.”

Once Peachy’s hoof was free from the wire, Dr. Demierre soaked the foot in disinfectant, and began an aggressive course of antibiotic treatments, including regional distal limb perfusion and systemic antibiotics. Finally, the foot was wrapped while the treatments did their work.

Dr. Demierre returned to check on Peachy and continue the antibiotic treatments six times over the past two months. “I performed recheck radiographs of the hoof a month after the injury and there was no fracture where we saw the initial line that caused concern,” said Dr. Demierre. “The margins of the coffin bone had reabsorbed slightly, but overall the injury was healing well.”

peachy santiago demierre palm beach equine clinic success story puncture radiography
A view of Peachy’s healing hoof and therapeutic shoeing on January 11, 2020.
peachy santiago demierre palm beach equine clinic success story corrective therapeutic shoeing
Dr. Demierre worked with Chillcutt’s farrier, Juan Rivera, on a therapeutic shoeing plan.

Once the bandages were removed, Dr. Demierre worked with Chillcutt’s farrier, Juan Rivera, on a therapeutic shoeing plan. Rivera used a hospital plate with disinfectant on the injured hoof, and a bar shoe with a pour-in pad on the opposite hind hoof. At the first shoeing reset a month later, he transitioned the right hoof to a bar shoe with a pour-in pad.

Peachy’s recovery plan included stall rest until Dr. Demierre gave the green light for hand walking six weeks after the injury. At eight weeks, she was trotting on a lunge line, and earlier this month Peachy’s rider Kloey sat on her for the first time.

“The outcome was excellent,” said Dr. Demierre. “She is perfectly sound with no medication and will be back in normal shoes by the end of this month.”

peachy santiago demierre palm beach equine clinic success story
Peachy and Kloey back to work. Photo courtesy of Corey Chillcutt.

Chillcutt is hopeful that Peachy and Kloey will return to their training and will be running barrels in the future. “Dr. Demierre was amazing; his treatment plan was successful and Peachy was back to work much quicker than we ever thought. Words can’t describe the gratitude we have for Dr. Demierre, his technician Emma Sexton, and everyone at the clinic. Their dedication has been phenomenal.”

As of February 14, Peachy is back to her old self, according to Chillcutt, who noted, “She is happy to be back to work and she loves her job!”


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A Laser That’s Therapeutic… and REGENERATIVE

Palm Beach Equine Clinic is the only equine veterinarian based in Wellington, FL, with the powerful SmartRLT Laser.

Palm Beach Equine Clinic’s Dr. Natalia Novoa goes far beyond standard treatment by utilizing Regenerative Laser Therapy.
Palm Beach Equine Clinic’s Dr. Natalia Novoa goes far beyond standard treatment by utilizing Regenerative Laser Therapy.

Dr. Natalia Novoa utilizes this revolutionary sport horse medicine tool to treat a variety of injuries and wounds with clinically documented success. The SmartRLT laser is a portable Class IV laser, the most potent and dynamic on the market, as an essential non-invasive therapy for use in the barn and at horseshows. Not only is Dr. Novoa’s regenerative laser extremely effective in treating injuries that were previously considered career-ending, but it is also especially beneficial for enhancing body condition and performance of the equine athlete. 

Clinical and scientific results of the SmartRLT include:


  • Repair of ligament and tendon lesions
  • Reduces scar tissue within and around injuries
  • Reduces inflammation
  • Increases collagen production
  • Increases blood circulation to bring nutrients to the site
  • Realigns muscle fibers for stronger healing
  • Provides analgesia (reduces pain)
  • Enhances tissue oxygenation
  • Increases cell proliferation (generates more cellular energy)

Regenerative Laser Therapy has successfully treated injuries to structures such as:


  • Cartilage/bone/joints
    • Neck and poll, stifles, temporo mandibular joint (TMJ), hocks, fetlocks, and coffin joint
  • Sore feet and laminitis
  • Sore muscles (especially back and gluteal)
  • Suspensory ligaments and branches
  • Superficial flexor tendons
  • Deep digital flexor tendon and its insertion inside the hoof
  • Inferior and superior check ligaments
  • Collateral ligaments
  • Summer sores and scratches
  • Scar tissue
  • Open wounds and punctures
  • Sub-dermal infections
  • Post-operative incisions
  • Sacroiliac joint and kissing spine
Left front suspensory ligament medial branch core lesion before and after regenerative laser therapy. Photo courtesy of SOUND.
Left front suspensory ligament medial branch core lesion before and after regenerative laser therapy. Photo courtesy of SOUND.
Deep digital flexor tendon before and after regenerative laser therapy. Photo courtesy of SOUND.
Deep digital flexor tendon before and after regenerative laser therapy. Photo courtesy of SOUND.

Regenerative Laser Therapy Case Study: Lameness

Patient Condition Grand Prix level show jumper with left front lameness.
Evaluation Magnetic Resonance Imaging (MRI) showed intra-osseous fluid accumulation in the left front third metacarpal condyle.
Treatment 20 sessions of Dr. Novoa’s SmartRLT.
Result Fluid in the third metacarpal condyle was resolved.
Palm Beach Equine Clinic Regenerative Laser Therapy Case Study: Lameness.
Palm Beach Equine Clinic Regenerative Laser Therapy Case Study: Lameness.

Custom Treatment for Your Unique Horse


Dr. Novoa’s SmartRLT is a pioneering technology that has evidence-based settings and treatment protocols to optimize the effectiveness for each unique patient. Treatments are customized for the specific structure, acute or chronic conditions, deep to superficial and skin pigmentation to reach the best outcomes.

Regenerative Laser Therapy provides a warm, soothing sensation and does not require sedation. Treatments can be performed at the barn or horseshow. Be sure to share your competition schedule with your veterinarian so treatments can be done within a safe and legal timeframe.  

General Protocols for Regenerative Laser Treatments

Pre and Post Performance: 1-3 sessions
Acute Conditions: 6-10 sessions for the first two weeks
Chronic Conditions: 2-3 sessions per week for approximately 10 weeks

Laser Therapy 101


Laser therapy is beams of electromagnetic energy that interact chemically and biologically with the targeted tissue or injury. This creates photobiomodulation, allowing maximum penetration of tissue structures. Laser therapy releases endorphins while increasing cellular activity, blood flow and enhancing tissue oxygenation. Essentially, it enhances the body’s natural healing mechanisms and expedites the restorative process.

Regenerative Laser Therapy goes far beyond standard lasers.

Regenerative Laser Therapy releases greater energy per pulse to create a photomechanical effect at the cellular level. It can be directed to the target injury or lesion to regenerate, revitalize, remodel, repair and realign tissue. Therefore, it is essential for equine sports medicine, lameness, rehabilitation and optimizing performance.  

Regenerative Laser Therapy may only be administered by a veterinarian. Dr. Novoa is the only veterinarian based full-time in South Florida offering the SmartRLT treatments.

Understanding Energy Support for the Performance Horse

Marilyn Connor Palm Beach Equine Clinic Veterinarian

Dr. Marilyn Connor of Palm Beach Equine Clinic Discusses Balancing Your Horse’s Energy Sources for Performance

The modern equine athlete is asked to train and compete at far more demanding levels than horses in nature. Providing your horse with a diet that matches their metabolic needs, activity level, and training demands is key to success. To fuel our sport horses, we must first understand their nutrition and energy needs and give them the adequate support to succeed.

Physical Demands

Anaerobic vs. Aerobic Exercise

Palm Beach Equine Clinic is a major sponsor and partner of equestrian competitions across disciplines

Glucose is stored in the liver and muscle cells as Glycogen, or a complex carbohydrate. Glycogen is broken down into glucose to meet metabolic energy requirements and provides energy for short to medium duration physical activity. Additionally, fat can be broken down and converted into glucose through a longer and more complex process.

Exercise can be characterized into two general categories: anaerobic and aerobic. Anaerobic exercise is characterized by short bursts of maximal effort activity, while aerobic exercise includes low to moderate intensity activity that lasts for a longer duration.

Both anaerobic and aerobic exercise utilize glucose as the primary source of fuel. Anaerobic and aerobic exercise differ in their secondary source of energy utilized once circulating glucose is depleted. Anaerobic exercise utilizes glycogen stores after glucose is depleted, while aerobic exercise is fueled by fat sources.

No equestrian sport is entirely anaerobic or aerobic. Most disciplines will have periods that require anaerobic and aerobic energy metabolism. Racehorses and western performance horses work at high intensity, fast speeds for short periods of time, requiring the body to utilize anerobic metabolism to produce energy. Show jumping and polo horses primarily use aerobic exercise yet will switch to anaerobic metabolism to keep up with energy demands of their sport. Eventing and endurance racing horses rely primarily on aerobic metabolism to support their energy needs over long periods of activity.

To support your horse during any type of sport, they must have a balanced nutrition program that sets them up for success.

Forage First

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic forage first

“Providing high quality forage is always my top focus for any nutrition program, regardless of the horse’s breed, age, gender, metabolic needs or athletic activity,” says Dr. Connor.

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic grain

Horses are herbivores and evolved to survive by grazing on a steady supply of fresh grasses and plants. Research conducted on horses in nature shows that the average wild horse will spend 15 to 17 hours per day grazing and will travel 20 to 30 miles per day in their search for adequate food and water sources. To accommodate for the lifestyle of the modern sport horse, owners must provide high quality forage sources.

Fresh grass contains an optimal blend of key nutrients including protein, carbohydrates, vitamins and fatty acids. Once grass is cut, dried and baled as hay, the nutritional benefits begin decreasing. A week after cutting, hay loses about 60% of its vitamin A, E, and Omega 3 fatty acid content. As a general rule, horses should consume 1 to 1.5% of their body weight in hay or forage per day, with some high performing equine athletes requiring 2 to 2.5% to meet their energy needs.

When hay and forage alone are not enough to support the intense metabolic needs of the equine athlete, grain, and concentrated feed become an important part of the nutritional plan.

Building Blocks of Energy Sources

Feeding your horse with the appropriate mixture of carbohydrates, proteins, and fat is essential for fueling athletic performance.

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic
Dr. Connor recommends the Platinum Performance Wellness and Performance Formula supplement which is available through the Palm Beach Equine Clinic Pharmacy.
Dr. Connor recommends the Platinum Performance Wellness and Performance Formula supplement which is available through the Palm Beach Equine Clinic Pharmacy.

A horse whose training requires a high level of aerobic exercise, such as a dressage horse, should receive an adequate amount of fat and carbohydrates in their diet to fuel them through longer duration training sessions by providing extended, long-lasting energy sources. Racing and barrel horses, utilizing anaerobic exercise, require a higher percentage of carbohydrates in their diets to support them through maximal effort exercise for shorter periods of time.

Carbohydrates are sourced from forage, grains, and concentrated feeds. Forage sources provide a complex source of fibrous carbohydrates that require more time for the body to digest. Concentrated feeds and grains contain starchy carbohydrates that are easily digested and quickly converted into energy to fuel a horse through intense training. A well-balanced concentrated feed will also have an appropriate blend of fat, protein, and trace minerals.

Protein is an important part of the equine diet and is found in fresh grass, dried forage, and concentrated feeds in varying amounts. Protein is made of amino acids, which are the building blocks for growth, development, repair, and maintenance of body tissues. The modern equine athlete requires a substantial amount of dietary protein to support muscle growth and ongoing tissue repair.

Fat is a key component in most equine concentrated feeds and may be supplemented by adding flax seeds, flax oil, rice bran, and corn oil. These fat sources will provide slow burning calories for sustained energy release. Fat can be especially useful for supplementing a horse’s diet when they are a “hard keeper” or if they have an underlying metabolic condition that requires dietary carbohydrates to be limited.

It is important to remember that not all fats are created equal; as some fat sources can decrease or increase inflammation in the body. Flax seed and flax seed oil are rich in anti-inflammatory omega 3 fatty acids and can be an excellent source of energy. Corn oil is commonly used to add calories and fat; however, it is a less desirable supplement due to its higher percentage of omega 6 fatty acids, which contribute to inflammation. Concentrated feeds will have varying levels of added fats depending on the type of horse it is designed to feed.

Balancing Your Horse’s Energy Sources for Performance

Whatever equestrian discipline is your passion, your horse will need to be fueled by a balanced nutritional plan.

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic polo

“Feeding instructions provided on grains and concentrated feed products are designed by nutritional companies as guidelines; they are not rules and should be adjusted based on total sources of nutrition,” said Dr. Connor.

Establishing the proper balance of forage, starchy carbohydrates, fat sources, vitamins, and minerals will be different for each unique horse and the demands placed upon them.

Understanding the nutritional demands of your horse can be very simple or very intricate, depending on your unique equine athlete. When designing a feeding program, it is important take into consideration your horse’s athletic discipline, performance level, metabolic needs, stage of life, and any underlying medical conditions. Furthermore, your horse’s nutritional needs will vary over time and as they age, so it is important to periodically assess your horse’s body condition and consult with a knowledgeable veterinarian.

Speak with Dr. Marilyn Connor of Palm Beach Equine Clinic about your horse’s unique nutritional needs to ensure your horse is fully supported and on track to reach your competitive goals.

Schedule a Nutritional Consultation with Dr. Connor

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