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Month: April 2020

Taking a Chance on Madison

Palm Beach Equine Clinic helps one mini donkey survive a roller coaster of health concerns

The popular veterinary adage, “if only they could just tell us how they feel,” never rang more true than in the case of an 11-year-old miniature donkey mare named Madison. Owned by Sariah Hopkins, “Madi” came to Palm Beach Equine Clinic by referral and was diagnosed with hyperlipemia, a common issue in miniature donkeys. Madi’s case, however, was never exactly how it seemed.

Hopkin’s describes Madi as the “center of attention.” Rescued from an animal hoarding situation by Safe Harbor Sanctuary in Nashville, TN, where Hopkins serves on the Board of Directors, Madi was officially adopted by Sariah and her husband Joel in 2015.

“She was one of 40 horses and donkeys being kept on four acres of land,” said Sariah, who relocated to Juno Beach, FL, with Madi in tow in 2018. “She has always had a super sweet, calm personality, but likes to kick up her heels. We’ve done behavioral health therapy work with foster children and she makes everyone who meets her fall in love. She is so engaging.”

After trading Tennessee for Florida, Madi didn’t adjust to her change in environment with ease. According to Sariah, a systematic decline in her health started while the mare tried to adjust to a new barn, environment, farrier, and life. “She was depressed,” said Sariah. “She wasn’t her bright-eyed self. She’s a donkey and she will eat anything so when she went off her grain and refused alfalfa, I called a local vet to pull fluids and run blood work.

“I reviewed the results with my vet in Tennessee who knows Madi and her history,” continued Sariah. “They were catastrophically bad, and she told me I needed to get Madi to a clinic immediately. I was referred to Palm Beach Equine Clinic by my friend Nataliya Boyko. Within minutes, I was on the phone with her vet, Dr. Bryan Dubynsky, and soon after we were on our way.”

Madison Miniature Donkey Palm Beach Equine Clinic Patient
Madison being treated by the team at Palm Beach Equine Clinic

Once Madison arrived at Palm Beach Equine Clinic, she was treated primarily by Dr. Abby Berzas and overseen by Dr. Dubynsky. They diagnosed her with hyperlipemia, and she remained at the clinic for two weeks.

Hyperlipemia is a common metabolic disease of ponies, miniature horses, and donkeys. In affected patients, an increase in serum triglyceride concentrations (hypertriglyceridemia) puts them at risk for liver failure, renal failure, and multiorgan dysfunction that can ultimately lead to death.

Genetically, donkeys are designed to live in harsh environments with poor-quality forage. As a result, they tend to put on weight and gain excess fat reserves when living on relatively lush pasture. Unfortunately, when they stop eating for any reason – usually stress induced –  hyperlipemia may develop due to a ‘negative energy balance’  where more energy is being used than is being taken in through eating. The essential organs of the body still require a food supply, so it uses the energy that has been stored as fat deposits. The result is that free fatty acids are circulated to the liver and converted to glucose for use by the body.

Madison Donkey Success Story Palm Beach Equine Clinic Abby Berzas success story equine hospital

However, donkeys are not able to efficiently turn off this fat release. The blood soon fills up with excess fat in circulation, causing them to become very sick and uncomfortable. This circulating fat is measured in the blood as triglycerides.

Madison’s case presented as a severe spike in triglycerides, which can be reduced by introducing sugars into the system. The sugar causes the body to release insulin and drive the triglycerides down.

“She responded well the first day, but we didn’t see the improvement that we would have liked or that she needed,” said Dr. Berzas. “We started more aggressive treatments the following day with insulin therapy and antibiotics. The dextrose caused a physiological increase in insulin, but it wasn’t enough. As soon as she had insulin therapy her triglyceride levels started coming down. They decreased significantly and she started eating again.”

Madison remained on insulin therapy for a week and was evaluated hourly by Palm Beach Equine Clinic veterinarians to monitor the possibility of hypoglycemic shock. When Madison was able to eat regularly and maintain low triglyceride levels without any help, she was discharged.

“I had access to Madi daily, and we made the most of her time in the hospital with long hand walks, grazing, and relaxing in her stall,” said Sariah. “I got updates from the clinic every two to three hours when I wasn’t there, and without any more clinical signs, she appeared to be improving.

Madison Miniature Donkey Palm Beach Equine Clinic Patient

“But, when I got her home she still was not herself,” continued Sariah, who spent hours sitting in Madi’s stall with her. She moved home to Sariah and Joel’s private farm while they did all they could to eliminate the stress that had supposedly led to Madi’s condition. “She was good for 24 to 48 hours and then would slide backwards again. One afternoon, I was sitting in her stall and she had a coughing fit that I was able to video. I sent it to [Dr. Berzas] and she came out to the farm to check on Madi.”

Dr. Berzas performed a thoracic ultrasound and spotted comet tails in her lungs, leading to one thing: pneumonia.

“We were wracking our brains to figure out what the original stressor might have been that led to the hyperlipemia, but Madi did not display any signs of pneumonia at the clinic and did not cough once,” said Dr. Berzas. Then, there it was! Donkeys are stoic, tough animals, and sometimes they don’t give us traditional clinical signs.”

While hyperlipemia was the result, pneumonia was the cause.

“Cortisol, also known as the ‘stress hormone’ has a vast array of effects within the body, and it is one of the first triggers for the body to recruit energy from the its peripheral stores,” explained Palm Beach Equine Clinic Internal Medicine Specialist Dr. Peter Heidmann. “It minimizes discomfort and increases blood pressure and metabolic rate, basically saying, ‘Now is not the time to conserve energy for the future. I need energy now in order to survive.’ In Madison’s case, the infection prompted the body to need more than average energy – it needed extra fuel to fight the infection.” 

The typical diagnostic procedure for pneumonia is a tracheal wash procedure, but after consulting with Dr. Heidmann, Dr. Berzas elected to try and mitigate any further stress on Madison by choosing a less invasive procedure. Instead, Dr. Berzas used a special stylette that allowed them to go through the nasal sinuses and cleanly aspirate back cellular fluid for analysis. This option is called a Bronchoalveolar Lavage (BAL), and is most typically used for diagnosing cell types in the lungs.

“After culturing her fluid aspirate, she went back on antibiotics and responded well,” said Dr. Berzas. “She also had nebulizer treatments that delivered antibiotics directly to the lungs, which is the best way to treat the infection.”

happy healthy Madison miniature donkey

One month after the pneumonia diagnosis, Sariah was proud to report that Madi had made a full recovery. “When we brought her in that first day, we frankly were getting ready to say goodbye,” said Sariah. “We were devastated, and Dr. Dubynsky agreed to try and save Madi. Thank goodness he did!”

Once the pneumonia was cleared, Madi’s routine returned to normal and the hyperlipemia was no longer an issue. Today, Madi is happily running Sariah and Joel’s farm.

“Palm Beach Equine Clinic treats some of the top sport horses in the world, but I feel that Madi – a very special donkey – received the same treatment. Dr. Berzas was 100% available to me, and she championed Madi. I could not be more thankful to her and the entire team of veterinarians and staff who rallied around our Madi.”

Sariah Hopkins

“When we have a case that’s particularly challenging to diagnose,” Dr. Berzas remarked, “it just reminds us of how fortunate we are to be part of a team of specialists. At Palm Beach Equine Clinic, we are able to tap into the knowledge and experience of our fellow veterinarians from different specialties, and really deliver that value for the patient.”

Madison, happy and healthy sunbathing.

Sariah chronicled Madi’s condition and recovery on her Facebook page, developing quite a fan base for the little donkey. Madi’s story is far from over, but now she’s telling it herself and can be followed on Facebook as @MadisonJoelleDonk.

Care for Our Horses and Equestrians Amid COVID-19

The following information was requested by the Village of Wellington and posted at https://www.wellingtonfl.gov/767/Equestrian-Information

By Dr. Scott Swerdlin, President of Palm Beach Equine Clinic

For the health and safety of ourselves, our loved ones and the horse community, we must adhere to the recommendations from the Center for Disease Control and Prevention to help reduce the spread of COVID-19. We are fortunate that Wellington, specifically the Equestrian Overlay Zoning District, is not a high-density area. The Village offers picturesque idyllic weather beautiful horse farms and an abundance of expertise in all facets of the equine industry. Now is a unique opportunity for those who had been occupied by hectic schedules to take a step back, de-stress and even enjoy social distancing while saddling up.

Let’s make the most of this time while awaiting the demise of the novel coronavirus by continuing to ride and train our horses. Let’s try to keep a degree of normalcy in our daily routines at the farm and use this time wisely by improving our skills as horsemen. Let’s use this time to ensure that our horses and riders are healthy, fit and ready to resume competition when the appropriate time arrives.

Adjusting to Riding and Horse Care While Staying Healthy and Safe

Spending time riding and caring for your horse is a productive use of time. However, it is imperative that we proceed safely. Suggestions that I would make to help equestrians adhere to local, state and national health recommendations include:

flatten the curve village of wellington coronavirus covid19
  • Make Social Distancing mandatory at the barn. Everyone at the barn, including riders, parents, trainers and grooms, must practice Social Distancing by keeping six feet away from others. No exceptions! Do not permit individuals to congregate in the tack room or aisle ways. While in the saddle, please keep a safe distance away from fellow riders. Many facilities are limiting the number of people allowed at the barn or in the riding ring at any one time. Establishing scheduled riding times may help to streamline this while allowing everyone to participate with their horses. In addition, riders should severely limit the number of guests that they bring onto the property.
  • Be vigilant with cleaning and sanitizing protocols by including surfaces and everyday objects often overlooked, such as whiteboard markers, doorknobs, stall latches, grooming brush handles, and crossties. Be mindful of disinfecting reins, saddles, and stirrups and washing brushes, polos, wraps and saddle pads. Barn staff should implement a routine of wiping down barn cleaning tools, such as pitch forks, wheelbarrows, etc.

  • Make sanitizers, alcohol spray bottles or disinfecting wipes available throughout the barn. Washing your hands is one of the most effective ways to prevent the spread of this disease, so try to wash your hands upon arrival at the barn, before leaving, and insist that your staff wash their hands between handling different horses.
  • Make suitable arrangements for reliable backup care in the event that you or your horse’s caretakers become sick. Organize detailed written instructions on feeding, medications and general care of your horse and provide these written instructions to the barn manager.
  • Meet with your staff and grooms regularly to make sure everyone is being consistent in safety and cleaning protocols and has the most up to date information. Have them self-monitor for any signs of fever, coughing or sickness. If anyone experiences any signs of COVID-19, they should be required to remain in their homes and self-isolate to prevent further spread of the coronavirus. Work with your staff to ensure they are taken care of and compensated, if possible, during sick time. Likewise, if anyone suspects that they may have been exposed to COVID-19 or has travelled to areas where the virus is active within the past month, then they should not go to the barn for 14 days.

Our horses are blissfully oblivious of the pandemic, and we must remember that they still need daily attentive care. With the COVID-19 pandemic, we must adjust to help flatten the curve while remaining dedicated to the health, training and care and of all our horses. Should anyone have any questions or need assistance with caring for their horse’s health, please call Palm Beach Equine Clinic at 561-793-1599.

Coronavirus & Veterinary Medicine on Horse Radio Network

Palm Beach Equine Clinic Horse Radio Network Podcast Radio Interview

Dr. Scott Swerdlin talks COVID-19, equine veterinary medicine, and horse industry impacts with The Horse Radio Network host Glenn the Geek.

Listen to the Horse Radio Network’s interview with Palm Beach Equine Clinic President Dr. Scott Swerdlin. At about 4:30 into the video, Dr. Swerdlin talks about how veterinary clinics and equestrians are adjusting to life amid the novel coronavirus pandemic. The Horse Radio Network is the leading online radio (podcast) network for horse lovers worldwide. 

Dr. Swerdlin is a Florida native whose family raised cattle and horses. After attending Tulane University, he pursued a master’s degree in equine reproduction at the University of Florida, and graduated from Auburn University School of Veterinary Medicine in 1976. Dr. Swerdlin was then appointed Chief of Clinical Services at Clark Air Force Base in the Philippines. Following his tour in the military, he started a private practice in south Florida. He served on the state Board of Veterinary Medicine from 1981-1987, and received the Gold Star Award for outstanding contributions to veterinary medicine in the state of Florida. In 1999, he became a member of the Royal College of Veterinary Surgeons and is licensed to practice in Great Britain.

More Coronavirus News & Updates

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Care for Our Horses and Equestrians Amid COVID-19
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Happy Birthday Belle: Recovering Geriatric Colic Case Turns 34

When Jennifer Penn learned that her horse Belle was in the beginning stages of a bout with colic in February, she knew she was not ready to say goodbye to her beloved horse. The 33-year-old American Quarter Horse named “Wagners Mint Joker”, but known to Penn and her family as Belle, was the horse of a lifetime.

Penn’s mother, Becky Seton, and late grandfather, Bob Lowery, both of Vero Beach, FL, purchased a then 12-year-old Belle for Penn in 1998. “We were both 12-years-old and it was a match made in heaven,” recalled Penn. “I had outgrown my show pony, so it was time to look for an all-around horse that I could show and have fun with. I am an only child, so she is like a sister to me. As I grew up, I experienced life right alongside her.”

Belle quickly lived up to her reputation as an all-around horse, actively competing with Penn at AQHA breed shows, open and 4-H circuits throughout Florida, show jumping events, and they excelled in western trail competitions. Belle even pulled a cart for a time!

When Penn was 18, she started her own lesson program with Belle at the helm. “Belle provided a solid foundation for many riders, both young and old,” she said. “She not only taught me how to become a horsewoman, but she has also impacted so many young people’s lives and taught them showmanship skills. She’s special to me and my mother Becky, but also to so many people who have gone on to become very successful horsemen and women.”

While Belle was partially retired in 2018, the same year she was the guest of honor and Penn’s wedding, the mare gave her last lesson about six months ago. She was still being ridden once a week with the occasional trail or pony ride for yet another up-and-coming rider.

Jennifer Penn Geriatric Colic Case Palm Beach Equine Clinic Surgery

Belle was thriving in retirement until colic threatened to disrupt her life of luxury.

On Saturday morning, February 1, Belle had not been drinking from her water buckets, did not finish her breakfast, and had only passed manure twice throughout the night before; abnormal signs that Penn took very seriously. “She’s tough as nails, so she was not showing any signs of discomfort; she was just standing there quietly in her stall. By knowing her habits we were able to identify a problem and make early decisions.”

Belle was initially treated by her primary veterinarian, Dr. Kelly Alderman of Alderman Veterinary Services based in Fellsmere, FL. Based on Dr. Alderman’s recommendation, Belle was transported to Dr. Karie Vander Werf’s Treasure Coast Equine Emergency Services in Palm City, FL, where an ultrasound on Sunday showed a displacement of her large colon.

“It was very obvious to us that if we were going to consider surgery, we would have to do it sooner rather than later,” said Penn. “The decision was made to preserve her strength and transport her to Palm Beach Equine Clinic for Dr. Weston Davis to operate on her.

“It was because of his confidence in the surgery despite her age, that I had a peace in the decision to proceed with surgery,” continued Penn.

One of three board-certified surgeons at Palm Beach Equine Clinic, Dr. Weston Davis performed the emergency colic surgery to remove a right dorsal impaction in the large colon and correct a severe displacement caused by the altered motility within the intestines.

“Her primary veterinarian had done everything that she could medically do for the horse before referring the case to Palm Beach Equine Clinic,” said Dr. Davis. “In some colic cases, a prolonged course of medical treatments might result in the horse no longer being a surgical candidate. When things were not improving quickly enough, the horse was sent to us. Our main concern was to determine if Belle was as healthy a surgical candidate that she could possibly be.”

According to Dr. Davis, Belle’s physical examination and blood work revealed her to be a very healthy, albeit geriatric, colic case. “She is the oldest horse that I have performed colic surgery on. At the time of her arrival, Belle was well-hydrated with balanced electrolytes levels and stable organ systems. She was an overall good candidate for colic surgery, even at 33-years-old,” he said.

While not every geriatric colic case is well-suited for surgical intervention, Dr. Davis considers two factors before moving forward with any surgery. “The surgery has to make sense for the horse, meaning that they are a healthy candidate with the ability to recover, and they have the will to live,” said Dr. Davis, who noticed how resilient Belle was from the moment he saw her. “The other point is that the surgery needs to be financially reasonable for the client. In Belle’s case, there was a will to live, and a strong emotional connection with this horse.”

After a successful colic surgery, Belle was moved to recover in the Palm Beach Equine Clinic Hospital where she was cared for round-the-clock by Dr. Candelaria Chunco and hospital staff.

“Dr. Davis was great, and Candelaria was fantastic,” said Penn. “They were both so kind, and I received regular text updates. I knew that they were invested in her recovery. When she stood up after anesthesia, I remember Dr. Davis saying to me, ‘this horse is a badass’, and she really is!”

Belle returned home to Vero Beach, FL, on February 19, and celebrated her 34th birthday on March 27. “Her recovery was slow, but she is doing well, regaining an appetite, working her way back to regular turnout, and starting to act like her old self again,” said Penn. “She is an incredibly special horse to not only me and my mother, but to my husband, family, friends, and the horse community here. It’s so wonderful to have her back home.”

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