The $25,000 Palm Beach Equine Clinic Grand Prix took place on Sunday, September 3, 2023, at Equestrian Village in Wellington, FL. The class served as the highlight event to close out the ESP Labor Day show. Sharn Wordley (NZL) and Valentine Car, owned by Fernando Cardenas, bested a field of 27 entries to take home the top prize.

Héctor Loyola (PUR) designed a technical track for the starting field of horse-and-rider combinations. Wordley and Valentine Car went toward the end of the order and produced a fault-free effort. In the end, 10 pairs managed a clear first round to advance to the jump-off.

“I thought the course was great,” shared Wordley. “The time was a bit fast for younger horses, but there were already 10 clear, and if the time had been slower there would have been 13 or 14 in the jump-off. For riders, where there’s a tight time on the first round, that’s where you must make your best judgment as to the pace you feel that your own horse is comfortable with.”

Wordley and Valentine Car were the second to last pair to return for the jump-off. The duo stopped the clock at 41.798 seconds to take first place. Wordley has been partnered with Valentine Car for the past two years, and they have earned many top placings together.

“He’s very quick-footed,” said Wordley of the 14-year-old Warmblood gelding. “Even in a fast jump-off like the one today it’s hard to beat him. He just skims over the jumps. I think we’ll do one more of these shows this summer, and then we’ll start doing FEI classes in the fall. The shows here are great for younger and older horses to help prepare them for bigger classes, so I want to bring them down here once more this year.”

Gabriel de Matos Machado (BRA) and Evabellie W, owned by Emily Wood, claimed second place with a time of 42.866 seconds. Dylan Daly (IRL) and Cinderella Z, owned by Jacqueline Steffens Daly, secured third place after stopping the clock at 44.280

Palm Beach Equine Clinic is the Official Veterinarian of the Wellington International Summer Series in Wellington, FL. Veterinarians are available on-site to provide exceptional care to competing horses as well as those in the surrounding Wellington area. View results, live stream replays, and more at For more information about Palm Beach Equine Clinic, visit

Sharn Wordley and Valentine Car
Sharn Wordley and Valentine Car
Photo by Wellington International/Cassidy Klein
Sharn Wordley and Valentine Car in their winning presentation for the $25,000 Palm Beach Equine Clinic Grand Prix.
Sharn Wordley and Valentine Car in their winning presentation for the $25,000
Palm Beach Equine Clinic Grand Prix.
Photo by Wellington International/Cassidy Klein

As elevated temperatures continue to prevail throughout the country, it is important that horse owners never underestimate how heat and humidity can affect equines. Even during the winter months, it is crucial to monitor how your horse is reacting to variations in temperature, especially when traveling to and from or relocating to Florida and other southern regions for the season.

Many problems can arise when temperatures climb, so as a starting point horse owners should pay attention to the amount of sweat their horse is producing. Anhidrosis, or the inability to sweat normally, can be a common challenge, particularly in hot, humid climates.

“Anhidrosis can develop acutely but generally develops gradually,” explained Dr. Natalia Novoa of Palm Beach Equine Clinic. “Horses lose 65-70% of their body heat through sweating, so the inability to sweat can be a potentially dangerous condition for them.”

Dr. Natalia Novoa
Photo by Jump Media

In addition to lack of sweat, signs of Anhidrosis can include increased respiratory rate, elevated body temperature, areas of hair loss, or dry and flaky skin.

There are several treatment options for Anhidrosis including supplements, lifestyle changes, and alternative medicine practices.

“Electrolyte supplements and access to salt blocks are important to replenish chloride, sodium, and potassium,” said Dr. Novoa. “A Vitamin E supplement can also be beneficial because it is an antioxidant that helps with the oxidative damage due to environmental heat stress.”

In addition to supplements, it is important to keep the horse in a shaded and well-ventilated area if possible. It can also be helpful to keep the horse’s body clipped during the summer season.

Another treatment option is adding one serving of dark beer a day to the horse’s feed. The alcohol in beer is a vasodilator so it helps open capillaries allowing heat to pass through more rapidly to stimulate sweat.

Alternative medicine therapies such as acupuncture can also help decrease symptoms of Anhidrosis. “Acupuncture is very effective at clearing heat,” explained Dr. Novoa. “The normal functions of sweat glands and sweating are regulated by the heart, the lungs, and the triple heater. Heat and humidity can block the Qi flow of those meridians, which are pathways connecting acupuncture points, leading to Anhidrosis.

Furst Filou, owned by Maura Weis, demonstrating acupuncture points for Anhidrosis.

Photo courtesy of Dr. Natalia Novoa

“Acupuncture treatment strategies are designed to clear the summer heat, nourish the Yin, and promote body fluids,” continued Dr. Novoa. “Opening up certain points where the heat tends to collect will help release neurotransmitters that affect the flow of blood and lymph.”

According to Dr. Novoa, there are three areas to work on during the acupuncture process:

1. Heart: Helps with blood supply

2. Lung: Controls Wei Qi, which dominates the opening and closing mechanisms of the sweat glands

3. Triple Heater: Controls pathways of body fluids

“It requires a few acupuncture sessions to see a change,” said Dr. Novoa. “The process is different for each horse. It can also help with symptoms like exercise intolerance, tachypnea, and fatigue.”

New Xiang Ru San powder promotes heat and fluid disbursement through healthy sweating and clears Summer-Heat.

Photo courtesy of Dr. Natalia Novoa

Another alternative treatment option is Chinese herbal medicine. New Xiang Ru San powder has proven to be a clinically effective aid for non-sweaters as it promotes heat and fluid disbursement through healthy sweating and clears Summer-Heat. New Xiang Ru San is a blend of the Chinese herbs Bian Dou (hyacinth bean), Xiang Ru (mosla), Hou Po (magnolia bark), Lian Qiao (forsythia), and Jin Yin Hua (honeysuckle flower). Bian Dou eliminates Damp, Xiang Ru clears Summer-Heat, Hou Po moves Qi and eliminates Damp, Lian Qiao clears Heat and opens the Exterior, and Jin Yin Hua clears Heat Toxin, detoxifies, and releases Exterior.

Overall, it is important to manage a horse with Anhidrosis carefully. In addition to considering the techniques described earlier, try to exercise them when temperatures are lower in the early morning or late evening. Also, make sure to allow plenty of cool-down time after exercise and monitor their respiration rate.

Anhidrosis is one of many significant issues to be aware of during temperature increases. Contact Palm Beach Equine Clinic to learn more about precautions that can be taken to keep horses happy and healthy throughout the summer season.

Where did you grow up and what is your background with horses?

I’m Canadian, and I grew up in Winnipeg, Manitoba. Even though I lived in the city I was obsessed with horses from a young age and begged my mom for riding lessons. When I was 17 years old I started grooming horses for the polo circuit in Winnipeg and the obsession continued from there.

When and why did you decide to become a veterinarian? 

I wasn’t sure what to do after high school, and becoming a veterinarian had always been a possibility but I couldn’t decide. I took a year off and went backpacking in Australia. During that time, I worked on a mango farm one and of the dogs got into a scrap with another dog. He was cut up so I took the first aid kit and doctored his wounds. That’s when I decided becoming a veterinarian was the way to go. I called my mom the same night and told her, and she was more than a little relieved.

Who has been the biggest influence in your life or career? What did they teach you?

The biggest influence in my life is my mom. She has taught me too many things to count. At the top of that list is to work hard in whatever you do. She taught me to always put forth your best effort, always leave a place better than how you found it, and always be kind and respectful to whomever you meet.

The biggest influence in my career is Dr. Jorge Gomez. He also believes in the importance of hard work, and he has helped me learn how to run a business. He has instilled in me the value of doing a good, thorough job and maintaining a high standard of practice.

What do you enjoy most about working with performance horses?

What I enjoy most about working on performance horses is a simple answer: watching a horse you care for succeed and perform well. The horses we work on are incredible athletes, and it’s a privilege to be a part of the team that cares for them.

What do you enjoy most about working at Palm Beach Equine Clinic?

What I enjoy the most about working at Palm Beach Equine Clinic is having so many specialists and vets with experience available to help with complicated cases. There is always someone to ask or give advice, and surrounding yourself with people like that ensures you are always providing the best standard of care possible.

What is something interesting that people may not know about you?

Scuba diving is my absolute favorite non-equine activity. In a different life if I never was a horse-crazy person I would have been a marine biologist and found a job that included scuba diving.


Keeping Horses in the Game

Navigating Lameness Prevention and Treatment

Owners and riders have the responsibility of making sure their horses are healthy and sound. Horses are incredible athletes both in and out of the show ring, so it is important that they are cared for like any elite athlete. Non-equestrians do not equate performance horses to football players, marathon runners, or gymnasts, but horse owners and veterinarians know the same level of commitment is required to keep equine athletes in optimal health and fitness.

The goals of Sport Horse Medicine are to keep horses feeling and performing at their best, detect subtle changes, appropriately address underlying issues, and correctly diagnose and treat injuries to get horses back to optimum health. Despite being powerful and strong animals, horses are relatively fragile. One day they are competing in perfect form, and the next they might walk out of their stall lame. Thus begins the process of addressing the issue and determining a treatment plan.

Palm Beach Equine Clinic has a team of veterinarians who specialize in Sport Horse Medicine to keep equine athletes performing at their best.
Photo by Jump Media

Lameness can manifest itself in different ways, from subtle decreases in performance to severe and obvious signs of pain. Lameness is not a diagnosis or disease; it is the symptom of an underlying issue. Palm Beach Equine Clinic in Wellington, FL, has a team of veterinarians who specialize in Sport Horse Medicine and are skilled at diagnosing and treating the root causes of lameness. Pinpointing the underlying issue is the crucial first step in proper rehabilitation.

Understandably, practicing proactive prevention is the best approach to avoiding incidents of lameness. It is important to do what we can to prevent serious incidents such as falling, missteps, and accidents with other horses. Key to these efforts is detecting signs of lameness as early as possible so underlying issues do not exacerbate or cause longer-term lameness. Prevention techniques combined with proper training and rest, high-quality nutrition, and correct and balanced farrier work, help reduce usual wear-and-tear injuries.

Catching Lameness Early
Early recognition of the signs of lameness may help prevent more serious injuries from occurring. A firm understanding of what is “normal” for your horse is crucial to identifying subtle changes in behaviors, movement, or body conditions.

Once a day, do a hands-on leg check. During this exam, compare opposite legs to detect signs of heat, swelling, or sensitivity. While exercising the horse make sure you are aware of a shortness of stride, decrease in performance, reduced stamina, or changes in attitude. If you suspect a problem, give the horse a few days off. If the signs return when work is resumed ask your veterinarian to examine them. Remember that a mild problem can turn into a career-limiting condition if left untreated.

Scheduling routine performance evaluations with your veterinarian can also help catch signs of lameness early. Thorough evaluations often consist of:

• History from rider and trainer covering the how, what, when, and why of the perceived lameness
• Physical examination and limb palpation to detect swelling or soreness
• Lameness or motion examination, both in hand and under tack, to see how the horse moves and may be compensating
• Flexion testing to narrow down the problem area
• Diagnostic analgesia (nerve blocks) to pinpoint the specific area causing pain
• Isolation and confirmation of the problem area
• Diagnosing underlying issues through imaging such as a radiograph (x-ray), ultrasound, nuclear scintigraphy (bone scan), magnetic resonance imagining (MRI), or computed tomography (CT)
• Specific identification of the lameness or performance problem

Treatment Options
Even with preventative care, we cannot avoid all injuries. Therefore, it is important to work with your veterinarian to develop the best treatment plan for when an injury occurs. There are a wide range of traditional treatment methods including conservative treatment (rest, ice, compression), medical management (non-steroidal anti-inflammatory drugs, steroids), intra-articular medication (joint injections), soft tissue treatment (self-derived biologic therapies such as stem cells or pro-stride and shockwave, laser, and ultrasound), and as a last resort, surgery.

Veterinary practices like Palm Beach Equine Clinic also offer a holistic treatment approach through the use of Alternative Therapies. Often used in conjunction with traditional medicine, these therapies can be uniquely tailored to enhance a horse’s performance and overall health. Alternative Therapies include acupuncture and electro-acupuncture, veterinary medical manipulation (chiropractic adjustments), laser therapy, shockwave treatments, and Chinese herbal medicine.

Many causes of lameness are not intuitive, which makes them difficult to diagnose without the knowledgeable eye of an experienced Sport Horse Medicine veterinarian. At Palm Beach Equine Clinic, the goal is to get horses “back in the game” and keep them safe throughout their athletic careers.

Palm Beach Equine Clinic veterinarians and staff strive to be a vital part of the equine athlete’s support team and are committed to delivering comprehensive care specialized to the individual horse’s career, discipline, performance level, and training demands. Contact Palm Beach Equine Clinic today to make sure your horse is in optimal health.

Palm Beach Equine Clinic served as Official Treating Veterinarian during the Longines Global Champions Tour (LGCT) of Miami Beach in Miami, FL, from Sunday, April 9 through Sunday, April 16, 2023. Dr. Christopher Elliott was on-site daily during this international competition. Keep reading to learn about Dr. Elliott’s week while at this one-of-a-kind venue.

Dr. Elliott at LGCT Miami Beach: Dr. Christopher Elliott of Palm Beach Equine Clinic was on-site daily at LGCT of Miami Beach.
Photo courtesy of Dr. Christopher Elliott

Arrival of International Horses – Sunday, April 9, 2023
The first day started at the airport with the arrival of the international horses. During this process, Palm Beach Equine Clinic veterinarians worked alongside the government veterinarians from the United States Department of Agriculture (USDA) to make sure all the horses arriving were happy and healthy. While the horses were still on the airport tarmac, a team of government and local veterinarians performed the first two steps of the arrival process. First, we checked and cross-referenced microchips to confirm each horse’s identity. Then we took blood samples from each horse.

All horses entering the U.S. had to be in quarantine for 48 hours under USDA government control. There are very strict veterinary protocols to ensure no diseases are inadvertently introduced into the country. Upon arrival in quarantine, horses were inspected by the USDA veterinarians for any evidence of illness or injury. All the horses in quarantine had their temperature taken and were inspected for any ectoparasites.

After being strictly monitored, including twice-daily veterinary inspections and temperature checks, the international horses were released from strict quarantine into the controlled competition environment. The international horses were housed in separate stables from domestic American horses. They were also kept separate in the training arena. Throughout the duration of the competition, all international horses were strictly monitored by both government veterinarians and the official veterinarians of the competition. All of these procedures are designed to prevent the inadvertent introduction of foreign or infectious diseases and protect the U.S. horse population. Fortunately, all of the international horses that arrived in Miami had no health concerns.

Arrival Examination Day for National Horses, Horse Inspection, and Arena Familiarization – Thursday, April 13, 2023
I began Thursday at the competition venue with the arrival examination for all FEI horses who were already in the United States.

We inspected each national horse for any obvious signs of illness or injury, and then we scanned their microchip. Our microchip readers are linked via Bluetooth to our phones so when we scan a microchip, we can see all of the horse’s FEI details within the veterinary side of the FEI HorseApp. The app gives us all the information we need to know about the horse and whether all of the documentation was done correctly. Before the horses arrived at the competition venue, the owners and riders were required to complete documentation on the FEI HorseApp including the self-declaration of health stating that their horses were healthy prior to arriving at the venue. They also had to take their horses’ temperatures in the morning and evening for three days prior to arrival at the FEI venue and record it in the app.

Horse Inspection: Dr. Christopher Elliott supervised the national and international horses going through the horse inspection.
Photo courtesy of Dr. Christopher Elliott

After we checked that information, we looked at the horse’s passport to make sure it was up to date with all of its vaccinations. We checked that the last Equine Influenza vaccination was within six months and 21 days of arrival at the horse show. We also asked the rider or groom to take the horse’s temperature right then and there to make sure it is good.

Once the horses were all checked in, the horse inspection for national and international horses got underway. I supervised all of the national and international horses going through horse inspection. As the Official Treating Veterinarian, I worked with the veterinary delegate who traveled in from Italy since LGCT has a very international team. During the horse inspection, my role was to make sure everything ran smoothly. I was also there to examine any horses that might not have been successful through the jog but fortunately they all passed the jog. After the horse inspection, it was time for arena familiarization and schooling where I stood ringside to make sure all horses stayed injury free.

Competition Days – Friday, April 14 through Sunday, April 16, 2023
The competition days started really early. Thankfully at this event it’s not too bad because you get to see the sunrise over the ocean. The warm-up and schooling arena opened at 5:30 a.m., so I was on-call by the schooling arena then to make sure all horses were happy and healthy.

Morning view: Dr. Christopher Elliott’s morning view at LGCT of Miami Beach.
Photo courtesy of Dr. Christopher Elliott

Once the competition began, I was right there at the in-gate with the emergency veterinary kit bag just in case I needed to attend to any horses in the ring. Fortunately we only had to look at a couple of very minor things throughout the competition.

In gate view: Once competition began Dr. Christopher Elliott was at the in-gate with the emergency veterinary kit bag.
Photo courtesy of Dr. Christopher Elliott

In the afternoons my role changed to supporting the horses’ recovery from the competition day. Dr. Sarah Allendorf from Palm Beach Equine Clinic came down from Wellington each afternoon to help. Between the two of us, we examined horses after they competed and advised riders and grooms on how best to look after them in preparation for the next day. We administered some supportive therapies within the rules of the FEI. On Saturday it was very hot and humid, so we administered some fluids to help the horses recover and ensure they were fit and healthy for the following day.

On Sunday afternoon while the final CSI2* competition was taking place, Dr. Allendorf and I prepared the international horses for their next journey. We made sure the horses were healthy and ready to travel. We escorted them to the airport where they went on to the next LGCT event – Mexico City!

On Sunday afternoon while the final CSI2* competition was taking place, Dr. Allendorf and I prepared the international horses for their next journey. We made sure the horses were healthy and ready to travel. We escorted them to the airport where they went on to the next LGCT event – Mexico City!

As winter winds down and everyone looks ahead to the exciting spring and summer show season, there are preparations that can be taken in your horse’s care to ensure you get off on the right hoof. Close communication with your veterinarian can help you stay on track and ensure everything is properly addressed. Vaccinations, deworming, therapies and treatments, as well as shipping care and paperwork are all important to think about. At Palm Beach Equine Clinic in Wellington, FL, Dr. Elizabeth Barrett works with her clients to stay organized for the upcoming show season.

Dr. Elizabeth Barrett competing in Wellington, FL.
Photo by Bridget Ness Photography


Horses are generally vaccinated twice per year in the fall and spring. If you and your horse are traveling to a new area for the spring and summer season, it is important to think about the requirements of that area or diseases more commonly found there. As an example, Dr. Barrett notes that the Potomac Fever vaccine is not always administered in Florida but can be important for horses traveling to the northeastern part of the country.

Vaccinations also need to be administered with enough time prior to shipping or competing, making scheduling considerations more crucial. Dr. Barrett maintains consistent communication with her clients to find the most optimal day to vaccinate such that it coincides with the horse’s existing schedule. While horse owners and barn managers help organize timing, Dr. Barrett stays prepared on her end by counting her patients and ordering enough vaccines for them.

“The responsibility goes both ways,” said Dr. Barrett. “Usually, the farm manager will let me know that they have some time off from showing, so it’s a good time for spring vaccines. I might also remind them that it’s getting to be time to do that so they can work it into their schedules.”

Dr. Elizabeth Barrett.
Photo courtesy of Dr. Elizabeth Barrett


Springtime is also a good opportunity to deworm. When horses have traveled from one area to another, it is more crucial. While Dr. Barrett recommends worming twice annually, she explained that it is necessary to pay attention to each individual horse. Examining the horse and knowing the horse’s situation should guide the worming program. Horses that show clinical signs of worms, such as issues with weight and coat, should have a fecal egg count performed no matter what time of year.

Therapies and Treatments

Many horses are completing busy winter show schedules and heading into a break before ramping back up again. This downtime is a great window of opportunity to help address any issues that may have emerged. Dr. Barrett suggests having your horse treated at the beginning of a break to allow more time for the treatment to settle in. Some joint injections and therapies require longer recovery times, so that needs to be planned accordingly.

“After the winter show circuit, I go over all the horses completely to see if there are any issues,” detailed Dr. Barrett. “If there is any lameness or any maintenance we need to do, we try to time it so that the horse has at least a small break before they ship to their next show. Sometimes the horse just needs downtime, and during the spring is often the time they can get that rest. It’s also a good time for different training routines, such as a water treadmill or hill work to change up the program a little bit.”


Spring and summer showing and shipping go hand in hand. Remembering all the paperwork that needs to be completed ahead of time is key to avoiding a last-minute scramble. Health certificates and Coggins papers are necessary documents for horses to travel both domestically and internationally. Dr. Barrett notes that it takes at least two days for a vet to complete this paperwork for national travel, so it is essential to keep that in mind when arranging an interstate trip. International travel health certificates take longer to prepare and have more requirements, necessitating additional forethought.

Once the logistics are handled, the horse must be physically prepared to ship. The longer the trip, the more stress it can put on the horse. Even trips as few as three hours can increase health concerns. Stomach ulcers are always a risk, so Dr. Barrett suggests administering preventative omeprazole paste to help keep your horse comfortable. Again, Dr. Barrett stresses that each horse needs to be considered individually, so a horse more prone to ulceration might also benefit from sucralfate when shipping.

“I would scope the stomach of any horse we are worried about that is clinically showing signs that they could have ulcers,” shared Dr. Barrett. “When they ship, it helps to try to feed them a little bit at a time with a steady supply of hay throughout the trip so that their stomach is full.”

Shipping fever and colic are other common issues. Taking your horse’s temperature and monitoring their behavior can help detect the problem sooner. Dr. Barrett also offers a couple of tricks to keep your horse hydrated and feeling comfortable in travel. Feeding a wet mash with mineral oil before the journey helps prevent impaction. Getting your horse accustomed to an electrolyte-flavored water beforehand allows you to produce the same familiar flavor on the road to encourage even the most stubborn drinker.

Additional precautions can be made to prevent other injuries. Considering the horse and weather will guide the best plan. For example, in warmer weather a horse that travels well might do better without wraps, but a horse that is more self-destructive could still need extra protection. Certain halters can cause rubs in warmer weather too. Dr. Barrett cautions that injury can also be caused by a travel buddy.

“It is really important to pay attention to what horses are next to each other,” emphasized Dr. Barrett. “I’ve seen plenty of injuries where one horse is picking on another and causing trouble. I’ve seen more injuries from that than self-inflicted horse wounds, but both can happen. You have to be careful.”

It helps to have cameras on the horses during longer trips to ensure there are no issues. Since the driver usually stops for gas every four hours or so, that is a good time to check on the horses and offer water. For trips of more than 10 hours, it can help to stop and unload the horses to give them a break. Many commercial shippers will drive directly, so in those cases, the health preparations you make are even more significant.

In all of your organization for spring, the most important thing is to stay in contact with your veterinarian. They will be able to inform your decisions, help with timing issues, and make the best possible plan for you and your horse.

Which veterinarian do you work with, and how long have you been at Palm Beach Equine Clinic?

I work with Dr. Bryan Dubynsky who specializes in sport horse medicine. I started working at Palm Beach Equine Clinic at the beginning of 2022. I began as a veterinary technician in the Hospital Barn and then transitioned to working with Dr. Dubynsky.

What does a typical day look like for you at Palm Beach Equine Clinic?

A typical day starts with restocking the vet truck. I always make sure we have all the drugs and supplies we will need for the day. Once the truck is stocked, we spend the day traveling to different barns in the area treating and evaluating horses.

Laura Romero at a Purina Mills conference in October 2022.
Photo courtesy Laura Romero

What made you decide to become a veterinary technician?

I grew up in Okeechobee, FL, and I enrolled in my high school’s veterinarian program. I was also part of the agricultural program at my school. I found both of those courses very interesting, and they inspired me to become a veterinary technician.

What is your background with horses?

I grew up riding western as a kid and always loved being around horses.

What do you enjoy doing in your free time?

I love to travel and spend time with my friends.

When Natasha Masri purchased Gypsy, a then four-month-old miniature donkey, on October 21, 2022, she could not wait to take her new pet home. Less than two weeks later Gypsy arrived at Masri’s farm along with four other miniature donkeys and horses.

While the other new animals were thriving at Masri’s farm, Gypsy’s health slowly started to decline. By January of 2023, Masri could tell that Gypsy was not herself. The young miniature donkey was lethargic, laying down a lot, and losing weight. Masri called her regular veterinarian to examine Gypsy. After a few days it was evident that Gypsy’s condition was not improving so Masri and her veterinarian decided to call Palm Beach Equine Clinic in Wellington, FL, for an internal medicine specialist.

Dr. Fernando Marqués is a board-certified internal medicine specialist at Palm Beach Equine Clinic.
Photo courtesy of Dr. Fernando Marqués

“Within two hours Dr. Fernando Marqués was at our farm ready to help,” recalled Masri. “When I met Dr. Marqués my anxiety vanished because I could tell he knew what he was doing. He was very good about talking to me as he was working with Gypsy, which was invaluable to me as someone without a medical background.”

Dr. Fernando Marqués with Gypsy.
Photo courtesy of Dr. Fernando Marqués

Dr. Fernando Marqués, a board-certified internal medicine specialist, began his evaluation of Gypsy by asking Masri for the miniature donkey’s medical history. Masri explained Gypsy was lethargic, losing weight, had a fever, and had bloodwork abnormalities. Dr. Marqués then continued with a physical exam to learn more about Gypsy’s overall health.

“When I did a physical exam of Gypsy, I found a cardiac murmur,” explained Dr. Marqués. “The cardiac murmur was consistent with the laboratory finding, which was regenerative anemia. The thickness of the blood changes when an animal has anemia, and that can create a cardiac murmur. After discovering that, we decided to investigate the diagnosis of regenerative anemia further. We always want to try to fix the underlying problems and really get to the root of the issue.”

The next step included Dr. Marqués taking ultrasounds of Gypsy’s thorax and abdomen.

“On the right side of the thorax there were some minor ultrasonographic changes but otherwise everything else looked normal,” said Dr. Marqués. “Then we went ahead and did imaging of the thorax and abdomen with x-rays. In this case, we wanted to determine if it was a nutritional problem, an infection, a parasite, or something else. On radiography, there was nothing relevant that I could find.”

After examining Gypsy, Dr. Marqués, Masri, and her regular veterinarian decided that the miniature donkey should be sent to Palm Beach Equine Clinic for further evaluation. Gypsy arrived at the clinic, and Dr. Marqués immediately started her on intravenous (IV) fluids, vitamin B12, and a dewormer. He also ran additional blood tests beyond the ones the regular veterinarian completed at Masri’s farm and performed a fecal test.

“While Gypsy was at Palm Beach Equine Clinic, we gave her IV fluids, monitored her, made sure she was eating enough nutrients, and performed bloodwork tests,” explained Dr. Marqués. “We found Gypsy’s regenerative anemia was multifactorial, infectious, parasitic, and nutrition related. After a few days of a dewormer and a different feeding program, she started eating really well and gaining weight again. All the blood parameters were normalizing as well. During this time, I was in contact with Masri and her regular veterinarian so we could work as a team. It was important we were all on the same page and communicating on a daily basis.”

After five days of receiving a different feeding program and a parasite treatment at Palm Beach Equine Clinic, the team decided that Gypsy could return home under the care of Masri’s regular veterinarian. Dr. Marqués outlined a new feeding plan for Gypsy to make sure she was getting all of the nutrients she needed. Masri also switched Gypsy over to timothy hay, which is easily digestible and has high fiber and energy content. Additionally, Dr. Marqués and Masri decided it might be best to feed Gypsy separately from the other animals to ensure she was eating her entire portions of grain and hay. Once Gypsy was back home, Dr. Marqués continued to check in with Masri and her regular veterinarian.

“I was extremely impressed with the way Dr. Marqués was able to collaborate with our general veterinarian,” described Masri. “He kept her in the loop so when Gypsy came home there was a plan in place and everyone was communicating.”

Dr. Fernando Marqués with Gypsy.
Photo courtesy of Dr. Fernando Marqués

Since coming home to the farm, Gypsy has returned to being energetic and running around with the other miniature donkeys and horses as she did when Masri first met her.

“As a new miniature donkey and horse owner, having a go-to for these animals at the beginning of their lives leaves me feeling so grateful and confident that I can handle anything with them,” said Masri. “Anytime I have an emergency, Palm Beach Equine Clinic will be the first place I call.”

“As a new miniature donkey and horse owner, having a go-to for these animals at the beginning of their lives leaves me feeling so grateful and confident that I can handle anything with them,” said Masri. “Anytime I have an emergency, Palm Beach Equine Clinic will be the first place I call.”

Since coming home to the farm, Gypsy has returned to being energetic and running around with the other miniature donkeys and horses as she did when Masri first met her. “As a new miniature donkey and horse owner, having a go-to for these animals at the beginning of their lives leaves me feeling so grateful and confident that I can handle anything with them,” said Masri. “Anytime I have an emergency, Palm Beach Equine Clinic will be the first place I call.”

Dr. Natalia Novoa has been part of the Palm Beach Equine Clinic team since 2011. Dr. Novoa focuses primarily on sport horse medicine, lameness, pre-purchase exams, chiropractic adjustments, acupuncture and preventative medicine.

When and why did you decide that you wanted to become a veterinarian?
I decided to become a veterinarian when I was in high school. I enjoyed working with animals at my family’s farm. I spent time with the farm’s vet, and I learned how to do artificial insemination before I even finished high school. I liked the problem-solving aspect of it. I found it fascinating to have the ability to identify and understand what the problem was and then help relieve the suffering of animals after injuries or illnesses. It was an indescribable sensation. Nothing beats helping an animal when they are sick or in pain. There is nothing more rewarding than knowing you are making a difference in a horse’s life. It is a very satisfying feeling.

Dr. Natalia Novoa joined the team of veterinarians at Palm Beach Equine Clinic in 2011.
Photo courtesy of Dr. Natalia Novoa

What aspects of equine medicine interest you most, and what types of cases do you find most rewarding?
I am most interested in sports medicine and lameness (conventional medicine) as well as alternative medicine (chiropractic adjustments and acupuncture). The most rewarding cases for me are the challenging ones where I have to “solve the puzzle.” I like when I have to rely on my detailed observation including a thorough exam and accurate history, then put together all the data and information I gathered from the diagnostic tools, choose the appropriate treatment, and then reach a successful outcome. 

What do you enjoy most about working with performance horses?
I enjoy treating them as top athletes through the combined use of our practical skills,  the new technology, and evolving therapies. At Palm Beach Equine Clinic, we are very fortunate to work on a variety of horses of all disciplines, including horses that are the best athletes in the world in dressage, show jumping, polo, etc. We use the most advanced equipment to provide the best service. Also, at Palm Beach Equine Clinic we have an amazing team of veterinarians with different specialties, knowledge, and skills to help these performance horses execute and perform at their best.

Dr. Natalia Novoa focuses on sport horse medicine, lameness, pre-purchase exams, chiropractic adjustments, acupuncture, and preventative medicine.
Photo courtesy of PBEC

What has been one of your favorite moments while working for Palm Beach Equine Clinic?
One of my favorite moments was when my daughter Lola told me she wanted to be a veterinarian after watching the process of resolving a challenging lameness case in a grand prix level show jumping mare. Lola was able to observe the positive outcome and cheered for the mare when she won a big jumper class. 

What is something interesting that people may not know about you?
I am a fearless squash player, and I also enjoy playing tennis and ping pong. I love traveling with my family and showing my daughter Lola the world.

What is something interesting that people may not know about you?
I am a fearless squash player, and I also enjoy playing tennis and ping pong. I love traveling with my family and showing my daughter Lola the world.

The importance of good quality hoof care in competition horses cannot be denied. Farriery can be a major asset during the show season and beyond. The farrier can be proactive in keeping the horse’s feet healthy and thus preventing lameness. Learn more as Dr. Stephen O’Grady of Palm Beach Equine Clinic in Wellington, FL, explains the philosophy behind correct basic farriery in sport horses.

The Hoof
The equine hoof is unique as it is comprised of a group of biological structures (anatomy) that follow the laws of biomechanics. Therefore, if the veterinarian and farrier know the anatomy of the equine foot combined with an understanding of the biomechanics and good basic farriery principles, proper physiological farriery can be consistently applied (see Figure 1A and 1B). There are three important aspects of farriery used to keep the horse sound, beginning with the appropriate foot trim, along with the correct size and placement of the horseshoe.

Fig. 1A – Illustration shows the biological structures of the hoof and the biomechanical focus.
Fig. 1B – Biomechanical properties of the foot. (Black arrow is COR). Note the moments on either side of the COR.

The farrier session begins with an evaluation of the conformation of each foot. This means viewing the foot from the front, the side, and behind to observe the height of the heel bulbs (see Figure 2). It is important for the clinician to observe the horse in motion to see whether the horse’s foot lands flat or slightly heel first, which is desired. If the horse lands markedly heel first with a toe flip, it is a sign the heels have migrated dorsally (toward the front), decreasing the ground surface in the palmar section of the foot, or the size of the shoes is too small. The foot that lands toe first is an indication that the musculotendinous unit of the deep digital flexor tendon is shortened or the horse is experiencing palmar foot pain. Lastly, the foot should be observed for an asymmetrical landing pattern that is dictated by limb conformation because, if severe, a heel bulb can be displaced proximally resulting in the foot conformation termed “sheared heels.”

Fig. 2 – Illustrations of what is considered good foot conformation. Lateral view shows straight bony alignment of the digit and a parallel hoof-pastern axis. DP view shows straight alignment of the digit and a line across the coronet is parallel with a line on the ground. Ground surface of the foot shows good proportions on either side of a line across the widest part of the foot. Note foot is basically as wide as it is long.

The Trim
The use of guidelines or landmarks when approaching the trim provides consistent, repeatable results that can be used on each foot regardless of the conformation. The three guidelines used are: 1. Trimming the foot to achieve a straight or parallel hoof-pastern axis, 2. using the widest part of the foot, which correlates closely with the center of rotation, and 3. trimming the palmar foot (heels) to the base of the frog or to where the heels of the hoof capsule and the frog are on the same plane (see Figure 3A and 3B). A closer look at these three guidelines, which are all interrelated, will help to show their importance.

Fig. 3A – Yellow dotted line shows the bony alignment of the digit. Red line shows the straight hoof-pastern axis.
Fig. 3B – Black line is the widest part of the foot and the yellow dotted line shows the heels trimmed to the base of the frog. Star is position of COR.

1. If the dorsal (front) surface of the pastern bone and the dorsal surface of the hoof are parallel or form a straight line, then the bones of the digit (in the hoof) are in a straight line, and the force from the weight of the horse will go through the center of the joint. Furthermore, and equally important, if the hoof-pastern axis is straight, the weight will be distributed evenly on the bottom or the solar surface of the foot.

2. The second guideline is the center of rotation (COR). The COR is located a few millimeters palmar (behind) the widest part of each foot. This guideline allows the farrier to apply the appropriate biomechanics to each foot. The foot is trimmed in approximate proportions on either side of the widest part of the foot, which addresses the moments on either side of the COR and provides biomechanical efficiency.

3. Lastly, the palmar section of the foot is trimmed to the base of the frog or trimmed such that the heels of the hoof capsule and the frog are on the same plane. Adherence to this guideline keeps the soft tissue structures (frog, digital cushion, ungula cartilages) within the hoof capsule, which is necessary to absorb concussion and dissipate the energy of impact (see Figure 4). It is important to remember that heels do not grow tall; they grow forward. If the heels migrate forward, the soft tissue structures will be forced in a palmar direction out of the hoof capsule. Furthermore, as the heels migrate forward, the weight is placed on the bone via the lamellae thus bypassing the soft tissue structures of the foot. Allowing the heels to migrate forward also decreases the ground surface of the foot. Two examples of this guideline are shown in Figures 5A, 5B and 6A, 6B where the palmar foot was managed appropriately, and a size larger shoe was applied.

Fig. 4 – Illustration shows the relationship between the osseous and soft tissue structures within the hoof capsule. If heels migrate dorsally, load is transfer to the bone (note arrow).
Fig. 5A – Heels have migrated dorsally and red circle shows the soft tissu structures displaced proximally out of the hoof capsule.
Fig. 5B – Same foot after the heels have been trimmed and a larger shoe has been applied.
Fig. 6A – Heels are low and have migrated dorsally with the soft tissue structures displaced proximally out of the hoof capsule.
Fig. 6B – Same fott after the heels have been trimmed and a larger showe and heel elevation applied.

The three guidelines described here can be applied to any foot and can serve as a basis for maintaining a healthy foot and a basic starting point for applying farriery to a horse with poor foot conformation or one with a distorted hoof capsule. Figures 7A and 7B illustrate a hoof where all three of these guidelines have been applied.

Fig. 7A – The three guidelines applied to the foot. Note the proportions on either side of the widest part (black line) of the foot.
Fig. 7B – Shows the length of the shoe and the wide expanse of the shoe creating a platform under the palmar section of the foot.

Thoughts From Dr. Stephen O’Grady
Most competition horses now show year-round instead of on a seasonal basis. My observation is based on years of experience regarding the farriery performed on these horses. Many of these horses are given a rest from competition prior to leaving for Wellington for the winter show season. Many horses arrive with very reasonable foot conformation. However, upon arrival, horses are often shod with various specialty shoes, wedges, pads, pour-ins, etc., as a means of protection and perhaps to enhance their performance.

As the season progresses and the workload becomes more intense, the sole thickness starts to decrease, and the feet become softer from multiple baths. Now the farriery that was applied for protection at the onset may be causing pressure on the thinner, softer structures of the foot, thus becoming somewhat detrimental. The horses continue to be trimmed and shod on a monthly basis, and the farrier may not be aware of the change in the integrity of the hoof structures, especially the sole, and perhaps some horses may be over-trimmed. As the season progresses into March, the structures of the foot deteriorate further as a result of the workload. Many horses begin to become foot sore. At this point, the farrier options become limited because all the protective methodology was already used at the beginning of the season.

One recommendation would be to refrain from trimming the sole (trade the hoof knife for a wire brush), create ground surface in the palmar foot with a rasp, and decrease toe length vertically from the dorsal section of the foot to preserve mass. Always remember that adequate breakover in the shoe is important, as it decreases the stress in the deep digital flexor tendon and decreases the moment about the distal interphalangeal joint, both of which preserve sole thickness.

I remember the words of Joe Pierce when I was an apprentice learning the farrier trade many years ago, “No one will know if you leave the last few rubs of the rasp on the foot, but everyone will know if you take a few too many rubs!”

Palm Beach Equine Clinic offers a farriery consultation service to both veterinarians and farriers. This unique service provides a second opinion or simply “another set of eyes” available to both professions when treating difficult farriery cases. Please call 561-793-1599 or visit for more information.