Dr. David Priest Utilizes Dynamic Endoscope and Performs Surgery to Help Four-Year-Old Harness Racer Get Back in Action

For equine athletes to perform their best, optimal respiratory health is crucial, and particularly paramount for harness racehorses. According to Dr. David Priest, Palm Beach Equine Clinic veterinarian with a keen interest in respiratory health, a racehorse moves roughly 70 liters of air through its lungs over the duration of one second while exercising. To simulate the movement of that amount of air outside the anatomy of a horse’s body, it would require two industrial ShopVacs on full power.

David Priest Palm Beach Equine Clinic Veterinarian

A colloquial condition known as “roaring”, or recurrent laryngeal neuropathy, is a fairly common issue among horses, and it restricts the amount of air able to reach the lungs through the horse’s upper respiratory system. The condition usually affects the left side of the larynx – the equine left recurrent laryngeal nerve is longer than the right – with paralysis that does not allow for an adequate amount of air to travel to the lungs.

According to Dr. Priest, equine anatomy plays a factor in the prevalence of this condition. There is a correlation with the length and size of the neck to the nerve pathways that travel from the brain to the chest, around the heart, and back up to the throat. Although mild cases of recurrent laryngeal neuropathy can be tolerated, the condition becomes particularly serious when a horse’s work involves high-intensity aerobic exercise.

“We often see recurrent laryngeal neuropathy described as a paralyzed flapper,” said Dr. Priest. “If you imagine the flaps of the larynx as cabinet doors, then the horse should be able to hold the doors open without problem while at rest. Yet, when the airflow picks up during exercise, that muscle is sometimes not strong enough to hold the doors open, and it collapses into the airway.”

Just before the start of 2019, Dr. Priest received a call from Stephanie Reames, the trainer of a four-year-old harness racehorse with symptoms pointing to recurrent laryngeal neuropathy. During his diagnostic process, Dr. Priest performed an endoscopy while the horse was resting to provide a baseline observation.

“I saw what I thought was a minor abnormality, but I did not know what amount of laryngeal strength this horse had,” said Dr. Priest. “The roaring noise usually occurs when the disease is progressive, and this horse was making a little bit of noise.


Palm Beach Equine Clinic - Dynamic endoscope showcasing the collapse of the left larynx flap
Dynamic endoscope showcasing the collapse of the left larynx flap.
Palm Beach Equine Clinic - Dynamic endoscope of the larynx with clear air flow at exercise after tie-back surgery
Dynamic endoscope of the larynx with clear air flow at exercise after tie-back surgery.

“This particular horse was in training for the harness racing season, so the owners and trainer wanted to figure out the root of the issue as swiftly as possible,” continued Dr. Priest. “The most effective way to accomplish that is to utilize a dynamic endoscope.”

A dynamic endoscope is a video recording device worn by the horse during exercise. It allows veterinarians to see the larynx, and therefore view signs of recurrent laryngeal neuropathy in real-time. Dr. Priest observed the disease as a grade C on the universal grading system for rating the disease, which translates to a full collapse of the left larynx flap.

Once diagnosed, Dr. Priest recommended an aptly-named laryngeal tie-back surgery, which involves stitching the larynx flap to surrounding cartilage in order to hold it open for optimal airflow. He performed the surgery at Palm Beach Equine Clinic a couple of days after making the diagnosis, and the horse returned home to its training base at South Florida Training Center in Lake Worth, FL, the same day.


The dynamic endoscope on a harness racehorse ready for exercise
A view of the dynamic endoscope on a harness racehorse.
The dynamic endoscope on a harness racehorse ready for exercise.

The suggested recovery time is 30 days to allow for the surgical incisions to heal. Once healed, this horse immediately returned to full harness racing training.

“The horse is doing fantastic and we are hoping to qualify for racing in the next three weeks, and we will most likely head north to Pennsylvania to race,” said Reames. “Dr. Priest is absolutely amazing and was extremely professional from start to finish. There is always a hesitation when you learn that a horse needs surgery, but Dr. Priest was so prompt with the diagnosis and procedure, and the horse healed so quickly. We have high hopes for another successful racing season!”

In February of 2020, Dr. Priest performed a second dynamic endoscopy to observe the condition and effectiveness of the tie-back surgery. “The disease usually results in a 20-30% reduction in airflow, which causes a small performance decline resulting in a speed reduction of maybe one second. This horse’s particular case was perfect at the one-year check, which is key because that one second can be the difference between winning and losing!”

Evaluate your Horse’s Respiratory Health by Contacting PBEC

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Categories
Patients

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.

Not So Peachy Anymore

“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.”

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.

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!”

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.

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

Fill out the form below or call 561-793-1599 to get started.

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Categories
Surgery

When the Bone Breaks

Palm Beach Equine Clinic is Changing the Prognosis for Condylar Fracture Injuries

Palm Beach Equine Clinic is changing the prognosis for condylar fracture injuries in race and sport horses. Advances in diagnostic imaging, surgical skillset, and the facilities necessary to quickly diagnose, treat, repair, and rehabilitate horses with condylar fractures have improved dramatically in recent years.

Palm Beach Equine Clinic is changing the prognosis for condylar fracture injuries among sport horses.
Photo by Jump Media

Most commonly seen in Thoroughbred racehorses and polo ponies, a condylar fracture was once considered a career-ending injury. Today, however, many horses fully recover and return to competing in their respective disciplines.

What is a Condylar Fracture?

A condylar fracture is a repetitive concussive injury that results in a fracture to the cannon bone above the fetlock due to large loads transmitted over the cannon bone during high-speed exercise. On a radiograph, a condylar fracture appears as a crack that goes laterally up the cannon from the fetlock joint and out the side of the bone, essentially breaking off a corner of the cannon bone, sometimes up to six inches long.

A condylar fracture is a repetitive strain injury that results in a fracture to the cannon bone above the fetlock due to large loads transmitted during high-speed exercise.

“A condylar fracture is a disease of speed,” said Dr. Robert Brusie, a surgeon at Palm Beach Equine Clinic who estimates that he repairs between 30 and 50 condylar fractures per year. “A fracture to the left lateral forelimb is most common in racehorses as they turn around the track on a weakened bone and increased loading.”

Scan showing the screws inserted during surgery (right). This patient, a Thoroughbred racehorse, walked away from surgery comfortably and is recovering well.

Condylar fractures are further categorized into incomplete and non-displaced (the bone fragment hasn’t broken away from the cannon bone and is still in its original position), or complete and displaced (the fragment has moved away from the cannon bone itself and can often be visible under the skin).

Additionally, condylar fractures can occur laterally or medially. According to fellow Palm Beach Equine Clinic surgeon Dr. Weston Davis, most condylar fractures tend to be lateral on the outside condyle (a rounded projection on a bone, usually for articulation with another bone similar to a knuckle or joint).

“Most lateral condylar fractures are successfully repaired,” said Dr. Davis. “Medial condylar fractures tend to be more complicated configurations because they often spiral up the leg. Those require more advanced imaging and more advanced techniques to fix.”

What is the Treatment?

The first step in effectively treating a condylar fracture through surgery is to accurately and quickly identify the problem. Board-certified radiologist Dr. Sarah Puchalski utilizes the advanced imaging services at Palm Beach Equine Clinic to accomplish exactly this.

“Stress remodeling can be detected early and easily on nuclear scintigraphy before the horse goes lame or develops a fracture,” said Dr. Puchalski. “Early diagnosis of stress remodeling allows the horse to be removed from active race training and then return to full function earlier. Early diagnosis of an actual fracture allows for repair while the fracture is small and hopefully non-displaced.”

Surgical lag screws are used to reconnect the fractured condyle with the cannon bone.
Photo by Jump Media

Once the injury is identified as a condylar fracture, Palm Beach Equine Clinic surgeons step in to repair the fracture and start the horse on the road to recovery. Depending on surgeon preference, condylar fracture repairs can be performed with the horse under general anesthesia, or while standing under local anesthesia. During either process, surgical leg screws are used to reconnect the fractured condyle with the cannon bone.

“For a small non-displaced fracture, we would just put in one to two screws across the fracture,” explains Dr. Davis. “The technical term is to do it in ‘lag fashion,’ such that we tighten the screws down heavily and really compress the fracture line. A lot of times the fracture line is no longer visible in x-rays after it is surgically compressed. When you get that degree of compression, the fractures heal very quickly and nicely.”

More complicated fractures, or fractures that are fully displaced, may require additional screws to align the parts of the bone. For the most severe cases of condylar fractures, a locking compression plate with screws is used to stabilize and repair the bone.

Palm Beach Equine Clinic surgeon Dr. Jorge Gomez approaches a non-displaced condylar fracture while the horse is standing, which does not require general anesthesia.

A view of Palm Beach Equine Clinic’s standing surgical suite.

“I will just sedate the horse and block above the site of the fracture,” said Dr. Gomez. “Amazingly, horses tolerate it really well. Our goal is always to have the best result for the horse, trainers, and us as veterinarians.”

According to Dr. Gomez, the recovery time required after a standing condylar fracture repair is only 90 days. This is made even easier thanks to a state-of-the-art standing surgical suite at Palm Beach Equine Clinic. The four-and-a-half-foot recessed area allows doctors to perform surgeries anywhere ventral of the carpus on front legs and hocks on hind legs from a standing position. Horses can forgo general anesthesia for a mild sedative and local nerve blocks, greatly improving surgical recovery.

“A condylar fracture was once considered the death of racehorses, and as time and science progressed, it was considered career-ending,” concluded Dr. Brusie. “Currently, veterinary medical sciences are so advanced that we have had great success with condylar fracture patients returning to full work. Luckily, with today’s advanced rehabilitation services, time, and help from mother nature, many horses can come back from an injury like this.”

Dr. Jordan Lewis Palm Beach Equine Clinic Veterinarian

Dr. Jordan Lewis is a graduate of the University of Florida College of Veterinary Medicine and has dedicated her professional career to serving her home state. Dr. Lewis grew up with horses and completed an internship in equine medicine and surgery at the Equine Medical Center in Ocala.

Get to know Dr. Lewis:

1. What is your background with horses?

I moved from New York City to Fort Lauderdale, FL, when I was eight years old. My dad grew up loving horses, and when I was two, he bought a horse. We would travel from our home in New York City to visit him in the Pocono Mountains every weekend to ride. My first experience on a horse was riding double with my dad through cornfields. When I was eight years old, we moved to Florida and I was lucky enough to get my own pony. I got totally hooked on horses and I competed on the Arabian circuit as a teenager.

2. What inspired you to pursue veterinary medicine?

As a child, I participated in local 4-H programs and had the experience of touring an equine surgical and rehabilitation facility. I realized early that this was exactly what I wanted to do as my career.

3. When did you join Palm Beach Equine Clinic and what is your specialty?

I joined the team at Palm Beach Equine Clinic in June of 2005. I love the fact that we have such a dynamic team of veterinarians to work with and consult on difficult cases. I wouldn’t say I have a main focus as I am able to do everything from sports medicine and lameness exams to reproduction work thanks to the clinic’s wide range of cases and capabilities.

Dr. Jordan Lewis. Photo courtesy of Palm Beach Equine Clinic

4. What advice would you give someone who wants to become an equine vet?

I would tell them that a career in large animal veterinary care is not just a job, it is a lifestyle. If it is what you are meant to do, you will love every minute of this lifestyle. I get to be outside and around horses all day. For me, this is the greatest profession.

5. What is one of the most interesting cases you have worked on?

The most interesting case I have worked on was a pericardial effusion. The condition is caused by excess fluid between the heart and the sac surrounding the heart, known as the pericardium. To remove the fluid, I performed a pericardiocentesis, which involved placing a drain within the sac around the heart to drain the excess fluid and relieve pressure on the heart. That is not something you get to do every day!

Even in the winter months, it is important not to underestimate the heat, humidity, and sun. Palm Beach Equine Clinic stresses the importance of proper hydration and sun protection year-round, especially to Florida-based equestrians and winter season snowbirds.

There are many problems that can arise when temperatures climb, including overheating, dehydration, and colic. When the weather becomes chilly in Florida, horses often quit drinking as much water. This can lead to additional problems such as impaction. Your horse’s hydration is critically important for health and performance

Remember these 5 easy ways to protect your horse from sun and dehydration:

Your horse’s hydration is critically important for health and performance in all climates. Photo by Jump Media

1. During extended periods of turnout, and when competing, horses should always have access to shaded areas. Scheduled rides and extended turnout should take place when the temperatures are lower, usually early mornings or in the evening on hot days, so the horse is not in direct sunlight.

2. The average horse drinks between five and 10 gallons of water per day. Therefore, easy and frequent access to clean, fresh water is a necessity. Pay special attention to increased intake during particularly hot days and plan accordingly.

3. Sodium in a horse’s diet is crucial for maintaining proper hydration. Providing a salt block or supplementing with properly measured electrolytes in a horse’s feed or water can help ensure that sodium requirements are being met and that your horse is drinking a sufficient amount of water.

Palm Beach Equine Clinic stresses the importance of proper hydration and sun protection year-round, especially to Florida-based equestrians and winter season snowbirds.

4. Especially in the extreme summer heat, 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. In addition to lack of sweat, signs of anhidrosis can include increased respiratory rate, elevated temperature, areas of hair loss, or dry and flaky skin. If you notice any of these signs, contact Palm Beach Equine Clinic immediately.

5. Clean water buckets often and always fill with fresh water before leaving the barn. Veterinarians often recommend placing one bucket of fresh water and one bucket of electrolytes. Usually, a horse will balance his electrolytes with the opportunity to drink from one or more of these buckets.

These are just a few of the important issues to be aware of during the temperature change in Florida. Contact Palm Beach Equine Clinic to learn more about precautions that can be taken to keep horses happy and healthy throughout the winter competition season.

Typically, when a horse’s gait feels off or may be lacking usual impulsion, the rider often assumes it to be an issue of lameness associated with the forelimbs or hindlimbs. However, that may not always be the case. Utilizing advanced diagnostic imaging techniques, Palm Beach Equine Clinic is able to accurately pinpoint the specific area that is affecting overall performance. In many cases, the cervical vertebrae are often identified as the cause of lameness, asymmetry, and poor performance.

Vertebral Anatomy

A Link Between Neck Issues and Lameness. A computed tomography scan showing a normal sagittal view of the fourth and fifth cervical vertebrae by Palm Beach Equine Clinic.
A computed tomography scan showing a normal sagittal view of the fourth and fifth cervical vertebrae. Photo courtesy of Palm Beach Equine Clinic

The neck is composed of seven articulating cervical vertebrae running from the head to the thorax, named C1 through C7. The neck allows movement of the head while protecting the spinal cord and providing an avenue for nerves to travel. Impingement on the spinal cord and nerves connected to the cervical vertebrae can exhibit neurologically as ataxia, neck pain, or lameness.

Signs of Lameness Related to the Neck

In a lameness exam, a veterinarian will perform flexion tests and palpate areas of the body looking for decreases in the horse’s range of motion or pain upon flexion. The rider may pick up on subtle lameness issues associated with the neck by feeling a change in the horse’s suppleness or resistance to yielding in a certain direction. Lameness may even present itself as a difference in the horse’s balance, such as being heavier on the forehand, or performance issues such as late lead changes. The tried-and-true “carrot test” can also show if a horse is resistant to flexing their neck.

Identifying Lameness through Diagnostic Imaging

Historically, neck issues related to performance are generally diagnosed through a process of ruling out other areas of the body. Diagnostic imaging can now be the most powerful and effective tool for identifying the cause of lameness related to cervical injury and hereditary malformation.

A Link Between Neck Issues and Lameness. Computed Tomography (CT) scans have revolutionized the ability to assess the entire neck and can be performed while the horse is standing and under light sedation. Photo courtesy of Palm Beach Equine Clinic
Computed Tomography (CT) scans have revolutionized the ability to assess the entire neck and can be performed while the horse is standing and under light sedation. Photo courtesy of Palm Beach Equine Clinic

Computed Tomography (CT) scans have revolutionized the ability to assess the entire neck and can be performed while the horse is standing and under light sedation. Computed Tomography images can be rendered into three-dimensional models and sliced in any orientation, allowing the veterinarian to evaluate the vertebrae in great detail that is incomparable to standard radiographs (x-rays). These comprehensive CT scans offer veterinarians a thorough profile so they can accurately diagnose and initiate an effective response.  

A standing CT scanner is the latest addition to Palm Beach Equine Clinic’s arsenal of diagnostic imaging modalities. Currently, Palm Beach Equine Clinic is the only equine hospital in South Florida offering this capability. Compared to other modalities such as MRI or Nuclear Scintigraphy, Computed Tomography offers a valuable return for its rapid acquisition of images. If you suspect there is an issue in your horse’s neck please, contact Becky at Palm Beach Equine Clinic at 561-793-1599 to schedule an appointment.