Palm Beach Equine Clinic of Wellington, FL, is a worldwide leader in sport horse medicine and emergency colic care. While symptoms of colic should be treated medically first, surgical intervention can be necessary, and the team at Palm Beach Equine Clinic is prepared for every situation.
With three Board-Certified Surgeons on staff, as well as a state-of-the-art hospital and the most advanced surgical equipment, Palm Beach Equine Clinic has a very high success rate in saving horses from life-threatening colic. The veterinarians take pride in their equine clients returning to full intended use and continuing to perform at their highest levels.
Causes and Symptoms
Colic is defined as any source of abdominal discomfort in the horse. Abdominal pain or problems within the gastrointestinal tract can arise unexpectedly from many different origins, including but not limited to: spoiled feed, abrupt changes in feed, parasite infestation, sand ingestion, lack of water consumption, excess stress, or changes in the weather. Many times there is not a well-defined inciting cause.
The most important step any owner can take is to recognize the symptoms as early as possible and immediately call their veterinarian. Pawing, rolling, looking at the abdomen, sweating, loss of interest in food and water, and absence of gut sounds in any of the four quadrants are common symptoms. The sooner the veterinarian gets involved in treatment, the better the horse’s chance of survival.
In the event of an emergency, the surgeons and veterinarians of Palm Beach Equine Clinic are available 24/7. When an equine patient is admitted to the hospital, every step is taken to quickly diagnose the problem and correct it immediately.
Tests and Diagnosis
Board-Certified Surgeon Dr. Weston Davis explained that one of the biggest challenges in the sport horse population is determining surgical versus non-surgical colic cases.
“We do not want to put a non-surgical case through the risk of anesthesia and the months of healing time, so we try to spare that at all costs and determine the surgical cases as accurately as we can,” Dr. Davis detailed. “On the split side of that, we try to operate as quickly as possible on any horse that needs surgery and not miss any surgical lesion types.”
There are several methods for differentiating surgical cases. Simple physical exam findings, such as the color of the gums, heart rate, gut sounds, and level of pain can all be supportive of surgical necessity. A variety of tests may also include abdominal ultrasounds and rectal exams.
An Abdominocentesis (or belly tap) is performed on every questionable colic case, where fluid is collected from around the intestines and analyzed for color and character. A variety of other laboratory tests will be run on the fluid as well, with the aim of quickly determining if the horse’s bowel is compromised.
Surgical Procedures
If surgery is necessary, there are a few different approaches that may be performed depending on the specific case.
For chronic colic cases, such horses with longstanding, intermittent colic, an abdominal exploratory procedure may be done with laparoscopy. This option can be done with the horse standing and is a minimally invasive way to examine the full abdomen.
In most acute cases, further steps must be taken. If the veterinarian determines that the horse is a surgical candidate, the patient will go under general anesthesia. The surgeons try to make as small of an incision as they can to perform the needed surgical correction.
“If we intervene early, we can take a strangulating or compromised lesion – one that most people understand as a twist – and we can go into the abdomen and correct the twist, reposition everything appropriately, explore the remainder of the abdomen to make sure nothing else is going on, and then close them up,” Dr. Davis explained. “Some of these surgeries can be as quick as 30 minutes and require just an untwisting, repositioning, and closure. The ones that are bad are the usually the cases that have a more severe twist or have been going on longer.”
In more severe or long-standing cases, the surgery can require a resection and an anastomosis procedure to excise a compromised or devitalized segment of the intestine. The surgeon then joins the healthy ends back together.
“Even more advanced procedures would be like a re-plumbing of the intestines,” Dr. Davis noted. “One of the most common examples of this would be a patient with damage to the end of the small intestine, near or involving its junction with the cecum. In a case like this, we would perform a ‘jejunocestomy’ where we join another part of the small intestine to a different position on the cecum.”
Post-Operative Recovery
After any surgery, there is a process of recovery, which Palm Beach Equine Clinic makes as easy as possible for its clients. In the traditional recovery, most horses will remain in the hospital for a few days. In the post-operative period, they generally receive fluids until they are ready to eat and drink, 3-5 days of antibiotics, and 5-7 days of anti-inflammatories.
“The recovery process is highly dependent upon how sick they are after surgery,” Dr. Davis stated. “Some horses will bounce back and be home 48 hours later, but a very sick horse could potentially spend seven to ten days in the hospital until they are healthy enough to get off fluids and go home.”
After leaving the hospital, the horse is usually placed on one month of stall rest, followed by another month of turnout in a small paddock. In between eight to 12 weeks, the horse will usually be fully recovered and ready to start back to work.
Physical Therapy
With the sport horse in mind, PBEC pays special attention to the health of the abdomen following surgery. The health of the abdominal incision and prevention of infection or hernias is very important. In most cases, the surgeon will recommend physical therapy and special exercises to re-strengthen the horse’s abdominal muscles so that it can get back to work quickly and have a strong abdominal musculature when it does.
“Making the horse walk backwards is one thing that will make them tighten and work their abdominal musculature,” Dr. Davis shared. “Pinching or tickling around their tail head is another common exercise to make them do something similar to a stomach crunch.”
As one of the top equine emergency care centers in the world, Palm Beach Equine Clinic is prepared to handle any case, 24 hours a day, seven days a week, and 365 days a year.
“With the combination of quick surgical intervention, excellent surgical care, and specialized post-operative measures, Palm Beach Equine Clinic has a very high rate of return to athletic performance for all of our colic cases,” Dr. Davis concluded.
Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. To find out more, please visit www.equineclinic.com or call 561-793-1599.
Several regions across the U.S. have reached the peak of the winter show season, and with the increase in equine travel, as well as large populations of horses in close contact with one another, proper vaccination protocols are as important as ever.
Dr. Kathleen Timmins of Palm Beach Equine Clinic in Wellington, FL, is often asked why proper equine vaccination protocols are imperative for all horses, and her answer voices directly to the welfare of the horse.
“You could save your horse’s life!” she said. “It is really important from an infectious disease standpoint, but also for mosquito-borne diseases or rabies; these are diseases that are life-threatening for lack of a $25 vaccine.”
Vaccinations: When, What, and How
According to Dr. Timmins, recommended vaccination protocols vary by vaccine and by the location of the horse, but the core group of vaccines is relatively standardized. As a rule, horses should receive vaccines to prevent mosquito-borne diseases like Eastern Equine Encephalitis (EEE), Western Equine Encephalitis (WEE), and West Nile Virus twice a year. Equine Encephalitis is characterized by the swelling of the brain in an infected horse, while West Nile Virus infects the central nervous system and may cause signs of Encephalitis, including those ranging from fever to weakness and paralysis of the hind limbs.
“Vaccinations against mosquito-borne diseases become very important in south Florida because we have mosquitoes year-round,” said Dr. Timmins. “As you go further north, owners may sometimes choose to only vaccinate against those once a year.”
Included in the twice-a-year vaccination program is a Flu/Rhino dose. Flu vaccination prevents the illness in horses much the same way it does in humans, while the Rhino vaccine is key in helping to prevent the Equine Herpesvirus (Rhinopneumonitis). Equine herpesvirus type 1 (EHV-1) and Equine herpesvirus type 4 (EHV-4) most commonly result in respiratory disease in horses and can progress to neurological disease.
East and West Equine Encephalitis, West Nile, and Flu/Rhino can all be administered as a combination vaccine requiring only one injection.
In addition to vaccinations given twice a year, annual vaccinations include those to prevent Potomac horse fever, a potentially fatal illness that affects the digestive system and is caused by the intracellular bacterium Neorickettsia risticii; Strangles, a bacterial infection of the upper respiratory tract; and Tetanus, an acute, often fatal disease caused by the bacteria Clostridium tetani found in soil.
Much like the vaccinations administered to humans, the companies that produce the vaccines are in constant transition, adapting each vaccine to the most common strains to ensure the most accurate prevention of disease.
The Role of the Horse Show
To combat the rise of infectious disease outbreaks, many horse show organizers have taken a proactive step to reduce the spread of disease by developing vaccination requirements for the show grounds. This is a step towards preventing disease as an organized community, according to Dr. Timmins.
“No one wants sick horses,” she said. “All horse show organizers can do is put the requirements out there and hope that people comply and that they understand why vaccinations are so important.
“When a horse pops with a fever at a show everyone is alarmed,” continued Dr. Timmins. “If proper vaccination protocols are followed, it is easier for us to figure out why that horse has a fever and treat them quickly and appropriately.”
Negative Reactions
There are occasional cases of horses reacting negatively to certain vaccinations, making a regular schedule difficult. After receiving a vaccine intramuscularly, some horses experience local muscular swelling and soreness or signs including fever, anorexia, and lethargy. Severe reactions such as anaphylaxis can also occur in rare, extreme cases.
According to Dr. Timmins, there are procedures in place to help keep horses that suffer reactions on a systematic vaccination plan without threatening their health or competition schedules.
“What I will do first is break up the vaccinations so we can figure out which one is bothering the horse,” said Dr. Timmins. “Then sometimes all it takes is a change in the vaccine company because the particular horse is reacting to their preservative or their carrier. Veterinarians can also pretreat with a nonsteroidal anti-inflammatory drug to avoid really bad reactions. Finally, there is always an option to administer intranasal vaccines rather than using an injectable.
“Very few horses have severe reactions to vaccines and for the most part, the horses traveling to shows are part of a young and healthy populations,” continued Dr. Timmins.
As the winter horse show season continues throughout the U.S., horse health must be a priority and vaccinations are a simple way for the equine community to do their part.
“Vaccinations are an easy and relatively inexpensive way to prevent infectious disease outbreaks, and keep our horses healthy and safe,” she said. “There’s just no reason not to vaccinate.”
More About Dr. Timmins
Dr. Kathleen A. Timmins is a 1993 graduate of the Ohio State University School of Veterinary Medicine. She completed her internship in equine medicine and surgery at the Illinois Equine Hospital near Chicago. Prior to coming to Florida, Dr. Timmins practiced in Aiken, South Carolina, where she met her husband, John, who plays polo professionally. Growing up in Central Ohio, Dr. Timmins began her relationship with horses as a child on the hunter/jumper circuit. She continues to ride and show as much as possible. She and her husband are enjoying parenthood with their daughter Schuyler.
Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. Make Palm Beach Equine Clinic a part of your team by calling 561-793-1599.
Palm Beach Equine Clinic of Wellington, FL, has a team of over 30 skilled veterinarians, including three Board-Certified Surgeons, one of the world’s only Board-Certified equine Radiologists, and numerous other experts in their fields. Palm Beach Equine Clinic’s surgical team leader, Dr. Robert Brusie, is a nationally renowned Board-Certified surgeon whose surgical specialties include orthopedic, arthroscopic, and emergency cases. Dr. Brusie has been the head surgeon with Palm Beach Equine Clinic for the past 20 years and is a beloved part of the team.
Dr. Brusie graduated from Michigan State University College of Veterinary Medicine. He completed his surgical residency at the Marion DuPont Scott Equine Center in 1989 and has been in private practice ever since. He became a Diplomate of the American College of Veterinary Surgeons in 1994. Dr. Brusie joined Palm Beach Equine Clinic in 1996.
Dr. Brusie is a Board-Certified Surgeon who is recognized for his expertise in colic surgery, as well as for his skill in arthroscopic surgery. His surgical experience expands the clinic’s progressive care in both emergency and elective procedures. He has published articles on numerous topics, including the equine intestinal tract and septic arthritis in horses. Dr. Brusie is married and has three daughters.
What was your background with horses growing up?
I grew up on a farm in Michigan. We had usually between 200-600 head of cattle and always between four to six horses. Our horses were cow ponies or driving horses. My dad loved horses and had to have them around. My family has owned our farm for six generations – it pretty much occupied all of our time besides sports and school. Needless to say, we didn’t have much time to show horses.
When and why did you decide to become a veterinarian? Did you know you wanted to be a surgeon from the start?
I decided to become a veterinarian at an early age. I think I was seven or eight years old when I pulled my first calf. One of my dad’s hired men called me ‘doc’ when I was about that age. When I went to college, my plan was to become a large animal veterinarian and live in my hometown and continue to farm part-time with my three brothers. All of that changed when I was in Veterinary school at Michigan State University. Dr. Ed Scott was one of the five surgeons at MSU. He was a gifted surgeon and a great teacher. He kind of steered me into an equine internship at Auburn University. It was one of those things that the more you did, the more you wanted to do to improve yourself. I operated my first colic by myself when I was three weeks out of vet school (32 years ago).
How did you first start working at Palm Beach Equine Clinic?
I was a surgeon at a clinic in Atlanta. In 1996 I had performed surgery for a client of Dr. Paul Wollenman’s. He had started this practice in 1975. He asked me if I needed a job. I was planning on staying in Atlanta for the rest of my career. I received phone calls from the other two partners over the next nine months, and eventually with encouragement from my fiancé, now wife Melissa, I took the job.
What do you love most about working at Palm Beach Equine Clinic?
We have an exceptional group of veterinarians and staff here. The depth and scope of our veterinarians is amazing due to the large caseload. On any individual case, there may be two to three doctors that have input on the case to ensure no stone is left unturned.
Additionally, we are so privileged to work on some of the best show, race, and polo horses in the world. It is truly an honor.
What sets the surgical services at Palm Beach Equine Clinic apart?
Between Drs. Gomez, Davis, and myself, we perform just about every soft tissue and orthopedic surgeries that are done in our field.
Personally, my greatest sense of success is when I see a horse back after surgery going as good or better than it was prior to surgery.
What are the biggest changes you have seen in sport horse medicine over the years?
Currently, the most exciting thing we see going on in medicine is regenerative therapy. Twelve to 15 years ago, we were harvesting bone marrow from the sternum and injecting it into lesions in tendons and ligaments. Now we manipulate the bone marrow or other sources of stem cells to promote more rapid and more functional healing of some of these injuries. I can assure you that in 10-20 years what we are doing now will seem stone-aged by then. There are some very clever minds performing some serious research in this field.
How do you stay up-to-date on new medical advances?
Every veterinarian at Palm Beach Equine Clinic tries to attend as many meetings as time allows. We also do a weekly journal club at our clinic to discuss recently published papers in veterinary and human medicine and surgery.
What is the most interesting or challenging surgery that you have done?
Dr. Gomez and I had a three-year-old racehorse that had split his P1 (long pastern bone) and cannon bone in the same leg in a race. We were able to piece together both bones perfectly and the horse recovered brilliantly. He probably could have returned to racing, however, the owners elected to retire him to life as a breeding sire.
How do you spend your free time when you are not working?
When I’m not doing something with my family, I really enjoy woodworking. My current project is building a kitchen table for Sarah, my assistant of 12 years. In the summer, I get roped into helping on my brother’s farm.
What is something interesting that people may not know about you?
I have three daughters who I am very proud of and tend to brag on maybe a little too much. My oldest, who was a nationally ranked swimmer, is now an anesthesiologist in human medicine. My middle one is either number four or five (depending on the week) in the nation in debate, and my youngest will probably run the free world (you will have to ask her if she wants to).
How else is the family involved in horses?
My wife (Melissa) and youngest daughter (Kayla) are horse nuts in the true sense of the word. Anything to do with horses (especially show hunters) they are dialed in. Melissa loves riding, and Kayla shows in hunters and equitation.
What makes Palm Beach Equine Clinic a special place for you?
I am blessed to have three good men as business partners. They are my good friends and great people. We are very lucky to have 20-plus veterinarians working with us who are very knowledgeable and caring individuals. We feel like a little practice, but with a lot of people who just get the job done.
Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. Make Palm Beach Equine Clinic a part of your team!
Palm Beach Equine Clinic in Wellington, FL, has state-of-the-art surgical and advanced diagnostic imaging equipment available. With board-certified Radiologist Dr. Sarah Puchalski, Palm Beach Equine Clinic uses the Equine Standing Magnetic Resonance Imaging (MRI) and a Nuclear Scintigraphy (bone scan) camera to quickly and accurately diagnose injuries for their clients.
Every horse owner dreads seeing signs of lameness or discomfort in any horse, whether it is a backyard companion or a top-caliber sport horse. For performance horses, however, one of the first questions many owners ask upon contacting a veterinarian about a problem is, ‘Can the horse safely and comfortably return to work?’ Using Palm Beach Equine Clinic’s cutting-edge technology, Dr. Puchalski can quickly and accurately answer that question.
The Equine Standing MRI produces highly detailed images in several different planes to capture a complete image of a desired area. An MRI is best used to further define a specific area of both bony or soft tissue that has been pinpointed as the origin of lameness. The process can be completed while the horse is in a standing position and requires only light sedation.
Similarly, the process of Nuclear Scintigraphy (bone scan) begins with the injection of a radioactive isotope, specifically named Technetium 99. The isotope attaches to the phosphorous proteins localized within the bone and is absorbed over a few hours’ time. A specialized nuclear isotope gamma ray camera is used to capture images of the skeletal anatomy with a 360-degree view. Points of interest “light up” on the image to indicate increased metabolic activity and the site of injury.
Lameness or performance problems are most frequently approached through routine x-rays and ultrasounds, which can appear normal. Thus, it is difficult to diagnose subtle problems because the most common tools are not sensitive enough to diagnose in every case. At PBEC, the Equine Standing MRI and Nuclear Scintigraphy equip veterinarians with an advantage when troubleshooting a lameness issue and helps them to determine a correct, quick diagnosis.
Coupled with advanced technology, Palm Beach Equine Clinic is also one of very few equine practices in the U.S. with a Board Certified Radiologist on staff, and thanks to Dr. Puchalski, hundreds of MRI and bone scans are read each year at Palm Beach Eqine Clinic. In addition to state-of-the art diagnostic tools, the technology also affords economic benefits to owners.
“MRIs can give a definitive diagnosis, and that saves time and money in the long run,” said Dr. Puchalski. “For example, if a horse goes lame and is examined and treated empirically, which is a diagnosis based on likely problems through common diagnostic procedures, it either stays sound or it becomes lame again or even non-functional in three to six months. This method sets back the commencement of the appropriate therapy.
“What the MRI does is allow the horse to be treated early and correctly,” continued Dr. Puchalski. “Otherwise, you may not be treating the correct issue, and the horse could end up lame again very soon.”
Nuclear Scintigraphy does not produce a scan that is as specific, but it gives Dr. Puchalski the opportunity to procure a concrete quick diagnosis, as well as evaluate the whole horse for secondary problems.
“Oftentimes the primary problem in one place is making a horse sore in other places,” she said. “Owners like to know the root problem, but to also quickly diagnose secondary problems so the entire horse can be treated at once.”
As the official veterinary hospital of the Winter Equestrian Festival (WEF) and the Adequan® Global Dressage Festival (AGDF), Palm Beach Equine Clinic sees a high concentration of sport horses in need of care. In turn, owners of those horses are eager to see their horses quickly and happily return to competition.
“The biggest benefit to Palm Beach Equine Clinic and the Wellington community as a result of these MRI and Nuclear Scintigraphy scans is accessibility,” concluded Puchalski. “Anyone can call from the horse show to the clinic, get a scan scheduled quickly- in and out, get results fast, and then their training program can be changed immediately.”
About Dr. Sarah Puchalski
Dr. Sarah Puchalski is from Davis, CA, where she was an associate professor at the University of California in their Department of Surgical and Radiological Sciences. In 1995, she received her BS in biology from Simon Fraser University in British Columbia, and in 1999 earned her Doctor of Veterinary Medicine from the University of Saskatchewan in Saskatoon, where she received the ACVS Outstanding Large Animal Surgery Student award that same year. Dr. Puchalski interned in Field Service and Sports Medicine at New Bolton Center at the University of Pennsylvania in 2001, and completed her residency in radiology at UC Davis in 2005.
Dr. Puchalski has devoted her career to teaching and improving equine health through the development and refinement of diagnostic techniques. In 2011, she contributed to two books on the topic of equine lameness. Her recent contributions include chapters in “Diagnosis and Management of Lameness in the Horse,” edited by Ross and Dyson, as well as in “Veterinary Computed Tomography and the Clinical Veterinary Advisor: The Horse, Equine Colic and Veterinary Clinics of North America.” She also has contributed close to 50 scientific articles concerning the diagnosis of equine lameness to many periodic journals, including Veterinary Radiology & Ultrasound: the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association; Veterinary Pathology; Equine Veterinary Journal; the American Journal of Veterinary Research; Equine Veterinary Education; Journal of the American Veterinary Medical Association; and Journal of Veterinary Internal Medicine.
Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. Make Palm Beach Equine Clinic a part of your team!
Palm Beach Equine Clinic is proud to serve as the local headquarters for emergency services and equine diagnostics during the winter show season in Wellington, FL. As the official veterinary hospital of the Winter Equestrian Festival (WEF) and the Adequan® Global Dressage Festival (AGDF), Palm Beach Equine Clinic has been the premier surgical facility in Wellington for over three decades.
While competing in South Florida, horses and riders from around the globe have access to Palm Beach Equine Clinic’s state-of-the-art hospital for all of their sport horse needs. Palm Beach Equine Clinic has a team of over 30 veterinarians, which includes three Board-Certified Surgeons, a Board-Certified equine Radiologist, and numerous other experts in their fields. All competitors and their traveling veterinarians are welcome for the support of services and collaboration throughout the season.
Referral Veterinarians Welcome
The referring relationship between veterinarians is most commonly seen in the specialty departments of surgery, internal medicine, ophthalmology, and advanced diagnostic imaging. At Palm Beach Equine Clinic, the advanced diagnostic imaging and surgical technology is unmatched, and the three Board-Certified Surgeons are skilled in many procedures that require high levels of expertise and advanced current equipment. As a result, many veterinarians refer their clients to the facility for specialty services.
Dr. Weston Davis, one of the Board-Certified Surgeons on the staff at Palm Beach Equine Clinic, works with many referral cases. Throughout the year, veterinarians from all over Florida frequently refer their clients to Palm Beach Equine Clinic for surgical procedures and advanced diagnostic imaging. The referring veterinarians may range anywhere from general practitioners to other surgeons that do not have access to surgical facilities or the most modern diagnostic imaging modalities while on the road.
“As a rule, we are friendly with referring doctors and take care of their clients with as much high-level care and professionalism as possible,” Dr. Davis stated. “It is important to us to maintain good relationships with the veterinarians that refer to us for specialty work. We always try to facilitate whatever level of involvement they desire. If they want to come and be there for the surgical procedure, we make that happen, and if they just want to send the case and not be as involved, we can do that as well. However, we also always collaborate with the referring veterinarian and the client as a team. If they send a horse in for a surgical procedure, we are going to do the procedure and then connect the client with the referring physician for the follow-up.”
Talented Surgeons and Advanced Diagnostic Imaging
The cutting-edge services available at Palm Beach Equine Clinic are made possible by the expertise of the hospital’s talented surgeons, along with the assistance of state-of-the-art diagnostic imaging and comprehensive surgical and medical resources. The combination brings many of the best veterinarians in the world to Palm Beach Equine Clinic for assistance with their most complex cases.
Among the hospital’s features, the latest in surgical technology enables less invasive operations that result in faster recovery times for the horse. Dr. Davis explained how diagnostic imaging is used during surgery to help guide procedures and assure the best possible result.
“Magnetic Resonance Imaging (MRI) and other advanced diagnostic imaging modalities can often be used for three-dimensional mapping to help enhance the surgical technique,” he noted. “There are some fractures in particular where the surgeon can map out the exact configuration of the fracture off of the MRI scan. We are then able to place markers with the MRI to guide a more exact, refined surgery.
“Intra-operatively, x-rays are taken to view progress, particularly for fracture repairs,” Dr. Davis continued. “The digital radiographs allows us to view the fracture in two planes to ensure optimal screw placement and fracture repair. Ultrasound is also frequently used in surgery for some of the more delicate procedures, specifically with soft tissue.”
Other surgical procedures may be guided with Arthroscopy, which aids in visualization of a joint; Laparoscopy, which uses a camera inserted into the abdomen; or Endoscopy, which is used in upper airway procedures. With the most advanced diagnostic imaging technology onsite, Palm Beach Equine Clinic is the go-to hospital for equine owners and referral veterinarians from around the world during the winter season in Wellington.
Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. Make Palm Beach Equine Clinic a part of your team! To find out more, please call 561-793-1599.
Dr. Tyler Davis graduated from the University of Glasgow School of Veterinary Medicine in Glasgow, Scotland, and performed his undergraduate studies at Pennsylvania State University. He then became a member of the Royal College of Veterinary Surgeons. Dr. Davis was born in Linesville, Pennsylvania, and is married to Dr. Janet Greenfield, also a Palm Beach Equine Clinic veterinarian. He enjoys fly-fishing and spending time with his wife and their two children.
How did you get your start with horses?
Entering vet school, my intentions were always to work in large animal medicine. I actually thought I might focus on farm animals, having grown up in a farming area in Pennsylvania. My focus turned to horses alone after starting to work with the university research ponies and spending more time around the equine hospital in my first year of vet school.
When and why did you decide to become a veterinarian?
My interest in veterinary medicine started in middle school. I participated in 4-H, raising animals for our county fair, and had friends who were farmers. Between the two I met many of the local vets and experienced the veterinary profession. When offered to ride along with them on calls, I agreed. While I did investigate other degrees within the science/biology field, I settled on veterinary medicine.
What was the experience of attending veterinary school in another country, and how did that enhance your education?
I was lucky to have the opportunity to attend vet school at the University of Glasgow in Scotland. Attending vet school in a different country afforded me the opportunity to visit places and experience cultures I would have otherwise never had. Also, I believe the experience allowed me to see agricultural practices in a different light, when compared to those practices in the USA. I participated in externships both in the UK and in the USA (knowing I wanted to move back home following graduation) while attending vet school, allowing me to discover different qualities from each.
Why did you choose to focus on dentistry?
I think that I have a strong focus in dentistry but have a number of other skills as well. When starting at PBEC there were only 1-2 other doctors in the practice performing routine dentals floats and the like. I enjoyed the dental work and began steering my focus on the topic through wet labs, continuing education seminars, etc.
What kinds of work are involved with equine dentistry?
My focus in dentistry goes beyond simply floating teeth. While routine dental floats do take up a large portion of my dentistry duties, there are other aspects of the field, which I participate in as well. I also see horses for dental examinations when we may think there is a relationship between the dentition/head and their ability to perform at their desired level. Tooth extractions make up another portion of the dentistry I perform. Occasionally we find infected or fractured teeth on the routine dental exams, but more often these horses are referred to us, either with a diagnosed tooth problem or with a related complaint (not eating, plays with bit during work, throwing head, etc.). We are able to bring these horses to the clinic to be “worked up” (diagnosis through x-ray, oral exam, etc.) and treated (oral tooth extraction, sinus flush, etc.). We have a great facility offering versatility with cases. I work closely with our surgical staff so that if needed, we can put a horse under general anesthesia if more invasive surgical procedures are merited.
What do you love about working at PBEC?
Palm Beach Equine Clinic has both a great facility and great staff. It is a joy working here.
What are some of your other interests?
My other interests include archery, fishing, and woodworking. Typically if I am not working then I am spending time with my beautiful wife and daughters.
What is something interesting that people may not know about you?
Growing up in Pennsylvania, I am actually a pretty good Polka dancer.
The veterinarians at Palm Beach Equine Clinic in Wellington, FL, caution horse owners of recent toxicity cases that have arisen in South Florida suspected by the low growing weed, Creeping Indigo. Although Creeping Indigo is not native to Florida and has been reportedly growing in the state since the 1920s, the plant has recently spread from the past summer’s humid conditions. Most toxic plants are not palatable to horses and therefore do not pose as much risk; however, it appears that horses are eating Creeping Indigo with suspected fatal effects. The only real treatment is to recognize and remove the poisonous plant from all grazing areas.
Palm Beach Equine Clinic’s Dr. Kathleen Timmins explained that veterinarians in South Florida are suspecting Creeping Indigo cases more often and in more places than ever before. Many people are unaware of the problems this toxic plant can cause.
Signs and Symptoms
“Toxicity from Creeping Indigo can present itself through a number of different symptoms, which can make it difficult to recognize and definitively diagnose,” Dr. Timmins noted. “There is no test or treatment, and the damage that it causes can be irreversible. The only true treatment is limiting their exposure to it.”
The most important step to avoid illness is to eradicate the plant from all pastures and grazing areas. Horse owners should walk through their property and review grass areas for the plant. Creeping Indigo is a prostrate plant that is commonly found in high traffic areas of grass, such as parking lots, turf, roadsides, medians, and overgrazed pastures. Flowers arise from the base of the leaves and are pink to salmon in color. It often grows under the grass, and when it is not flowering, it can be difficult to see. It also has a very deep root, so it is not easy to pull up.
Both neurologic and non-neurologic signs are documented, and researchers are uncertain how much Creeping Indigo a horse needs to consume before clinical signs appear.
The most notable signs are neurologic; horses may seem lethargic or have less energy than usual. Head carriage is often low, and there may be rhythmic blinking and jerking eye movements. An abnormal gait may be noticed, characterized by incoordination and weakness in all limbs.
Non-neurologic signs may include high heart and respiratory rates, high temperature, watery discharge from the eyes, discoloration of the cornea or corneal ulceration, or ulceration of the tongue and gums.
“There are so many varied symptoms that it is often not the first diagnosis you would think of,” Dr. Timmins explained. “There are also many other toxic plants, but if horses have access to good quality feed or grazing, they will not usually eat the toxic plants. The best solution is to find the plant, get rid of it, and not have to find out if it has been consumed.”
Treatment
Horses that are quickly removed from the plants may recover completely, but there is no effective treatment, and symptoms may persist. The best way to prevent poisoning is to stop access to paddocks where Creeping Indigo is present and to remove plants by physical means or herbicide application.
Shipping fever is a respiratory disease complex associated with the transport of horses. A common scenario for shipping fever is when a horse is transported from its barn to another state to attend a show. The horse may be healthy and well-hydrated before entering the trailer, but the stress of travel can weaken the immune system.
Another leading factor is tying a horse’s head up while trailering long distances. The mucociliary apparatus of the trachea, which clears dirt and debris from the lower airway, is interrupted due to dehydration, change in temperature, and the inability of the horse to lower its head. The introduction of foreign material into the lower airway can lead to pneumonia, fluid in the pleural cavity (surrounding the lungs), and associated respiratory distress.
Signs and Symptoms to Watch For
Common symptoms noted are hyperventilation, increased rectal temperature, coughing, and nasal discharge after travel. The horse may seem depressed, not willing to work, and not interested in food or water. It is important to call the vet immediately if any of these symptoms are observed after a horse travels. The faster an infection in the lower airway is treated, the quicker and more likely the horse can recover. Shipping fever, if left untreated, can lead to severe pleuropneumonia, which can be life-threatening.
Treatment of Shipping Fever
Initial treatment includes antibiotics, anti-inflammatories, and hydration. If pneumonia progresses without treatment, surgery may be indicated, which can include removal of a rib and placement of chest drains (to drain fluid around the lungs). The vet should be called, and it is crucial to begin treatment at the earliest sign.
There are several preemptive steps that can be implemented to reduce the risk of a horse developing respiratory disease related to travel:
- Split up long trailer rides over several days. Be sure to take breaks and let horses out of the trailer at least every 6-8 hours, if possible.
- Ensure the horse is properly hydrated before travel. Common preventative practice includes administration of oral or IV fluids by a veterinarian prior to travel.
- Discontinue any immunosuppressant drugs 48 hours prior to travel. This includes steroids such as dexamethasone.
- Ship horses in a box stall or similar enclosure so their heads do not have to be tied during travel.
- Ask a veterinarian about immunostimulant drugs that can be given prior to travel.
As more and more international-level sport horse competitions are brought to North America, the import and export of equine athletes overseas has increased significantly. Moreover, with the winter show season in Florida, horses from around the world are about to make a pilgrimage to South Florida.
Either for a purchase or regularly scheduled show-season travel, Dr. Jordan Lewis of Palm Beach Equine Clinic works with Florida state veterinarians to simplify the process of importing and exporting horses to and from international destinations.
Where to Begin
The transport process begins with obtaining travel documents, including an equine passport and health certificate, and organizing travel arrangements with a professional equine shipper. Once travel is organized, checking the horse’s health is suitable for traveling is always the top priority.
“The most important thing to have in order is health records, up-to-date vaccinations, and complete preventative care,” said Dr. Lewis. “Much of the testing upon import and export depends on the outbreaks of different diseases in the import and export countries. The requirements change year to year and even month to month.”
Dr. Lewis is one of the many veterinarians at Palm Beach Equine Clinic who helps owners navigate through the ever-changing import, export, and quarantine regulations.
Requirements Differ Depending on the Specific Import and Export Countries
“Most horses that are coming from Europe to the U.S. to compete in Florida fly into Miami and are placed in a two- or three-day U.S. Department of Agriculture (USDA) quarantine depending on the country they are arriving from,” said Dr. Lewis. “If they are arriving from South America, however, requirements are different and they will spend seven days at USDA in Miami.”
It is there that the most current regulations are upheld and tests are performed to rule out the presence of any threatening diseases.
When importing to the U.S., Dr. Lewis affirms that many tests are required through bloodwork, including equine infectious anaemia (EIA) or coggins; piroplasmosis, which is a tick-borne disease; glanders, a common bacterial disease; and dourine, a parasite-born venereal disease. When traveling from South America, horses are also tested for other parasites, such as screw worms. When exporting from the U.S., testing will vary based on the regulations of the destination country, its current health precautions and common parasites or diseases.
CEM Quarantine
Once the initial quarantine is complete, geldings are released into the general population, while stallions and mares are transitioned to Contagious equine metritis (CEM) quarantine at either a commercial or private quarantine facility.
CEM is a venereal disease in horses caused by bacteria and is only spread during breeding or through infected semen during artificial insemination. CEM quarantine is recommended for all horses entering the U.S. from Europe, but not necessary for those flying in from South America as the disease is not present in those countries.
According to Dr. Lewis, CEM quarantine takes about 15 days for mares and 35 to 40 days for stallions. Taking this into account, she recommends owners plan a month to complete the travel regulations for a mare and two months for a stallion. Horses that are continually showing obviously don’t have this time built into their travel schedules, and that is where waiver tents enter the equation.
Mares and stallions that bypass CEM quarantine are shipped in a sealed trailer to the competition facility where they enter quarantine in a waiver tent to keep them secure from the general horse population while competing.
If horses are admitted into a traditional CEM quarantine, veterinarians like Dr. Lewis perform the appropriate tests and cultures that clear a horse for approved release into a new home or to the event.
“We work very closely with state veterinarians to do all the blood draws and testing for imported horses, as well as stay on top of the requirements of export countries so each horse can easily and safely transition into the equine population,” said Lewis.
While requirements may change often, the ultimate goal of veterinarians like Dr. Lewis and her colleagues remains the same: releasing safe, healthy, and happy horses to travel into the U.S. and all countries around the world.
Horses are competing around the world more than ever. It is important for all horse owners to implement a routine for vaccinations and biosecurity protocols to keep their horses healthy. Many infectious diseases are easily transmitted between horses and spread quickly through a stable or showground if the proper measures are not taken. The veterinarians at Palm Beach Equine Clinic are very experienced with isolation cases and always available to discuss the important steps that should be taken to maintain effective biosecurity protocols. Palm Beach Equine Clinic encourages owners to reach out to their veterinarians at any time for more information or alert doctors of a suspected potential risk.
Preventative Equine Healthcare
The best first line of defense for horse owners is to maintain current equine vaccinations. Equine Influenza and Equine Herpes Virus (EHV-1) are two deadly diseases that are highly contagious and should always be included in a routine vaccination program. In the United States, it is now required for all horses attending a USEF competition to be vaccinated for Equine Influenza and EHV-1 prior to any event. Official documentation of vaccinations being administered within the previous six months must accompany the horse to the competition.
Vaccination does not guarantee absolute protection against any diseases, and biosecurity measures should also be taken as added protection.
Biosecurity is a preventative measure taken to reduce the risk of transmission of infectious diseases by people, animals, equipment, or vehicles. Biosecurity is important at all times, even when an outbreak has not occurred.
The Stress of Travel
Owners that use commercial transport for their horses should confirm that the trailers have been disinfected between each shipment. Trailers should always be well ventilated, and horses should be provided with fresh, clean water at all times. The stress of travel can decrease a horse’s immune system, causing more vulnerability to disease. It is important to monitor your horse’s behavior and health closely before, during, and after traveling.
Preventing the Spread of Diseases
Simple day-to-day practices in health care and hygiene are also very important in reducing the risk of contracting an infectious disease. Washing hands between grooming horses and regularly cleaning grooming supplies can reduce the spread of infection. When attending a horse show or moving horses to a new location, a footbath for all persons entering or leaving the barn at each doorway can be effective in disinfecting shoes to reduce tracking disease into the barn. If horses are showing a depressed attitude, have stopped eating, are running a fever, and/or have a runny nose, contact your veterinarian immediately. Early medical attention for an infectious disease makes a large impact on the recovery of your horse and the equine community’s safety.
The best way to safeguard any horse’s health is to keep the immune system strong with support from a suitable nutrition and exercise program. Vaccinations, a proper deworming program, and biosecurity practices will provide additional protection.