As Palm Beach Equine Clinic’s newly appointed Hospital Manager, Sarah Panico brings her love of horses and her past experiences of riding, competing, barn, and show management to PBEC. An avid horse lover since the age of seven, Panico became a working student as a young adult until she almost left the industry when she was 19.
“I was looking to change jobs and do something entirely different,” explained Panico. “My mom saw a job application for the hospital technician position at Palm Beach Equine Clinic on social media. I wasn’t going to apply for it, but she convinced me, and I’m forever grateful for that.”
When she joined the team at Palm Beach Equine Clinic, located in Wellington, FL, Panico thought she wanted to become a veterinarian. However, she changed her mind after discovering her true passion while working as a veterinarian technician. She found that she enjoyed the hands-on role of being a hospital technician, which involved following treatment plans and taking care of the horses in the clinic’s care. Critical cases were especially appealing to her as she enjoyed the concentrated care each case required.
“When I first started working here, I thought I had a decent amount of knowledge about horses and their care,” commented Panico. “But working with the team of Veterinarians at PBEC, it has given me the opportunity to gain a wider variety of knowledge and experience. It inspires me to keep learning and growing. The Palm Beach Equine veterinarians thoroughly enjoy teaching just as much as you enjoy learning from them.”
Panico’s day-to-day tasks as Hospital Manager are much more extensive than when she was a hospital technician. Her job responsibilities involve overseeing the hospital, managing patients, training employees, and managing critical cases. She also updates and schedules the patients’ treatment plans, assists in prepping patients for surgery, coordinates admitting/discharging patients, and assists the doctors with procedures, morning rounds, and assessments.
Nine years later, Panico still enjoys coming to work every day. She loves taking care of her patients and being a part of their recovery process. She also credits her team and co-workers with making the management aspect of her role something she enjoys as well.
“We have a great team of dedicated people here,” said Panico.
When veterinarians work to diagnose illness or injury in a horse, they must rely on their knowledge, problem-solving skills, and the resources available to them. At Palm Beach Equine Clinic (PBEC), a new 2024 Canon Aquilion LB Exceed Dual Energy Computed Tomography (CT) scanner is making that process easier, faster, and more precise. Along with PBEC’s other imaging modalities, including radiographs, ultrasound, MRI, and nuclear scintigraphy, veterinarians can get a clear picture of what’s wrong, make a precise surgical plan if needed, and design comprehensive treatment plans. PBEC is the only facility in South Florida with a Canon Aquilion LB Exceed CT scanner, and it is available for referring veterinarians.
“It can be a life-saving technology,” said Dr. Karen Beste, a board-certified surgeon at PBEC and the head of the imaging team. “It can change outcomes for horses. In its first month of use, the new Canon CT scanner has already told us that a horse didn’t have the fractured leg that we initially thought. We were able to take the horse directly into surgery and save its life.”
The new CT scanner at PBEC is able to show detail that is not detectable on routine imaging modalities, providing soft tissue detail. In addition, it can help veterinarians scan areas of the equine body that were previously difficult or impossible to see, such as the pelvis, sacroiliac, hip joints, stifles, entire limbs, and the neck.
“The neck is a really difficult area to image,” said Dr. Beste. “Routine radiographs don’t provide 3D detail. We can add contrast for myelograms, which allows us to look for dynamic compressions in the spine. We can see detailed changes that may impact a horse’s ability to perform and be a safe horse to ride. We are able to get full neck CTs, all the way to thoracic vertebrae, even on really large horses. Because acquisition times of images are so fast, horses are under general anesthesia for a very short time, which is better for any horse but particularly for a neurologic horse.”
While PBEC’s Canon Aquilion LB Exceed CT scanner has incredible technology, it’s nothing without the experts to manage the scanning and read the scans, which include board-certified radiologists Dr. Sarah Puchalski and Dr. Stacie Aarsvold, who look at every scan.
“Images are viewed by world-renowned radiologists the moment we get them,” noted Dr. Beste. “The whole imaging team is well trained and has so much experience. In addition to that, some of the best surgeons in South Florida can be present during the scan. If needed, horses can be taken directly from the CT into surgery, where CT-guided surgeries are performed. It is especially helpful if a horse is already under general anesthesia because they can go right into surgery in one anesthetic episode. The CT can make a surgical approach more precise, and the surgeon is able to perform it more quickly. The surgeon knows exactly what they need to do and doesn’t have any guesswork.”
If you or your veterinarian would like to take the guesswork out of diagnosing your horse, reach out to the PBEC team today to learn more or make an appointment for a scan at 561-793-1599.
Wellington, FL – Palm Beach Equine Clinic is thrilled to announce the addition of a 2024 Canon Aquilion LB Exceed Dual Energy Computed Tomography (CT) scanner to its lineup of modern medical imaging modalities. Palm Beach Equine Clinic is currently the only facility in South Florida with a Canon Aquilion LB Exceed CT scanner, which is six times faster than other CT capabilities.
With increased speed, there is less motion and consequently a sharper and more accurate image. This specific CT scanner is also equipped with Dual Energy, which permits Palm Beach Equine Clinic veterinarians to visualize subchondral bone injury and edema. This CT scanner is also supplied with artificial intelligence to maximize the quality of the image.
“There is no other CT in South Florida that can compete with the quality of the images produced by our scanner,” stated Dr. Scott Swerdlin, President of Palm Beach Equine Clinic. “Our hospital takes enormous pride in being the foremost world-class facility equipped with the industry’s most advanced technology for the diagnosis, treatment, and rehabilitation of your valued sport horse.”
CT technology utilizes electron beams to digitally identify structures on multiple planes, from multiple angles, allowing veterinarians to examine structures, such as the skull, spine, and distal limbs, on an intricate level.
The Canon Aquilion LB Exceed Dual Energy CT scanner combines extremely detailed image quality with the versatility needed for advanced veterinary medicine. The technology of this CT scanner allows remarkable imaging of bone and soft tissue structures at the highest resolution. The entire scanning unit of the Canon Aquilion LB Exceed Dual Energy CT sits on a gantry, which moves in all directions around the patient. The system can be elevated to scan the head and neck or lowered to scan the distal limbs of a standing horse. The CT scanner’s large bore, or opening of the CT scanner, size of 90cm allowed Palm Beach Equine Clinic veterinarians to produce a CT image of an equine pelvis for the first time.
“We are very excited to bring this world-class technology to Wellington and provide an incomparable service to horse owners in the area,” said Dr. Swerdlin. “Our new Canon Aquilion LB Exceed Dual Energy CT scanner will allow us to more accurately diagnose injuries in every part of a horse’s body, while also making the process easy and extremely quick, literally in a matter of seconds. The imaging team consists of a talented group of imaging-specific technicians as well as veterinarians which include Board-Certified Radiologists Drs. Sarah Puchalski and Stacie Aarsvold. Our imaging team is headed by Dr. Karen Beste, Board-Certified Surgeon, who will coordinate and communicate with all referring veterinarians.”
The modern medical imaging modalities at Palm Beach Equine Clinic, including CT, magnetic resonance imaging (MRI), digital radiographs, and nuclear scintigraphy (bone scan), permit veterinarians to make a timely diagnosis and are available for all equine patients, even if their primary veterinarian is not at Palm Beach Equine Clinic.
“I would like to personally extend an invitation to all Wellington veterinarians to visit Palm Beach Equine Clinic to learn more about what the Canon Aquilion LB Exceed Dual Energy CT scanner has to offer in their practice,” concluded Dr. Swerdlin. Palm Beach Equine Clinic has provided the highest quality of equine health care for more than 40 years. With cutting-edge technology and great compassion for the horses, Palm Beach Equine Clinic is committed to providing exceptional service for both patients and owners. For more information on what Palm Beach Equine Clinic has to offer, visit www.EquineClinic.com, or call 561-793-1599.
All photos courtesy of Palm Beach Equine Clinic
About Palm Beach Equine Clinic Palm Beach Equine Clinic is a full-service medical facility offering care 24 hours a day, 365 days a year. Equipped with a surgical center, advanced diagnostic imaging units, laboratory, pharmacy, reproductive station and breeding shed, recovery stalls, and isolation unit, Palm Beach Equine Clinic has the necessary tools for diagnosing and treating a variety of cases. Palm Beach Equine Clinic is ideally based in the international hub of elite equestrian competition, Wellington, Florida, and is within riding distance of the Winter Equestrian Festival, Global Dressage Festival, and National Polo Center. Palm Beach Equine Clinic is proud to care for all horses, whether they are an Olympic-level athlete, trusted show pony, or reliable trail horse.
Dr. Santiago Demierre has been an integral part of the Palm Beach Equine Clinic team of veterinarians for the past 10 years. Dr. Demierre primarily focuses on equine performance medicine and is passionate about the prevention and treatment of lameness in sport horses. Keep reading to learn more about Dr. Demierre’s backgroundand his role at Palm Beach Equine Clinic.
Dr. Demierre was raised in San Antonio de Areco, a small town in the countryside outside Buenos Aires, Argentina. He grew up immersed in the equine industry as his father was a racehorse breeder and trainer. Dr. Demierre completed his veterinary medicine degree from the Universidad de Buenos Aires in 2012.
He began his career at Palm Beach Equine Clinic as an intern and then went on to become an ambulatory veterinarian before focusing on sport horse medicine. Dr. Demierre currently cares for some of the country’s top polo, jumper, and dressage horses.
“We have worked with Dr. Demierre several times now, and we love his determination and patience when it comes to the welfare of our horses,” said U.S. show jumping athlete Ali Boone. “He is the first one there in any urgent care we have needed, and he not only puts the animals’ needs above all else, but he also takes the time to explain and talk through any diagnosis and situation that needs special attention.”
At Palm Beach Equine Clinic, Dr. Demierre enjoys being surrounded by a diverse group of exceptional veterinarians who are always available to advise on a case. Dr. Jorge Gomez, Dr. Robert Brusie, and Dr. Scott Swerdlin have all played influential roles in Dr. Demierre’s career by providing guidance on managing cases and clients.
In his free time, Dr. Demierre stays busy riding polo ponies, fishing, hunting, hiking, and enjoying time outdoors.
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 seconds.
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 WellingtonInternational.com. For more information about Palm Beach Equine Clinic, visit EquineClinic.com.
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. 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 ofDr. 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 ofDr. 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.
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.
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
Vaccinations
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
Deworming
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.”
Shipping
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.
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 equineclinic.com for more information.
Equine ulcers have long been a common concern for horse owners. Our understanding of ulcers has dramatically improved over time through medical advancement, and there is currently more nuance to the diagnostics, treatment, and management of horses suffering from these internal sores. Gastroscopy and ultrasound have become more readily available, and their increased accessibility have allowed non-specialty practitioners more experience and a greater comfort level with these tools. These developments throughout the industry have led to more animals being correctly diagnosed and appropriately treated.
Jordan Lewis, DVM of Palm Beach Equine Clinic (PBEC) sees a variety of equine ulcer cases. She breaks them down into three categories: gastric ulcer disease of the squamous mucosa, gastric ulceration of the glandular mucosa, and colon ulcers of the right dorsal colon.
Equine gastric ulcer disease of the squamous mucosa refers to the ulcers found on the stomach’s inner lining closer to the esophagus. They are primarily caused by exposure to stomach acid and vary in severity depending on the amount of time the stomach’s lining has been in contact with the stomach acid.
“We often see this increased stomach acid exposure with the squamous mucosa in performance horses due to the mechanical aspects of exercise and abdominal pressure,” Dr. Lewis described. “The increase in acid production and contact time can also be seen in fasting animals and animals with delayed gastric emptying or slowed motility.”
Glandular mucosa describes the stomach lining around the pyloric region closer to the intestines. Ulcers found here are typically caused by a decrease in mucosal blood-flow as well as a decrease in mucus production, which normally serves as a protective barrier for the stomach lining. Stress and non-steroidal anti-inflammatory drugs (NSAIDS) such as phenylbutazone (“bute”) or flunixin meglumine (“Banamine®”) are the usual culprits in this case.
Similarly, ulcers found in the colon are also usually caused by stress and NSAID administration, leading to a decrease in the mucosal wall protection resulting in ulceration and inflammation.
“In some cases with colon ulcers of the right dorsal colon, we see minimal thickening noted on the right abdominal wall, but other times it can be more severe thickening with more ominous clinical signs of colic, fever, hypoalbuminemia (protein loss), ventral and limb edema, and diarrhea,” detailed Dr. Lewis.
The tricky thing about ulcers is that they do not always present with the same symptoms in every horse. It can be difficult to know when it’s time to be a little more invasive in order to take a closer look at a horse’s digestive system. At a minimum, persistent symptoms warrant a veterinarian consultation.
“The range of symptoms can vary from mild to severe,” Dr. Lewis explained. “The horse might be being a picky eater, or they might exhibit moderate to severe colic symptoms like signs of abdominal discomfort such as pawing or rolling. Even still, some horses present with the only outward sign being poor performance.”
Dr. Lewis uses varying diagnostic tools for a complete understanding of the affliction. Sometimes she will perform the Succeed test, which is a fecal test that generally helps indicate the presence of ulcers. Another option is to perform a gastroscopy with a three-meter endoscope to see the stomach where both forms of gastric ulcers are found. Ultrasound is the primary diagnostic tool to look for thickening of the right dorsal colon wall indicating ulceration in the colon. Basic bloodwork to determine total albumin, a protein made by the liver, also helps indicate more severe cases of colon ulcers.
Once a horse has been diagnosed with ulcers of any variety it’s important to begin treatment, especially since horses suffering from ulcers are predisposed to colic. Because each type of ulcer disease has a different underlying cause, the treatment protocol and medications are also different.
Though omeprazole paste used to be thought of as the cure-all, today we know that it is only part of the puzzle. Dr. Lewis recommends an omeprazole paste for at least a four-week period and uses other medications in conjunction with this depending on what type of ulcer she is treating. For horses that have ulcers of the squamous mucosa experiencing more severe, colic-like symptoms, Dr. Lewis adds a dose of sucralfate before meals to the protocol. If she finds ulcers in the glandular and pyloric region of the stomach, misoprostol and prostaglandin analog is used. For ulcers of the right dorsal colon, sucralfate is used as a coating agent while misoprostol is used as a treatment.
In addition to medication, some lifestyle adjustments can aid in maintaining an ulcer-free digestive tract. “It’s helpful if we can provide a more natural, less stressful environment for these horses with continuous grazing on pasture or hay as well as more turnout,” stated Dr. Lewis.
She continued, “Horses with gastric ulcers do well on adding alfalfa hay as a buffering agent before a grain meal, while horses with colon ulcers do well on a low-bulk diet, meaning less forage and a more complete feed-based pellet. Adding a psyllium-based supplement can be helpful for these horses too.”
Even with the best curative efforts, some horses can continue to suffer from ulcers, underscoring the importance of monitoring your horse for any changes even after treatment. Because sport horses have an increased likelihood of developing gastric ulcers due to exercise, their constant work also increases the odds of them have recurring ulcers. Personality and demeanor also play a part.
“Horses that have recurrent ulcer disease tend to be horses that internalize more and are stressed easily,” said Dr. Lewis.
She highlighted some additional measures that can be taken to help continuously protect the stomach’s lining, noting the importance of a regulated diet and more opportunity to relax, as well as treatment with a prophylactic dose of omeprazole paste.
If you think your horse feels a little off from their normal behavior, it might be time to discuss different diagnostic options with your veterinarian. Trust your gut – it might just help your horse’s too.
