Category: Medical

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.

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.”

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

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

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

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

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

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

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

Photo courtesy of Dr. Natalia Novoa

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

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

1. Heart: Helps with blood supply

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

3. Triple Heater: Controls pathways of body fluids

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

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

Photo courtesy of Dr. Natalia Novoa

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

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

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

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.

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.”

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.

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.”

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.

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.

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.

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.

Featured on Horse Network

In order for a racehorse to successfully speed down the track, a jumper to navigate a quick and clear round, or a dressage horse to perform a picture-perfect test, the horse must have a healthy respiratory system.

Regardless of discipline or level of training, it is key to ensure a horse is breathing properly for its overall wellbeing. 

If a horse is having respiratory problems, there are several ways that a veterinarian can investigate the issue. One of the most effective tools is a dynamic endoscope, a video recording device that can be worn by the horse during exercise to observe the respiratory system while they are active. 

Respiratory Specialist, Dr. David Priest of Palm Beach Equine Clinic (PBEC), focuses on upper airway diagnosis and surgery for equine athletes and often uses a dynamic endoscope to evaluate his patients.

The equine respiratory system is responsible for bringing large amounts of oxygen in and out of the lungs, where it is then used to fuel complex bodily processes. It comprises two sections, the upper and lower airways. The upper airway begins with the nostrils and extends through the larynx and into the trachea. The lower airway is made up of the lungs, which rest behind the shoulder, extend up the back, and reach toward the end of the ribcage. 

Dr. David Priest

Photo by Jump Media

“Even a small decrease in lung capacity or impingement on airflow can have dramatic effects on overall health and performance,” described Dr. Priest. “Problems affecting the upper and lower airways may overlap but can include coughing or odd noises, exercise intolerance, nasal discharge, or labored breathing at rest.”

During exercise, the amount of air moved in and out of the horse increases proportionately to how hard the horse is working. The more demanding the work, the more oxygen must be used. A horse at rest inhales approximately 3.5 liters of air per second (L/s), and increases exponentially to 70 L/s at maximum exertion, according to Dr. Priest.

“If a horse is showing signs of difficulties in its respiratory health, veterinarians may use radiography or ultrasound to image the lungs,” explained Dr. Priest. “Going beyond greyscale images [such as radiographs], the veterinarian may also evaluate the upper respiratory tract through the use of an endoscope. An endoscope is a medical device with a small lens on the end that can be inserted through the horse’s nostril to view the horse’s pharynx.”

A dynamic endoscope on a harness race horse.

Photo courtesy of PBEC

If a horse is having trouble breathing only while working, it is necessary for a veterinarian to be able to evaluate them while they are active. To perform that assessment, a dynamic endoscope is used. This allows veterinarians to examine the horse’s pharynx, epiglottis, and trachea in motion. The dynamic endoscope will detect throat abnormalities and provide more information on respiratory issues or problems that are not seen when the horse is resting. 

“The soft tissue structures of the horse’s upper airway experience a significant amount of force when the horse is exercising,” remarked Dr. Priest. “There is also a significant difference in resting and exercising forces, and this causes the upper airway tissues to appear anatomically normal at rest, even if they are functioning abnormally during exercise.”

A dynamic endoscope is often used with horses that have recurrent laryngeal neuropathy, commonly known as “roaring.” Recurrent laryngeal neuropathy restricts the amount of air able to reach the lungs through the horse’s upper respiratory system. This is a useful tool to diagnose the problem and also to evaluate the effectiveness of the surgery.

Respiratory difficulties during exercise can have a significant negative impact on a horse’s health and performance. A dynamic endoscope is a valuable and informative tool in Equine Sports Medicine. Once the issue is identified, there are several treatment or surgical options to address specific respiratory illness. If your horse is making an abnormal noise during exercise, or if you suspect breathing problems, contact your veterinarian to make sure your horse is performing at its best.