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Category: Medical

The Benefits of Biologics: Regenerative Medicine for the Equine Athlete

Palm Beach Equine Clinic veterinarian Dr. Bryan Dubynsky examining the horse's front leg before administering a self-derived biologic treatment.

Veterinarians Help Horses Self-Heal to Maintain Optimal Health and Performance

When horses are not performing up to their usual standards, regardless of discipline, the signs can be subtle. Usually, it is the rider who first picks up on a slight feeling and questions whether something is off. A horse may suddenly be lacking impulsion, be uneven in its stride, or tripping more than usual. In the jumper ring, a horse’s discomfort can present itself as rails down. Riders can easily attribute these issues to their own shortcomings, but the veterinarian is able to understand if, and decide when, there may be an underlying issue. Helping equine athletes reach their full potential and maintain optimal health is the goal of sport horse medicine.

Sebastian, a 13-year-old Selle Francais gelding, had garnered accolades in the jumper ring at competitions around the world. While competing at the 2021 Winter Equestrian Festival (WEF) in Wellington, Florida, his performance was waning. He was not jumping the clear rounds he had cranked out consistently through his career, knocking down rails while jumping off his right lead in particular. Although owner Serena Marron had just purchased Sebastian in the fall of 2020, she knew that something was not right. She was aware of Sebastian’s capabilities and conferred with her veterinarian, Dr. Bryan Dubynsky of Palm Beach Equine Clinic, to get to the root of his performance issue.

Sebastian - Serena Marron - Sportfot photo from Winter Equestrian Festival 2021 in Wellington Florida 2
Serena Marron and Sebastian competing at WEF 2021 (Photo by Sportfot).

“Sebastian had a super clean vetting with no previous injuries, but his right-side fetlocks would often get a little sore,” said Marron. “My trainer and I decided to have Dr. Dubynsky evaluate Sebastian, and he opted for a self-derived biologic treatment in all four fetlocks and hocks. I’ve had horses respond well to this type of treatment in the past, so I knew it was a reliable option.”

Self-derived biologic treatments are a form of regenerative medicine, which encourage the body to self-heal through stimulating naturally occurring biological processes. Regenerative medicine is used to treat or prevent joint disease and soft tissue injuries and works to decrease some of the detrimental biologic processes that can inhibit or slow recovery. By promoting healing and a healthy joint environment, veterinarians are better able to support horses throughout their athletic careers. 

regenerative self-derived biologic therapy for horses

“Biologic agents found in the horse’s own blood can be harvested, concentrated, and returned to the affected area of that same horse,” explained Dr. Dubynsky. “This self-derived serum combines naturally occurring growth factors and anti-inflammatory mediators, among other agents, that can improve the structure, strength, and speed of healing. In equine sports medicine, we commonly use regenerative therapies to treat musculoskeletal injuries and as a preventative therapy to proactively preserve joint health.”

Some regenerative therapies, like the biologic treatment used for Sebastian, can be prepared stall-side and administered during one appointment. Autologous (self-derived) serums are natural and steroid-free with no drug-withholding times for horses competing in FEI or recognized competitions.

“As with many horses performing at the top of their respective sports, Sebastian had obvious synovitis in his joints,” noted Dr. Dubynsky. “Opting to treat this inflammation with a self-derived biologic as opposed to a corticosteroid promotes better long-term joint health instead of a quick fix.”

Palm Beach Equine Clinic veterinarian Dr. Bryan Dubynsky performing a flexion on the horse's hind leg before administering a self-derived biologic treatment.
Palm Beach Equine Clinic veterinarian Dr. Bryan Dubynsky performance evaluation on the lunge line before administering a self-derived biologic treatment.

After the injections, Sebastian was given a couple of weeks off from jumping to let the regenerative treatment do its job. Upon returning to full work, the difference in Sebastian was very apparent to Marron.

“I could tell the treatment worked right off the bat,” said Marron. “I could feel a difference in his body by the way he propelled off the ground and how he felt in training the day after a big class. He felt all around more balanced and even on each lead, which was a noticeable improvement.”

Sebastian soon regained his reputation for agile, clear rounds. The pair was able to successfully resume competition plans by jumping in the FEI two- and three-star divisions for the remainder of the WEF circuit. They now plan to continue competing at that level throughout the summer, along with national grand prix classes. “Sebastian has spent years jumping at the five-star level,” added Marron, “so we do whatever we can that will help him continue feeling his best.”

Sebastian - Serena Marron - Sportfot photo from Winter Equestrian Festival 2021 in Wellington Florida
Serena Marron and Sebastian competing at WEF 2021 (Photo by Sportfot).

Horses can reap the benefits of self-derived biologic treatments well before a serious injury occurs that could derail training or require a lengthy recovery. Different forms of regenerative therapy, such as stem cells, platelet rich plasma (PRP), and interleukin-1 receptor antagonist protein (IRAP), are actively being researched and improved upon. This evolving facet of equine medicine is now a common component of the competitive horse’s comprehensive, long-term care. 

“Traditional medicine tends to focus on treating the symptoms of health problems while regenerative medicine targets the root causes,” explained Dr. Dubynsky. “Non-steroidal anti-inflammatory drugs and corticosteroids can diminish the body’s healing response over time, and they do not address the underlying condition. In contrast, self-derived biologics stimulate normal, healthy tissue production instead of weaker scar tissue that is prone to re-injury.”  

Although Sebastian only underwent the self-derived biologic treatment, regenerative therapies can often be used in conjunction with other medications or alternative therapies. Palm Beach Equine Clinic’s veterinary team carefully assesses each horse to determine which treatments would be the most beneficial for the individual horse. To speak with a Palm Beach Equine Clinic veterinarian about your horse’s performance or regenerative therapy options, call 561-793-1599 or visit www.equineclinic.com.

Spring Flowers Bring Pollen Showers: How to Help Your Horse Cope with Allergies

A PBEC patient with a swollen eye due to allergies or a bug bite.

Got allergies?  Well, chances are, your horses do, too.

With warmer temperatures and spring blooms pushing up pollen levels, it seems like everyone at the barn – human and animal – is coughing and congested. If you have ever wondered what you can do to help a horse suffering from allergies, Palm Beach Equine Clinic veterinarian Dr. David Priest shares his knowledge on addressing allergies and helping horses breathe easy. In his daily veterinary work, Dr. Priest primarily focuses on equine respiratory health. He is experienced in treating conditions ranging from concerning coughs to obstructive or mechanical issues affecting airway function, such as recurrent laryngeal neuropathy (commonly known as “roaring”).

Types and Triggers of Equine Allergies

An allergy is an immune system response to a typically harmless substance, called an allergen. Allergic reactions can range from mild, gradual annoyances to sudden and severe. Generally, allergies manifest two ways in horses; in the respiratory tract or as topical skin allergies.

2. Respiratory Allergies

Respiratory allergies are somewhat similar to asthma in humans and are most commonly referred to as inflammatory airway disease. These respiratory allergies are most often caused by environmental allergens, such as dust, mold, and pollen. Nasal discharge, tearing eyes, and coughing can also be linked to respiratory allergies.

An increase in respiratory rate or an increase in respiratory effort – such as labored breathing or exercise intolerance – are two classic signs. Also, when a horse has a thick mucus-like discharge from its nasal passages, it is concerning to veterinarians as it could indicate an infectious type of respiratory illness. A veterinarian can distinguish whether the culprit is an allergen or if there is an underlying mechanical cause of the respiratory issue. Additionally, horses that experience a dramatic change in their environment may be affected. For example, those traveling from New York to Florida may suffer from completely different allergens such as tree pollens or smoke caused by the burning of sugarcane fields.

2. Skin Reactions

Allergies affecting the skin commonly appear as hives, dermatitis, or hair loss. The administration of topical products as well as a change in the type of stall bedding can trigger such reactions. Topical skin reactions can occur in a specific area or cover the horse’s entire body. Allergies to the common bacteria Dermatophilosis can occur resulting in a painful skin condition. Oftentimes, antifungal or bacterial shampoos can help alleviate this reaction. Consulting your veterinarian is key to determining if your horse suffers from allergies that may undermine your horse’s health or future.

The same allergens that cause respiratory symptoms can also cause skin reactions, but veterinarians tend to approach treatments differently for the two types of reactions.

Pictures: Upon arriving in Florida, this horse was hit with a allergic reaction causing hives all over its body accompanied by severe itching. The patient was initially treated with tripelennamine (injectable antihistamine) and dexamethasone, and then prescribed oral antihistamines and given an allergy and skin supplement to allow the horse to more comfortably adjust to its new environment.

Diagnosing Equine Allergies

Like most conditions, your veterinarian will start by getting a history of the problem, when it first appeared, and any changes that may have occurred recently in the horse’s diet or environment. They will follow with a physical examination, noting the site or region of the horse’s body where there is a flare up. Specific tests such as a biopsy and culture can be performed to rule out other skin conditions or causes – parasites, bacteria, or tumors. A bronchoalveolar lavage (BAL) or a tracheal wash where the veterinarian collects respiratory secretions and then performs a cytology of that fluid can determine if there are abnormalities or specific types of bacteria causing an infection. Serum (blood) allergy testing or imaging, such as an ultrasound of their chest, may be utilized to assess airway health and function and determine if the cause is allergy related.

Treatment and Taking Action Against Allergens

As in a visit to the human allergist, horses can undergo intradermal (skin) allergy testing to pinpoint the source of a horse’s reaction. For this procedure, the horse has a large patch of hair clipped down on their neck so that tiny amounts of various allergens can be injected into a grid pattern. The veterinarian will examine this grid during different time intervals for signs of an allergic response and determine if a targeted treatment can be taken against those specific allergens.

Photos: A PBEC patient with a swollen, tearing eye aggravated by itching, and its improvement after treatment with prescribed Neo-Poly-Bac-HC (eye medication), flunixin meglumine (Banamine), and protection by a fly mask.

Once the veterinarian determines your horse is suffering from allergies and not another condition, the first thing you can do is try to identify and eliminate the allergen. Figuring out what may have been associated with the onset of the allergic reaction is an inexpensive solution, and often the most effective approach.

From a stable-wide perspective, the most important thing you can do is try to minimize dust and flies, two of the most common allergens. While horses are not generally allergic to flies, some can be allergic to fly bites or specific fly species. Insect bites also increase the horse’s stress level, which can further contribute to the immune system’s response.  While eliminating insects and environmental allergens is impossible, there are several tactics barn managers can take to mitigate both problems.

A good manure disposal system can cut the population of insects in the barn, as will a reduction in any standing water, especially in the springtime when flies and mosquitoes start to reemerge. Owners can protect their horse from insects by using fly sprays, masks, sheets, and boots, and keeping horses inside during times of the days when bugs are most active. Dust- and pollen-related allergic reactions tend to occur when horses are in the barn because it is a closed-air environment. Dust control tactics, such as wetting hay and shavings, keeping barn aisles clean and swept, and managing fresh airflow in the barn with fans and open doors and windows all contribute to better airflow.

Veterinary treatment is the next line of defense in treating allergies. For acute reactions, some horses benefit from short-term treatment with corticosteroids or antihistamines. Those treatments, however, can have side effects and are prescribed when other interventions, such as modifying the environment to reduce the allergen, are ineffective. Immunomodulatory therapy (allergy shots) is another option that may be effective and can be discussed with your veterinarian.

Knowing how to identify allergies affecting your horse and taking steps to eliminate the allergens will lead to easier breathing and happier horses in your stable. For more information, contact Dr. David Priest at Palm Beach Equine Clinic by calling 561-793-1599.

Keeping Horses in the Game

Navigating Lameness Prevention and Treatment

Our responsibility with horses is to keep them healthy and sound. Horses are incredible athletes, and we ask a lot of them. It’s important that they are cared for as the elite athletes they are. Non-equestrians do not equate an equine athlete to a football player, marathon runner, or gymnast, but as horse owners we know that the same level of dedication is required to keep them in optimal health and fitness.

Daniel Bluman and Cachemire de Braize by Jump Media. Sport horse medicine at winter equestrian festival 2021
As the Official Veterinarian of the Winter Equestrian Festival, Palm Beach Equine Clinic has experience providing sport horses with top care. Pictured is Daniel Bluman and Cachemire de Braize, photo by Jump Media.

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

Lameness can manifest itself in different ways, from subtle decreases in performance to severe and obvious signs of pain. Lameness, however, is not a diagnosis or disease; it’s the symptom of an underlying issue, which Palm Beach Equine Clinic veterinarians specializing in Sports Medicine are skilled at diagnosing and treating. Pinpointing the underlying issue is a crucial step in proper rehabilitation.

Prior to rehabilitation comes the constant practice of proactive prevention. Understandably, it is important to do what we can to prevent serious incidents such as falling, missteps, and accidents with other horses. Key to preventative 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 normal wear-and-tear injuries.

Keys to Catching Lameness Early

Early recognition of the signs of lameness may help prevent more serious injuries from occurring that could shorten a performance horse’s career. Having a firm understanding of what your horse’s “normal” is will be crucial to identifying subtle changes in behaviors, movement, or body conditions:

  • Do a daily hands-on leg check, comparing opposite legs to detect heat, swelling, or sensitivity
  • Watch for shortened strides, decreased performance, reduced stamina, changes in attitude
  • Give the horse a few days off if you suspect a problem; if the signs return when they go back to work, ask your veterinarian to examine them
  • Remember that a mild problem can blossom into a career limiting condition if left untreated
Dr. Marilyn Connor soundness exam palm beach equine clinic sport horse veterinarian in Wellington, Florida

Schedule routine performance evaluations by your veterinarian. A thorough evaluation will often consist of:

  • History from rider/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 (a.k.a. nerve blocks) to pinpoint the specific area causing pain
  • Isolation and confirmation of the problem area
  • Imaging – Radiograph (X-Ray), Ultrasound, Nuclear Scintigraphy (Bone Scan), Magnetic Resonance Imagining (MRI), Computed Tomography (CT) – to diagnose underlying issues
  • Specific identification of the lameness or performance problem

Treatment Options

Though preventative care is crucial, we cannot avoid all injuries. Therefore, it is important to work with your veterinarian to develop the best treatment plan before an injury occurs. There are traditional treatment methods such as conservative treatment (rest, ice, compression), medical management (NSAIDS, steroids), intra-articular medication (joint injections), soft tissue (self-derived biologic therapies such as stem cells or pro-stride and shockwave, laser, and ultrasound), and as a last resort, surgery.

Sabine Schut-Kery and Sanceo by Jump Media.
Also the official veterinarian of the Adequan Global Dressage Festival, PBEC has expertise in a variety of sport horse disciplines. Pictured is Sabine Schut-Kery and Sanceo, photo by Jump Media.

Palm Beach Equine Clinic also offers comprehensive Alternative Therapy options for when traditional sports medicine is not your choice. Veterinarians create treatment and rehabilitation programs using traditional and non-traditional therapies, laser, therapeutic ultrasound, acupuncture and Chinese medicine, and shockwave therapy. Palm Beach Equine Clinic can help advise when an alternative method may be the appropriate or adjunct treatment.

There are many non-intuitive causes of lameness that horsemen alone cannot diagnose without the watchful eye of an experienced Sport Horse Veterinarian. At Palm Beach Equine Clinic, the goal is to get horses “back in the game” and keep them safe throughout their athletic careers. PBEC veterinarians know how frustrating injuries can be for horse owners who have personally dedicated years of constant effort and resources to the maintenance of high caliber sport horses. PBEC veterinarians strive to be a part of each winning team’s successes and have been committed to delivering comprehensive care. Contact your Palm Beach Equine Clinic veterinarian today to make sure your horse is in their optimum health.

What to Expect BEFORE Your Mare is Expecting

Considerations for Breeding the Sport Horse Mare

Newborn foal Felix Hope out of Becky Blue, owned by Meg McDermott and bred by Dr. Katie Atwood.
Newborn foal Felix Hope out of Becky Blue, owned by Meg McDermott and bred by Dr. Katie Atwood.

Breeding is not typically on the forefront of owners’ minds when it comes to their high-performance sport horse mare. The focus is mostly on keeping those mares at their best, in terms of health, athleticism, and performance. Prospects for them being bred are usually reserved for well after their competition schedule winds down.

Often when sport horse mares are injured and their careers are either put on hold or cut short altogether, breeding may become the next best option for the owner to consider. Depending on the injury sustained and their overall health and age, breeding can be a great alternative for the out-of-work mare. However, modern reproduction techniques have made breeding the sport horse mare not only an option reserved for after their careers have come to a close. Through embryo transfer, mares can produce multiple foals during the same season all while continuing their training and competition schedules.

With the possibility of breeding comes a significant number of unknowns, so we asked Palm Beach Equine Clinic veterinarian Dr. Katie Atwood to guide us through the process of examining a mares’ reproductive health and the different options for creating a foal.


Start with a vision for the future foal

The first step when embarking on the breeding process is to choose the stallion. This decision hinges entirely on what the owner’s vision and end goal may be for the future foal.

“The owner will need to know what they want that future foal’s purpose to be before choosing a stallion,” Dr. Atwood explained. “Owners should already be in the process of choosing a stallion or have already decided before examining the mare.”

Dr. Katie Atwood - Palm Beach Equine Clinic sperm analysis procedure reproduction

“There are countless breeding stallions across all different breeds and disciplines, and it all comes down to the owner’s opinion and preferences. If I have personally met the stallion, I can comment on their disposition, but I do not make recommendations on one stallion versus another. As the veterinarian, I pay attention to their health and fertility versus the external qualities that do not play a role in reproduction. I let the professionals – owners, riders, and trainers – make those decisions,” said Dr. Atwood. 

Evaluating the mare’s reproductive soundness

After assessing the mare’s overall health and taking into account her breeding history, Dr. Atwood will begin with the reproductive soundness exam. This usually includes a rectal ultrasound and palpation of the uterus, ovaries, and cervix. Dr. Atwood also typically performs a vaginal speculum exam to examine the quality of the mare’s cervix. All the information that Dr. Atwood gathers during this step helps to determine what stage the mare is at in her estrous cycle, identify any potential issues, and establish the next steps.

“When performing that first ultrasound, I look for endometrial cysts, fluid or air, and mucus in the uterus,” said Dr. Atwood. “I examine both ovaries to make sure they appear normal and are cycling normally. There are a lot of elements that can change depending on the time of year and where the mare may be in her cycle. But if we are examining her during breeding season, then I can evaluate whether or not there are any abnormalities.”

During the ultrasound, Dr. Atwood will look for signs of Endometritis, an inflammation and infection of the most superficial layer of the uterus and a big reason why mares can’t get pregnant. It is important to identify issues such as this before taking any further steps.

breeding mare ultrasound exam by reproduction equine veterinarian Dr. Katie Atwood
breeding mare ultrasound exam by reproduction equine veterinarian Dr. Katie Atwood

Age can bring about changes to the uterus, as can any previous pregnancies, so a uterine biopsy is also recommended for older mares (generally over 14 years old) before being bred. Some of those changes, such as fibrosis, are irreversible, which is also crucial to know before you proceed further with breeding.

Maiden mares can also have their own challenges if being bred for the first time at a later stage in their life. “When a middle-aged or older mare has not had a foal before, her cervix does not relax. This means that they more easily maintain fluid in their uterus and that can present its own complications,” commented Dr. Atwood. Dr. Atwood also notes that the conformation of the mare’s external genitalia needs to be taken into consideration. If the mare’s anatomy predisposes her to uterine infections, there will likely be complications throughout the pregnancy.

Getting the timing right

Since many sport horses will travel frequently over far distances and through different climates, its important to consider the mare’s natural estrous cycle and her best time for ovulation. “Here in south Florida, a lot of clients will want to breed their horse when they arrive for the winter season,” said Dr. Atwood. “Their mare may have been in New York for the last 8 months, so her uterus is still influx with New York seasons and she is anestrous, meaning that she is not cycling.”

When the mare is in her seasonal anestrous, her uterus is flaccid and her ovaries are not producing follicles. The veterinarian can administer a hormonal therapy to help trigger ovulation, however, Dr. Atwood tries to go the natural route whenever possible. In these situations where the owner wants to breed the mare and are traveling from up north, Dr. Atwood has a simple yet effective trick.

“I usually recommend putting the mare under lights starting in the beginning of December and lasting until they are bred. This is a very simple, economic way we can naturally stimulate the mare to cycle. The mare only needs to be under lights from 4 p.m. until 11 p.m. and the brightness test is that you’ll need to be able to read a newspaper in the darkest corner of the stall,” said Dr. Atwood.

embryo transfer breeding mare Dr. Katie Atwood

Considering a surrogate mare

Using a surrogate mare is one of the most popular routes for breeding sport horse mares. This process requires an embryo transfer, meaning that an embryo from the donor mare will be transferred to a surrogate, or recipient, mare to carry the foal to term. Embryo transfer has become a leading method for breeding as it relieves many of the owner’s concerns regarding the mare’s health and carrying the foal. It also allows the mare to be bred at an ideal reproductive age without any interruptions to their training and competition schedules.

“The average gestation period for a horse is 11 months and you’re only producing one foal per year with traditional breeding. Embryo transfer allows the mare to produce multiple foals per year while remaining in their normal routine,” commented Dr. Atwood.

What the surrogate mare process entails

Dr. Atwood cautions that a one-to-one ratio is not a good plan for a surrogate mare. In other words, she advises that you do not choose one single mare you’d like to be the surrogate, but rather go through a commercial recipient herd.

Embryo transfer surrogate mare giving birth at Palm Beach Equine Clinic
A surrogate mare giving birth at Palm Beach Equine Clinic.

“I advise clients to not just rely on another one of their mares as a surrogate,” said Dr. Atwood. “In a perfect world, I would line up three recipient mares for every donor mare. The donor and recipient mares have to be on the same cycle because if you are going to take an embryo out, you have to put it in a uterus that’s ready for that embryo.”

Though the deposit to reserve a mare in a commercial herd can be costly and often nonrefundable, it guarantees that there will be a mare in the herd on any given day that is ready to receive the embryo. When it comes time for the embryo transfer, the mare whose uterus is the best quality on that day will receive the embryo. Prior to the embryo transfer, the donor mare will still undergo an ultrasound and palpation exam to determine her reproductive health.

Genetically, the recipient mare has no contribution to the genetic makeup of the foal if breeding through embryo transfer. The foal will be with that recipient mare from birth to weanling (six months), so there is a possibility that some of her personality traits could rub off but that is often not the case. “The recipient mare is usually under the age of eight, an appropriate size, and has a nice, calm disposition,” commented Dr. Atwood. “Some owners do have the recipient mare shipped to their personal barn during the last stages of the pregnancy because they want to be part of the foaling process or have their own team and veterinarian there for that process.”

Speak with a veterinarian about your mare’s breeding options

sport horse breeding at palm beach equine clinic
Newborn foal “Lady” owned by Ponies and Palms Show Stables and bred through an embryo transfer.

If you are considering breeding your mare, keep in mind the time of year, whether you’d like to use a surrogate, and what you want the final result to be. The breeding process can be a bit overwhelming, especially for those who are new to it, but Palm Beach Equine Clinic veterinarians are here to assist and guide you in the process whenever help is needed. At the end of the day, for Dr. Atwood, the reproductive process is her passion, so she is always eager to meet new patients and help plan for a new foal.

“I love the creation of life,” Dr. Atwood remarked. “Equine medicine is intriguing, but you’re usually handling sick, unhealthy animals. With reproduction, I am working with healthy animals and making their babies, which I love.”


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Master of Manipulation

Veterinary Medical Manipulation Case Study

Palm Beach Equine Clinic Veterinarian Dr. Ryan Lukens Veterinary Chiropractic Adjustment Manipulation vertebrae

When the “chiropractor” visits the barn to adjust your horse, what’s really being done is called veterinary medical manipulation, which Dr. Ryan Lukens, DVM, CVMMP, of Palm Beach Equine Clinic defines as the art of improving motion at segmental levels, including bones, the supporting soft tissue structure, and nerves. The ultimate goal of veterinary medical manipulation is to allow free movement throughout the horse’s body by restoring normal range of motion.

The way Dr. Lukens determines what specific segments to manipulate is by motion palpation, or by examining for a decrease in motion. Not only does this have the ability to relieve pain and soreness, but it also reduces the chance of horses having to physically compensate for an area of their body that may not be functioning properly. This act of compensating for being off balance is a frequent cause of sport horse injuries. Regular adjustments by a certified veterinary medical manipulation practitioner helps the horse to maintain their natural balance and full range of motion to perform at the best of their ability.  

Medical manipulation can benefit every horse, from miniature pasture pets to grand prix equine athletes. In addition to improving their range of motion, adjustments can help calm nerves associated with the “fight or flight” instinct.  This can lead to calming effects across various bodily systems such as neutralizing stomach acids, lowering blood pressure and cortisol, and strengthening the immune system.

Case Study

One notable case Dr. Lukens recalls involved a nine-year-old Dutch Warmblood gelding was training at Third Level dressage. The horse was roughly 300 pounds overweight and was too head shy to even have a fly mask put on. Under work, it presented with right front limb lameness and stiffness on the left while traveling left. Balance is essential for dressage, and this horse struggled with its natural balance.

Aerial view showing the spines of both scapula bones clearly visible because of the lack of musculature. Dr. Ryan Lukens Palm Beach Equine Clinic
Aerial view showing the spines of both scapula bones clearly visible because of the lack of musculature.

The horse showed severe cavitation of the muscling in its neck at the first evaluation. The divots seen in the neck indicate the atrophy of the paracervical muscles which is not normal. Though circumstances like this are seen often, it can be a sign that the horse’s nerves are not functioning properly, and that the muscles are suffering. When adjusting the horse, Dr. Lukens found that the horse had restricted movement at the poll and cervical vertebrae 5, 6, and 7 to the left, which essentially covers the whole lower neck on that side, and the sixth cervical vertebrae on the right side.

Atrophied paracervical muscles, shown as divots in the neck, improved after just two sessions and four weeks of training. Dr. Ryan Lukens Palm Beach Equine Clinic
Atrophied paracervical muscles, shown as divots in the neck, improved after just two sessions and four weeks of training.

The horse tolerated the adjustments and was more welcoming to hands on the neck, face, and ears after the manipulations Dr. Lukens performed. Four weeks later, after just two sessions, the muscles appeared more filled out in the neck, signaling improvement. On the left side of the neck, the muscle mass became very convex, signifying proper muscle tone. Dr. Lukens adjusted only the head and neck while treating the horse to see what changed and how the horse performed before making further adjustments. The horse lost about 100 pounds of fat with training, and the right front lameness improved without any other treatment or medical manipulation.

Convex musculature of the neck showing a significant improvement after manipulation sessions. Dr. Ryan Lukens Palm Beach Equine Clinic
Convex musculature of the neck showing a significant improvement after manipulation sessions.

“The diagonal lameness that this horse presented could have been the result of lower cervical pain,” said Dr. Lukens. “The underdevelopment of the muscles of the cervical region that support the scapula was a large clue to the primary problem of this horse’s lameness.”

“Restrictions in the cervical region can cause the horse to keep its head in an extended position and decrease the range of motion within the facet joints of the vertebrae. This decrease, along with local inflammation and the overall restricted range of motion, causes a decrease in the frequency of nerve firings. Nerves that are not firing properly can lead to cartilage degeneration, adhesions, and decreased circulation,” he continued.

Often issues a horse presents physically can be tied back to its inability to access its full range of motion. It is important to have horses routinely examined by a certified veterinary medical manipulation practitioner to ensure proper range of motion, especially if they have demanding jobs that could exacerbate minor injuries with continued work. Dr. Lukens believes that a veterinarian trained in medical manipulation is the safest choice for the horse.

“A veterinarian’s extensive knowledge of anatomy and understanding of when not to adjust a horse is key. Medical manipulation is a safe treatment if performed by the correct practitioner under the correct circumstances. A veterinarian can use a whole-body approach to treating lameness or enhancing performance while ensuring the horse’s safety and well-being.”

Dr. Lukens

To learn more about veterinary medical manipulation or to schedule an evaluation for your horse, contact Palm Beach Equine Clinic by calling 561-793-1599.


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Surprise – It’s a Boy: A Friesian’s Journey to Becoming a Gelding

When Debbie Cruz imported her 2012 Friesian from Europe, she was excited to welcome the gelding into her life. However, the mount she purchased as a gelding from The Netherlands still had a lot of stallion left in him. Literally.

Marquis, Cruz’s hopeful dressage mount, arrived safe and sound to her home in Miami, FL, in early 2020. When he started to display quintessential stallion-like behavior, she called her veterinarian, Dr. Joseph Zerilli, to help her determine the cause of this very “un-gelding like” behavior.

“I was told that he had been gelded while in The Netherlands, but when he came home, he was acting exactly like a stud rather than the sweet gelding I thought would be arriving,” said Cruz. “I wasn’t sure what the cause could have been, but I knew something wasn’t right.”

Dr. Zerilli performed a blood test as part of his exam, which revealed very high levels of testosterone for a horse that was supposed to be a gelding. The level of testosterone present was a solid marker for a retained testis, one that would require surgery to remove. Marquis was referred to Dr. Weston Davis, a board-certified surgeon at Palm Beach Equine Clinic in Wellington, FL.

Dr. Davis used a hCG stimulation test and abdominal ultrasound to determine if testicular tissue was present and the source of Marquis’ testosterone levels were confirmed: he was a cryptorchid. Also known as a “rig” or “ridgling,” a cryptorchid horse has one or both testes that are not fully descended into the scrotum. In Marquis’ case, he had a retained left testis within the abdomen.

In a normal stallion, the testes gradually descended from just below the kidneys, through the inguinal canal, and into the scrotum. This happens either in utero or during the first few weeks of life. Occasionally, either one or both testes fail to descend for reasons that are still not fully understood by veterinarians. A cryptorchid stallion can be further classified as either inguinal when the testis is in the inguinal canal, or abdominal when the testis remains in the abdominal cavity, which was the case for Marquis.

cryptorchid marquis surgery laparoscopy Dr. Weston Davis Palm Beach Equine Clinic

“During surgery, the horse was placed under general anesthesia and we used the laparoscopic camera inserted into the abdomen to examine the retained testis,” said Dr. Davis.

A laparoscopy is an endoscopic procedure where a fiberoptic video camera and surgical instruments are introduced into the abdomen through a small incision. This permits the observation of the inside of the abdomen and allows abdominal surgeries to be performed without a large incision into the abdominal cavity.

“We could see that there was torsion, which indicates restricted blood flow and often pain, as well as severe enlargement,” said Dr. Davis. “The testis, which had become quite large, was then exteriorized through an enlarged paramedian incision. Marquis recovered from anesthesia without complication and with an excellent prognosis.”

“The biggest victory in this rather rare case is that the horse was relieved of pretty severe discomfort and the owner could enjoy the gelding disposition she was expecting.”

Dr. Davis

Aside from pain from the torsion and subsequent enlargement within the body, Marquis’ risk of developing malignant (cancerous) tumors was increased with the testis left inside his body. Prompt diagnosis and surgery likely prevented more critical problems in the future for Marquis.

After recovering from surgery at Palm Beach Equine Clinic’s onsite hospital, Marquis was returned home to Cruz without his retained testis and a new attitude.

“I am very grateful to have had my horse seen by Dr. Weston Davis and his staff. I am not only happy that he was able to get his surgery with one of the best surgeons in the country, but also that it was such a success.”

Debbie Cruz
Marquis owned by Debbie Cruz - cryptorchid success story by veterinary surgeon Dr. Weston Davis
Marquis owned by Debbie Cruz

Marquis’ recovery progressed quickly after he returned to his home barn, and he is now back in the tack with Cruz. “I am looking forward to a long journey with him,” she said. “I am thankful to everyone at Palm Beach Equine Clinic for the care they provided Marquis. I couldn’t see myself going anywhere else.”

Good Vs. Bad Bugs: How Environment Affects Horses’ Gut Health

Dr. Peter Heidmann internal medicine veterinarian equine gut microbiome health abdominal ultrasound
Dr. Peter Heidmann evaluating a patient through an abdominal ultrasound.

Anyone who has experience with horses is aware of the very real threat of losing a horse to colic or other gastrointestinal disease. But looking back on the history of equine death causes, colic still holds the same percentage as it did 20 years ago, standing firm as the second highest cause of death behind natural causes. Why hasn’t modern medicine decreased the chance of losing horses to colic? Why do we all still share the common fear of our horses colicking out of the blue, with little warning and minimal reliable strategies to prevent problems?

The answers to these questions remain a work-in-progress, but over the past 10 years, veterinarians and researchers have learned a lot about the role of the equine gut microbiome on all sorts of health outcomes, including colic, maldigestion, dysbiosis, and a myriad of other health problems.

The organisms that cause diarrhea are mostly bacteria –Salmonella and Clostridium difficile are among the most common

The equine gut microbiome is an ecosystem composed of quadrillions of microbes, including bacteria, fungi, and even viruses, which interact and coexist in the gastrointestinal tract and contribute to overall gut health and well-being. In equines, when the microbiome is disrupted in such a way that populations of beneficial bacteria and yeast have declined and/or populations of harmful pathogenic bacteria and yeast have increased, it is not unusual to see issues such as colic and colitis, laminitis, among other serious conditions.

Like each individual horse, each microbiome is unique; regional, dietary, and even breed and genetic differences can create diverse microbiomes, and varying degrees of digestive health. Even within one horse’s microbiome, the “top end” of the colon can be drastically different from the “bottom end” in terms of the population and diversity of microbes. The way all the organisms perform and act within the microbiome determines the functionality of the gut as a whole. Board-certified internal medicine specialist Dr. Peter Heidmann leads the Internal Medicine department at Palm Beach Equine Clinic and takes us on a deeper dive into the equine gut microbiome.

Microbiome and Nutrition

“When we’re working to improve overall GI health, we are basically trying to increase the population of ‘good bugs’ and crowd out the ‘bad bugs,” Dr. Heidmann remarked.  The combination of probiotics, prebiotics, and diet are all key factors that influence what happens on the inside of a horse’s gut. According to Dr. Heidmann, a well-balanced diet is most important, but the sources of nutrients also play a huge role in promoting gastrointestinal health.

“Probiotics can limit lactic acid production and prevent huge swings in pH in the cecum. This happens through many pathways, but largely by encouraging fiber fermenters over bacteria that like to gobble sugars and produce lactic acid,” he said. “Prebiotics provide additional, non-starch nutrients and are meant to support healthy flora, or microbes. Prebiotics also limit the likelihood and severity of dysbiosis, or microbial imbalance, when the diet changes, like what can happen following sudden exposure to too much starch-rich feed.”

Excessive amounts of starch-rich grains can reduce populations of healthy flora, decrease the types of bacteria that are present in the colon, and also promote overgrowth of unhealthy flora. In turn, overly homogenous populations limit a horse’s resilience to stress, dietary changes, and other unpredictable changes such as those in weather.

Oats and other starch-rich grains cause increases in propionic acid-producing bacteria, while hay-only diets increase acetic acid-producing flora, and therefore promote more diverse and stable populations of beneficial bacteria and yeasts. On the flipside, feeding hay and no grain means the nutrients are being digested much more slowly and will promote more diversity and stability of flora populations.

“At the same time, some ‘good’ bugs are also decreased when a hay-only diet is fed, especially ones that rely on easy-to-digest starchy grains,” noted Dr. Heidmann. “One type of organism, the Lachnospiraceae, is among the most prevalent type present in a healthy horse’s hindgut, and its population also diminishes when grain is not being fed.”

Ultimately, some easily digestible concentrate feeds promote healthy bacterial populations and release lots of energy quickly, yet it is fairly easy and risky to over-do the easily digestible feed. Not only do abrupt changes in diet increase the risk of upsetting a horse’s healthy microbiome, but feeds that are high in carbohydrates can also promote gas formation, lactic acidosis, and other types of colic. “Simply put, garbage in equals garbage out,” Dr. Heidmann explained.

Other Stressors to the Microbiome

Aside from what goes into the horse, there are other factors that determine the behavior of the microbiome and the overall functionality of the gut. Genetic makeup almost certainly plays a role in the way organisms manage the nutrients going in and, in turn, impacts the horse. Stress is another significant factor that definitely has a relationship with the gut, though it remains difficult to draw clear lines of “cause and effect” when studying all the ways that stress affects a horse’s gut health.

Dr. Peter Heidmann palm beach equine clinic veterinarian internal medicine wellington horse abdominal ultrasound

It is common knowledge among trainers that horses with anxious, “stressed-out” personalities seem prone to developing stomach ulcers. Separate from stress caused by riding, changes in surroundings, or even changing stablemates can make a difference in the organisms in a horse’s gut.  Even when the feeding program remains consistent, a change in workload or their neighboring stall-mate invites stress and can promote ulcers.

“There is reason to believe that colon ulcers indicate problems in the gut microbiome,” said Dr. Heidmann. “Organisms, both healthy and not, vary between different barns, even in the same region or town, and those differences are also associated with differences in a horse’s microbiome. Even if horses are on the exact same food, with the same hay and turnout schedule, the flora is going to be different due to varying exposure to new microorganisms.” But this doesn’t mean we shouldn’t subject our horses to change. Many competition horses are accustomed to changes in environment and can perform without major gastrointestinal issues. The primary goal is to maintain as much consistency as possible when horses go through geographical changes that may disrupt their gut health.

“The relationship between stress and gut health isn’t as simple as a cause-and-effect relationship, where stress leads to a direct change in the behavior of the bugs, or where a change in flora directly increases a horse’s stress levels. It is a complex, dynamic interaction; it’s a constant feedback loop.”

Dr. Heidmann

It is difficult enough to separate cause from effect when looking at the relationships between gastrointestinal flora and factors like diet, exercise, pre- and probiotics, or supplemental digestive enzymes.  But explaining the relationship between horse’s behavior and their GI flora is inherently subjective, and therefore even more difficult to confirm. 

“It may seem far-fetched to think that a horse’s behavior might be affected by the balance of flora in their GI tract, but some microbes appear to have developed mechanisms that encourage certain behaviors by producing compounds that mimic the horse’s own neurotransmitters,” reflected Dr. Heidmann. “This can translate into increasing hunger signals or stimulating cravings for certain foods.  Some microbes can enhance taste sensation, and others can co-opt a horse’s normal signaling pathways to enhance mood or increase discomfort by slowing gastrointestinal motility.  Any or all of these mechanisms may be up or down regulated during changes in the balance of GI flora.”

Still More to Learn

Veterinary science and research still have a long way to go to draw firm associations between illness and the microbiome. According to Dr. Heidmann, “it’s not known yet if the disease is the cause of the change in microbiome flora or if it is the result of a change in the flora, but for sure there is a strong relationship between these things.  For now, we don’t yet know if the horse has an unusual balance of organisms because of its problems with chronic colic, or if it is the reverse: that the colic is rooted in an unusual balance of GI organisms.”

With today’s modern scientific tools and research methods, we are closer than we’ve ever been to understanding the dynamics between microbiome and overall health. Comprehensive understanding of the interplay between diet and digestion, between the microbiome and behavior, and between food and flora remains a work-in-progress, but ongoing studies promise to shed light on our current understanding.

In the interim, a consistent regime of diet and exercise, with workload tailored to each horse’s skillset and stage of training, remain the best ways to minimize risk and promote healthy GI flora. “Prebiotics and probiotics and other micronutrients are sometimes necessary,” said Dr. Heidmann, “but the most important things remain hay and sunshine, water and exercise, and consistency most of all.”


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Neuromuscular Biopsies: Cracking the Code on Muscle Disorders in Horses

Dr. Peter Heidmann internal medicine veterinarian palm beach equine clinic neuromuscular biopsy

Identifying the root of performance issues in equine athletes can be like connecting a puzzle of often-ambiguous signs, or a process of elimination through diagnostics. Veterinarians can exhaust all the tools in their medical arsenal trying to figure out why a horse may be losing muscle mass and stamina or refusing to work, but the answer could be hiding in the horse’s muscle tissue. Palm Beach Equine Clinic’s Internal Medicine Specialist Peter Heidmann, DVM, DACVIM, has a keen interest in connecting these signs and identifying muscle disorders.

“Correctly diagnosing and treating muscle disorders in horses can be a very rewarding process, because once you develop an effective treatment plan, the horse will usually experience an extraordinary recovery. I’ve had cases where we sent muscle biopsy samples to a pathologist, enacted a treatment plan, and then sent another sample six months later to check our progress. The results were so impressive that the pathologist called to confirm that it was the same horse!”

Dr. Heidmann

Muscle disorders can present with a range of signs from muscle stiffness and pain to extreme cases of muscle atrophy. Most commonly, presentations occur during training and may include pain, stiffness, tremors, and a reluctance to move. Such symptoms usually lead veterinarians to conduct a full lameness evaluation.

“We usually look at mechanics first, and when there is no lameness determined and no joint, tendon, or ligament issues, we can further narrow down the search to determine if there is nerve impingement leading to muscle atrophy,” said Dr. Heidmann, who will often see a horse with such impingement work very well at an extended trot, but lose all power or appear stiff and lame as soon as the gait is collected.

To confirm a horse’s neuromuscular health and proper function, Dr. Heidmann will first run a blood panel to test for abnormal elevations in two enzymes. The first is serum creatine kinase (CK), which is released within just a few hours of muscle damage. Elevations in CK are usually consistent with training, transport, or taxing exercise. The second is serum aspartate transaminase (AST), which is an enzyme that rises more slowly after muscle injury, and can provide a veterinarian with knowledge about the body’s longer-term response.

Dr. Heidmann runs a blood panel to test for abnormal elevations in the enzymes creatine kinase and aspartate transaminase.
Dr. Heidmann runs a blood panel to test for abnormal elevations in the enzymes creatine kinase and aspartate transaminase.

“If you think of muscle cells as little balloons, once you pop one, CK and AST are released into the blood,” said Dr. Heidmann. “When these numbers are high, we know we have way too many balloons popping all at the same time. Then we just have to figure out why.”

Neuromuscular Biopsies Leading to Diagnoses

The diagnosis of a particular neuromuscular disorder can be challenging, since many of the symptoms are the same, regardless of the underlying disease. After blood testing, neuromuscular disorders can be diagnosed using a muscle biopsy. This minimally invasive, but highly revealing procedure is one that Dr. Heidmann turns to often in order to not only diagnose, but to also provide life and career-saving treatments.

Dr. Peter Heidmann internal medicine veterinarian palm beach equine clinic neuromuscular biopsy bergstrom needle gluteus muscle
Dr. Peter Heidmann internal medicine veterinarian palm beach equine clinic neuromuscular biopsy bergstrom needle gluteus muscle

“I usually use a Bergstrom needle, which is used to collect the sample through a tiny site in the horse’s skin. The muscle tissue then falls into a slot in the needle, and is removed to be examined under a microscope,” said Dr. Heidmann, who also says the most common locations for collecting muscle biopsies, depending on the symptoms, include the triceps, top line, hamstring, gluteal muscle, and tail head of a horse. “You can physically see some of the things that aren’t functioning properly even if the enzymes aren’t high.

“The beauty of a muscle biopsy is that you are looking at where the nerves come into the muscle, so you can detect abnormal nerve supply to an area while leaving the horse with nothing more than a nick in the skin,” he continued. “Once we see the muscle tissue, we can tell if the horse requires nutritional changes, injections, or other treatments. Non-invasive nerve stimulation is what the future holds for the treatment of many muscle disorders, but it is still an evolving treatment in veterinary medicine right now.”

Once the muscle biopsy is collected, Dr. Heidmann can go to work identifying the problem while the horse immediately returns to work. Non-invasive diagnostics and treatments are the wave of the future in both human and equine medicine. For Dr. Heidmann, neuromuscular biopsies are helping him to look below the surface of a horse’s skin to evaluate, diagnose, and provide treatments without making a single cut.

Learn more about Equine Internal Medicine by clicking here.

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Considerations for the Aging Performance Horse | Part 2

Catch up on Part 1 of Considerations for the Aging Performance Horse first by clicking here.

Provide a safe, comfortable environment

Clean stall at Palm Beach Equine Clinic Horse Hospital in Wellington Florida.

Ensuring your aging has a well-bedded, sanitary space with adequate water and protection from rain, snow, direct sun, and biting insects will help keep them comfortable. Middle-age and senior horses may also become more sensitive to respiratory irritants such as mold, fungus, dust, and pollen. As a result, it is recommended that barn and stall cleaning is done while the horse is in turnout or being ridden so they do not breathe in dust stirred up during cleaning. Minimizing their exposure to these irritants by maintaining a clean and well-ventilated stable will go a long way in keeping an older horse healthy.

Schedule regular veterinary performance evaluations

Dr. Marilyn Connor Palm Beach Equine Clinic Senior Horse Health Flexion Performance

Like all athletes, horses can experience physical setbacks and are not always so quick to bounce back as they age. Osteoarthritis and laminitis are two common medical conditions that become more prevalent with age. It is important for the middle-age and senior performance horse to be managed with proper veterinary care, farriery, and a suitable training program.

Routine performance evaluations by a veterinarian are a useful tool in detecting subtle changes in a horse’s gait and movement before issues become injuries. A veterinarian will be able to suggest the appropriate treatment, such as anti-inflammatories, joint injections, biologic therapies, or alternative medicines, to maintain and even increase the horse’s flexibility, range of motion, balance, and ease any discomfort. Many owners begin consulting their veterinarian on regenerative and alternative therapies well before their horse has reached senior years as these therapies may help to support longevity in performance and better health for the horse’s organ and musculoskeletal systems. 

Pay attention to changes in behavior and contact your veterinarian

Changes in the horse’s behavior or energy level, even minor or seemingly unimportant changes, can be indicators of underlying issues or disease. Exercise intolerance, poor coat condition, weight loss, stiffness, dropping feed, or changes in how much water they drink can be signs that something may be going on and should be communicated to your veterinarian. The sooner issues are identified, the sooner the horse can receive the right care and ultimately ward off serious illnesses.

Dr. Kathleen Timmins Palm Beach Equine Clinic

Periodic preventative care checkups, performed at least bi-annually, can be key to catching many age-related conditions and diseases that owners may not notice in their everyday care due to a gradual onset. Involving your veterinarian in the management of your senior horse will go a long way toward ensuring their health and happiness throughout their golden years. Reach out to your Palm Beach Equine Clinic veterinarian for any questions about your horse’s health at any age by calling 561-793-1599 to schedule an appointment.


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Considerations for the Aging Performance Horse | Part 1

aging performance horse veterinary care senior geriatric

From a veterinary perspective, horses can be considered “middle-aged” by 13 years of age, and “seniors” by 20 years of age. Although many sport horses may just be coming into their prime for training and competing during these years, horses show signs of aging at different rates just like humans do. As horses age some physiological functions start to decline, and they require extra care to maintain their overall health and condition.

Advances in diagnostics, therapies, and medications can help to support equine athletes and keep them performing well into their golden years. While many of the same health factors apply to horses of all ages, several additional and significant concerns should be considered for the aging horse.

Meet your horse’s nutritional needs

equine nutrition aging performance horse

Aging impacts a horse’s ability to digest and utilize the nutrients in its feed as well as its ability to maintain weight and muscle mass. Senior horses require a diet that is highly digestible, palatable, and has an amino acid profile that will maintain muscle mass. As diet is one of the most crucial facets of a horse’s care, owners can consult their veterinarian to make sure they are fueling their aging horse with an adequate ratio and amount of high quality of forage, grains, vitamins, and minerals.

“When it comes to the best nutrition for senior horses, access to high-quality forage is very important and some horses may need free-choice quality hay to maintain optimum health,” said Dr. Marilyn Connor of Palm Beach Equine Clinic. “There are many commercially available feeds labeled as “senior” that are formulated to meet the dietary needs of the middle age to senior horse. These feed products are often beneficial to all adult horses as they are processed to be nutrient dense and highly digestible.”

There are many additional factors that go hand-in-hand with feeding a senior horse, such as minimizing the risks of colic and ensuring the best dental health. A veterinarian will be able to advise the owner if their senior’s diet is meeting the horse’s needs and setting them up for success in the years to come. 

Be mindful of dental health

Tyler Davis Equine Dentistry Senior Performance Horse Health

The digestion process begins in the mouth, so maintaining good dental health is imperative. Equine teeth, unlike human or a small animal teeth, will continue to grow throughout the horse’s life. An annual dental exam by a veterinarian will go far in preventing and fixing sharp points, hooks, chipped or fractured teeth, or damage to soft tissue within the mouth.

“In geriatric horses, the teeth are no longer erupting as quickly and as a result they may not develop sharp points as quickly. With age however, the teeth wear which causes the crown to thin and roots to shorten. As this happens, the teeth are more prone to damage and fracture. Regular dental exams – at least on an annual basis – will catch these potential issues sooner than if allowed to become problematic.”

Dr. Tyler Davis of Palm Beach Equine Clinic

“Another condition more common in geriatric horses is Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH). This condition affects the incisors and occasionally the canine teeth and can be very painful. Often times, EOTRH can be recognized as irritability, head shyness, or if the horse struggles to bite treats like carrots. We can make a definitive diagnosis of this through taking radiographs,” continued Dr. Davis.

Monitor internal health

Palm Beach Equine Clinic Laboratory
Palm Beach Equine Clinic Laboratory

Older horses are more prone to developing endocrine diseases such as Equine Metabolic Syndrome (EMS) or Pituitary Pars Intermedia Dysfunction (PPID or Cushing’s disease). These diseases can lead to progressive deterioration of healthy tissue and have major negative effects on almost every bodily system in the horse. A horse with unmanaged PPID is more likely to experience episodes of laminitis, chronic infections, anhidrosis, and infertility, as well as career-ending soft tissue injuries. Research indicates that between 20 to 30 percent of horses over the age of 13 have PPID, many with no clinical signs making the disease go unnoticed.

“I recommend that all my patients over the age of 13 start annual endocrine metabolic testing to look for early changes associated with PPID or EMS. Horses can start to develop these diseases at as early as seven-years-old. I think it is critical to be proactive in the middle-age and senior horse so we can start treatments to correct the hormone imbalances before they begin to cause long term damage or the horse sustains an injury that might have otherwise been avoided.”

Dr. Marilyn Connor of Palm Beach Equine Clinic

Routine blood tests, such as a Complete Blood Count (CBC) or Serum Chemistry analysis are useful in identifying changes to the horse’s red and white blood cell counts (to see if they may be anemic) and to assess internal organ function. Having your horse tested every six to 12 months will be helpful for tracking and detecting any changes in their health and implementing treatment early on.

Immune system function also gradually declines with age, making middle-age and senior horses more susceptible to illnesses. It is important for owners to stay vigilant and up to date on their horse’s core vaccines, and to consult their veterinarian about timing and frequency of boosters to make sure their horse is protected.   

Palm Beach Equine Clinic also recommends routine fecal testing to evaluate the horse’s internal parasite count and implementing a consistent deworming program. This is imperative for clients based in Florida year-round due to the lack of frost which usually kills many parasite eggs in northern climates. Fecal egg count testing should be performed twice per year, in the spring and fall, to assess parasite load in the intestines. It is important to note that not all parasites are susceptible to every deworming product, and the results of a fecal test will give the veterinarian insights as to the type of parasites and which dewormer is best to administer for that unique horse. Palm Beach Equine Clinic veterinarians have access to the laboratory equipment onsite to run the vast majority of these tests for rapid same day results.

Click here for Part 2 of Considerations for the Aging Performance Horse.


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