A Look at Palm Beach Equine Clinic’s Advanced Imaging Technology

Dr. Sarah Puchalski reviewing a CT scan at PBEC.
Photo by Jump Media

Palm Beach Equine Clinic takes pride in being a world-class facility for the diagnosis, treatment, and recovery of some of the industry’s most valued sport horses, as well as backyard companions. A vital area of the Equine Hospital that helps veterinarians to diagnose subtle or acute lameness is the Advanced Imaging Department.

Producing thousands of scans a year across all modalities, the Palm Beach Equine Clinic Imaging Department offers an on-staff, board-certified radiologist, and equipment that elevates the effectiveness of lameness diagnostics. Lameness is no longer a guessing game as PBEC veterinarians have an arsenal of imaging technologies to capture inside the horse.

Tour the PBEC Imaging Department:


Palm Beach Equine Clinic bone scan nuclear scintigraphy diagnostic imaging

Nuclear Scintigraphy (Bone Scan)

Nuclear scintigraphy begins with the injection of a radioactive isotope called Technetium 99 that is bound to a phosphate analogue. The isotope – phosphate molecule attaches to the mineral matrix of the bone in areas where bone is active. A gamma camera is then used to capture images of the skeletal anatomy. Points that “light up” on the image indicate increased metabolic activity as a possible site of injury.

Standing Magnetic Resonance Imaging (MRI)

The standing MRI produces highly detailed, cross-sectional images of bone and soft tissue in multiple different planes to fully image a desired region. The standing MRI requires sedation (not anesthesia) and is best used to further define a specific area that has already been pinpointed as the origin of lameness.

Computed Tomography (CT)

Similar to its use in humans, CT allows veterinarians the unique opportunity to conveniently explore areas of a horse’s body that were previously inaccessible. The machine produces 360 degree images of a horse’s neck, spine, and head and can be conducted while a horse is standing and under only light sedation.

Endoscopy

An endoscope is an instrument that allows veterinarians to look inside the body by being inserted through a natural opening or incision. A tiny camera on the instrument allows an in-depth view of internal structures such as the upper and lower respiratory track, gastrointestinal and urinary tracts, as well as the cervix and uterus of mares.

Palm Beach Equine Clinic Sport Horse Medicine Radiography

Digital Radiography

Used routinely, radiographs are traditional x-rays that are made available within seconds for digital viewing and evaluation.

Ultrasonography

An ultrasound machine generates high-frequency sound waves, which echo an image back to the machine where bone appears white, fluid appears black, and all other structures are on a grayscale. An ultrasound is non-invasive, usually does not require sedation, does not use radiation or require injecting radioactive isotopes, and provides real-time images.


“These tools can give a definitive diagnosis, and that saves time and money in the long run,” said board-certified radiologist Dr. Sarah Puchalski. “For example, if a horse goes lame and it gets seen and treated empirically, which is a diagnosis based on likely problems through common diagnostic procedures, it either stays sound or it becomes lame again or even non-functional in three to six months. This method sets back the commencement of the appropriate therapy.

“What these modalities do is allow the horse to be treated early and correctly,” continued Dr. Puchalski. “Otherwise, you may not be treating the correct issue, and the horse could end up lame again very soon.”

Brittany Riddle, manager of PBEC’s Nuclear Scintigraphy Department, is fascinated by the structure of the horse’s body and helps to produce hundreds of bone scans per year.

“I’ve always had a strong interest in the anatomy of horses,” said Riddle, who spends her workday keeping patients comfortable and calm while operating a gamma ray camera housed in its own suite at Palm Beach Equine Clinic. “The horses are under light sedation for standing scans and these usually take from one to four hours depending on the type of scan. Usually during the winter competition season, we have anywhere from two to three horses being scanned daily.

“The variety of patients we treat is always interesting,” continued Riddle. “We see patients from all aspects of the industry. From racehorses to polo ponies, western performance, dressage, top show jumpers and hunters.”

According to Palm Beach Equine Clinic President Dr. Scott Swerdlin, having the latest in diagnostic capabilities drives the success of the Clinic.

“Many years ago, we committed to establishing Palm Beach Equine Clinic as an all-inclusive hospital and making it the most advanced referral center in the country,” said Dr. Swerdlin. “By investing in the very best personnel and equipment, we are able to provide the very best care we can for our patients.”

Palm Beach Equine Clinic is the only equine veterinarian based in Wellington, FL, with the powerful SmartRLT Laser.

Palm Beach Equine Clinic’s Dr. Natalia Novoa goes far beyond standard treatment by utilizing Regenerative Laser Therapy.
Palm Beach Equine Clinic’s Dr. Natalia Novoa goes far beyond standard treatment by utilizing Regenerative Laser Therapy.

Dr. Natalia Novoa utilizes this revolutionary sport horse medicine tool to treat a variety of injuries and wounds with clinically documented success. The SmartRLT laser is a portable Class IV laser, the most potent and dynamic on the market, as an essential non-invasive therapy for use in the barn and at horseshows. Not only is Dr. Novoa’s regenerative laser extremely effective in treating injuries that were previously considered career-ending, but it is also especially beneficial for enhancing body condition and performance of the equine athlete. 

Clinical and scientific results of the SmartRLT include:


  • Repair of ligament and tendon lesions
  • Reduces scar tissue within and around injuries
  • Reduces inflammation
  • Increases collagen production
  • Increases blood circulation to bring nutrients to the site
  • Realigns muscle fibers for stronger healing
  • Provides analgesia (reduces pain)
  • Enhances tissue oxygenation
  • Increases cell proliferation (generates more cellular energy)

Regenerative Laser Therapy has successfully treated injuries to structures such as:


  • Cartilage/bone/joints
    • Neck and poll, stifles, temporo mandibular joint (TMJ), hocks, fetlocks, and coffin joint
  • Sore feet and laminitis
  • Sore muscles (especially back and gluteal)
  • Suspensory ligaments and branches
  • Superficial flexor tendons
  • Deep digital flexor tendon and its insertion inside the hoof
  • Inferior and superior check ligaments
  • Collateral ligaments
  • Summer sores and scratches
  • Scar tissue
  • Open wounds and punctures
  • Sub-dermal infections
  • Post-operative incisions
  • Sacroiliac joint and kissing spine
Left front suspensory ligament medial branch core lesion before and after regenerative laser therapy. Photo courtesy of SOUND.
Left front suspensory ligament medial branch core lesion before and after regenerative laser therapy. Photo courtesy of SOUND.
Deep digital flexor tendon before and after regenerative laser therapy. Photo courtesy of SOUND.
Deep digital flexor tendon before and after regenerative laser therapy. Photo courtesy of SOUND.

Regenerative Laser Therapy Case Study: Lameness

Patient Condition Grand Prix level show jumper with left front lameness.
Evaluation Magnetic Resonance Imaging (MRI) showed intra-osseous fluid accumulation in the left front third metacarpal condyle.
Treatment 20 sessions of Dr. Novoa’s SmartRLT.
Result Fluid in the third metacarpal condyle was resolved.
Palm Beach Equine Clinic Regenerative Laser Therapy Case Study: Lameness.
Palm Beach Equine Clinic Regenerative Laser Therapy Case Study: Lameness.

Custom Treatment for Your Unique Horse


Dr. Novoa’s SmartRLT is a pioneering technology that has evidence-based settings and treatment protocols to optimize the effectiveness for each unique patient. Treatments are customized for the specific structure, acute or chronic conditions, deep to superficial and skin pigmentation to reach the best outcomes.

Regenerative Laser Therapy provides a warm, soothing sensation and does not require sedation. Treatments can be performed at the barn or horseshow. Be sure to share your competition schedule with your veterinarian so treatments can be done within a safe and legal timeframe.  

General Protocols for Regenerative Laser Treatments

Pre and Post Performance: 1-3 sessions
Acute Conditions: 6-10 sessions for the first two weeks
Chronic Conditions: 2-3 sessions per week for approximately 10 weeks

Laser Therapy 101


Laser therapy is beams of electromagnetic energy that interact chemically and biologically with the targeted tissue or injury. This creates photobiomodulation, allowing maximum penetration of tissue structures. Laser therapy releases endorphins while increasing cellular activity, blood flow and enhancing tissue oxygenation. Essentially, it enhances the body’s natural healing mechanisms and expedites the restorative process.

Regenerative Laser Therapy goes far beyond standard lasers.

Regenerative Laser Therapy releases greater energy per pulse to create a photomechanical effect at the cellular level. It can be directed to the target injury or lesion to regenerate, revitalize, remodel, repair and realign tissue. Therefore, it is essential for equine sports medicine, lameness, rehabilitation and optimizing performance.  

Regenerative Laser Therapy may only be administered by a veterinarian. Dr. Novoa is the only veterinarian based full-time in South Florida offering the SmartRLT treatments.

Marilyn Connor Palm Beach Equine Clinic Veterinarian

Dr. Marilyn Connor of Palm Beach Equine Clinic Discusses Balancing Your Horse’s Energy Sources for Performance

The modern equine athlete is asked to train and compete at far more demanding levels than horses in nature. Providing your horse with a diet that matches their metabolic needs, activity level, and training demands is key to success. To fuel our sport horses, we must first understand their nutrition and energy needs and give them the adequate support to succeed.

Physical Demands

Anaerobic vs. Aerobic Exercise

Palm Beach Equine Clinic is a major sponsor and partner of equestrian competitions across disciplines

Glucose is stored in the liver and muscle cells as Glycogen, or a complex carbohydrate. Glycogen is broken down into glucose to meet metabolic energy requirements and provides energy for short to medium duration physical activity. Additionally, fat can be broken down and converted into glucose through a longer and more complex process.

Exercise can be characterized into two general categories: anaerobic and aerobic. Anaerobic exercise is characterized by short bursts of maximal effort activity, while aerobic exercise includes low to moderate intensity activity that lasts for a longer duration.

Both anaerobic and aerobic exercise utilize glucose as the primary source of fuel. Anaerobic and aerobic exercise differ in their secondary source of energy utilized once circulating glucose is depleted. Anaerobic exercise utilizes glycogen stores after glucose is depleted, while aerobic exercise is fueled by fat sources.

No equestrian sport is entirely anaerobic or aerobic. Most disciplines will have periods that require anaerobic and aerobic energy metabolism. Racehorses and western performance horses work at high intensity, fast speeds for short periods of time, requiring the body to utilize anerobic metabolism to produce energy. Show jumping and polo horses primarily use aerobic exercise yet will switch to anaerobic metabolism to keep up with energy demands of their sport. Eventing and endurance racing horses rely primarily on aerobic metabolism to support their energy needs over long periods of activity.

To support your horse during any type of sport, they must have a balanced nutrition program that sets them up for success.

Forage First

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic forage first

“Providing high quality forage is always my top focus for any nutrition program, regardless of the horse’s breed, age, gender, metabolic needs or athletic activity,” says Dr. Connor.

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic grain

Horses are herbivores and evolved to survive by grazing on a steady supply of fresh grasses and plants. Research conducted on horses in nature shows that the average wild horse will spend 15 to 17 hours per day grazing and will travel 20 to 30 miles per day in their search for adequate food and water sources. To accommodate for the lifestyle of the modern sport horse, owners must provide high quality forage sources.

Fresh grass contains an optimal blend of key nutrients including protein, carbohydrates, vitamins and fatty acids. Once grass is cut, dried and baled as hay, the nutritional benefits begin decreasing. A week after cutting, hay loses about 60% of its vitamin A, E, and Omega 3 fatty acid content. As a general rule, horses should consume 1 to 1.5% of their body weight in hay or forage per day, with some high performing equine athletes requiring 2 to 2.5% to meet their energy needs.

When hay and forage alone are not enough to support the intense metabolic needs of the equine athlete, grain, and concentrated feed become an important part of the nutritional plan.

Building Blocks of Energy Sources

Feeding your horse with the appropriate mixture of carbohydrates, proteins, and fat is essential for fueling athletic performance.

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic
Dr. Connor recommends the Platinum Performance Wellness and Performance Formula supplement which is available through the Palm Beach Equine Clinic Pharmacy.
Dr. Connor recommends the Platinum Performance Wellness and Performance Formula supplement which is available through the Palm Beach Equine Clinic Pharmacy.

A horse whose training requires a high level of aerobic exercise, such as a dressage horse, should receive an adequate amount of fat and carbohydrates in their diet to fuel them through longer duration training sessions by providing extended, long-lasting energy sources. Racing and barrel horses, utilizing anaerobic exercise, require a higher percentage of carbohydrates in their diets to support them through maximal effort exercise for shorter periods of time.

Carbohydrates are sourced from forage, grains, and concentrated feeds. Forage sources provide a complex source of fibrous carbohydrates that require more time for the body to digest. Concentrated feeds and grains contain starchy carbohydrates that are easily digested and quickly converted into energy to fuel a horse through intense training. A well-balanced concentrated feed will also have an appropriate blend of fat, protein, and trace minerals.

Protein is an important part of the equine diet and is found in fresh grass, dried forage, and concentrated feeds in varying amounts. Protein is made of amino acids, which are the building blocks for growth, development, repair, and maintenance of body tissues. The modern equine athlete requires a substantial amount of dietary protein to support muscle growth and ongoing tissue repair.

Fat is a key component in most equine concentrated feeds and may be supplemented by adding flax seeds, flax oil, rice bran, and corn oil. These fat sources will provide slow burning calories for sustained energy release. Fat can be especially useful for supplementing a horse’s diet when they are a “hard keeper” or if they have an underlying metabolic condition that requires dietary carbohydrates to be limited.

It is important to remember that not all fats are created equal; as some fat sources can decrease or increase inflammation in the body. Flax seed and flax seed oil are rich in anti-inflammatory omega 3 fatty acids and can be an excellent source of energy. Corn oil is commonly used to add calories and fat; however, it is a less desirable supplement due to its higher percentage of omega 6 fatty acids, which contribute to inflammation. Concentrated feeds will have varying levels of added fats depending on the type of horse it is designed to feed.

Balancing Your Horse’s Energy Sources for Performance

Whatever equestrian discipline is your passion, your horse will need to be fueled by a balanced nutritional plan.

Understanding Energy Support for the Performance Horse Palm Beach Equine Clinic polo

“Feeding instructions provided on grains and concentrated feed products are designed by nutritional companies as guidelines; they are not rules and should be adjusted based on total sources of nutrition,” said Dr. Connor.

Establishing the proper balance of forage, starchy carbohydrates, fat sources, vitamins, and minerals will be different for each unique horse and the demands placed upon them.

Understanding the nutritional demands of your horse can be very simple or very intricate, depending on your unique equine athlete. When designing a feeding program, it is important take into consideration your horse’s athletic discipline, performance level, metabolic needs, stage of life, and any underlying medical conditions. Furthermore, your horse’s nutritional needs will vary over time and as they age, so it is important to periodically assess your horse’s body condition and consult with a knowledgeable veterinarian.

Speak with Dr. Marilyn Connor of Palm Beach Equine Clinic about your horse’s unique nutritional needs to ensure your horse is fully supported and on track to reach your competitive goals.

Schedule a Nutritional Consultation with Dr. Connor

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

Categories
Surgery

When the Bone Breaks

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

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

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

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

What is a Condylar Fracture?

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

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

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

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

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

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

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

What is the Treatment?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

4. Especially in the extreme summer heat, horse owners should pay attention to the amount of sweat their horse is producing. Anhidrosis, or the inability to sweat normally, can be a common challenge, particularly in hot, humid climates. In addition to lack of sweat, signs of anhidrosis can include increased respiratory rate, elevated temperature, areas of hair loss, or dry and flaky skin. If you notice any of these signs, contact Palm Beach Equine Clinic immediately.

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

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

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

Vertebral Anatomy

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

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

Signs of Lameness Related to the Neck

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

Identifying Lameness through Diagnostic Imaging

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

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

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

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

Thrush, rainrot, and scratches are problems that most equestrians have probably encountered, but in the hot, often humid summer months, these issues can incessantly plague horses and their owners. While different in their presentation, thrush, rainrot, and scratches have a lot in common. For horse owners, there are several problems that arise due to environmental factors or predisposing conditions, but these issues can easily be prevented or treated with proper care and management.

This month, Palm Beach Equine Clinic’s Dr. Bryan Dubynsky shared his expertise on the causes, treatment, and prevention of thrush, rainrot, and scratches.

Thrush

Thrush is an infection within the horse’s hoof most commonly caused by bacteria that invade the deep clefts or grooves (known as sulci) of the frog. Fusobacterium Necrophorum is the common bacterial culprit, which naturally occurs in the environment, especially in wet, muddy, or unsanitary areas. Thrush bacteria thrive where there is a lack of oxygen.

Some horses are predisposed to developing thrush due to conformation, such as a rather high heel or deep sulci, or a narrow or contracted heel. The bacteria will manifest in horse’s feet that are not picked out regularly, or standing in muddy, wet environments, including paddocks or stalls that have not been cleaned properly. Thrush can typically be first identified by the odor. The frog will have a strong, rotten odor and become spongy. Visually, the frog can even exudate (ooze) pus.

The treatment for thrush is fairly simple as it is very sensitive to oxygen. The most important thing is to have your vet or farrier trim or debride the frog to expose affected areas to the air. It is best to keep the hoof clean and dry. Adding a common detergent to the thrush areas, such as Betadine or any commercial product (Thrush Buster, Coppertox, etc.) will help to kill the bacteria. Most importantly, if the horse is not removed from those predisposing environmental factors, treatments can be ineffective.

Maintaining a level of activity for our equine partners will increase blood flow to the feet and promote health in the area. Horses found in dry environments with ample space to move typically do not suffer from thrush. The activity of horses moving keeps the frogs healthier. The more blood flow you have in the foot, the less chance there is for infection to manifest. Thrush does not always cause lameness. In extremely rare cases, thrush can penetrate deeper and cause an infection in deeper tissue or even in the coffin bone. When in doubt, always contact your veterinarian.

Rainrot (Dermotophilus Congolensis)

Rainrot is caused by a naturally occurring bacteria named Dermotophilus, which produces spores. The condition is recognized as scabby, scaly, crusty spots on areas of the horse that have been exposed to rain. It is commonly seen on the neck or across the back (dorsum). Rainrot is not typically apparent on the legs or under the belly. A surplus of rain on the skin washes away the natural protective oils. Once the skin is stripped of the natural protective layer or any sort of trauma to the skin barrier occurs, which can be even as simple as an insect bite, the Dermotophilus spores are able to invade the deeper dermis skin layers. The spores penetrate into the deeper layers of the dermis, and the body reacts by sending white blood cells and proteins to fight the invaders.

This reactive response causes small pustules, scabs, and bumps to form. Similar to thrush, rainrot is an environmental issue. It is most commonly seen in warm areas with high humidity, excess rain, and insects. The most important prevention is to keep horses out of prolonged periods of rain. A horse can be out in the rain for short periods of a day or two, but if it is constantly in hot and rainy conditions with biting insects, more than likely the horse will develop rainrot.

Palm Beach Equine Clinic Veterinarian Dr. Bryan Dubynsky
Dr. Bryan Dubynsky of Palm Beach Equine Clinic.

Dr. Dubynsky emphasizes that topical products are not worth anything if the horse is not removed from the environmental factors. Once you remove the environmental factors, a keratolytic agent (something that exfoliates keratin), such as benzoyl peroxide or an antibacterial shampoo, will help the skin heal. He also cautions that if the horse does have scabs, you do not necessarily want to pick the scabs off because then you are leaving open skin without protection for more bacteria to invade. The most important tip to healing is to keep the area dry.

In very rare, severe cases of rainrot, it is best to contact your veterinarian to put the horse on antibiotics. If left untreated, and the horse is not removed from the environmental causative factors, the infestation can lead to Staphylococcal Folliculitis; a type of Staph bacteria that will invade the hair follicles and cause a more serious situation.

Scratches

Scratches is a generic term for many different ailments. The definition of scratches can be a bacterial, fungal, or viral dermatitis or inflammatory condition of the pastern or fetlock. It is defined as a chronic Seborrheic Dermatitis, characterized by hypertrophy and exudation on the palmar plantar surface of the pastern and fetlock.

There are certainly predisposing factors for scratches, including the same environmental factors that cause thrush or rainrot. Predisposing factors for scratches include horses that are bathed often or stand in wet conditions all the time. Horses that have an excess amount of hair on their legs, especially draft horses, may be more prone to developing scratches. This is because the hair traps dirt and moisture on the skin. Scratches can develop in horses that are bathed too often, such as the intensely managed show horse. Frequent bathing of the horse can strip away the natural protective oils and barrier of the dermis. This allows bacteria or fungi to invade. When moisture penetrates the skin, it causes an inflammatory reaction. This presents as heat, redness, pain, and loss of protection to keep bacteria out.

The most effective first step for prevention and treatment should be to eliminate environmental predisposing factors. Removing excess hair during humid months and keeping horses clean and dry to the best of your ability will reduce the probability of developing an infection. Bathing horses once a day with Betadine or antifungal/antibacterial shampoo will help to clear the infection. Be sure to leave the shampoo on for 20 minutes for all of the medicine to penetrate. Rinse thoroughly, and make sure the horse is completely dry. In order to effectively treat the bacteria, horses, especially their legs, should be completely towel- or air-dried before being returned to their stalls or paddocks.

As always, contact your veterinarian immediately if there appears to be a deeper infection present, or if you would like more detailed information on how to treat and prevent these bacterial infections. To contact your Palm Beach Equine Clinic veterinarian, call 561-793-1599 or visit www.equineclinic.com.

The summer weather is here! With the humid weather, pesky flies are at their worst, which creates problems for many horse owners often leading to summer sores, medically known as Habronemiasis.

What are Summer Sores?

Summer sores are lesions on the skin caused by the larvae of equine stomach worms Habronema. These worms in the horse’s stomach produce eggs that pass through the digestive tract and are shed in the horse’s feces. Barn flies typically gather around manure and ultimately collect the parasite’s larvae on their extremities. Summer sores will occur when flies carrying the larvae deposit the eggs onto an open wound or the mucous membranes of a horse. The larvae infect the open wound or mucous membranes, causing an inflammatory reaction including symptoms of inflammation, discharge, and the production of granulation tissue infected with larvae.

Detecting Summer Sores

One way to detect a summer sore is the visible granulation of tissue containing small yellow, rice-like larvae within the skin and a mucopurulent (mucus or pus-like) discharge associated with the wound. Prevention is the most effective way of controlling summer sore outbreaks and the best way to protect horses is to implement effective methods for:

Healthcare Reminder: Equine Summer Sores
Healthcare Reminder: Equine Summer Sores
  • fly control
  • manure removal
  • proper wound care
  • an effective de-worming program

A diligent de-worming program is the most important element of prevention because effective de-wormer disrupts the parasite’s life cycle internally. The key is to kill both adult worms in the stomach and the larvae that form in the skin tissue.

Treating Summer Sores

For treatment of summer sores themselves, corticosteroids are administered to reduce the inflammatory hypersensitivity reaction, and antimicrobials treat any secondary infections that may develop as the result of an open wound. If not treated properly, summer sores can last up to several months and possibly require a costly surgical procedure to remove the granulated tissue and larvae. At the first sign of a summer sore, contact your veterinarian at Palm Beach Equine Clinic at 561-793-1599 to discuss treatment and develop an effective fly-management program for your barn.

Palm Beach Equine Clinic has the most advanced state-of-the-art diagnostic imaging equipment available. More specifically, Equine Standing Magnetic Resonance Imaging (MRI) allows Palm Beach Equine Clinic to quickly and accurately diagnose injuries for their clients.

equine standing mri palm beach equine clinic
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Every horse owner dreads seeing signs of lameness or discomfort in any horse, whether it is a backyard companion or a top-caliber sport horse. For performance horses, however, one of the first questions many owners ask upon contacting a veterinarian about a problem is, “Can the horse safely and comfortably return to work?” Using Palm Beach Equine Clinic’s cutting-edge equine standing MRI technology, the clinic veterinarians are best equipped to answer that question.

The equine standing MRI produces highly detailed images in several different planes to capture a complete image of the desired area. An MRI is best used to further define a specific area of bony or soft tissue that has been pinpointed as the origin of lameness. The process can be completed while the horse is in a standing position and requires only light sedation.

equine standing MRI horse palm beach equine clinic

Lameness or performance problems are most frequently approached through routine x-rays and ultrasounds, which can come back normal. Thus, it is difficult to diagnose subtle problems because the most common tools are not sensitive enough to pick them up. At Palm Beach Equine Clinic, the Equine Standing MRI gives veterinarians an advantage when troubleshooting a lameness issue and helps them to determine a correct diagnosis in a timely manner.

Hundreds of MRIs are read each year at Palm Beach Equine Clinic. In addition to being a state-of-the-art diagnostic tool, the equine standing MRI technology also affords economic benefits to owners by having their horse’s problem diagnosed and treated safely, effectively, and quickly.

Caring for the Senior Performance Horse

Part 2

The veterinarians at Palm Beach Equine Clinic take pride in emphasizing the importance of proper care for equine athletes that are aging into their senior years. Advances in equine medicine are enabling horses to perform longer. Last month, we discussed the importance of routine veterinary examinations to ensure top health, appropriate fitness programs to maintain stamina and muscle mass, treatments for physical discomfort, and proper care throughout the hot summer months. This month, we highlight how the evaluation of metabolic and organ function and proper parasite control can benefit the senior performance horse.

Horses from the ages of 12 and older are considered “senior.” Many horses that are in the prime of their careers are over this threshold and may require extra maintenance in order to continue performing at their best. Maintaining these athletes in peak condition requires teamwork between the owner and their veterinarian.

Metabolic Function of the Senior Performance Horse

An important component of physical health in the aging equine is the metabolic function. As horses age, they become more prone to develop a metabolic disease known as Cushing’s disease. Cushing’s disease, also known as Pituitary Pars Intermedia Dysfunction (PPID), is when disfunction of the pituitary gland results in increased production of Adrenocorticotrophic Hormone (ACTH), ultimately creating overproduction of the hormone Cortisol. Cortisol is the stress hormone and a surplus of this hormone negatively affects the body.

Veterinarians use the fasting test of ACTH that evaluates the hormone levels to screen for possible Cushing’s disease. This hormone test should be conducted every six months to monitor hormone production.

Cushing’s disease is often detected in older horses between 16 and 23 years of age, but it has been documented in horses as young as eight years old. A few of the clinical signs of Cushing’s disease include a change in body conformation such as the development of a swayback and pot belly, lethargic attitude, and in some horses the growth of long, “curly” hair with delayed shedding. Horses suffering from Cushing’s disease are at serious risk to develop laminitis without any specific predisposing causes.

Occasionally, horses may have Cushing’s disease without showing any outward clinical signs as the onset is quite slow. A simple blood test will be extremely helpful in the early detection of Cushing’s and other metabolic diseases.

Organ Function and Parasite Control

Blood tests are also necessary to determine whether a horse has anemia (low red blood cells). Serum chemistry testing can evaluate liver and kidney function to ensure these organ systems are working properly. Palm Beach Equine Clinic has the laboratory equipment on site to run the vast majority of these tests for rapid same-day results.

Palm Beach Equine Clinic also suggests a fecal test to evaluate a horse’s internal parasite count. In Florida, the peak worm season is year-round due to the lack of frost. The effectiveness of different dewormers can be measured using a fecal egg count reduction test, which involves performing a fecal egg count before and after deworming a horse. Equine tapeworms are difficult to identify in fecal examinations, so deworming for tapeworms annually with a product containing praziquantel, available in products such as Zimectrin Gold®, Equimax®, and Quest Plus®, is strongly recommended.

Establishing an effective deworming program for equine parasites has become a debated topic as veterinarians have changed their views on worming in recent years. New research has found that a minimal parasite load within the horse’s hind gut is actually helpful in producing a natural immunity. However, it is crucial to control the parasitic load. Due to the emergence of new resistant parasites, the recommended method is to practice proper barn management for prevention and control along with rotational treatment with anthelmintic medications.

Environmental management is imperative to equine parasite control. Veterinarians recommend removing manure from pastures at least twice weekly. Mowing and harrowing pastures regularly will break up manure and expose parasite eggs to the sun. If possible, rotate the use of pastures by providing a period of rest or allowing other livestock to graze them. Grouping horses by age in a pasture can reduce exposure to certain parasites.

Additionally, reducing the number of horses per acre to a minimum can prevent overgrazing and reduce fecal contamination of the grazing area. Owners should consider feeding horses in a feeder for hay and grain rather than on the ground. Lastly, caregivers should routinely groom all horses to remove bot eggs from the hair to prevent possible ingestion.

Contact Palm Beach Equine Clinic for an Evaluation of Your Senior Performance Horse

It is important for owners to consider all of these issues in the senior performance horse and coordinate with their veterinarian for routine testing in horses 12 years and older. Have questions? Contact your Palm Beach Equine Clinic veterinarian today. Did you miss “Caring For The Senior Performance Horse Part 1?” CLICK HERE to catch up.