Category: Patients
A recent popular post on PBEC’s social media was about retired Davie County, FL, police horse Charlie, who injured himself in true equine fashion – spectacularly and with no one knowing how – during the night while turned out in a field. Charlie was adopted by the mother of one of the Davie County police officers who also works for the Sheriff’s Department. They brought Charlie to PBEC to repair a large laceration on his side.
Dr. Michelle Maguire was on hand to care for Charlie and explained the steps it took to get him back to healing. Dr. Maguire and her team administered intravenous sedation in order to repair with him standing up then injected local anesthesia around the circumference of the laceration, which measured approximately 12 by 18 inches.
“This case was particularly challenging because it was a very large area with multiple flaps and went through many layers, including skin, subcutaneous tissue, and the muscle layers overlying the thorax,” said Dr. Maguire. “Luckily there was no penetration into the thoracic cavity.”
Dr. Maguire used walking sutures to close the laceration, extending from the skin flap’s deep dermis to the underlying fascia of the body wall. This approach helps eliminate
dead space to help prevent seroma formation and infection, reduce skin tension, promote wound closure, and lower the risk of dehiscence, a surgical complication where a wound ruptures along the incision after surgery.
Because the skin can’t handle tension, you can’t just suture the skin itself. Dr. Maguire also used a Jackson Pratt drain, a commonly used surgical drain that provides a constant, low suction to pull fluid from a surgical incision site to decrease swelling and reduce the risk of infection. The drain consists of a thin, rubber tube and a soft, round squeeze bulb, or “grenade” on the end that maintains negative pressure and allows for an active drainage system.
Dr. Maguire noted that Charlie’s prognosis is very good, and he is expected to make a full recovery. He has been doing well at home, and the wound has held together without dehiscence.
She added, “The aftercare protocol was a course of systemic antibiotics and anti-inflammatories, along with maintaining a compressive for the first two weeks postoperatively until skin sutures were removed.
“The horse handled everything very well,” she continued. “He was in pain the first day postoperatively, but as the inflammation subsided, he was a normal happy horse.”
The team at Palm Beach Equine Clinic is happy to report that Charlie is back home grazing. While he will have a scar, it won’t affect his quality of life, and he will have quite a story to tell his friends!
When Natasha Masri purchased Gypsy, a then four-month-old miniature donkey, on October 21, 2022, she could not wait to take her new pet home. Less than two weeks later Gypsy arrived at Masri’s farm along with four other miniature donkeys and horses.
While the other new animals were thriving at Masri’s farm, Gypsy’s health slowly started to decline. By January of 2023, Masri could tell that Gypsy was not herself. The young miniature donkey was lethargic, laying down a lot, and losing weight. Masri called her regular veterinarian to examine Gypsy. After a few days it was evident that Gypsy’s condition was not improving so Masri and her veterinarian decided to call Palm Beach Equine Clinic in Wellington, FL, for an internal medicine specialist.
Photo courtesy of Dr. Fernando Marqués
“Within two hours Dr. Fernando Marqués was at our farm ready to help,” recalled Masri. “When I met Dr. Marqués my anxiety vanished because I could tell he knew what he was doing. He was very good about talking to me as he was working with Gypsy, which was invaluable to me as someone without a medical background.”
Photo courtesy of Dr. Fernando Marqués
Dr. Fernando Marqués, a board-certified internal medicine specialist, began his evaluation of Gypsy by asking Masri for the miniature donkey’s medical history. Masri explained Gypsy was lethargic, losing weight, had a fever, and had bloodwork abnormalities. Dr. Marqués then continued with a physical exam to learn more about Gypsy’s overall health.
“When I did a physical exam of Gypsy, I found a cardiac murmur,” explained Dr. Marqués. “The cardiac murmur was consistent with the laboratory finding, which was regenerative anemia. The thickness of the blood changes when an animal has anemia, and that can create a cardiac murmur. After discovering that, we decided to investigate the diagnosis of regenerative anemia further. We always want to try to fix the underlying problems and really get to the root of the issue.”
The next step included Dr. Marqués taking ultrasounds of Gypsy’s thorax and abdomen.
“On the right side of the thorax there were some minor ultrasonographic changes but otherwise everything else looked normal,” said Dr. Marqués. “Then we went ahead and did imaging of the thorax and abdomen with x-rays. In this case, we wanted to determine if it was a nutritional problem, an infection, a parasite, or something else. On radiography, there was nothing relevant that I could find.”
After examining Gypsy, Dr. Marqués, Masri, and her regular veterinarian decided that the miniature donkey should be sent to Palm Beach Equine Clinic for further evaluation. Gypsy arrived at the clinic, and Dr. Marqués immediately started her on intravenous (IV) fluids, vitamin B12, and a dewormer. He also ran additional blood tests beyond the ones the regular veterinarian completed at Masri’s farm and performed a fecal test.
“While Gypsy was at Palm Beach Equine Clinic, we gave her IV fluids, monitored her, made sure she was eating enough nutrients, and performed bloodwork tests,” explained Dr. Marqués. “We found Gypsy’s regenerative anemia was multifactorial, infectious, parasitic, and nutrition related. After a few days of a dewormer and a different feeding program, she started eating really well and gaining weight again. All the blood parameters were normalizing as well. During this time, I was in contact with Masri and her regular veterinarian so we could work as a team. It was important we were all on the same page and communicating on a daily basis.”
After five days of receiving a different feeding program and a parasite treatment at Palm Beach Equine Clinic, the team decided that Gypsy could return home under the care of Masri’s regular veterinarian. Dr. Marqués outlined a new feeding plan for Gypsy to make sure she was getting all of the nutrients she needed. Masri also switched Gypsy over to timothy hay, which is easily digestible and has high fiber and energy content. Additionally, Dr. Marqués and Masri decided it might be best to feed Gypsy separately from the other animals to ensure she was eating her entire portions of grain and hay. Once Gypsy was back home, Dr. Marqués continued to check in with Masri and her regular veterinarian.
“I was extremely impressed with the way Dr. Marqués was able to collaborate with our general veterinarian,” described Masri. “He kept her in the loop so when Gypsy came home there was a plan in place and everyone was communicating.”
Photo courtesy of Dr. Fernando Marqués
Since coming home to the farm, Gypsy has returned to being energetic and running around with the other miniature donkeys and horses as she did when Masri first met her.
“As a new miniature donkey and horse owner, having a go-to for these animals at the beginning of their lives leaves me feeling so grateful and confident that I can handle anything with them,” said Masri. “Anytime I have an emergency, Palm Beach Equine Clinic will be the first place I call.”
“As a new miniature donkey and horse owner, having a go-to for these animals at the beginning of their lives leaves me feeling so grateful and confident that I can handle anything with them,” said Masri. “Anytime I have an emergency, Palm Beach Equine Clinic will be the first place I call.”
Since coming home to the farm, Gypsy has returned to being energetic and running around with the other miniature donkeys and horses as she did when Masri first met her. “As a new miniature donkey and horse owner, having a go-to for these animals at the beginning of their lives leaves me feeling so grateful and confident that I can handle anything with them,” said Masri. “Anytime I have an emergency, Palm Beach Equine Clinic will be the first place I call.”
There’s nothing more exciting than buying a young horse with a lot of potential. When Margo Crowther of Fort Myers, FL, purchased three-year-old “Sissy” she was looking forward to the young mare’s future as a barrel racer.
In 2016, when Sissy was a four-year-old, Crowther, a professional barrel racer, took the mare to an event in South Carolina. The pair successfully made it to the top 30 in a barrel race competition to qualify for the final taking place the next day. Unfortunately, while making the turn around the first barrel in the final, Sissy slipped and fell down. Crowther came off, caught Sissy, and took her back to the stabling area to check her over.
Photo courtesy of Margo Crowther
“Once we reached the stalls, Sissy began to limp with her hind end,” explained Crowther. “After traveling home, I knew something wasn’t right. We immediately brought her to Dr. Weston Davis at Palm Beach Equine Clinic. Dr. Davis is the best, and he’s a good friend of mine. He was also the only vet that had worked on Sissy at that point.”
Dr. Davis examined Sissy when she arrived at Palm Beach Equine Clinic in Wellington, FL. She was lame at the walk but had no swelling or signs of where the injury was located.
Photo by Springer
“We ended up doing a bone scan to diagnose Sissy,” commented Dr. Davis. “She had a really hot bone scan at the hock. We decided to do several different special x-ray views and found she had a central tarsal bone fracture. This is a very uncommon source of lameness in equine athletes. It was an atypical slab fracture, which meant it spanned from one joint to the next.”
Dr. Davis and his team of veterinarians found the fracture on x-rays, but a standing magnetic resonance imaging (MRI) was performed to help accurately define the fracture configuration.
“We did our surgical planning on the MRI,” said Dr. Davis. “Then we put a screw across the fracture line. A lag screw stabilization promotes compression and primary healing of the bone and is considered the treatment of choice for this type of injury.”
Sissy stayed at Palm Beach Equine Clinic for a few days then returned home to Crowther’s farm where she remained on stall rest for four months. Her next step was a few weeks of daily hand walking, followed by a gradual return to working under saddle. Crowther made sure to take it slow with Sissy, especially in the beginning. Dr. Davis checked the mare on a monthly basis throughout the recovery period. At Sissy’s three-month check-in, Dr. Davis removed the screw.
After a successful recovery, Crowther and Sissy made their return to the show ring exactly seven months after the injury happened. The duo competed in the Fort Smith Derby in Fort Smith, AR, where the pair won $26,000.
“It was a huge accomplishment and even more so since it was her first run back from her injury,” explained Crowther. “We were all shocked, to say the least.”
Sissy is now 11 years old and continues to be Crowther’s main competition horse. In 2022, Crowther and Sissy competed at the National Finals Rodeo, known as the “super bowl of rodeo,” where the pair won $86,000 in prize money. Sissy’s lifetime earnings have topped $450,000.
“Sissy is a family member to my husband and me as well as our kids,” Crowther said of the mare. “She means the world to all of us. My kids joke that if I could build her a stall in the house I would. She is the kindest horse, and she loves her job. She is one in a million.”
Thanks to the team of top veterinarians at Palm Beach Equine Clinic, Sissy was able to have a successful career as a barrel racer. Crowther and Sissy will continue to compete and look forward to more top-place finishes.
Thanks to the team of top veterinarians at Palm Beach Equine Clinic, Sissy was able to have a successful career as a barrel racer. Crowther and Sissy will continue to compete and look forward to more top-place finishes.
One of the greatest fears for a rider is that their once-in-a-lifetime horse will become injured. In 2019, this worry turned into a reality for Rileigh Tibbott who was thinking about retiring her heart horse, Charley. Before making that difficult decision, Tibbott decided to take Charley to Dr. Bryan Dubynsky of Palm Beach Equine Clinic (PBEC) in Wellington, FL, for another opinion. Although it took more than a year, the decision to trust PBEC with Charley’s care ended up changing the outcome of his career as a performance horse.
Tibbott and her show jumping mount Charley, a now 14-year-old Warmblood gelding by Numero Uno, competed together in the Under 25 division and at the FEI three-star level. At the time, the main cause of Charley’s lameness was soreness in his front feet. After meeting with Tibbott and examining Charley, Dr. Dubynsky felt that he could work with Charley’s farrier to help the gelding.
“Instead of doing MRIs or any other diagnostic work I focused on working with Rileigh and the farrier as a team to get him shod properly,” explained Dr. Dubynsky. “My pitch to Rileigh was to fix the foundation on the horse. He was foot sore but I thought most of the issue was due to being improperly trimmed. There was a lot of excess foot on him, and a lot of foot imbalance. He also had some coffin joint compression areas that needed to be alleviated.”
Once Dr. Dubynsky began working with Rileigh’s farrier, the team found success almost immediately and Charley was able to return to the show ring.
Unfortunately, since Charley had gone so long with poor foot balance, he had also developed sidebones, a condition that results in the ossification of the collateral cartilages of the foot. The condition causes the collateral cartilages, which are found on the inside and outside of the foot, to become a harder and less flexible bone. Normally it is not problematic unless the sidebones become excessive. If that happens, a horse can more easily hit themselves in that area and fracture the sidebones causing lameness. At the beginning of 2020, Charley’s sidebones became an issue when he was competing on the grass derby field during the Winter Equestrian Festival in Wellington, FL.
“Charley overstepped taking off to a jump and his hind studs tore through and cut one of his sidebones,” recalled Tibbott. “Unfortunately, after getting stitched up Charley developed an infection. This extended his recovery time and we spent months trying to get him sound again. Charley does not do well with time off so while trying to bring him back from that injury he managed to keep re-injuring himself. The most difficult injury was a suspensory issue in his left hind in April 2020.
“We tried multiple times for many months to start him back but every time it seemed as though jumping would not be an option for him again,” continued Tibbott of Charley’s recovery process. “Dr. Dubynsky knew how much this horse meant to me and really thought outside the box while trying to treat him. I had a few other veterinarians tell me that he needed to be retired but Dr. Dubynsky really fought to get him back in the ring for me.”
Dr. Dubynsky recommended a plan to bring him back slowly rather than giving up. The regimen included frequent check-ups and a close partnership with both the farrier and Tibbott. Dr. Dubynsky also injected areas he felt would help make Charley more comfortable and aid in his recovery.
“We injected his coffin joints and around the sidebones,” commented Dr. Dubynsky. “Most importantly, every several months we would repeat foot x-rays and make sure we were getting a proper balance trim. I always emphasize the trim, not being shod. For me, it’s 90% how you trim the foot and then 10% what you are putting on the bottom of it. The relationship between the vet and farrier was critical during Charley’s recovery process.”
After a total of 19 months, Charley made a full recovery and was able to successfully return to the show ring. Although Charley is now back competing, Dr. Dubynsky continues to check in on Charley regularly and work closely with the farrier to ensure Charley is performing at his best.
“My goal is to have him back in the grand prix ring,” said Tibbott of her plans for Charley. “Without Dr. Dubynsky and our access to such a world-class facility at PBEC, I think Charley’s outcome would have been very different.”
The phrase “It takes a village” is commonly heard in the equestrian world. From the groom and barn manager to the professional rider, there are multiple individuals who help a horse reach its full potential and continue performing at its best. Although many people may think a veterinarian is who you call only when tragedy strikes, Palm Beach Equine Clinic’s team of veterinarians pride themselves on being an integral part of a horse and rider’s success. For Megan McDermott, a young show-jumping professional, Palm Beach Equine Clinic’s team of professionals has been there every step of the way.
McDermott, who started riding at the age of seven, originally planned to have a career in the film industry after graduating college and continue riding as an amateur. However, after a fateful meeting with Daniel Bluman and months under his mentorship and coaching, McDermott began spending more time in the saddle and eventually made a full career switch. “I remember my first Saturday Night Light class was a three-star grand prix at the Winter Equestrian Festival, and at the time, I had just turned pro so I didn’t have a trainer,” shared McDermott. “Dr. Richard Wheeler was the last person to speak to me before I went into the ring and the first person I saw when I came out.
“Not only is he a fantastic veterinarian, but he also acts as an advocate and understands that you’re doing this because you love horses and that there’s a business aspect to it as well,” she continued. “He’s able to give phenomenal advice and really understands the rider’s perspective. He also understands the trajectory of the horses’ careers and at what point they need to peak and is very conscious of your money, your time, and of course, your horses’ careers. He’s more than just a veterinarian, and I think all his clients feel that their wins are his wins.”
During the summer, McDermott spends a lot of her time traveling to different shows in the Northeast, sometimes making it difficult for her horses to be seen by their primary veterinarian. “If Richard can’t see me where I am during the summer, he’s extremely willing to collaborate with other veterinarians,” she noted.
McDermott recalled when her horse Tizimin LS sustained a severe injury while competing at HITS Saugerties in 2018. “Tizi was my first FEI horse, and we shared a really special bond,” she commented. “We were competing in a big jumper class and going clear, and then at the last jump, something happened, and his hind end just gave out. At the time, people thought he was going to have to be put down in the ring. It was horrible.”
She continued, “Dr. Sarah Allendorf was there at the ring when it happened. Richard wasn’t there, but he had dealt with something similar before, and he was the only person who told me Tizi would be able to recover. We sent Tizi to Rhinebeck [Animal Hospital], and Richard was there for me every step of the way. He was constantly talking to all the veterinarians there and so invested in helping me get him back into the ring.” Tizi stayed at Rhinebeck for three months before getting the green light to return home, where he continued to recover and returned to the FEI ring in 2020.
Although Dr. Wheeler is McDermott’s primary veterinarian, she shared that her success is thanks to a collaborative effort with other veterinarians at Palm Beach Equine Clinic.
McDermott explained, “All of the veterinarians there are extremely collaborative. Most veterinarians get very possessive in a way that makes them single-minded, but I think it’s really important to be open to different perspectives and be creative, and all of the veterinarians at Palm Beach Equine have been like that for me. Although Richard is my primary veterinarian, Dr. Sarah Allendorf, Dr. Laura Hutton, and Dr. Selina Watt have also done a lot for me and my horses. Managing sport horses is a bit of an art form, and I think they all understand sport horses a lot more than most veterinarians do.”
For more information on Palm Beach Equine Clinic, visit www.equineclinic.com.
Palm Beach Equine Clinic is one of the foremost equine surgical centers in the world with three board-certified surgeons on staff, led by Dr. Weston Davis. As a busy surgeon, Dr. Davis has seen many horses with the dreaded “kissing spines” diagnosis come across his table. Two of his most interesting success stories featured horses competing in the disciplines of barrel racing and dressage.
Flossy’s Story
The words “your horse needs surgery” are ones that no horse owner wants to hear, but to Sara and Kathi Milstead, it was music to their ears. In 2016, Sara – who was 17 years old at the time and based in Loxahatchee, Florida – had been working for more than a year to find a solution to her horse’s extreme behavioral issues and chronic back pain that could not be managed. Her horse Two Blondes On Fire, a then-eight-year-old Quarter Horse mare known as “Flossy” in the barn, came into Sara’s life as a competitive barrel racer. But shortly after purchasing Flossy, Sara knew that something wasn’t right.
“We tried to do everything we could,” said Sara. “She was extremely back sore, she wasn’t holding weight, and she would try to kick your head off. We tried Regu-Mate, hormone therapy, magna wave therapy, injections, and nothing helped her. We felt that surgery was the best option instead of trying to continue injections.”
At the time, Sara and her primary veterinarian, Dr. Jordan Lewis of Palm Beach Equine Clinic (PBEC), brought Flossy to PBEC for thorough diagnostics. They determined Flossy had kissing spines.
Kissing Spines Explained
In technical terms, kissing spines are known as overriding or impinging dorsal spinous processes. The dorsal spinous process is a portion of bone extending dorsally from each vertebra. Ideally, the spinous processes are evenly spaced, allowing the horse to comfortably flex and extend its back through normal positions. With kissing spines, two or more vertebrae get too close, touch, or even overlap in places. This condition can lead to restrictions in mobility as well as severe pain, which ultimately can lead to back soreness and performance problems.
“The symptoms can be extremely broad,” acknowledged Dr. Davis. “[With] some of the horses, people will detect sensitivity when brushing over the topline. A lot of these horses get spasms in their regional musculature alongside the spinous processes.” A significant red flag is intermittent, severe bad behavior, such as kicking out, bucking, and an overall negative work attitude, something that exactly described Flossy.
Lakota’s Story
With dressage horse Lakota owned by Heidi Degele, there were minimal behavior issues, but Degele knew there had to be something more she could do to ease Lakota’s pain.
“As his age kicked in, it was like you were sitting on a two-by-four,” Heidi said of her horse’s condition. “I knew his back bothered him the most because with shockwave he felt like a different horse; he felt so supple and he had this swing in his trot, so I knew that’s what truly bothered him.” Though she could sense the stiffness and soreness as he worked, he was not one to rear, pin his ears, or refuse to work because of the pain he was feeling.
Heidi turned to Dr. Davis, who recommended a surgical route, an option he only suggests if medical treatment and physical therapy fail to improve the horse’s condition. “Not because the surgery is fraught with complications or [tends to be] unsuccessful,” he said, “but for a significant portion of these horses, if you’re really on top of the conservative measures, you may not have to opt for surgery.
“That being said, surgical interventions for kissing spines have very good success rates,” added Dr. Davis. In fact, studies have shown anywhere from 72 to 95 percent of horses return to full work after kissing spines surgery.
After Lakota made a successful recovery from his surgery in 2017, he has required no maintenance above what a typical high-level performance horse may need. Heidi attributes his success post-surgery to proper riding, including ground poles that allow him to correctly use his back, carrot stretches, and use of a massage blanket, which she has put into practice with all the horses at her farm. Dr. Davis notes that proper stretching and riding may also prolong positive effects of injections while helping horses stay more sound and supple for athletic activities.
Lakota, who went from Training Level all the way up through Grand Prix, is now used by top working students to earn medals in the Prix St. Georges, allowing them to show off their skills and earn the qualifications they need to advance their careers.
Flossy’s Turnaround
Flossy was found to have dorsal spinous process impingement at four sites in the lower thoracic vertebrae. Dr. Davis performed the surgery under general anesthesia and guided by radiographs, did a partial resection of the affected dorsal spinous processes (DSPs) to widen the spaces between adjacent DSPs and eliminate impingement.
Sara took her time bringing Flossy back to full work. Within days of the surgery, Sara saw changes in Flossy, but within six months, she was a new horse.
“Surgery was a big success,” said Sara. “Flossy went from a horse that we used to dread riding to the favorite in the barn. It broke my heart; she was just miserable. I didn’t know kissing spines existed before her diagnosis. It’s sad to think she went through that pain. She’s very much a princess, and all of her behavioral problems were because of pain. Now my three-year-old niece rides her around.”
Sara and Flossy have returned to barrel racing competition as well, now that Sara graduated from nursing school, and have placed in the money regularly including two top ten finishes out of more than 150 competitors.
“I can’t even count the number of people that I have recommended Palm Beach Equine Clinic to,” said Sara. “Everyone was really great and there was excellent communication with me through every step of her surgery and recovery.”
By finding a diagnosis for Flossy and a way to ease her pain, Sara was able to discover her diamond in the rough and go back to the competition arena with her partner for years to come.
Colic is every horse owner’s worst nightmare, but when the colicking patient is also pregnant, colic emergencies pose an even bigger challenge for their owner and the team of veterinarians entrusted with their care. In late February, a pregnant mare was brought to Palm Beach Equine Clinic by her owner for colic. Leading the PBEC team on this case were Drs Justin McNaughten DACT, Peter Heidmann, DACVIM, and Elizabeth Barrett, DACVS-LA. We spoke with Dr. McNaughten about the steps he and the team took to keep both the mare and foal safe.
What was the mare’s status when she was admitted to the clinic?
The presenting complaint was colic. At the time of admission, the mare had an elevated heart rate of 120 beats per minute. We then passed a nasogastric tube, which resulted in approximately 15 liters of spontaneous reflux. Once the stomach was decompressed, we proceeded with the rest of the colic work-up. As the mare was in the later stage of pregnancy, the foal occupied the majority of the abdomen. Findings on rectal palpation and abdominal ultrasound were inconclusive. The working diagnosis was ileus or decreased gut motility, but the root cause was still unknown. As part of the medical treatment, the mare had to be fasted. We started her on IV fluids with prokinetics, electrolytes, and dextrose as a source of nutritional support for the foal. Overnight, the mare remained comfortable but continued to have small amounts of reflux. The next morning, she was showing new signs of gas distension, which were not present at the time of admission. An abdominocentesis or ab-tap revealed elevations from the normal peritoneal fluid values suggesting that surgery was warranted.
What factors did you take into consideration before deciding to treat the mare?
When we are dealing with pregnant mares, we often make decisions based on the stage of pregnancy. The biggest obstacle is trying to treat the mare and doing what is safe for the foal in utero. For example, we may use different medications that are safe during one stage of pregnancy and not another, or delay procedures until after the mare delivers the foal. In this case, the owner didn’t have an ovulation date because the breeding had occurred in a paddock. A couple of diagnostic tests can be used to provide a rough estimate of the foal’s gestational age, measuring fetal orbit and the fetal aortic diameter. The results are interpreted as a rough estimate as the reference values have not been determined for each breed. Unfortunately, in the mare, gestation length does not correlate with fetal readiness or her foal’s ability to survive once it’s born. We also performed a diagnostic test to help determine fetal readiness based on evaluating the mare’s mammary secretions. In this case, we specifically measured the pH level.
Based on the mare’s need for colic surgery and the pH levels of her mammary secretions, the team of specialists discussed the options, weighing a fairly extensive list of potential risk factors for the mare and the foal. The owner was presented with the options of performing colic surgery with the foal still in utero or inducing parturition and performing colic surgery once she foaled. At the owner’s request, we induced foaling, which carries its own set of risks and can be life-threatening to both the mare and foal.
In this case, fortune was on our side. Following a successful assisted vaginal delivery, the newborn filly was hitting each of our targets for neonates. Although the filly was not showing any external signs of prematurity, we took radiographs of the knees and hocks as a precaution. The x-rays showed that the filly was a bit premature based on the incomplete ossification of the cuboidal bones, which make up the knees and hocks.
Following the delivery, the mare was then taken into surgery. During the colic surgery, Dr. Barrett identified and removed a very large fecalith, which we assumed was the root of the problem as it had the potential to obstruct the bowel. A fecalith is a hard concretion of ingested material that may increase in size and end up being a blockage in the gastrointestinal tract.
What did their postoperative care look like?
Post-surgery, the mare did very well. While hospitalized, she remained comfortable, tolerated refeeding, and displayed great maternal behavior. The filly was started on prophylactic antibiotics and given milk initially through a feeding tube until the mare had enough milk to sustain the foal. Approximately 48 hours after foaling, the filly developed signs of neonatal maladjustment syndrome, which manifests as neurologic abnormalities. One moment the foal was healthy, bright, and nursing, and the next, she was dull, listless, and disoriented. The condition subsided following IV administration of neuroprotective agents and through the use of the Madigan foal squeeze technique. The Madigan squeeze technique is a physical compression procedure that involves wrapping a foal’s upper torso with loops of soft rope and applying pressure for 20 minutes, which replicates the compression a foal experiences during birth.
Post-surgery, the mare did very well. While hospitalized, she remained comfortable, tolerated refeeding, and displayed great maternal behavior. The filly was started on prophylactic antibiotics and given milk initially through a feeding tube until the mare had enough milk to sustain the foal. Approximately 48 hours after foaling, the filly developed signs of neonatal maladjustment syndrome, which manifests as neurologic abnormalities. One moment the foal was healthy, bright, and nursing, and the next, she was dull, listless, and disoriented. The condition subsided following IV administration of neuroprotective agents and through the use of the Madigan foal squeeze technique. The Madigan squeeze technique is a physical compression procedure that involves wrapping a foal’s upper torso with loops of soft rope and applying pressure for 20 minutes, which replicates the compression a foal experiences during birth.
After a few days, both mare and foal were discharged to the care of the farm. At home, the pair were placed on stall rest followed by additional exercise restrictions allowing time for the mare’s abdominal incision to heal and the filly’s cuboidal bones to fully mature. Now, exactly one month later, I’m happy to say that both the mare and her foal are thriving.
Palm Beach Equine Clinic is available 24/7 for any equine emergency and works regularly with referring veterinarians. For more information, call 561-793-1599.
When Margo Crowther of Fort Myers, FL, was looking to add a new addition to her string of barrel racing horses, she made one very important phone call. That call was to Palm Beach Equine Clinic. Dr. Weston Davis, board-certified surgeon and veterinarian at Palm Beach Equine Clinic, has been working with Crowther to keep her horses healthy, as well as performing career-saving procedures.
In 2016, Dr. Davis helped Crowther and her 2012 Quarter Horse mare Shes Packin Fame, or “Sissy,” return to the ring after what could have been a detrimental injury. Sissy suffered a rare slab fracture to the central tarsal bone in her left hock while competing in a barrel racing competition. After a diagnosis aided by Palm Beach Equine Clinic’s advanced diagnostic imaging equipment and a surgery performed by Dr. Davis, Shes Packin Fame not only returned to running barrels, but the mare was also back to winning the next year.
When Crowther found a new prospect named Grandiose Guy, or “Mater,” she turned to Dr. Davis to ensure her intended purchase would be a good fit. The Quarter Horse gelding was named the Barrel Futurities of America (BFA) Horse of the Year just after she purchased him, crowning him the top four-year-old in the country.
“When I was thinking about buying him, I called Dr. Davis and sent him videos of the horse working to review,” said Crowther, who started the purchase process late last year and chose to involve Dr. Davis in all aspects of the pre-purchase evaluation. “The horse was in Georgia, so he reviewed them from Palm Beach Equine Clinic in Wellington and gave me the stamp of approval. Once a pre-purchase was performed, I sent all the x-rays to Dr. Davis and he told me to move forward.
“I trust Dr. Davis and the team at Palm Beach Equine Clinic so much!” continued Crowther. “Barrel horses work hard and it’s so important to have a great relationship with the vet who oversees their care and knows them well in order to keep them happy and healthy.”
Regardless of breed or discipline, a pre-purchase exam involves certain steps that allow the potential owner and veterinarian to investigate the horse’s health and condition. The veterinarian gathers and interprets information by physically examining the horse’s body systems and conformation, as well as reviewing the health history. A lameness assessment is completed, including flexion tests, soft tissue structure palpation and movement evaluation. Diagnostic medical imaging tools, such as radiography, ultrasonography, endoscopy, magnetic resonance imaging, nuclear scintigraphy, or computed tomography, may be used to provide a more detailed and comprehensive profile of the horse.
Crowther purchased Mater and started running him at the beginning of last year, bringing him to the largest one-day rodeo, The American, in the Dallas Cowboys stadium in Texas in February. The competition had a $1 million payout and Mater and Crowther placed fifth.
“After so many runs, we brought him home from Texas and got him over to Dr. Davis for any maintenance work that needed to be done to keep him feeling his best,” said Crowther. “I am very picky about where I take my horses; there has to be good ground and I will not run their legs off. In conjunction with that, maintenance work with Dr. Davis is important. He performs flexion tests, utilizes the imaging at Palm Beach Equine Clinic if necessary, and makes recommendations about my horses’ health and overall well-being.”
Dr. Davis sent Mater home from Palm Beach Equine Clinic with a clean bill of health and Crowther gave the gelding a little time off before their next run. After returning to work, Mater headed to the National Barrel Horse Association (NBHA) Florida State Championships in Kissimmee.
Crowther’s diligence and Dr. Davis’ knowledge paid off when Mater won both his runs and clinched the open final at NBHA Florida State Championships. With more than 700 entries, Mater and Crowther topped them all and were crowned overall champions of the event.
“Palm Beach Equine Clinic and Dr. Davis have been a huge part of the success I have had with all of my horses,” said Crowther. “They are always there when I need them, whether I’m headed to the clinic in Wellington or they are coming to me in Fort Meyers. It’s nice to be able to know your vet will be there for you whenever you need them.”
When dressage rider Meagan Davis and owner Scott Durkin think about the goals they have for their dressage horse Royale, they have tunnel vision for the grand prix ring. Royale, a 16-year-old Oldenburg gelding (Routinier x Ironman) was well on his way to accomplishing that goal during the 2019 season when something strange started happening.
Photo courtesy of Meagan Davis
After arriving at their winter home in Loxahatchee, FL, from a northern base in Stone Ridge, NY, Davis kicked off Royale’s winter competition schedule with a show in January. The horse was coming off a very successful fall season that included CDI Intermediaire I and CDI Prix St. Georges victories at the New England Dressage Fall Festival and Dressage at Devon.
“Our first show was unusually chilly and I noticed that Royale was breathing a little hard and didn’t sweat very much,” recalled Davis. “I didn’t think that much of it because of the weather, but when we returned home and it warmed up, he wasn’t sweating at all.
“He could not catch his breath after being perfectly fit a month before,” continued Davis. “I rely on Palm Beach Equine Clinic for the care of all the horses in my barn and I immediately turned to Dr. Robert Brusie.”
Dr. Brusie is a Board-Certified Surgeon at Palm Beach Equine Clinic and was diligent about ruling out any physical causes of Royale’s obvious discomfort and decline in performance. After flexion tests, checking for musculoskeletal problems, and assessing soreness or wear and tear, Dr. Brusie turned to Palm Beach Equine Clinic’s Internal Medicine Specialist Dr. Peter Heidmann.
“Dr. Brusie was watching me work him one day, noticed the decline in muscle, the lack of sweating, and labored breathing, and recommended we take a deeper look with a specialist,” said Davis. “That is why I trust Palm Beach Equine Clinic with the care of my horses. They have so many tricks up their sleeves, and their clients are fortunate that the veterinarians collaborate so well together in order to do what’s best for the horse.”
Dr. Heidmann’s first step was to asses any neurological causes by testing for equine protozoal myeloencephalitis (EPM) and Lyme disease. Both were negative. He then moved on to a nutrient analysis.
“When you see weakness and poor muscle mass in a horse, two of the things you test for right away are vitamin E and selenium deficiencies,” said Dr. Heidmann. “Both are common causes of decreased performance due to low concentrations in local soil or the soil where a horse’s hay derives from.”
No deficiencies were found in Royale, which prompted Dr. Heidmann to move on to muscle testing. He drew blood from Royale, put him in work, and then drew blood again four to six hours later. When comparing enzymes in the blood from before and after work, Dr. Heidmann looked for any large increase, which would indicate the problem was in the muscles themselves. Royale’s tests, once again, came back normal.
At this point, Dr. Heidmann returned to the case history and started following the shortness of breath symptom, noting, “Breathing abnormalities in horses are difficult to diagnose by simply listening because their chest wall is so thick. What I wanted to asses was prolonged recovery. This is done by placing a bag over a horse’s nose to get them to breathe deeply. Once the bag is removed, breathing should regulate within two to three breaths. Royale needed four to five breaths.”
Once Dr. Heidmann identified a possible cause, he performed abronchoalveolar lavage (BAL), which is essentially a lung sample used to identify abnormal cells. He inserted a small-diameter tube through the trachea, flushed saline into the lung, and then suctioned it back out.
“Sure enough, when I examined the sample, there was mucus and abnormal cells,” said Dr. Heidmann. “Despite his bloodwork being normal and no obvious infections, Royale was battling equine asthma or ‘heaves.’”
The treatment for asthma in horses is very similar to what’s done for humans and includes an anti-inflammatory bronchodilator drug and inhaled steroids.
“While his breathing issues were significant enough to affect performance, Royale’s treatments were relatively mild with immediate and substantial improvement,” said Dr. Heidmann. “I used nebulized herbal remedies, steam, and Ventipulmin, which is an oral syrup.
“I’m a less-is-more person and veterinarian,” he continued. “I try to have the best outcome with the least amount of medications. Additionally, we created some routines that would minimize environmental dust and allergens, such as using a hay net, wetting down hay and bedding, or using chopped newspaper as bedding.”
Royale stayed on the prescribed medication through his trip home to New York and came off them at the end of May. Today, he is back in work and has regained the fitness and muscle he had during the fall. According to Davis, their goal is to step into the grand prix ranks during the upcoming season.
“My favorite cases are the sickest of the sick and the most elusive needle in a haystack,” concluded Dr. Heidmann. “Royale’s case definitely fell into the latter. It was really challenging, but rewarding because the outcome was a horse that is dramatically different than he was four months ago. But the most important part of this case for me was working together with Dr. Brusie. I would have not been successful in helping this horse if he hadn’t done all the work prior to coming to me. That kind of collaboration is what contributes to our success and sets Palm Beach Equine Clinic apart!”
When Margo Crowther of Fort Myers, FL, was looking to add a new addition to her string of barrel racing horses, she made one very important phone call. That first call was to Palm Beach Equine Clinic (PBEC). Dr. Weston Davis, board-certified surgeon and veterinarian at PBEC, has been working with Crowther for several years and has helped maintain her horses and even performed some career-saving procedures.
In 2016, Dr. Davis helped Crowther and her 2012 Quarter Horse mare Shes Packin Fame or “Sissy” return to the ring after what could have been a detrimental injury. Sissy suffered a rare slab fracture to the central tarsal bone in her left hock while competing in a barrel racing competition. After a diagnosis aided by PBEC’s state-of-the-art diagnostic imaging equipment and a surgery performed by Dr. Davis, Shes Packin Fame not only returned to running barrels, but the five-year-old mare was also back to winning the next year. Click here to learn more about Sissy!
Crowther Meets “Mater”
This time, Crowther turned to Dr. Davis to ensure that her intended purchase of a new horse was a good fit. When she met Grandiose Guy, known to her as “Mater,” she had to have him. The Quarter Horse gelding was named the Barrel Futurities of America (BFA) Horse of the Year just after she purchased him in 2017, crowning him the top four-year-old in the country.
“When I was thinking about buying him, I called Dr. Davis and sent him videos of the horse working to review,” said Crowther, who started the purchase process late last year. “The horse was in Georgia, so he reviewed them from PBEC in Wellington and gave me the stamp of approval. Once a pre-purchase was performed, I sent all the x-rays to Dr. Davis and he told me to move forward.
“I trust Dr. Davis and the team at PBEC so much!” continued Crowther. “Barrel horses work hard and it’s so important to have a great relationship with the veterinarian who oversees their care and knows them well in order to keep them happy and healthy.”
Crowther purchased Mater and started running him at the start of 2018, bringing him to the largest one-day rodeo, The American, in the Dallas Cowboys stadium in Texas in February. The competition had a $1 million payout and Mater and Crowther placed fifth.
“After so many runs, we brought him home from Texas and got him over to Dr. Davis for any maintenance work that needed to be done to keep him feeling his best,” said Crowther. “I am very picky about where I take my horses; there has to be good ground and I will not run their legs off. In conjunction with that, maintenance work with Dr. Davis is important. He performs flexion tests, utilizes the imaging at PBEC if necessary, and makes recommendations about my horses’ health and overall well-being.”
Dr. Davis sent Mater home from PBEC with a clean bill of health and Crowther gave the gelding a little time off before their next run. After returning to work, Mater headed to the National Barrel Horse Association (NBHA) Florida State Championships in Kissimmee in mid-June.
Success for Crowther and Mater
Crowther’s diligence and Dr. Davis’ knowledge paid off in full when Mater won both his runs and clinched the open final at NBHA Florida State Championships. With more than 700 entries, Mater and Crowther topped them all and were crowned overall champions of the event.
“PBEC and Dr. Davis have been a huge part of the success I have had with all of my horses,” said Crowther. “They are always there when I need them, whether I’m headed to the clinic or they are coming to me in Fort Meyers. It’s nice to be able to know your vet will be there for you whenever you need them.”