Category: Patients
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.
In order for top-level performance horses to compete at their best, they must have full range of motion throughout their bodies as well as the ability to move freely. When a horse is out of alignment, a joint, whether it is in the spine or elsewhere in the body, is restricted in its normal range of motion. Veterinary medical manipulation, or what is known as a chiropractic adjustment in humans, is a form of alternative medicine that aims to solve this issue. The goal of any adjustment is to restore the optimal range of motion to that joint, which will subsequently alleviate inflammation in and pressure on surrounding nerves and soft tissue.
Dolton, a nine-year-old Hanoverian gelding owned by Karin Flint, is a well-known name in the para-dressage world. The gelding won two individual gold medals with Roxanne Trunnell at the 2020 Paralympic Games in Tokyo, Japan. Dolton was special from a young age and won his first bronze medal when he was only six years old at the 2018 FEI World Equestrian Games. The pair is trained by Andrea Woodard, who often rides Dolton herself and stays very involved in all aspects of his care. Woodard and Dr. Natalia Novoa of Palm Beach Equine Clinic, who have worked together to treat Woodard’s own horses, thought Dolton could benefit from medical manipulation.
“What I found with Dolton was very common with any dressage horse,” noted Dr. Novoa. “When working with Dolton I make sure that he is correctly aligned. I also address any pinched nerves, tight muscles, tight myofascial, and anything else that could create pain. I saw that the adjustments and the myofascial release were very beneficial for him.”
When a horse is out of alignment, it may result in their gait appearing different than usual, even at a walk. If one area of the body is not functioning properly, horses have to compensate, which can result in many common sport horse injuries. Medical manipulation aims to fix this issue by applying varying amounts of pressure to specific segments of the horse’s body, mainly focusing on the spine. This form of manual therapy, performed by a certified practitioner, often targets joint issues and muscular development. Additionally, medical manipulation can help in stimulating nerve reflexes and reducing pain.
“I like that I can tell Dr. Novoa what I’m feeling, and she tells me what she feels,” described Woodard. “We trust each other’s judgment, which helps in pinpointing where the issue is in the horse. Sometimes it’s something in Dolton’s body that’s not sitting how it’s supposed to. If something is out of position and Dolton is not moving how he is supposed to, other parts of his body can get sore.”
If done routinely, medical manipulation can benefit a horse’s natural balance, topline, and overall performance while also aiding in pain and soreness relief. Once Dr. Novoa began working with Dolton on a regular basis, it became easier for her to not only focus on the areas he needed help with the most, but also to fix them.
“The more I continued working with him the better he performed,” commented Dr. Novoa. “We were able to identify the misalignments and any patterns so that we could more easily correct them. He was progressively more comfortable with treatments as we continued with a regular program in place because he knew what to expect. He is a very sensitive horse. I know his areas of strength and weakness, so we developed a system that works for him, and we continue to have great results.”
Being certain that Dolton’s body is functioning properly is extremely important in para-dressage. Flint makes sure that both Woodard and Dr. Novoa are integral in his care so that Trunnell and Dolton can be confident stepping into the ring.
“With para-dressage you never know what you’re going to get that day with your body,” described Flint. “This means that it is really important to know what horse you’re getting. That’s why chiropractic work, all their care, and overall health is so important.
“The reason we like Dr. Novoa is that she’s very knowledgeable about the physics and mechanisms of the horse,” continued Flint. “Someone who isn’t familiar with this can do more damage, which is true with humans too. Someone who doesn’t listen to signals can end up putting the horse in more pain. She is very, very good at what she does.”
Sport horses are able to perform at their best when they are comfortable and have proper range of motion throughout their body. It is helpful to have horses examined by a certified veterinary medical manipulation practitioner to check that their body is moving properly and to decrease the chance of an injury due to compensation. Call Palm Beach Equine Clinic today at 561-793-1599 to set up an appointment.
Featured in The Plaid Horse
A new life is something to celebrate, but when a newborn foal has complications and a fever of unknown origin, the fear can be overwhelming. For Robin Hogan of Myrland Stables in Davie, Florida, getting her newborn foal the help it unexpectedly needed was the first priority.
Hogan fell in love with her mare Vogue, a black and white Gypsy Vanner, when it came to her barn for training. The two connected instantly. There was only one caveat; Vogue was pregnant. Still, Hogan welcomed the added bonus and was excited for the chance to raise a foal that could eventually join Vogue in the equine therapy program that she is planning.
Vogue had a somewhat difficult birthing, but eventually “My Wildest Dream,” known in the barn as Eros, was born. Everything seemed good as Hogan navigated the early days of caring for Eros and his mother after birth, but at only four days old, Hogan noticed that Eros’ playful, spirited attitude had changed.
“He was a little bit on the lethargic side,” remembered Hogan. “I walked Eros and his mom out to the pasture, and he seemed to decline when he was there, like it must have taken all his energy to get to the pasture. It was surprising because just the day before he was running around, and even the night before he was running and playing. It just happened that quick. It was crazy. I noticed he was peeing out of his umbilicus (navel) which was a big red flag.”
Hogan was able to move Eros back to the barn and found that he had an extremely high temperature. Hogan called her veterinarian, Dr. Natalie Carrillo, and they were able to bring the foal’s temperature down slightly. However, when it spiked again, he was administered intravenous fluids and the decision was made to take Eros to Palm Beach Equine Clinic (PBEC) in Wellington, Florida.
Hogan noted, “PBEC had come highly recommended, and I thought, ‘If you’ve got a chance to save him, this is it.’”
Dr. Clarisa Romero examining Eros at PBEC. 
Dr. Romero performing an ultrasound on Eros. 
Eros owned by Robin Hogan 
Vogue with Eros
Eros was admitted to Palm Beach Equine Clinic and placed under the care of board-certified internist Dr. Peter Heidmann and Dr. Sidney Chanutin. Upon examination and palpation of the foal’s umbilicus, they noted urine dripping out.
During fetal development, the umbilicus is connected to the urinary bladder via a tube called the urachus. Normally, within a few hours after birth, the urachus will shrink and close at the navel, and then urine is diverted to empty through the urethra into the bladder. When the urachus does not close completely, urine can dribble out from the umbilicus. This condition is referred to as patent urachus, and it may happen within the first few weeks of life, even after the urachus originally appeared to have sealed at birth.
Eros was diagnosed with patent urachus, along with omphalitis (infection of the umbilical stump) and septicemia (bacteria present in the blood), which are severe complications commonly seen in foals.
Dr. Chanutin performed an ultrasound examination on Eros, which confirmed the patent urachus and helped determine the presence and extent of infection in the umbilical structures. Blood cultures and a complete blood count were taken, as well as bacterial cultures of the navel to determine which bacteria were causing the infection. This helped the veterinarians confirm the appropriate antibiotic choice for the foal.
In some cases, surgical removal of the infected navel structures is needed. Surgery can fully close the opening between the urachus and the bladder, but thanks to a quick and thorough veterinary diagnosis, Eros avoided surgery.
Robin and Eros at PBEC. 
Eros recovered at Palm Beach Equine Clinic for two weeks with his mother Vogue by his side. He was treated with systemic antibiotic therapy, anti-inflammatory therapy, and gastroprotectants (Omeprazole). His umbilicus was treated topically to promote closure of the patent urachus.
After discharge, Eros remained on medication for an additional four weeks. His owner reported that once he returned home, he soon returned to his normal, happy self. Hogan remarked, “I was going through all these emotions having never had a colt before, and then he puts his little head on my shoulder, and I thought well we’re going to give you all the care we can! It was such a scary learning experience for a new horse owner. It was a steep learning curve.”
Hogan credited her barn manager, Alicia May, for helping care for Eros, as well as Dr. Carrillo and the veterinarians of Palm Beach Equine Clinic. “I have such confidence now in my veterinary care team. I have to say it’s all a team effort,” she said. “I had no doubt that my horses were in the right place for this kind of situation.”
Having fully recovered, Eros is now seven months old, and Hogan is training him regularly, getting him used to working with humans and becoming less sensitive to his environment in preparation for his future equine therapy work with his mother Vogue.
Robin and Eros at his first hose show. 
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.
Featured in The Plaid Horse, Pony Edition of August 2021 Issue
The old adage “no foot, no horse” is undeniably one of the truest statements when it comes to the horse. Many intricate structures compose this foundation, and the overall health of the hoof is paramount. So, what happens when a portion of your horse’s hoof is suddenly missing?
Owners Josh and Laura Gross found themselves in this predicament when their barn’s owner, Ayriel Italia, called them to say that their daughter’s Welsh pony had cut herself and needed immediate medical attention. While in the paddock, Blue Melody – known as Melody – had gotten her left hind hoof underneath the gate and suffered a serious laceration.
“We were initially frantic without more information,” recalled Josh. “We consider Melody a family member, and her rider is an eight-year-old.” The self-professed novice horse-owner parents had been learning the ropes of equine health and care through supporting their young daughter Saylor’s passion for horses. They turned to the expertise and guidance of Italia and trainer Shanna Sachenbacher, who immediately called veterinarian Dr. Kathleen Timmins of Palm Beach Equine Clinic.
Upon arriving at the barn, Dr. Timmins saw that Melody had an approximately two-inch-wide section of her hoof missing.
“A full thickness portion of the lateral hoof wall and the coronet band had been completely excised,” described Dr. Timmins. “It was a deep wound that exposed the sensitive laminae of the hoof. Thankfully, a thin section of the weight-bearing portion of the hoof distal to the laceration was spared, and the wound did not go deep enough to communicate with the distal interphalangeal joint or the coffin bone.”
The sensitive laminae are an interlaced network of connective tissue, nerves, and blood vessels beneath the hoof wall. This highly-vascular layer attaches to and protects the coffin bone. Injuries to the coffin bone or joint structures can be devastating, often with long-term effects on the horse’s soundness and on the development of the hoof. In Melody’s case, Dr. Timmins found the laceration to be “more bark than bite,” as it did not affect those critical structures. Although Melody would likely have some degree of abnormal hoof growth from the damaged coronary band, Dr. Timmins had an encouraging prognosis for the pony.
“Dr. Timmins was so responsive that by the time we arrived at the barn to fully learn what had happened, the wound was already cleaned and wrapped, and we were told that Melody would make a full recovery,” explained Josh.
After an initial assessment and treatment of the wound at their barn, Melody was brought to Palm Beach Equine Clinic so that she could be observed and receive comprehensive medical care. Intravenous antibiotics were administered, and the laceration was thoroughly cleaned and bandaged with an added frog pad to support the hoof. Melody progressed well and was able to be discharged only 48 hours later. Along with a lesson in proper cleaning and wrapping of the wound, Dr. Timmins gave Melody’s owners and caretakers antibiotic and nonsteroidal anti-inflammatory medications. She also recommended a biotin supplement to aid in healthy hoof growth and advised that Melody would benefit from a few weeks of shoes with clips, which would provide lateral support to the section of the hoof wall that lost integrity.
With a full team supporting Melody’s recovery, the injury and medical care become less daunting to the Gross family. Only two weeks after the laceration, the wound showed great improvement, and Melody was able to be shod and very lightly worked. Four weeks after the injury, Melody received the green light from Dr. Timmins to resume full work with Saylor in the saddle.
“Dr. Timmins’ responsiveness and calm demeanor made all the difference. She put our minds at ease, took great care of our extended family member, and helped her get back on her feet (hooves!) more quickly than we expected.”
Josh Gross
Injuries to horses’ legs and hooves can be unnerving. Having a veterinarian immediately assess an injury and determine if it affects any vital structures is crucial for recovery. In case of an equine medical emergency, do not hesitate to call the veterinarians of Palm Beach Equine Clinic at 561-793-1599.
Veterinarians Help Horses Self-Heal to Maintain Optimal Health and Performance
When horses are not performing up to their usual standards, regardless of discipline, the signs can be subtle. Usually, it is the rider who first picks up on a slight feeling and questions whether something is off. A horse may suddenly be lacking impulsion, be uneven in its stride, or tripping more than usual. In the jumper ring, a horse’s discomfort can present itself as rails down. Riders can easily attribute these issues to their own shortcomings, but the veterinarian is able to understand if, and decide when, there may be an underlying issue. Helping equine athletes reach their full potential and maintain optimal health is the goal of sport horse medicine.
Sebastian, a 13-year-old Selle Francais gelding, had garnered accolades in the jumper ring at competitions around the world. While competing at the 2021 Winter Equestrian Festival (WEF) in Wellington, Florida, his performance was waning. He was not jumping the clear rounds he had cranked out consistently through his career, knocking down rails while jumping off his right lead in particular. Although owner Serena Marron had just purchased Sebastian in the fall of 2020, she knew that something was not right. She was aware of Sebastian’s capabilities and conferred with her veterinarian, Dr. Bryan Dubynsky of Palm Beach Equine Clinic, to get to the root of his performance issue.
“Sebastian had a super clean vetting with no previous injuries, but his right-side fetlocks would often get a little sore,” said Marron. “My trainer and I decided to have Dr. Dubynsky evaluate Sebastian, and he opted for a self-derived biologic treatment in all four fetlocks and hocks. I’ve had horses respond well to this type of treatment in the past, so I knew it was a reliable option.”
Self-derived biologic treatments are a form of regenerative medicine, which encourage the body to self-heal through stimulating naturally occurring biological processes. Regenerative medicine is used to treat or prevent joint disease and soft tissue injuries and works to decrease some of the detrimental biologic processes that can inhibit or slow recovery. By promoting healing and a healthy joint environment, veterinarians are better able to support horses throughout their athletic careers.
“Biologic agents found in the horse’s own blood can be harvested, concentrated, and returned to the affected area of that same horse,” explained Dr. Dubynsky. “This self-derived serum combines naturally occurring growth factors and anti-inflammatory mediators, among other agents, that can improve the structure, strength, and speed of healing. In equine sports medicine, we commonly use regenerative therapies to treat musculoskeletal injuries and as a preventative therapy to proactively preserve joint health.”
Some regenerative therapies, like the biologic treatment used for Sebastian, can be prepared stall-side and administered during one appointment. Autologous (self-derived) serums are natural and steroid-free with no drug-withholding times for horses competing in FEI or recognized competitions.
“As with many horses performing at the top of their respective sports, Sebastian had obvious synovitis in his joints,” noted Dr. Dubynsky. “Opting to treat this inflammation with a self-derived biologic as opposed to a corticosteroid promotes better long-term joint health instead of a quick fix.”
After the injections, Sebastian was given a couple of weeks off from jumping to let the regenerative treatment do its job. Upon returning to full work, the difference in Sebastian was very apparent to Marron.
“I could tell the treatment worked right off the bat,” said Marron. “I could feel a difference in his body by the way he propelled off the ground and how he felt in training the day after a big class. He felt all around more balanced and even on each lead, which was a noticeable improvement.”
Sebastian soon regained his reputation for agile, clear rounds. The pair was able to successfully resume competition plans by jumping in the FEI two- and three-star divisions for the remainder of the WEF circuit. They now plan to continue competing at that level throughout the summer, along with national grand prix classes. “Sebastian has spent years jumping at the five-star level,” added Marron, “so we do whatever we can that will help him continue feeling his best.”
Horses can reap the benefits of self-derived biologic treatments well before a serious injury occurs that could derail training or require a lengthy recovery. Different forms of regenerative therapy, such as stem cells, platelet rich plasma (PRP), and interleukin-1 receptor antagonist protein (IRAP), are actively being researched and improved upon. This evolving facet of equine medicine is now a common component of the competitive horse’s comprehensive, long-term care.
“Traditional medicine tends to focus on treating the symptoms of health problems while regenerative medicine targets the root causes,” explained Dr. Dubynsky. “Non-steroidal anti-inflammatory drugs and corticosteroids can diminish the body’s healing response over time, and they do not address the underlying condition. In contrast, self-derived biologics stimulate normal, healthy tissue production instead of weaker scar tissue that is prone to re-injury.”
Although Sebastian only underwent the self-derived biologic treatment, regenerative therapies can often be used in conjunction with other medications or alternative therapies. Palm Beach Equine Clinic’s veterinary team carefully assesses each horse to determine which treatments would be the most beneficial for the individual horse. To speak with a Palm Beach Equine Clinic veterinarian about your horse’s performance or regenerative therapy options, call 561-793-1599 or visit www.equineclinic.com.
