When Grand Prix dressage rider Meagan Davis needs to make sure her horses are feeling their best, she turns to Palm Beach Equine Clinic, located in the heart of Wellington, FL. Palm Beach Equine Clinic has invested more than 30 years and the work of talented veterinarians in evolving the most advanced diagnostic imaging, surgical skills, alternative therapies, and overall care of sport horses across varying disciplines.

Meagan Davis Dressage, based in Loxahatchee, FL, and Stone Ridge, NY, has entrusted Palm Beach Equine Clinic with the care and maintenance of their string of dressage horses for nearly a decade. Drawn to the personalized care provided by Palm Beach Equine Clinic’s team of veterinarians, which includes six boarded specialists, head trainer Davis was immediately comfortable turning to the clinic for the care of her horses.

“Palm Beach Equine Clinic is the premier facility in South Florida,” said Davis, 28, who has been traveling to Florida to compete at events that include the prestigious Adequan® Global Dressage Festival since she was 18 years old. “If I am going to have a horse undergo any kind of surgery or maintenance work, I will choose Palm Beach Equine Clinic every time without a doubt.

“Knowing that I can compete well in a CDI because my horse is feeling his best gives me valuable peace of mind,” said Davis. “Being that we have a couple of older horses, maintenance is huge in keeping their longevity. We have a 19-year-old horse who could go out and compete fourth level tomorrow because he is so well cared for by our vets. For my younger horses, it’s about keeping them feeling their best so their careers are as long as these older horses we have.”

The Road to Grand Prix Glory: Royale is Back in Action Thanks to Palm Beach Equine Clinic
Meagan Davis and Royale, owned by Scott Durkin, competing in New York. Photo courtesy of Meagan Davis

A Quick Look at Meagan Davis Dressage

Davis herself competed internationally for the first time at age 11 in the FEI Pony Division at the America’s Cup in Blainville, Quebec, while riding under the tutelage of U.S. dressage rider Lendon Gray. The appearance earned her the distinction of being the youngest rider to represent the United States in international dressage competition. She won the USEF National Young Rider Dressage Championship in 2010 and went on to compete at the Young Rider World Cup in Frankfurt, Germany, that same year. There, Davis earned a title as the only U.S. rider to finish in the “A” final, where she was seventh.

Davis later rode under the direction of 2004 Olympic and 2006 FEI World Equestrian Games team gold medalist Hubertus Schmidt of Germany before launching her own business at the end of her junior career.

“I built the business up from there,” said Davis. “I got a couple low level green broke horses to start and continued their education up through the levels. Clients started to see us at shows and were coming to me.

“When I turned 21, I started to bring clients down to Florida with me,” continued Davis, who runs her boarding and training operation out of a Loxahatchee farm owned by her parents, Bill and Karen Davis.

Get Show Ring Ready with Palm Beach Equine Clinic

Davis currently oversees the care and training of 14 horses ranging in age from three to 23. Her own mount Royale, owned by longtime client Scott Durkin of New York, NY, is currently competing in the small tour division and contested five CDI events during the 2018 winter season. Davis is also currently producing a young horse, Damocles HLF, which her father found at an auction in Orlando. At only eight, the gelding is competing in the Developing Prix St. Georges ranks.

Davis also has a three-year-old gelding she is starting herself for Durkin, as well as clients competing at second and third level. There is even a dressage pony rounding out the string!

Trusting Palm Beach Equine Clinic

For Davis, the correct maintenance of the horses under her supervision is the cornerstone of her training program.

Palm Beach Equine Clinic’s own Dr. Robert Brusie, who graduated from Michigan State University College of Veterinary Medicine and is a board-certified surgeon, pays a visit to Meagan Davis Dressage when they arrive at their southern base each November. Giving all the horses a comprehensive exam, Dr. Brusie evaluates the needs of each individual horse to keep them fit and happy during the show season.

“He does a full work-up – flexions, injections, x-rays if needed,” said Davis. “There was a time when we weren’t doing these checks and what would happen is we would get going and I would find that something didn’t feel right and we would be missing shows during the season.”

Dr. Brusie is also responsible for vetting the majority of Davis’ horses. One, in particular, was a 14-year-old Westphalian who had a late flying change.

Part of the team at Meagan Davis Dressage, Scott Durking (left), Davis (center), and Isabel Ullman (right). Photo courtesy of Meagan Davis

“We discussed how the flying change was so late and if we would ever be able to fix that situation,” said Davis. “Dr. Brusie watched the horse go, I schooled the flying changes for him, we did the vetting, and he said, ‘You’ll have this change no problem.’ He gave me what he thought would be a good program for maintenance and muscle building and the next year we had changes. I competed him through fourth level.”

When the Unexpected Happens

Every horse owner knows that when it comes to a horse’s health, the unexpected is always a looming possibility. For Davis, however, the anxiety of caring for top level sport horses is slightly assuaged by having PBEC in her corner.

“We have a Friesian who was losing weight with no clear reason why,” said Davis. “I was referred to Dr. Heidmann, who was able to correctly diagnose a colon ulcer over the phone after listening to his symptoms. He told me exactly what to do and the horse was almost magically better!”

Dr. Peter Heidmann is the PBEC resident internal medicine specialist and rounds out a diverse group of veterinarians and specialists who provide comprehensive diagnostic and treatment care.

“It’s nice that they have such a wide variety of vets on staff,” continued Davis. “We have used their MRI machine to help diagnose a torn check ligament on a horse that has since made a full recovery and is back to work, we have had them quickly assess a minor colic that had the potential to be very serious, and we have had PBEC vets here for everything from gelding stallions to teeth floating.”

With the care of her horses always at its best, Davis has big plans for her clients and herself, saying, “I hope to move Royale up to the Grand Prix level in the next year, and I would love to qualify Damocles for the USEF Young & Developing Horse Dressage National Championships. As for the clients, they will all be qualifying for regionals, which is a big deal for adult amateurs at second level. It’s all made possible because Palm Beach Equine Clinic keeps all of our horses feeling their best.”

Have further questions about the services available at Palm Beach Equine Clinic? Call the clinic today at 561-793-1599 to learn more.

Any horse owner’s worst nightmare is realized when their mount begins to show the dreaded signs of colic. For Jody Stoudenmier, a Wellington, FL, resident and avid dressage rider, she knows the symptoms all too well.

Beatrix success story palm beach equine clinic colic surgery
Beatrix looking happy and fully recovered from her surgery.

Patient History

Stoudenmier owns an 11-year-old American-bred Dutch Warmblood mare that joined her string of horses at the end of 2016 and has competed through the Intermediate II level. Sidelined by a suspensory injury last year, Beatrix was prescribed stall rest to aid in her recovery by Dr. Robert Scott of Scott Equine Services based in Ft. Lauderdale, FL. An unfortunate but common side effect of the necessary stall rest was colic. Beatrix suffered from six bouts of colic that were resolved without surgery when Dr. Scott referred Stoudenmier and Beatrix to Palm Beach Equine Clinic.

“She is such a wonderful mare; a nice mover, very athletic, sweet, sensitive, and easy to handle in the barn,” said Stoudenmier of the mare that regularly competes at the Adequan Global Dressage Festival during the winter season. “When she was recovering from her injury we tried everything to prevent her from colicking – diet, medications, hand walking – but, nothing seemed to be working.”

It was then that Palm Beach Equine Clinic’s board-certified surgeon, Dr. Weston Davis, suggested a laparoscopic surgical approach.

“Her colic had never progressed so far that we needed to do surgery before,” explained Stoudenmier. “But, at that point, I was open to anything! After speaking with Dr. Davis, I immediately had a positive feeling about it.”

Dr. Davis’ Surgical Procedure

The procedure that Dr. Davis suggested was an endoscopic ablation of nephrosplenic space. In layman’s terms, as a result of Beatrix’s colic, her colon was essentially getting caught or entrapped over the nephrosplenic ligament, which connects the left kidney to the spleen. When the colon is entrapped in this position, its contents cannot move through it and the colon becomes distended, causing the horse considerable pain, and the inevitable colic.

Dr. Weston Davis surgery palm beach equine clinic

Dr. Davis’ solution was to close or perform an ablation of the nephrosplenic space to prevent further entrapment. The procedure can be conducted endoscopically where the horse does not have to be anesthetized, but undergoes a standing surgery with sedation and local anesthesia. A small incision is made in the left flank and the laparoscope is inserted through a smaller incision close by. The nephrosplenic space is then sutured closed so that the trough that forms the space between the kidney and spleen is obliterated and can no longer entrap the colon.

On October 9, 2017, Beatrix underwent a successful ablation of the nephrosplenic space at the hands of Dr. Davis.

“In the past, I have had several horses undergo surgery where they had to be anesthetized and it was very difficult to get them standing again after surgery,” said Stoudenmier. “We did not have that worry with Beatrix and the approach absolutely made a difference in her recovery.”

Post-Surgery Care and Recovery

Beatrix remained at Palm Beach Equine Clinic for a week and a half after surgery to jump-start her recovery before returning home to Stoudenmier, who has managed her post-surgery care with the help of both Dr. Davis and Dr. Scott.

“Dr. Davis was absolutely wonderful to work with,” said Stoudenmier of her experience at Palm Beach Equine Clinic. “He listened to my concerns, was patient, and kept his mind open.”

Dr. Davis paid a visit to Beatrix in mid-November to perform an ultrasound and together with Dr. Scott approved the mare to return to work. Stoudenmier has begun to introduce trot work into Beatrix’s routine and is optimistically expecting a full recovery, saying, “She looks super and everything looks good for the next two months. My goal by the end of the season is to get her back in the show ring!”

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Patients

Success Story: Freeman

In January 2016, the Pine Hollow team noticed something seemed off just before driving out of the Winter Equestrian Festival (WEF) with their horses. Stopping to check the horses before continuing off the showgrounds, Pine Hollow discovered Freeman, a promising and successful Dutch Warmblood, had swung his hind leg over the back of the trailer. Freeman’s stifle had ended up squarely on one of the hooks used to secure the back door, lodging the hook into his stifle and into the femoropatellar joint.

Emergency Veterinary Care

Recognizing the extreme peril facing Freeman, Pine Hollow immediately called for help from Palm Beach Equine Clinic, the Official Veterinarians of WEF.

“It took tremendous effort, creative thinking, and exceptional teamwork to free Freeman from the hook impaling his leg,” said David Blake, Pine Hollow’s internationally acclaimed rider and trainer. “Palm Beach Equine Clinic sent several of their top vets to help us rescue Freeman. The team of vets is truly great.”

Thanks in very large part to the help and determination of the vets, Pine Hollow and Palm Beach Equine Clinic were able to free Freeman from the trailer door.

At the Equine Hospital

From there, Freeman was transported to the nearby Equine Hospital, where he spent a few days recovering before it was agreed to pursue arthroscopic surgery on his femoropatellar joint.

“To be honest, it wasn’t looking good at all for the first day or so Freeman was there,” said Blake. “The joint was so severely damaged we didn’t know if it could be fixed. Our only chance of fixing the joint was surgery, so we agreed we would try everything possible.”

Dr. Weston Davis Palm Beach Equine Clinic
Dr. Weston Davis of Palm Beach Equine Clinic.

Dr. Weston Davis performed the surgery, after which Freeman remained in Palm Beach Equine Clinic’s care while he regained use of the leg.

“The team did a fantastic job there and kept Freeman until he was ready to begin long-term rehab with James Keogh,” said Blake.

When Freeman was finally ready to return home to Pine Hollow, Blake hoped at best Freeman would eventually be able to do light work and perform at a low level.

On the morning of December 30, 2015, Laurie Waggoner, director of rescue operations and founder of the South Florida SPCA, got a call that she gets all too often. Agriculture patrol had received reports of three emaciated horses in Miami Gardens, FL, that needed immediate care. Waggoner took action and hooked up her truck and trailer to make the drive to pick up the three horses. When she arrived, she found an Arabian and a Quarter Horse, both severely underweight, and a pony she estimated to be two years old laying in the mud, too weak and malnourished to even stand.

Amazing Grace South Florida SPCA Rescue Pony Palm Beach Equine Clinic

The pony, who was quickly named Amazing Grace or “Grace” had been down for more than 24 hours. Despite Waggoner’s best efforts, her team was unable to get Grace on her feet and decided the most humane option was to end Grace’s suffering. Calls went out to local veterinarians, but were met with a slow response the day before New Year’s Eve. While they waited for a veterinarian to become available, Waggoner and her team rolled Grace onto a blanket and carried her onto a trailer to make the trip back to the South Florida SPCA.

“When we pulled her off the trailer, she immediately started grazing,” said Waggoner. “The vet was on the way to euthanize her, but I saw that there was fight still left in her. We were able to pick her up and she stood with help. She was not ready to go.” Grace was made comfortable in a stall at the South Florida SPCA and stood with assistance over the next day. But, on the second day, she was no longer willing or able to make an effort to stand.

treatment veterinarian Amazing Grace South Florida SPCA Rescue Pony Palm Beach Equine Clinic

“I knew we were going to need help, but it was a holiday and locally everything was closed,” said Waggoner. “I called Palm Beach Equine Clinic (PBEC) and they told me to bring her right in.” Grace arrived at PBEC on New Year’s Day and was greeted by a team of veterinarians led by Dr. Scott Swerdlin, president of PBEC. She was treated for extreme starvation and neglect, which included constant blood work to monitor organ function, the administration of fluids, several meals of senior feed and alfalfa each day, and a lot of compassion from PBEC veterinarians.

Watch Amazing Grace’s Full Story

“She spent eight days at PBEC and returned to the South Florida SPCA ranch with the same will to live,” said Waggoner. “Five days later, I came out in the morning and she was standing on her own.” Grace was completely rehabbed in four months and put up for adoption at the end of 2016. On December 31, 2016, one year after she was found on the brink of death, Grace made her way across the U.S.-Canadian border to her new home at Sherwood Farm in St. Catharines, Ontario, with adopter Marilyn Lee.

show pony Amazing Grace South Florida SPCA Rescue Pony Palm Beach Equine Clinic

“I knew she would need special handling to give her the chance to succeed, which we were fully prepared to do,” said Lee, who also adopted a Thoroughbred from the South Florida SPCA in 2012. “I saw her current photo on South Florida SPCA’s Facebook page and thought, ‘Now there is a lovely pony’. Then I saw the photo of her laying in the dirt, and that was that.” One of Lee’s young riders, Abby Banis, had also learned of Grace’s story on social media and was waiting for the pony in the early morning hours the day she arrived at Sherwood Farm.

The two have been inseparable ever since. Grace’s training began immediately under the direction of Lee’s daughter, Robin Hannah-Carlton. Impressed by the pony’s love for jumping, Lee made plans to start showing Grace. The rescue pony won a reserve championship in the pony hunter division at the very first show she competed in with Banis in the irons.

Today, Grace is happy and healthy with the care of Lee and her staff, and the love of a little girl. The South Florida SPCA operates under the motto, “Your next champion just might be a rescue”, and for Grace, nothing could be closer to the truth.

Nearly eight months ago, Shes Packin Fame, a 2012 Quarter Horse mare owned by Margo Crowther of Fort Myers, FL, 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 (PBEC) state-of-the-art diagnostic imaging equipment and a surgery performed by PBEC’s own Dr. Weston Davis, Shes Packin Fame has not only returned to running barrels, the five-year-old mare is back to winning.

Success Story: Diligent Pre-Purchase Practices Put “Mater” in the Winner’s Circle

Crowther purchased Shes Packin Fame, affectionately known as Sissy, as a three-year-old after the mare reminded her of a horse she ran in college. Crowther trained Sissy herself and won or placed in nearly every barrel futurity she entered during the horse’s four-year-old year, accumulating $100,000 in prize money.

In November of 2016, Crowther and Sissy were competing at the No Bull Finals in Asheville, NC, when Sissy went down at the first barrel on the final day. The fall fractured the horse’s central tarsal bone, which was not easily diagnosed. Crowther met with a veterinarian in North Carolina who was unable to locate the fracture via x-ray before contacting Dr. Davis, who had managed Sissy’s healthcare since she joined Crowther’s string.

Dr. Davis utilized PBEC’s Equine Standing Magnetic Resonance Imaging (MRI) and Nuclear Scintigraphy (bone scan) modalities to locate a flat piece of separated bone known as a slab fracture.

The process began with a bone scan where Sissy was injected with a radioactive isotope named Technetium 99. The isotope attached to the phosphorous proteins localized within the bone and was absorbed. A specialized nuclear isotope gamma ray camera was used to capture images of the skeletal anatomy with a 360-degree view. Points of interest lit up on the image to indicate increased metabolic activity and was able to locate the site of the injury.

Following the identification of the injured area, a Standing MRI produced highly detailed images in several different planes to capture a compete view of the injury and further define the issue.

After Dr. Davis located and identified the fracture, he surgically inserted a screw into the central tarsal bone to stabilize the fracture. Sissy was discharged from the clinic on six months of recovery with follow-up diagnostic imaging every month to monitor the injury’s repair. During the fourth month of recovery, Dr. Davis removed the screw. At the end of March, Sissy was cleared to begin exercise and Crowther began by hand walking the mare slowly progressing to trotting her under tack. They started with ten minutes of exercise and worked up to 45 minutes.

“Weston was a huge part of Sissy’s recovery,” said Crowther, who set her sights on entering Sissy in the Old Fort Days Derby, held over Memorial Weekend in Fort Smith, AR. “It is the biggest derby of the year for five-year-olds. When it came time to enter, Weston rechecked the leg, did flexion tests, cleared her to run, and wished me good luck.”

When they arrived in Fort Smith, Sissy had not seen a barrel since the day of the injury. Crowther and Sissy posted a time of 16.405 seconds, the fastest time of the event, to win the 25-horse final and collect a $23,469 prize money check.

“She just came back so confident and so strong, like she never missed a beat,” said Crowther. “She always ran like an older horse, but I was surprised at her time. I knew she would be in the top ten, but I was surprised just how strong she was. Weston told me to let her set her own pace and that is what I did. I did not push her. So, when I called Weston to tell him we had won, he was very surprised.

“She feels like her hock is maybe even stronger than it was before the injury,” continued Crowther. “I am so thankful to Weston and Palm Beach Equine Clinic, and feel blessed that she has come back strong and healthy.”

With Sissy back in top form, Crowther’s next goal is a lofty one. Her hope is to qualify for and compete at the National Finals Rodeo in Las Vegas, NV, this December.

Jo Ann Hopkins and her 12-year-old Appendix-bred gelding, Blazer, were placed third in points in their local 1D barrel racing circuit. However, three months earlier, Blazer underwent surgery at Palm Beach Equine Clinic for a growing cyst in his sinus. On August 1, 2015, Dr. Weston Davis, DACVS, performed the surgical procedure on Blazer for an expansile paranasal sinus cyst of the left paranasal sinuses, extending to the right concho-frontal sinus.

Hopkins noticed that Blazer, who she calls “George” for his laid-back attitude, had a raised knot on his head this spring and consulted with her local vet, Dr. Kelly Alderman. The area was monitored closely and remained in a similar condition until June, when Hopkins noticed Blazer wheezing while running barrels and the knot increasing in size.

Diagnosing the Paranasal Sinus Cyst

Dr. Alderman performed radiographs on the site and aspirated the swelling where a substantial amount of fluid was removed. She confirmed that the bump was a suspected paranasal sinus cyst. At that point, Blazer was referred to Dr. Weston Davis of Palm Beach Equine Clinic, who advised Hopkins that the cyst was likely growing slowly within the sinus for a considerable amount of time with no clinical signs. The diagnosis was an expansile paranasal sinus cyst of the left paranasal sinuses, extending to the right frontal sinus.

Paranasal Sinus Cyst Surgery

For surgery, Blazer was placed under standing sedation and local analgesia (painkiller) and his head was aseptically prepared before Dr. Davis performed a frontonasal sinusotomy (incision into the sinus). He made an opening from the middle of Blazer’s head to the corner of his eye. Once the skin flap was elevated and the bone fractured, a large amount of fluid was evacuated, which is consistent with the contents of a paranasal sinus cyst. Dr. Davis also observed that the sinus cavity was extremely distorted and expanded. The cyst lining was debrided and removed, then the sinus was lavaged and a tube was advanced into the sinus cavity to facilitate drainage. The sinus was packed with gauze tied together and soaked in a dilute betadine. Finally, the bone flap was replaced and the skin was closed and covered with a sterile bandage.

Recovery

The gauze packing was removed 48 hours after surgery and upon release from Palm Beach Equine Clinic, Hopkins was instructed to monitor the incision for heat, swelling and discharge. Bute, in the amount of 2g, was administered orally once a day for five days and Dr. Alderman removed the sutures after 10 days.

Hopkins characterizes Blazer as a sweet gelding with heart to spare, and is happy to report that his recovery has been fantastic. After six weeks of stall rest and rehab time to get back in shape, Blazer recently won his first barrel race after surgery. According to Hopkins, Blazer is running better than ever thanks to Dr. Davis and the staff at Palm Beach Equine Clinic.

Palm Beach Equine Clinic is renowned for its exceptional care of performance sport horses of all disciplines around the world. Sometimes, the veterinarians and surgeons have the opportunity to treat the horses owned by their colleagues. This summer, Palm Beach Equine Clinic veterinary technician Megan O’Neal experienced the clinic’s surgical expertise firsthand when her rescued off the track Thoroughbred (OTTB) was diagnosed with severe spinal impingement (kissing spines).

Signs and Symptoms

O’Neal adopted Blessing, a 10-year-old mare, almost three years ago. After Blessing’s career on the track ended, she was given to Pure Thoughts Horse Rescue in Wellington, FL. Blessing had moved through a few foster homes before O’Neal gave her a forever home. Blessing had been successfully jumping three-foot courses with one of her previous foster homes. After adopting Blessing, O’Neal was jumping the mare as well, but only about two-feet high. She had plans to compete, but Blessing’s behavior changed under saddle. The mare began rearing and bolting, endangering both herself and her rider. Her attitude on ground handling turned sour as well, no longer enjoying being groomed and pinning her ears in agitation.

Identifying the Problem

With the help of Palm Beach Equine Clinic surgeon Dr. Weston Davis and the advanced imaging technology available at PBEC, O’Neal was able to pinpoint the cause of Blessing’s troubling change in behavior. The diagnosis was severe chronic back pain with dorsal spinous process impingement (kissing spine lesions). The vertebrae in her back from T16 – L1 were affected, which is the mid-section of the horse’s back, in the general region of where the back of the saddle sits.

Addressing the Problem Through Non-Surgical Treatments

The first course of action was to try several non-surgical techniques to treat Blessing’s pain. Dr. Davis tried treatments of intramuscular injections for arthritic pain and corticosteroid injections in between the spinal vertebras. A veterinary chiropractor adjusted the mare every few weeks. For almost eight months, several additional methods were tried to avoid kissing spines surgery including acupuncture, back stretches and oral muscle relaxants. In July, when the pain continued after all their efforts, O’Neal finally decided that surgery was the only option for recovery.

Kissing Spines Surgery

In the state-of-the-art hospital at Palm Beach Equine Clinic, Blessing was sedated to obtain pre-operative radiographs that map the exact site of the lesions. She was placed under general anesthesia and the surgical site was sterilely prepared. Dr. Davis made a single 20cm incision on the dorsal midline over the palpable dorsal spinous processes. Eighteen-gauge needles were inserted at regular intervals and used as radiographic markers to identify the interspinous spaces. The incision was extended through the supraspinous ligament at each site.

Dr. Davis used sterile surgical equipment, known as a bone rongeur, to elevate the soft tissues and resect some of the affected dorsal spinous processes (DSPs). The rongeurs, which are similar to large pliers, were used to slowly remove the edges of the overriding bone. This process frees the space between adjacent vertebrae until widened enough that the index finger of the surgeon could easily pass in the interspinous space. The site of resection was lavaged to remove any loosed tissues. Lastly, Intra-operative radiography was used as needed to confirm the location and completion of the surgery. Following confirmation, the supraspinous ligament was internally closed with absorbable sutures. The skin was closed with surgical staples and a stent was sutured in place over the incision. After several weeks of healing, the stent and staples were removed.

The kissing spines surgery was performed without complication and Blessing was provided a good prognosis. Soon after surgery, the space that was created between vertebrae filled with a non-painful, fibrous scar tissue. Blessing went home the following day after surgery. She was monitored closely at home and received routine peri-operative antibiotics (gentamicin and penicillin) and anti-inflammatories (phenylbutazone) for pain. Recently, O’Neal was given the okay from Dr. Davis to resume riding for normal exercise. O’Neal looks forward to continuing her partnership with this special mare. Thanks to Dr. Weston Davis and the team at Palm Beach Equine Clinic for their exceptional care to get Blessing back to happy and healthy!

A 12-year-old show jumper is moving nicely just 2 months after laboring to walk.

Palm Beach Equine Clinic Staff Surgeon Dr. Weston Davis operated on a severe lameness case on July 5 that had quickly progressed into an emergency situation.

Evaluation and Diagnosis

Annabelle was referred to Palm Beach Equine Clinic for advanced imaging and evaluation of severe subsolar abscessation in the Holsteiner mare’s left front foot that was not responding to aggressive therapies.

She was diagnosed with infectious pedal osteitis in the left fore and early stages of support limb laminitis in the right fore. Pedal osteitis is an infection of the coffin bone. Annabelle previously showed in the Adult Jumpers with her owner, Jennifer Knobel, but the infection had advanced to the point that she could barely walk.

Local veterinarian Dr. Kim Snyder vigorously managed Anabelle’s foot condition in the field before referring the case to Palm Beach Equine Clinic. She performed digital radiographs at the farm, but they failed to adequately define the lesion. She requested an MRI study of the foot to more accurately image the underlying causes of the persistent foot abscess, such as a foreign body, bone infection, sequestrum, or tumor.

Advanced Medical Imaging Technology

As the radiographs were not definitive enough alone, the team at Palm Beach Equine Clinic used their state-of-the-art MRI technology for a more detailed analysis. The MRI showed excess fluid and severe inflammation within the coffin bone. The infectious pedal osteitis had caused the bottom of the coffin bone to begin to deteriorate. Worsening the situation, Annabelle was reluctant to bear weight on her left foot. Then she developed mild laminitis in her right foot due to the increased load on the supporting limb to relieve pressure. The development of support limb laminitis determined the emergency status of the left fore lameness as laminitis could be a fatal complication.

Dr. Davis and the team at Palm Beach Equine Clinic took immediate action using the MRI scans for accurate surgical mapping. The MRI study documented exactly where the infectious pedal osteitis was located. This mapped position was used in comparison to the previously taken radiographs. Both imaging modalities were used intra-operatively to guide Dr. Davis precisely to the area of infected bone.

Surgery and Recovery

Annabelle was placed under general anesthesia, and the left front limb was prepared for surgery. A 5 cm long x 3 cm wide window was cut through the sole down to the surface of the coffin bone, through which the necrotic (infected) bony tissue was removed. Prior to recovery, the surgical site was packed with antibiotic powder and a full distal limb bandage was applied. Additional support of Soft-Ride boots and sole supports were positioned. Medical grade maggots were applied to the foot the day after surgery to safeguard absolute full debridement of all necrotic/infected tissues.

infectious pedal osteitis palm beach equine clinic
infectious pedal osteitis palm beach equine clinic

Annabelle was placed on a range of antibiotics. Pain was managed with local nerve blocks and anti-inflammatory medications. Her pain improved rapidly in the operated left limb and signs of laminitis in the right fore resolved as well. During her stall rest recovery, the foot was soaked routinely in Epsom salts. Betadine soaked gauze was applied over the frog and surgery site each day and the hoof was wrapped for protection.

Snyder continued to care for Annabelle in the post-op period. Synder’s husband and farrier, Jim Gilchrist, applied a shoe with a treatment plate to protect the bottom of the foot. This allowed for routine access by removal of three simple screws.

The initial cause of the abscess or why the infectious pedal osteitis progressed so aggressively is still unclear. Dr. Davis speculates that it was possibly a spontaneous abscess and for whatever reason, whether the depth into the foot or the presence of a highly infectious bacteria, Annabelle was just unlucky. Instead of draining like a “normal” abscess, this particular case established an infection within the bone. This made it impossible to clear the infection with even the most aggressive medical therapies apart from surgical removal.

Annabelle’s infectious pedal osteitis has cleared and her hoof is healing well. Now she is walking sound and has a favorable prognosis for further improvement with hopes of eventually return to work.

Thoroughbred Brazilian Triple Crown winner Bal a Bali was admitted to Palm Beach Equine Clinic on August 3, 2014. The elite athlete was treated for life-threatening laminitis by board-certified surgeon Dr. Weston Davis of Palm Beach Equine Clinic, in conjunction with Dr. Vernon Dryden, just months after his Triple Crown win in March of that year.

Photo by Rayetta Burr/Benoit Photo

Brazil’s 2014 Horse of the Year, Bal a Bali (Put It Back—In My Side, by Clackson) took an impressive win in the Grande Premio Cruzeiro do Sul (Brz-I) to become the country’s 12th Triple Crown winner. He finished the race in track-record time at Gavea racecourse.

Following his last start in June 2014, Bal a Bali was purchased by Fox Hill Farm and Siena Farm and imported to the U.S. in late summer, but unfortunately suffered from laminitis brought on during his travels. Bal a Bali was in a Florida quarantine center scheduled to fly to trainer Richard Mandella’s stable in California when the problems developed.

Bal a Bali Admitted to PBEC Equine Hospital

Bal a Bali was quickly moved to Palm Beach Equine Clinic in Wellington, Florida, where he was received by Dr. Weston Davis, who would oversee his care in the equine hospital for the next three months. Palm Beach Equine Clinic set aside an entire section of the hospital barn as a quarantine unit to meet the horse’s final import requirements while he was treated with aggressive cryotherapy – a gold standard of laminitis care. Hospital staff carefully monitored Bal a Bali and treated him with consistent cold-water spa treatments for several days throughout the severe acute phase of this disease. He was gradually weaned out of the spa as he improved clinically.

On two occasions, Dr. Davis performed intravenous regional perfusions of the horse’s feet with advanced stem cell treatments. A myriad of other medical therapies were administered throughout his stay. The progression of his laminitis was closely monitored with the use of diagnostic imaging and meticulous farrier care. Farriery care included ensuring optimal sole support and proper mechanics to decrease strain on the fragile lamina. By October, the horse was cleared to travel to Siena Farm in Kentucky. There, Dr. Dryden continued to treat the horse and he was then flown to California in January.

Winning his Battle with Laminitis

After a nine-month recovery process, Bal a Bali made a miraculous return to the track for his North American debut in May 2015. He cruised to victory in the $100,000 American (G3), a one-mile turf race for three-year-olds and up at Santa Anita Park. At that point, the five-year-old had captured 12 of 13 career starts and earned $570,078.

Bal a Bali’s comeback was no doubt a result of the outstanding care he received at Palm Beach Equine Clinic under the extraordinary supervision of Dr. Weston Davis and Dr. Vernon Dryden.

Thank you Fox Hill Farm and Siena Farm for the trust you placed in Palm Beach Equine Clinic.

Nelson Pessoa’s Miracle Horse: Artemide d’Ecaussinnes

By Jennifer Wood Media, Inc.

Owning a horse comes with a degree of uncertainty and worry. If your horse has a traumatic accident, sometimes the very best you can hope for are swift care and an eventual recovery. For show jumping legend Nelson Pessoa, seeing his horse Artemide d’Ecaussinnes with a severe trauma in the ring was a shock. But what came afterward surprised him even more.

Pessoa purchased Artemide d’Ecaussinnes, an eight-year-old BWP gelding, at the beginning of the year. The young horse showed at the FTI WEF with Pessoa’s rider, Stephan Barcha, and another junior rider, Joao Victor Castro. “It’s a horse that shows a lot of promise, to be a nice horse for speed classes or a junior horse. It’s a horse with a wonderful character,” Pessoa said.

Artemide’s trajectory changed in the blink of an eye on Friday, January 31, in the DeNemethy Ring in a 1.40m class. With Castro riding, the pair had a miscommunication at an oxer and landed on the standard. In a freak accident, the wood sheared from the attached metal strip holding the jump cup, which then went into the horse’s stomach. Luckily, horsemen on the side of the ring and the jump crew reacted quickly to be at the horse’s side, and the horse’s groom, Waldeci da Silva ran from the in-gate to help keep Artemide’s organs inside his body. In the gruesome accident, it was the quick thinking of these individuals that helped save his life.

“It was just really bad luck, it wasn’t anybody’s fault,” Pessoa recalled. “The horse was looked after really quickly. The staff from the show grounds was really good. They made the necessary decisions to help him.”

Those helping in the ring had the unenviable job of holding Artemide’s intestines to keep a bad situation from turning worse. Dr. Hilary Clayton was there shortly to start bandaging the horse, and Palm Beach Equine Clinic was quick to react as well, bringing the equine ambulance in immediately to transport Artemide less than a mile away to Palm Beach Equine Clinic (PBEC), where he went into surgery with no delay. All in all, only 30 minutes elapsed from the time of the accident to when Artemide went into emergency surgery.

The surgery was led by Dr. Robert Brusie and Dr. Weston Davis of PBEC, which has three Board Certified surgeons. Dr. Brusie praised the quick thinking of fellow competitors, the DeNemethy Ring jump crew Rafael Rios, Cesar Morales, and Steven Sarmiento, as well as da Silva.

“I called (horse show manager) David Burton and told him his people did a fantastic job keeping (the horse) quiet. That injury is really painful, with intestines out of his abdomen. The horse was panicky all the way over here until we anesthetized him, with extreme pain. I was really pleased with the way everything worked. We rehearse these kinds of things, (but) we mainly have fractures, ruptured tendons, as injuries. We do have drills before the season with the ambulance driver. It paid off. Nothing was a surprise, and nobody wondered what to do next. It’s being ready and prepared.”

When Dr. Brusie and Dr. Davis performed the surgery, they were pleased to see that while it was a traumatic injury, there were no vital organs pierced and that the horse’s bowel only had a tear in the section outside of the horse’s abdomen. A second incision was made in the horse’s abdomen to help facilitate the surgery.

“We were really fortunate with that guy,” Dr. Brusie remembered. “We ended up taking out about two feet of intestine. He broke a couple of ribs too.”

“It was good luck for us that the (Palm Beach Equine) Clinic is very close,” Pessoa said. “Dr. Brusie did an unbelievable job.”

Meet Palm Beach Equine Clinic’s Dr. Robert Brusie

Artemide’s miraculous recovery is the combination of quick thinking and amazing care at Palm Beach Equine Clinic, but Pessoa believes the horse’s mindset is what solidified his chances of recovery. “One important point is that the horse is an unbelievable patient. Two hours after he was back in the stable, he wanted to eat and he was drinking. We were waiting for an infection or a temperature, but he had no temperature. It was like it was just a little cut. Twenty-four hours after the surgery, the horse was looking like nothing happened with him,” he explained. Dr. Brusie agreed, “It’s a really good temperament horse. It took a lot of courage for him to stand there and not thrash around. He’s a good horse.”

Artemide is currently getting back in shape by walking on a treadmill. Dr. Brusie compared his situation to colic surgery, where after 10 days recovering at PBEC, he went home, and he can be ridden again 30 days after surgery.

Pessoa expressed, “They said it was a miracle. I really want to say for everybody that has a horse here at this horse show, this clinic is something. You hope things like this won’t happen, but for sure with the number of horses and the amount of jumping here, things like that happen sometimes. It’s a great thing to have this support. People don’t always realize this – we realize now because it happened to us. I’m very grateful for them.”

Along with Drs. Brusie and Davis, Pessoa also gave thanks to Dr. Jorge Gomez and Dr. Selena Passante, his treating veterinarians, along with “the staff, the jump crew from the horse show, they saw the situation and helped save the horse.”

“We had no idea whose horse it was; we just had to save his life,” said Dr. Brusie. “This horse was meant to live. I was amazed neither one of those sites had any infection after we were done. It was meant to happen, and he was meant to live. It was a good feeling and a day when it was good to be a veterinarian.”