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

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

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

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

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

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

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

regenerative self-derived biologic therapy for horses

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

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

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

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

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

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

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

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

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

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

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

DR. BRYAN DUBYNSKY Palm Beach Equine Clinic Veterinarian

Dr. Bryan Dubynsky joined the team of veterinarians at Palm Beach Equine Clinic in 2009 and specializes in treating sport horses, working to return them to top performance after injury or complication. Get to know Dr. Dubynsky:

1. Where did you grow up and what is your background with horses?

I grew up in Northern Indiana on a horse farm. I was fortunate enough to breed horses, show on the Midwestern circuit, and train our horses. My father is a physician and I’ve always grown up with an interest in medicine. Choosing to become a veterinarian seemed to be a natural fit that combined my love for horses and medicine.

2. Who has been the biggest influence in your life or career? What did they teach you?

I spent my entire childhood from eight to 18 years old with a third-generation horse trainer from Kentucky. He taught me horsemanship and patience, two crucial parts of a good foundation for successfully working around horses every day. If I could give advice to anyone thinking about becoming a veterinarian, it would be to seek out the top people in the industry and work with them. Learn as much as you possibly can from the people who have been practicing for a long time.

3. What is your specialty/main focus as a vet?

My main focus and interest is sport horse medicine. I love focusing on improving athletic performance and treating sports-related injuries to help clients get their equine partners back to the top!

4. What do you love about your job?

I love working at Palm Beach Equine Clinic for the exceptional medical and surgical capabilities and experiences available. I also love the camaraderie of all the employees; we really work as a team! Teamwork is paramount for making the clinic successful. I love the opportunities to travel throughout North America and Europe to see really cool places through work with my clients. I love working with the competition horses and being a part of the atmosphere of high-level competition, as well as caring for the sweet trail horses at home.

5. What is one of the most interesting cases you have worked on?

My own horse, Batman. He was an abandoned polo pony suffering from West Nile Virus. He was paralyzed for three days and no one wanted to treat him. We treated him with intensive care for three days and used a tractor as a last-ditch effort to get him to stand. He has since made a full recovery and is currently playing polo.


For Veterinary Technician Brianna Ploskunak, 22, of Royal Palm Beach, FL, horses are a passion. But not in the way you may think. Raised by a mother who rode and competed, Ploskunak found an early infatuation with all things equine that eventually drew her to veterinary medicine. At Palm Beach Equine Clinic, where she has been a part of the team since 2016, Ploskunak is one of 30 veterinary technicians who manage the hands-on care of equine patients and support the veterinarians in all aspects of the day-to-day operations. She works directly under Dr. Bryan Dubynsky, who specializes in sport horse medicine within the bustling competition atmosphere of Wellington, FL. 

We caught up with Veterinary Technician Brianna Ploskunak to find out more:

What was your first introduction to horses?

My mom used to be a rider herself, so I grew up constantly surrounded by horses. She [rode] dressage for many years. I quickly followed in my mother’s footsteps and fell in love with the animal and the sport, although I never competed myself. Being around horses my entire life, I felt the need to do whatever I could to advance the health of each and every horse that I see. It means a lot to me to be able to contribute to their fast and healthy recovery. 

What do you enjoy most about being a veterinary technician?

The number one thing I enjoy about treating horses is being a part of their journey from start to finish. Nothing brings me more joy than to see a horse that I have been working with through their recovery return to the show ring happy and healthier than ever before. These animals never cease to amaze me with their way of getting back onto their feet after an injury.

What is your average day like at Palm Beach Equine Clinic?

On an average day at Palm Beach Equine Clinic, I first meet Dr. Dubynsky to go over the morning appointments and gather all of the equipment and resources we need for the upcoming day. As we finalize our schedule, I work on completing all open items such as billing and inventory. We then prepare the truck to leave for the day and travel to a variety of different appointments throughout the Palm Beach County territory. Appointments vary depending upon the condition of the patient but often include radiographs and ultrasounds to injections and vaccinations. After we have seen all patients for that day, we return to the clinic and re-stock the inventory we have used that day. Lastly, we prepare for the following day by composing a new schedule of appointments and/or on-call horse show responsibilities.

Meet Palm Beach Equine Clinic Veterinary Technician Brianna Ploskunak
Meet Palm Beach Equine Clinic Veterinary Technician Brianna Ploskunak

What is your favorite part about being a member of the Palm Beach Equine Clinic team?

My future goal is to continue to learn from the many experienced veterinarians I work alongside every day and build my experience and knowledge in the industry. That’s probably my favorite part as well; working alongside such talented and genuine people willing to give me multiple opportunities to learn and grow as a professional. It’s very hard to find a group of superiors willing to go the extra mile to teach young employees. 

I have been able to experience some amazing things at Palm Beach Equine Clinic, including the intricacy of equine surgery and how the work of equine surgeons can bring a struggling horse back to top health. I really enjoy sports medicine because it’s not always sick horses – there is always something you can do to help the horse get back to peak performance. Whether it be radiographs, ultrasounds, injections etc., there is always something that can be done for the benefit and of the health of the horse. 

What can we find you doing when you are not at Palm Beach Equine Clinic?

When I’m not working, you can catch me racing go-karts and spending quality time with my family, especially my one-year-old nephew, Elijah!

As sport horses become faster and stronger, veterinary medicine is often challenged to break barriers to provide the best in diagnostic and maintenance care. Palm Beach Equine Clinic is consistently on the forefront of those advances and employs a team of veterinarians equipped with the latest developments in regenerative medicine.

Two resources that have become increasingly popular to treat equine injuries are Platelet Rich Plasma (PRP) and Interleukin-1 Receptor Antagonist Protein (IRAP) to encourage regeneration of injured or degenerative tissue. Managing joint diseases and injuries using these methods is ground-breaking, but logical at their core. They essentially use naturally-occurring proteins, cells, and other natural bodily processes. Regenerative therapies put the horse’s own biological mechanisms to work stimulating healing without the use of steroids or other drugs.

What is PRP?                                              

Platelets are among the very first cells to accumulate at an injured site, making them very important when simulating the repair process. Platelets contain granules filled with growth factors (the elements that aid in healing) and stimulate specified tissue to heal at an increased rate. To treat a horse with PRP, the veterinarians at PBEC are able to take a sample of the horse’s blood and concentrate the platelets in a high-speed centrifuge onsite. The harvest and processing procedure takes approximately 30 minutes before the concentrated platelet rich sample is injected back into the horse at the specific area of injury using sterile techniques and guided by ultrasound.

A PRP tendon injection taking place at Palm Beach Equine Clinic.
A PRP tendon injection taking place at Palm Beach Equine Clinic.

PBEC’s Board-Certified Staff Surgeon, Dr. Weston Davis, explained PRP use in more detail: “We harvest a large quantity of blood, anywhere from 60 to180 milliliters, and we process that to concentrate the segment that is very rich in platelets. We get a high concentration of platelets – we are hoping for five to eight times the concentration that you would get from normal blood. Then we take that platelet-rich extract and inject it back into an injured area to encourage a more robust healing response. Whenever you have an injury, platelets are one of the first cells that get there. They will aggregate, clump, and de-granulate. They release these granules, which are very rich in growth factors, and signal the body to start the healing process.”

What is IRAP?

IRAP is used to treat equine athletes that are susceptible to musculoskeletal injuries and osteoarthritis or degenerative joint disease. Joint trauma results in the release of inflammatory mediators such as Interleukin-1 (IL-1). IRAP uses a horse’s own anti-inflammatory protein found within the blood to counteract the destructive effects of IL-1 to slow the process of osteoarthritis. The process works by binding to the IL-1 receptors in the joint and blocking the continuation of damage and inflammation.

An injection being administered by use of a guided ultrasound. Palm Beach Equine Clinic
An injection being administered by use of a guided ultrasound at Palm Beach Equine Clinic.

“We often see joint damage in sport horses because of the nature of their work, but we try to avoid overuse of steroids in joints because steroids can have long term effects on cartilage,” said PBEC veterinarian Dr. Samantha Miles. “This is a way we can manage joint disease and stop inflammation without having to consistently use steroids every time. Some of our clients will maintain their horses on IRAP alone for joint injections.”

The goal to better serve sports horses that continue to improve athletically is the driving force behind the development of even more developed and precise techniques used in regenerative medicine. And, at PBEC, the work to break new ground is never finished.

“I believe we are learning more about these technologies with more advanced science behind what they do and how they do it,” said Miles. “These treatments are natural, drug-free, and competition safe, and necessity drives the need for regenerative therapies in the sport horse world.”

Horse Healthcare: Management of Thrush, Rainrot, and Scratches

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

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

What is Equine Thrush?

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

Causes of Equine Thrush

Some horses are predisposed to developing thrush due to conformation, such as a rather high heel or deep sulci, or a narrow or contracted heel. The bacteria will manifest in horse’s feet that are not picked out regularly, or standing in muddy, wet environments, including paddocks or stalls that have not been cleaned properly.

Thrush can typically be first identified by the odor. The frog will have a strong, rotten odor and become spongy. Visually, the frog can even exudate (oozing) pus.

Treating Equine Thrush

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

Maintaining a level of activity for our equine partners will increase blood flow to the feet and promote health to the area. Horses found in dry environments with ample space to move typically do not suffer from Thrush. The activity of horses moving keeps the frogs healthier. The more blood flow you have in the foot, the less chance that infection is able to manifest.

Thrush is not guaranteed to cause lameness. In extreme rare cases, Thrush can penetrate deeper and cause an infection in deeper tissue or even in the coffin bone. When in doubt, always contact your veterinarian.

What is Equine Rainrot (Dermotophilus Congolensis)?

Rainrot is caused by a naturally occurring bacteria named Dermotophilus, which produces spores. rainrot is recognized as scabby, scaly, crusty spots on areas of the horse that have been exposed to rain. It is commonly seen on the neck or across the back (dorsum). rainrot is not typically apparent on the legs or under the belly.

Causes of Rainrot

wet horse rain prevent rainrot

When there is a break in the skin, which can be even as simple as an insect bite, a surplus of rain on the skin washes away the natural protective oils. Once the skin is stripped of the natural protective layer or any sort of trauma to the skin barrier occurs, those spores are able to invade the deeper dermis skin layers. The spores penetrate into the deeper layers of the dermis, and the body reacts by sending white blood cells and proteins to fight the invaders. This reactive response causes the small pustules, scabs, and bumps to form.

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

Treating Equine Rainrot

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

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

What are Equine Scratches?

Scratches is a generic term for many different ailments. The definition of scratches can be a bacterial, fungal, or viral dermatitis or inflammatory condition of the pastern or fetlock. It is defined as a chronic Seborrheic Dermatitis (flaking of the skin), characterized by hypertrophy (enlargement of tissue from an increase in cells) and exudation (escape of liquid from blood vessels through pores or breaks in the cell membranes) on the rear (palmar plantar) surface of the pastern and fetlock.

Causes of Equine Scratches

There are certainly predisposing factors for Scratches, including the same environmental factors that cause Thrush or Rainrot. Predisposing factors for Scratches include horses that are bathed often or stand in wet conditions all the time. Horses that have an excess amount of hair on their legs, especially draft horses, also develop scratches easily because the hair traps dirt and moisture on the skin.

Scratches can develop in horses that are bathed too often such as the intensely managed show horse. The show horse is desired to be very clean, which can mean several baths a day. This will strip away the natural protective oils and barrier of the dermis, which allows bacteria or fungi to invade. When moisture penetrates the skin, it causes inflammation reacting with heat, redness, pain, and loss of protection to keep bacteria out.

Prevention and Treatment of Equine Scratches

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

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

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Q&A with Dr. Bryan Dubynsky

Bryan Dubynsky Palm Beach Equine Clinic Veterinarian

Get to Know Dr. Dubynsky

Q. Where did you grow up and what is your background with horses?

A. I grew up in Northern Indiana on a horse farm. I was fortunate enough to breed, show in the Midwest circuit, and train our horses.

Q. When and why did you decide that you wanted to become a veterinarian?

A. My father is a physician and I’ve always grown up with an interest in medicine. Choosing to become a veterinarian seemed to be a natural fit combining my love for horses and medicine.

Q. Who has been the biggest influence in your life or career? What did they teach you?

A. I spent my entire childhood from 8 to 18 years old with a third generation horse trainer from Kentucky. He taught me horsemanship and patience of which are two crucial foundations for successfully working around horses every day.

Q. What is your specialty/main focus as a veterinarian?

A. My main focus and interest is sport horse medicine. I love focusing on improving athletic performance and treating horse-related injuries to help clients get their equine partners back to the top!

Q. When did you join Palm Beach Equine Clinic and what do you like about working there?

A. I joined Palm Beach Equine Clinic in 2009. I love working here for the exceptional medical and surgical capabilities and experiences available. I also love the camaraderie of all the employees; we really work as a team! Teamwork is paramount for making the clinic successful.

Q. What is some advice that you would give someone who wants to become a veterinarian?

A. Pick out the top people in the industry and work with them. Learn as much as you possibly can from the people who have been practicing for a long time.

Q. What are some of your other hobbies or interests?

A. Polo, golf, guitar & music, hiking, seeing family and friends. Spending time with my lovely dog, Ginger.

Q. What do you love about your job?

A. I love the opportunities to travel all over the country and Europe to see really cool places to work with my clients. I love working with the competition horses and the atmosphere of high-level competition, as well as caring for the sweet trail horses at home.

Q. What is one of the most interesting cases you have worked on?

A. My horse Batman. He was an abandoned polo pony suffering from West Nile Virus. He was paralyzed for three days and no one wanted to treat him. We treated him with intensive care for three days and used a tractor as a last ditch effort to get him to stand. He has since made a full recovery and is currently playing polo.