Tag: horse health
Dr. Marilyn Connor of Palm Beach Equine Clinic Discusses Balancing Your Horse’s Energy Sources for Performance
The modern equine athlete is asked to train and compete at far more demanding levels than horses in nature. Providing your horse with a diet that matches their metabolic needs, activity level, and training demands is key to success. To fuel our sport horses, we must first understand their nutrition and energy needs and give them the adequate support to succeed.
Physical Demands
Anaerobic vs. Aerobic Exercise
Glucose is stored in the liver and muscle cells as Glycogen, or a complex carbohydrate. Glycogen is broken down into glucose to meet metabolic energy requirements and provides energy for short to medium duration physical activity. Additionally, fat can be broken down and converted into glucose through a longer and more complex process.
Exercise can be characterized into two general categories: anaerobic and aerobic. Anaerobic exercise is characterized by short bursts of maximal effort activity, while aerobic exercise includes low to moderate intensity activity that lasts for a longer duration.
Both anaerobic and aerobic exercise utilize glucose as the primary source of fuel. Anaerobic and aerobic exercise differ in their secondary source of energy utilized once circulating glucose is depleted. Anaerobic exercise utilizes glycogen stores after glucose is depleted, while aerobic exercise is fueled by fat sources.
No equestrian sport is entirely anaerobic or aerobic. Most disciplines will have periods that require anaerobic and aerobic energy metabolism. Racehorses and western performance horses work at high intensity, fast speeds for short periods of time, requiring the body to utilize anerobic metabolism to produce energy. Show jumping and polo horses primarily use aerobic exercise yet will switch to anaerobic metabolism to keep up with energy demands of their sport. Eventing and endurance racing horses rely primarily on aerobic metabolism to support their energy needs over long periods of activity.
To support your horse during any type of sport, they must have a balanced nutrition program that sets them up for success.
Forage First
“Providing high quality forage is always my top focus for any nutrition program, regardless of the horse’s breed, age, gender, metabolic needs or athletic activity,” says Dr. Connor.
Horses are herbivores and evolved to survive by grazing on a steady supply of fresh grasses and plants. Research conducted on horses in nature shows that the average wild horse will spend 15 to 17 hours per day grazing and will travel 20 to 30 miles per day in their search for adequate food and water sources. To accommodate for the lifestyle of the modern sport horse, owners must provide high quality forage sources.
Fresh grass contains an optimal blend of key nutrients including protein, carbohydrates, vitamins and fatty acids. Once grass is cut, dried and baled as hay, the nutritional benefits begin decreasing. A week after cutting, hay loses about 60% of its vitamin A, E, and Omega 3 fatty acid content. As a general rule, horses should consume 1 to 1.5% of their body weight in hay or forage per day, with some high performing equine athletes requiring 2 to 2.5% to meet their energy needs.
When hay and forage alone are not enough to support the intense metabolic needs of the equine athlete, grain, and concentrated feed become an important part of the nutritional plan.
Building Blocks of Energy Sources
Feeding your horse with the appropriate mixture of carbohydrates, proteins, and fat is essential for fueling athletic performance.
A horse whose training requires a high level of aerobic exercise, such as a dressage horse, should receive an adequate amount of fat and carbohydrates in their diet to fuel them through longer duration training sessions by providing extended, long-lasting energy sources. Racing and barrel horses, utilizing anaerobic exercise, require a higher percentage of carbohydrates in their diets to support them through maximal effort exercise for shorter periods of time.
Carbohydrates are sourced from forage, grains, and concentrated feeds. Forage sources provide a complex source of fibrous carbohydrates that require more time for the body to digest. Concentrated feeds and grains contain starchy carbohydrates that are easily digested and quickly converted into energy to fuel a horse through intense training. A well-balanced concentrated feed will also have an appropriate blend of fat, protein, and trace minerals.
Protein is an important part of the equine diet and is found in fresh grass, dried forage, and concentrated feeds in varying amounts. Protein is made of amino acids, which are the building blocks for growth, development, repair, and maintenance of body tissues. The modern equine athlete requires a substantial amount of dietary protein to support muscle growth and ongoing tissue repair.
Fat is a key component in most equine concentrated feeds and may be supplemented by adding flax seeds, flax oil, rice bran, and corn oil. These fat sources will provide slow burning calories for sustained energy release. Fat can be especially useful for supplementing a horse’s diet when they are a “hard keeper” or if they have an underlying metabolic condition that requires dietary carbohydrates to be limited.
It is important to remember that not all fats are created equal; as some fat sources can decrease or increase inflammation in the body. Flax seed and flax seed oil are rich in anti-inflammatory omega 3 fatty acids and can be an excellent source of energy. Corn oil is commonly used to add calories and fat; however, it is a less desirable supplement due to its higher percentage of omega 6 fatty acids, which contribute to inflammation. Concentrated feeds will have varying levels of added fats depending on the type of horse it is designed to feed.
Balancing Your Horse’s Energy Sources for Performance
Whatever equestrian discipline is your passion, your horse will need to be fueled by a balanced nutritional plan.
“Feeding instructions provided on grains and concentrated feed products are designed by nutritional companies as guidelines; they are not rules and should be adjusted based on total sources of nutrition,” said Dr. Connor.
Establishing the proper balance of forage, starchy carbohydrates, fat sources, vitamins, and minerals will be different for each unique horse and the demands placed upon them.
Understanding the nutritional demands of your horse can be very simple or very intricate, depending on your unique equine athlete. When designing a feeding program, it is important take into consideration your horse’s athletic discipline, performance level, metabolic needs, stage of life, and any underlying medical conditions. Furthermore, your horse’s nutritional needs will vary over time and as they age, so it is important to periodically assess your horse’s body condition and consult with a knowledgeable veterinarian.
Speak with Dr. Marilyn Connor of Palm Beach Equine Clinic about your horse’s unique nutritional needs to ensure your horse is fully supported and on track to reach your competitive goals.
Schedule a Nutritional Consultation with Dr. Connor
Fill out the form below or call 561-793-1599 to get started.
Horse Health Reminder: Hydration
Even in the winter months, it is important not to underestimate the heat, humidity, and sun. Palm Beach Equine Clinic stresses the importance of proper hydration and sun protection year-round, especially to Florida-based equestrians and winter season snowbirds.
There are many problems that can arise when temperatures climb, including overheating, dehydration, and colic. When the weather becomes chilly in Florida, horses often quit drinking as much water. This can lead to additional problems such as impaction. Your horse’s hydration is critically important for health and performance
Remember these 5 easy ways to protect your horse from sun and dehydration:
1. During extended periods of turnout, and when competing, horses should always have access to shaded areas. Scheduled rides and extended turnout should take place when the temperatures are lower, usually early mornings or in the evening on hot days, so the horse is not in direct sunlight.
2. The average horse drinks between five and 10 gallons of water per day. Therefore, easy and frequent access to clean, fresh water is a necessity. Pay special attention to increased intake during particularly hot days and plan accordingly.
3. Sodium in a horse’s diet is crucial for maintaining proper hydration. Providing a salt block or supplementing with properly measured electrolytes in a horse’s feed or water can help ensure that sodium requirements are being met and that your horse is drinking a sufficient amount of water.
4. Especially in the extreme summer heat, horse owners should pay attention to the amount of sweat their horse is producing. Anhidrosis, or the inability to sweat normally, can be a common challenge, particularly in hot, humid climates. In addition to lack of sweat, signs of anhidrosis can include increased respiratory rate, elevated temperature, areas of hair loss, or dry and flaky skin. If you notice any of these signs, contact Palm Beach Equine Clinic immediately.
5. Clean water buckets often and always fill with fresh water before leaving the barn. Veterinarians often recommend placing one bucket of fresh water and one bucket of electrolytes. Usually, a horse will balance his electrolytes with the opportunity to drink from one or more of these buckets.
These are just a few of the important issues to be aware of during the temperature change in Florida. Contact Palm Beach Equine Clinic to learn more about precautions that can be taken to keep horses happy and healthy throughout the winter competition season.
Thrush, rainrot, and scratches are problems that most equestrians have probably encountered, but in the hot, often humid summer months, these issues can incessantly plague horses and their owners. While different in their presentation, thrush, rainrot, and scratches have a lot in common. For horse owners, there are several problems that arise due to environmental factors or predisposing conditions, but these issues can easily be prevented or treated with proper care and management.
This month, Palm Beach Equine Clinic’s Dr. Bryan Dubynsky shared his expertise on the causes, treatment, and prevention of thrush, rainrot, and scratches.
Thrush
Thrush is an infection within the horse’s hoof most commonly caused by bacteria that invade the deep clefts or grooves (known as sulci) of the frog. Fusobacterium Necrophorum is the common bacterial culprit, which naturally occurs in the environment, especially in wet, muddy, or unsanitary areas. Thrush bacteria thrive where there is a lack of oxygen.
Some horses are predisposed to developing thrush due to conformation, such as a rather high heel or deep sulci, or a narrow or contracted heel. The bacteria will manifest in horse’s feet that are not picked out regularly, or standing in muddy, wet environments, including paddocks or stalls that have not been cleaned properly. Thrush can typically be first identified by the odor. The frog will have a strong, rotten odor and become spongy. Visually, the frog can even exudate (ooze) pus.
The treatment for thrush is fairly simple as it is very sensitive to oxygen. The most important thing is to have your vet or farrier trim or debride the frog to expose affected areas to the air. It is best to keep the hoof clean and dry. Adding a common detergent to the thrush areas, such as Betadine or any commercial product (Thrush Buster, Coppertox, etc.) will help to kill the bacteria. Most importantly, if the horse is not removed from those predisposing environmental factors, treatments can be ineffective.
Maintaining a level of activity for our equine partners will increase blood flow to the feet and promote health in the area. Horses found in dry environments with ample space to move typically do not suffer from thrush. The activity of horses moving keeps the frogs healthier. The more blood flow you have in the foot, the less chance there is for infection to manifest. Thrush does not always cause lameness. In extremely rare cases, thrush can penetrate deeper and cause an infection in deeper tissue or even in the coffin bone. When in doubt, always contact your veterinarian.
Rainrot (Dermotophilus Congolensis)
Rainrot is caused by a naturally occurring bacteria named Dermotophilus, which produces spores. The condition is recognized as scabby, scaly, crusty spots on areas of the horse that have been exposed to rain. It is commonly seen on the neck or across the back (dorsum). Rainrot is not typically apparent on the legs or under the belly. A surplus of rain on the skin washes away the natural protective oils. Once the skin is stripped of the natural protective layer or any sort of trauma to the skin barrier occurs, which can be even as simple as an insect bite, the Dermotophilus spores are able to invade the deeper dermis skin layers. The spores penetrate into the deeper layers of the dermis, and the body reacts by sending white blood cells and proteins to fight the invaders.
This reactive response causes small pustules, scabs, and bumps to form. Similar to thrush, rainrot is an environmental issue. It is most commonly seen in warm areas with high humidity, excess rain, and insects. The most important prevention is to keep horses out of prolonged periods of rain. A horse can be out in the rain for short periods of a day or two, but if it is constantly in hot and rainy conditions with biting insects, more than likely the horse will develop rainrot.
Dr. Dubynsky emphasizes that topical products are not worth anything if the horse is not removed from the environmental factors. Once you remove the environmental factors, a keratolytic agent (something that exfoliates keratin), such as benzoyl peroxide or an antibacterial shampoo, will help the skin heal. He also cautions that if the horse does have scabs, you do not necessarily want to pick the scabs off because then you are leaving open skin without protection for more bacteria to invade. The most important tip to healing is to keep the area dry.
In very rare, severe cases of rainrot, it is best to contact your veterinarian to put the horse on antibiotics. If left untreated, and the horse is not removed from the environmental causative factors, the infestation can lead to Staphylococcal Folliculitis; a type of Staph bacteria that will invade the hair follicles and cause a more serious situation.
Scratches
Scratches is a generic term for many different ailments. The definition of scratches can be a bacterial, fungal, or viral dermatitis or inflammatory condition of the pastern or fetlock. It is defined as a chronic Seborrheic Dermatitis, characterized by hypertrophy and exudation on the palmar plantar surface of the pastern and fetlock.
There are certainly predisposing factors for scratches, including the same environmental factors that cause thrush or rainrot. Predisposing factors for scratches include horses that are bathed often or stand in wet conditions all the time. Horses that have an excess amount of hair on their legs, especially draft horses, may be more prone to developing scratches. This is because the hair traps dirt and moisture on the skin. Scratches can develop in horses that are bathed too often, such as the intensely managed show horse. Frequent bathing of the horse can strip away the natural protective oils and barrier of the dermis. This allows bacteria or fungi to invade. When moisture penetrates the skin, it causes an inflammatory reaction. This presents as heat, redness, pain, and loss of protection to keep bacteria out.
The most effective first step for prevention and treatment should be to eliminate environmental predisposing factors. Removing excess hair during humid months and keeping horses clean and dry to the best of your ability will reduce the probability of developing an infection. Bathing horses once a day with Betadine or antifungal/antibacterial shampoo will help to clear the infection. Be sure to leave the shampoo on for 20 minutes for all of the medicine to penetrate. Rinse thoroughly, and make sure the horse is completely dry. In order to effectively treat the bacteria, horses, especially their legs, should be completely towel- or air-dried before being returned to their stalls or paddocks.
As always, contact your veterinarian immediately if there appears to be a deeper infection present, or if you would like more detailed information on how to treat and prevent these bacterial infections. To contact your Palm Beach Equine Clinic veterinarian, call 561-793-1599 or visit www.equineclinic.com.
When dressage rider Meagan Davis and owner Scott Durkin think about the goals they have for their dressage horse Royale, they have tunnel vision for the grand prix ring. Royale, a 16-year-old Oldenburg gelding (Routinier x Ironman) was well on his way to accomplishing that goal during the 2019 season when something strange started happening.
Photo courtesy of Meagan Davis
After arriving at their winter home in Loxahatchee, FL, from a northern base in Stone Ridge, NY, Davis kicked off Royale’s winter competition schedule with a show in January. The horse was coming off a very successful fall season that included CDI Intermediaire I and CDI Prix St. Georges victories at the New England Dressage Fall Festival and Dressage at Devon.
“Our first show was unusually chilly and I noticed that Royale was breathing a little hard and didn’t sweat very much,” recalled Davis. “I didn’t think that much of it because of the weather, but when we returned home and it warmed up, he wasn’t sweating at all.
“He could not catch his breath after being perfectly fit a month before,” continued Davis. “I rely on Palm Beach Equine Clinic for the care of all the horses in my barn and I immediately turned to Dr. Robert Brusie.”
Dr. Brusie is a Board-Certified Surgeon at Palm Beach Equine Clinic and was diligent about ruling out any physical causes of Royale’s obvious discomfort and decline in performance. After flexion tests, checking for musculoskeletal problems, and assessing soreness or wear and tear, Dr. Brusie turned to Palm Beach Equine Clinic’s Internal Medicine Specialist Dr. Peter Heidmann.
“Dr. Brusie was watching me work him one day, noticed the decline in muscle, the lack of sweating, and labored breathing, and recommended we take a deeper look with a specialist,” said Davis. “That is why I trust Palm Beach Equine Clinic with the care of my horses. They have so many tricks up their sleeves, and their clients are fortunate that the veterinarians collaborate so well together in order to do what’s best for the horse.”
Dr. Heidmann’s first step was to asses any neurological causes by testing for equine protozoal myeloencephalitis (EPM) and Lyme disease. Both were negative. He then moved on to a nutrient analysis.
“When you see weakness and poor muscle mass in a horse, two of the things you test for right away are vitamin E and selenium deficiencies,” said Dr. Heidmann. “Both are common causes of decreased performance due to low concentrations in local soil or the soil where a horse’s hay derives from.”
No deficiencies were found in Royale, which prompted Dr. Heidmann to move on to muscle testing. He drew blood from Royale, put him in work, and then drew blood again four to six hours later. When comparing enzymes in the blood from before and after work, Dr. Heidmann looked for any large increase, which would indicate the problem was in the muscles themselves. Royale’s tests, once again, came back normal.
At this point, Dr. Heidmann returned to the case history and started following the shortness of breath symptom, noting, “Breathing abnormalities in horses are difficult to diagnose by simply listening because their chest wall is so thick. What I wanted to asses was prolonged recovery. This is done by placing a bag over a horse’s nose to get them to breathe deeply. Once the bag is removed, breathing should regulate within two to three breaths. Royale needed four to five breaths.”
Once Dr. Heidmann identified a possible cause, he performed abronchoalveolar lavage (BAL), which is essentially a lung sample used to identify abnormal cells. He inserted a small-diameter tube through the trachea, flushed saline into the lung, and then suctioned it back out.
“Sure enough, when I examined the sample, there was mucus and abnormal cells,” said Dr. Heidmann. “Despite his bloodwork being normal and no obvious infections, Royale was battling equine asthma or ‘heaves.’”
The treatment for asthma in horses is very similar to what’s done for humans and includes an anti-inflammatory bronchodilator drug and inhaled steroids.
“While his breathing issues were significant enough to affect performance, Royale’s treatments were relatively mild with immediate and substantial improvement,” said Dr. Heidmann. “I used nebulized herbal remedies, steam, and Ventipulmin, which is an oral syrup.
“I’m a less-is-more person and veterinarian,” he continued. “I try to have the best outcome with the least amount of medications. Additionally, we created some routines that would minimize environmental dust and allergens, such as using a hay net, wetting down hay and bedding, or using chopped newspaper as bedding.”
Royale stayed on the prescribed medication through his trip home to New York and came off them at the end of May. Today, he is back in work and has regained the fitness and muscle he had during the fall. According to Davis, their goal is to step into the grand prix ranks during the upcoming season.
“My favorite cases are the sickest of the sick and the most elusive needle in a haystack,” concluded Dr. Heidmann. “Royale’s case definitely fell into the latter. It was really challenging, but rewarding because the outcome was a horse that is dramatically different than he was four months ago. But the most important part of this case for me was working together with Dr. Brusie. I would have not been successful in helping this horse if he hadn’t done all the work prior to coming to me. That kind of collaboration is what contributes to our success and sets Palm Beach Equine Clinic apart!”
Healthcare Reminder: Equine Summer Sores
The summer weather is here! With the humid weather, pesky flies are at their worst, which creates problems for many horse owners often leading to summer sores, medically known as Habronemiasis.
What are Summer Sores?
Summer sores are lesions on the skin caused by the larvae of equine stomach worms Habronema. These worms in the horse’s stomach produce eggs that pass through the digestive tract and are shed in the horse’s feces. Barn flies typically gather around manure and ultimately collect the parasite’s larvae on their extremities. Summer sores will occur when flies carrying the larvae deposit the eggs onto an open wound or the mucous membranes of a horse. The larvae infect the open wound or mucous membranes, causing an inflammatory reaction including symptoms of inflammation, discharge, and the production of granulation tissue infected with larvae.
Detecting Summer Sores
One way to detect a summer sore is the visible granulation of tissue containing small yellow, rice-like larvae within the skin and a mucopurulent (mucus or pus-like) discharge associated with the wound. Prevention is the most effective way of controlling summer sore outbreaks and the best way to protect horses is to implement effective methods for:
- fly control
- manure removal
- proper wound care
- an effective de-worming program
A diligent de-worming program is the most important element of prevention because effective de-wormer disrupts the parasite’s life cycle internally. The key is to kill both adult worms in the stomach and the larvae that form in the skin tissue.
Treating Summer Sores
For treatment of summer sores themselves, corticosteroids are administered to reduce the inflammatory hypersensitivity reaction, and antimicrobials treat any secondary infections that may develop as the result of an open wound. If not treated properly, summer sores can last up to several months and possibly require a costly surgical procedure to remove the granulated tissue and larvae. At the first sign of a summer sore, contact your veterinarian at Palm Beach Equine Clinic at 561-793-1599 to discuss treatment and develop an effective fly-management program for your barn.
As the summer heat rapidly approaches, the veterinarians of Palm Beach Equine Clinic remind all equine owners to keep their horses well hydrated.
Fresh, Clean Water
The average horse drinks between five and 10 gallons of water per day. It is important to provide clean, fresh water at all times and be aware of possible increased water consumption during extremely hot days.
Salt
Sodium in a horse’s diet is also very important to maintain proper hydration. Providing a salt block or supplementing with electrolytes can help ensure that a horse is meeting their sodium requirements.
Sweat It Out
Especially in the extreme summer heat, horse owners should pay attention to the amount of sweat their horse is producing. Anhidrosis, or the inability to sweat normally, can be a common challenge during the summer months, particularly in hot, humid climates. A horse with Anhidrosis is often called a “non-sweater.” In addition to lack of sweat, signs of Anhidrosis can include increased respiratory rate, elevated temperature, areas of hair loss, and dry, flaky skin. Presentation of these signs indicates that the horse should be seen by a veterinarian immediately.
Additional Tips
Make sure your horse has…
- Access to shade throughout the day.
- Exercise that is scheduled when the temperatures are lower, usually earlier or later in the day.
- Turnout that is limited to the night or cooler portions of the day.
- Fans indoors during extreme heat.
- Electrolyte supplementation as needed per veterinarian’s recommendation.
Chinese herbal medicine is a relatively new treatment among equine veterinarians in the western world, but the philosophy of herbals for healing has existed for thousands of years as part of Traditional Chinese Veterinary Medicine (TCVM). Helping to lead the Chinese herbal medicine charge westward, veterinarians at Palm Beach Equine Clinic (PBEC) have incorporated the use of herbs and herbal treatments as an integral part of their alternative therapy options for patients.
Similar to the use of all-natural methods to treat illness in humans, herbal medicine for animals also utilizes ancient Chinese formulas aimed at treating the underlying causes of a disease or illness to help the body heal itself, rather than only temporarily treating the presented symptoms.
One PBEC veterinarian who has found these all-natural methods as a benefit in her treatments is Dr. Janet Greenfield-Davis, who specializes in both acupuncture and Chinese herbal medicine.
“There is an herbal product for anything,” said Dr. Greenfield-Davis, who found herbal medicine six years ago when she started specializing in acupuncture, which joins Chinese herbal medicine as two of the most common forms of TCVM therapies. “Herbals treat a variety of ailments from sore muscles to problems affecting the liver, heart, kidneys, joints, and more. I pair the herbals with my acupuncture, which is traditionally the ancient Chinese way.”
Traditional Chinese Veterinary Medicine (TCVM) Methods
In TCVM, once a symptom of disharmony in the body or disease is identified, treatment proceeds through four possible branches, including acupuncture, food therapy, a form of Chinese medical massage called Tui-na, and Chinese herbal medicine. From topical treatments, including salves and powders, to edible treatments, Chinese herbal medicine not only draws on natural products, but also on the natural tendencies of the horse itself. Being herbivores, horses ingest herbs found in the wild while they are grazing.
While the traditional methods date back thousands of years, the treatments developed within Chinese herbal medicine are ever-evolving. Coupled with modern technology, historical and ancient Chinese wisdoms are still very effective. In addition, the treatments utilize the properties of many common herbs with widely known uses. By utilizing ginseng for fatigue, chamomile for calming, garlic as an antibiotic, and arnica as an anti-inflammatory, the recipes used in herbal medicine draw from only natural sources. This is making herbal treatments more common among sport horses that undergo drug testing for banned substances while competing.
“The competitive world is accepting herbal medicine more and more every year,” said Dr. Greenfield-Davis. “It provides an alternative for horses at high levels, especially in FEI classes, that need a little extra support. They aren’t drugs, they don’t test, and they are a natural product.”
Alternative Options
Dr. Greenfield-Davis believes that offering such alternative treatment options is a sizeable advancement for PBEC, in that herbal medicines provide owners with another option when traditional western medicines may not be their preference.
“It enhances our practice because it gives owners a place to turn,” she said. “There is a lot of stigma to using particular western drugs, and I think this gives people a choice; they don’t have to use the traditional western medicines anymore because they can now turn to eastern medicines.”
While it is a personal choice to use a more holistic or all-natural approach to veterinary care for some horse owners, herbs also represent a practical alternative. According to Dr. Greenfield-Davis, herbal medicine is the perfect choice when treating a horse with an aversion to needles, or for horses that do not respond to particular medicines or therapies.
“We are able to work in a more natural way instead of using steroids and things of that nature,” added Dr. Greenfield-Davis. “In some cases, I will use solely herbals and the treatments produce a lot of wonderful results.”
As PBEC continues to advance its alternative medicine therapies, the equestrian community is also learning to accept new possibilities. For PBEC and Dr. Greenfield-Davis, Chinese herbal medicine is a step into the future with a nod to ancient Chinese history.
About Dr. Janet Greenfield-Davis
Dr. Greenfield-Davis grew up in Northern California, and her passion for horses started during her time showing hunters on the “A” circuit, which later led her to study veterinary medicine at California Polytechnic State University. She graduated from veterinary school at the University of Glasgow in 2010 and has since specialized in equine acupuncture and herbal medicine. Dr. Greenfield-Davis hopes to continue her studies in holistic medicine by incorporating food therapy into her treatments at Palm Beach Equine Clinic.
Palm Beach Equine Clinic combines the best of conventional and alternative medicine to provide comprehensive, full-body care to both sport and companion horses. Dr. Natalia Novoa specializes in utilizing the best of both approaches to provide unmatched results.
“I believe that treating issues with both alternative therapies and conventional medicine is a perfect approach,” said Dr. Novoa, who has been a full-time member of Palm Beach Equine Clinic since 2011. “We can’t exchange one for other, and the combination usually makes for a great treatment plan.
“A chiropractic adjustment is an alternative therapy that I absolutely recommend,” continued Dr. Novoa. “It’s very useful for a horse that has injuries or soreness issues, but it’s also something that is very important for maintenance. You want to prevent problems instead of treat them. If a misalignment happens, that creates incorrect friction, which then leads to pain in the joints, muscle soreness, and stress on the tendons and ligaments, possibly leading to a soft tissue injury. Another advantage of chiropractic adjustments is that it is useful for FEI competition horses because of the restriction on medications at that level. It’s a way we can effectively treat a problem and stay within the regulations.”
According to Dr. Novoa, veterinarians who incorporate chiropractic adjustments in their treatment options do so with their own style. She has developed a system that she finds most effective, and her secret is out!
Dr. Novoa’s five steps to a chiropractic adjustment:
1. Horse History
Patient history is a pillar of medicine, which provides pivotal information.
“I always want to speak with riders, trainers, and grooms to get an understanding of what they feel and see,” said Dr. Novoa. “They spend the most time with the horse and know it the best. Sometimes, clients ask me to evaluate the horse first and tell them what I see and feel, which is when most people ask me if I have a crystal ball.”
While Dr. Novoa doesn’t travel with a crystal ball, her skill at reading a horse leads her to the second step.
2. Scan Acupuncture Points – “Acuscan”
A scan of the acupuncture points on a horse, which Dr. Novoa calls an “acuscan,” is always her next move. She checks the main acupuncture points from head to tail by using her tool of choice – the round end of a needle cap. This allows her to put firm pressure on a very specific point and then evaluate the horse’s reaction to that pressure.
“A reaction can indicate, for example, left front lameness or a sore neck, etc.,” said Dr. Novoa. “It’s not voodoo; you are piecing together your findings in the exams with the symptoms that the horse is presenting.”
3. Evaluate Horse Movement
After scanning the horse, Dr. Novoa likes to always see the horse move to dig deeper into any reactions she noticed while checking acupuncture points. She starts at the walk and then observes at the trot.
“This is where I incorporate conventional medicine and supplement my evaluation with flexion tests or hoof testers depending on what I see,” said Dr. Novoa. “I want to produce the most detailed picture before moving on to the adjustment.”
4. Make the Adjustments
“I adjust a horse the same way every time,” said Dr. Novoa. “This specific order ensures that I don’t miss anything and the horse receives a thorough adjustment of its entire body with special attention paid to any problem areas that I uncovered earlier in the process.”
Check and adjust these 10 points:
Point 1: TMJ (temporomandibular joint)
Point 2: Poll and neck
See fig. 1 & 2
Point 3: Front limbs, including lower limb joints and carpus (knee)
See fig. 3
Point 4: Shoulder and scapula on both sides to compare one with the other
Point 5: Withers
Point 6: Pelvis and back
See fig. 4
Point 7: Hind limbs, including hocks and stifles
Point 8: Sternum and T1/T2 vertebrae
Point 9: Tongue release
Point 10: Myofascial release if muscles spasm or a tense back and neck are indicated
5. Secondary Acupuncture Point Scan
“The final piece of the puzzle is to scan the acupuncture points again to compare what we had before versus what we have after the adjustment,” said Dr. Novoa. “If there are still reactions, I may do acupuncture or electro-acupuncture and utilize a class four regenerative laser.”
After her secondary scan, Dr. Novoa formulates a short and long-term treatment plan. In her experience, adjustments last for four to six weeks before a follow-up adjustment is indicated. If certain chronic injuries are flaring up, a horse may need an earlier follow-up.
“It’s all about listening to the horse. They will always tell you what they need; you just have to listen!”
Dr. Novoa
Internal Medicine: What’s it all about?
Palm Beach Equine Clinic President Dr. Scott Swerdlin often says, “If you want to attract equine veterinary specialists, you have to have impressive facilities and technology in place.” Palm Beach Equine Clinic is one of the few veterinary clinics in the country to offer clients the talents of board-certified specialists in nearly every branch of equine veterinary medicine. One such specialist is Peter Heidmann, DVM, DACVIM, a graduate of Tufts University School of Veterinary Medicine, who joined Palm Beach Equine Clinic in 2016.
Dr. Heidmann specializes in the treatment of internal medicine cases at Palm Beach Equine Clinic.
What attracted him? The facilities! In the heart of South Florida’s horse country and at the center of the busiest winter competition schedule in the world, Palm Beach Equine Clinic boasts an internal medicine and infectious disease center at its Wellington-based clinic.
The crown jewel of the center is the ability to stop airborne disease dead in its tracks with the U.S. Department of Agriculture (USDA) approved isolation stalls that completely enclose horses in their own environment with individual filtered airflow systems that do not reach other horses. On top of secure isolation and individual airflow systems in their internal medicine facilities, Palm Beach Equine Clinic also constructed areas for each stall where medications are prepared, equipment is stored, and dirty bedding is handled.
To further mitigate risk, veterinarians, technicians, and staff take every available precaution, including foot baths before entering the stalls and wearing personal protective equipment such as Tyvek suits, gowns, and face masks to provide multiple layers of protection against spreading disease. In some cases, a specific team of doctor, technician, and intern is assigned to a patient and won’t touch another horse for the duration of the treatment.
Accurately Diagnosing Internal Medicine Cases
Diagnostics is not a guessing game at Palm Beach Equine Clinic. With advanced imaging equipment, including a computed tomography (CT) machine, standing magnetic resonance imaging (MRI), and nuclear scintigraphy camera (bone scan), as well as radiography (x-ray) and ultrasonography capabilities, Palm Beach Equine Clinic is armed and ready to quickly and accurately diagnose internal medicine cases.
Dr. Heidmann refers to the facilities and his work at Palm Beach Equine Clinic as a luxury, saying, “I’ve managed many cases in various facilities going all the way back through internship, fellowship, and residency, but this is as nice as any place I have ever worked. It makes the risk to the horses so much lower, but also removes the anxiety for myself because I’m able to look a client in the eye and tell them that there is no risk. I don’t have a concern about disease spreading from one patient to another because at Palm Beach Equine Clinic we have the tools that we need.”
Understanding Internal Medicine
To understand how diagnostic tools are most effective, one must understand what exactly internal medicine is. In an effort to define internal medicine, Dr. Heidmann noted, “What you’ll see on the American College of Veterinary Internal Medicine (ACVIM) website is an emphasis on organ systems and organ system problems – respiratory disease, gastrointestinal disease, and neurologic disease being three of the most prevalent.
“What it really entails is a way of analyzing problems specific to the organ systems,” he continued. “It can be all over the map, and that’s part of what makes the specialty so fun and interesting.”
The most common internal medicine cases can be split into three categories:
- gastrointestinal (GI) problems
- neurological system issues
- respiratory diseases.
Gastro-Intestinal Problems in Horses
“When it comes to GI issues, I usually see horses in two categories,” said Dr. Heidmann. “Number one are the horses that may need to go to colic surgery and the horses that just had colic surgery. The other is horses with intestinal infections, often colitis in which they have heavy diarrhea.”
According to Dr. Heidmann, all of the treatments for colitis tend to boil down to the same thing: replacing their ongoing losses and letting the intestine heal itself. It doesn’t matter if it’s colostrum, salmonella, Potomac Horse Fever, or any other kind of infection.
Equine Neurologic System
The nervous system in a horse is made up of the brain, spinal cord, and several different kinds of nerves that are found throughout the body. These create complex circuits through which animals experience and respond to sensations. Unfortunately, many different types of diseases can affect the nervous system, including birth defects, infections, inflammatory conditions, poisoning, metabolic disorders, nutritional disorders, injuries, degenerative diseases, or cancer.
“Palm Beach Equine Clinic has an incredible ability to do advanced imaging and diagnostics on neurologic conditions,” said Dr. Heidmann. “With equipment like the standing CT, we can do scans of the head and neck with contrast – a CT myelogram – which really increases our ability to diagnosis a condition.”
Palm Beach Equine Clinic is able to locate problems not only on the top or bottom of a horse’s neck, but also on the sides of the neck – an area previously inaccessible to view even from myelograms under anesthesia.
“That’s part of the satisfaction of the job that I do; It’s not just ‘here is my experience and here is what I guess is going on.’ I have all of these options at my fingertips for diagnostics and tests. We can confidently confirm our clinical suspicions and then do treatment based on that.”
Respiratory Disease in Horses
As common as a cold for a human or acute in nature, Dr. Heidmann further breaks down the different kinds of common respiratory disease in horses into three categories:
Many a seasoned horseman will admit that success in any discipline of horse sport is dependent on healthy hooves. Palm Beach Equine Clinic proudly offers the most advanced equine podiatry services to referring veterinarians and clients.
As the winter show season reaches its peak in South Florida, hoof care is paramount and the importance of good quality hoof care in the competition horse can’t be denied. The equine hoof is unique, as it is comprised of a group of biological structures that follow the laws of biomechanics. To that end, the farrier is a major asset during the show season as he or she can be proactive in maintaining the health of a horse’s foot and help to prevent lameness.
There are three very important aspects of farriery science that the farrier will use to keep any horse sound:
1. The Trim
Trimming the foot in conjunction with the size and placement of the horseshoe. Typically, a farriery session will begin with an evaluation of the conformation of each hoof from the front, side, and behind to observe the height of the heels. Next, the farrier should observe the horse in motion to see whether the horse’s foot lands heel first, flat or toe first. Regarding the trim, many farriers no longer use the term ‘balance the foot’ – which has no meaning – and have begun to use guidelines or landmarks when approaching the trim.
The guidelines used are:
- Trimming to achieve a straight hoof-pastern axis
- Using the widest part of the foot which correlates to the center of rotation
- Trimming the palmar foot (heels) to the base of the frog or to the same plane as the frog.
A closer look at these three guidelines, which are all interrelated, will help to show their importance. If the dorsal (front) surface of the pastern and the dorsal surface of the hoof are parallel or form a straight line, then the bones of the digit (P1, P2, P3) are in a straight line, and the force from the weight of the horse will go through the middle of the joint. Furthermore, and equally important, if the hoof-pastern axis is straight, the weight will be distributed evenly on the bottom of the foot.
2. Center of rotation (COR)
As the COR is located a few millimeters behind the widest part of each foot, it allows the farrier to apply appropriate biomechanics to each foot. The foot is trimmed in approximate proportions on either side of the widest part of the foot, which provides biomechanical efficiency.
3. The Heel
One should trim the palmar section of the foot to the base of the frog or trim such that the heels of the hoof capsule and the frog are on the same plane. Adherence to this guideline keeps the soft tissue structures (frog, digital cushion, ungula cartilages) within the hoof capsule, which are necessary to absorb concussion and dissipate the energy of impact. We must remember that heels do not grow tall, they grow forward. If we allow the heels to migrate forward, the soft tissue structures will be forced backward out of the hoof capsule. Furthermore, as the heels migrate forward, the weight is placed on the bone and lamellae, thus bypassing the soft tissue structures of the foot. Allowing the heels to migrate forward also decreases the ground surface of the foot.
These three guidelines can be applied to any foot and they serve as a basis for maintaining a healthy foot, as well as a basic starting point for applying farriery to a horse with poor foot conformation or one with a distorted hoof capsule.
