Dr. Stephen O'Grady Palm Beach Equine Clinic Veterinarian
Dr. Stephen E. O’Grady, DVM, MRCVS

Palm Beach Equine Clinic is proud to have beneficial consulting relationships with many equine medical professionals throughout the country, including Dr. Stephen E. O’Grady, DVM, MRCVS, of Virginia Therapeutic Farriery. Dr. O’Grady provides advanced services in equine podiatry, offering comprehensive diagnosis, treatment, and maintenance for a variety of foot conditions using medical therapy as well as therapeutic shoeing.

Palm Beach Equine Clinic features the services of Dr. O’Grady for consultations year-round. With the experience and expertise of its world-class veterinarians, in addition to Dr. O’Grady’s wealth of knowledge, the Palm Beach Equine Clinic is able to provide the very best in advanced treatments in equine podiatry.

Equine Podiatry Services

There is no structure on the horse that is as susceptible to injury, disease, or “wear and tear” than the equine foot. Proper, timely hoof care can often make the difference between a sound performance horse and one with chronic lameness. Some of the problems that Dr. O’Grady consults on include:

  • Hoof Diseases
  • Laminitis
  • Severe Infections
  • Advanced White Line Disease
  • Therapeutic Horseshoeing
  • Hoof Wall Defects
  • Juvenile Orthopedics

Equine podiatry requires extensive knowledge of hoof anatomy, physiology, biomechanics and diagnostic imaging, as well as the farrier skills necessary to implement specialized shoeing. The combination of being educated as both a veterinarian and a professional farrier allows Dr. O’Grady to treat each foot problem with an understanding of the medical physiology and the mechanics involved. This blending of the two professions allows him to comprehensively diagnose, treat, and design a maintenance plan for a variety of foot conditions using medical therapy as well as therapeutic farriery. Dr. O’Grady also works together with referring veterinarians on difficult cases to discuss and assist with a plan that works for all parties.

Diagnostic Imaging for Equine Podiatry Cases

equine standing mri palm beach equine clinic
Palm Beach Equine Clinic offers a Hallmarq standing MRI that can provide a detailed diagnosis of any foot issues.

The advanced imaging equipment at Palm Beach Equine Clinic, in combination with Dr. O’Grady’s expertise, allow for comprehensive diagnosis and treatment of all hoof-related conditions. Palm Beach Equine Clinic offers a Hallmarq standing MRI that can provide a detailed diagnosis of any foot issues. Medical therapy, such as surgery and various medications, are often combined with therapeutic farriery for the best possible results. Dr. O’Grady’s methodology centers around using the basic principles of farriery, and when necessary, combining these principles with advanced technology and improved farrier products available on the market.

Equine podiatry consultations can be used for a variety of complicated hoof conditions where the problem is severe, chronic, and non-responsive to the present treatment. Hoof problems can include severe injuries, acute or chronic laminitis, hoof wall defects (non-healing quarter or toe cracks), hoof capsule distortions (club feet, long toe under-run heels), and severe hoof disease (infections, WLD, canker). There are many hoof-related problems that benefit from the advanced technology and farrier techniques available today.

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.

Categories
Medical

Equine Ophthalmology

Article by Susan M. Carastro, DVM, MS
Diplomate, American College of Veterinary Ophthalmologists

Palm Beach Equine Clinic is proud to have great consulting relationships with many equine medical professionals throughout the country, including Susan M. Carastro, DVM, MS, of the Animal Eye Specialty Clinic. A Diplomate of the American College of Veterinary Ophthalmologists, Dr. Carastro shared her expertise on some of the most common diseases of the equine eye.


Understanding the Equine Eye

Equines have a uniquely developed eye suited to accommodate the lifestyle and needs of our equine companions. The location of the equine eyes being on the side of the head allows for a more panoramic view for protection. This is imperative to the fight or flight response as visual detection of a threat is necessary to alert the flight animals to flee.

palm beach equine clinic sports medicine

Protecting the Horse’s Eyes

There are a few common diseases of the equine eye that are worth having basic knowledge about. Early recognition and proper treatment is ideal to minimizing damage to the eye. Eyelid cuts or lacerations can occur with contact of numerous objects, but most commonly occur with catching the eyelid on a metal S ring on buckets or nails, or splits in the lid margin from blunt trauma. Eyelid lacerations are easily identified and repaired with primary closure or suturing.

The eyelids have an extensive blood supply and can bleed excessively. As long as the globe is not damaged, the eyelids have an excellent capacity to heal with minimal impact on ocular health. No matter how extensive the laceration appears, every attempt should be made to salvage as much eyelid margin as possible. Allowing the eyelids to heal without suturing can result in poor cosmetic appearance, enhanced scarring, and irregular eyelid margins. The scarring can result in hair or lashes contacting the cornea surface causing chronic irritation or discomfort.

Corneal injuries are one of the most common vision-threatening and painful equine eye diseases. The cornea is the front clear part of the eye that protects the delicate intraocular structures. Ulcers are generally due to abrasion or puncture with environmental objects (hay, branches, and sand). Clinical signs of a corneal ulcer include squinting, tearing, swelling around the eye, redness to the eye, and/or cloudiness to the eye. Corneal ulcers can be confirmed by careful examination of the equine eye and staining with a green dye (fluorescein). Uncomplicated superficial corneal ulcers can heal without leaving any residual damage. Once an ulcer has occurred, the main concern is the risk of corneal infection. Topical therapy with antibiotics, as well as anti-fungal agents four times daily is recommended until the ulcer heals.

Equine Eye Infections and Conditions

Bacterial and/or fungal corneal infections can be devastating and result in loss of vision and the eye. These infections are more common in the southeastern United States with the heat and humidity supporting the growth of these organisms. If a corneal infection occurs, aggressive topical therapy up to every hour and in many cases, surgery, is necessary to save the eye.

Hourly medication can be quite difficult due to personal time constraints, and the horse will keep the eye forcefully closed because of the pain and light sensitivity. A subpalpebral lavage system can be placed for easier and more effective treatment. This is a small tube or catheter inserted through the upper or lower eyelid with the injection port being attached to the mane near the withers. The lavage allows for medication to be injected through the catheter to reach the eye without coming near the horse’s head. Corneal infections in horses can take months to clear. Corneal ulcers can also be extremely painful, thus pain control with atropine and banamine will minimize discomfort and distress.

Equine recurrent uveitis
Equine recurrent uveitis

Equine recurrent uveitis or moon blindness affects horses worldwide. Uveitis is an inflammation of the iris (colored part of the eye) that can be caused by numerous issues. These include trauma, infections in other parts of the body, or can be generated by the horse’s own immune system, but there is also a genetic predisposition for Appaloosas and Draft breeds.

Signs and Treatment of Equine Recurrent Uveitis

Clinical symptoms of uveitis include a painful eye (squinting, tearing), cloudiness to the eye, and swelling around the eye. If uveitis is diagnosed, evaluation for infections or inflammations elsewhere in the body should be pursued. This may include bloodwork, titers for specific infections including Leptospirosis, abdominal ultrasound, chest radiographs, and sampling of fluid from inside the equine eye.

If no underlying cause can be identified, the main goal is minimizing inflammation inside of the eye to control pain and limit the impact on vision.

Treatments that are used include topical steroids and nonsteroidal agents, oral steroids and nonsteroidal agents (banamine/bute), and atropine.

Management

The frustrating part of this disease is the recurrent nature. The interval of flare-ups can range between days to years in patients. Management for horses affected with uveitis is to limit the frequency and severity of the episodes with lifelong treatment. This can be accomplished with daily maintenance medication (topical and/or oral) even when there is no active inflammation. If the equine eye is still having flare-ups, surgical implantation of a device impregnated with anti-inflammatory medication called cyclosporine allows for a constant release of drug into the eye to limit episodes.

If the uveitis remains poorly controlled, further consequences including cataracts, glaucoma, and retinal detachment can result in loss of vision and a painful eye requiring removal of the eye.

Equine eye diseases can generally be managed with early recognition, assistance from your veterinarian in establishing a diagnosis, and effective treatment. Please contact your veterinarian if you notice any of the above symptoms as soon as possible, as it may save your horse’s eyesight. Any of Palm Beach Equine Clinic’s veterinarians are available to answer any questions.

sweating horse summer

In the summer months, it is extremely important to be aware of how the heat and sun can affect our horses. As the summer heats up around the country and especially in Florida, Palm Beach Equine Clinic would like to remind all equine owners to keep their horses in a cool, well-ventilated environment with protection from the hot weather.

There are many problems that can arise in the summer months from overheating, to dehydration, and even equine sunburn that owners should always keep in mind.

Covered Areas to Protect Your Horse

All horses should have access to shade and cool water throughout the day. Any exercise should be scheduled when the temperatures are lower, usually earlier or later in the day. Turnout should be limited to the night or cooler portions of the day, and fans can be provided indoors during extreme heat. 

equine sun protection in the summer heat

The average horse drinks between 5 to 10 gallons of water per day. It is important to provide clean, fresh water at all times and be aware of increased water necessities during extremely hot days.

Sweat and Sodium Levels

Sodium in your horse’s diet is very important to maintaining proper hydration. Providing a salt block or supplementing with electrolytes can help ensure that your horse is meeting their sodium requirements.

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 for our equine partners in the summer months, 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, flaky skin. If you notice any of these signs, contact your veterinarian immediately.

Equine Sunburn Tips

Horses with white on their faces or bodies are especially prone to sunburn and should be protected from the harsh UV rays of the sun. Providing shade, covering your horse’s skin with fly sheets or fly masks, and applying sunscreen are all helpful ways to prevent a burn.

Fly masks are now made with extensions to cover the nose and muzzle. There are many different sunscreen products made specifically for horses, but most products approved for human use are also safe for our equine partners. Once again, horses that are particularly prone to sunburn can be kept cool and safe from the sun by staying indoors during the day and being turned out at night.

These are just a few of the important issues to be aware of during the hottest time of the year in Florida and around the country. Remember to keep your horse cool, well-hydrated, and protected from the heat and sun. Contact the veterinarians at Palm Beach Equine Clinic to learn more about precautions that can be taken to keep your horse happy and healthy throughout the summer months.

Today’s competitive sport horses are asked to perform at their absolute best at the most prestigious competitions all over the world. Travel and life at the showgrounds can be extremely stressful for horses. Ulcers can affect any horse, but competitive sport horses with the extra stressors from a life of intensive work and travel are especially prone. Palm Beach Equine Clinic veterinarians want to ensure that your horse remains healthy and ulcer-free. There are many precautions that can be taken to prevent ulcers from developing, but if your horse does develop a problem, Palm Beach Equine Clinic is there to aid in treatment.

Gastric Ulcers and Hindgut Ulcers

There are two different kinds of ulcers – gastric ulcers and hindgut ulcers. The horse can develop one or the other, or both in combination, however gastric ulcers are most common. Gastric ulcers develop in the stomach, which is comprised of two different halves. The lower half of the stomach secretes acid and digestive enzymes to properly digest food. If the acid splashes up to the upper half of the stomach, there is minimal protection and causes painful erosion of the stomach lining.

Increased acidity in the stomach increases the chance of that acid will come in contact with the larger, unprotected portion, resulting in damage to the stomach lining. There are many different factors that can change the environment of the stomach and cause increased acid production, ultimately resulting in ulcers. The most common factors are drastic changes in feeding times or types of feed, undue stress, and corrosive medications.

Ulcer Prevention in Show Horses

For the competitive equine, the stress of traveling and showing, as well as any change in the environment or increased work, can increase the chances of ulcers forming. Abnormal sleep patterns at shows can cause added stress. It is important to ensure that the horse has ample bedding and space to feel comfortable enough to lay down to rest. Joint pain or other physical pain can also cause unnecessary stress to the horse’s system. Joint supplements, routine injections, and alternative therapies such as chiropractic and acupuncture can be used to keep the horse comfortable and stress-free.

Another major cause of gastric ulcers is chronic administration of phenybutazone (bute), banamine, or other nonsteroidal anti-inflammatory drugs (NSAIDs) as these medications can be corrosive to the stomach lining.

Diagnosing Equine Ulcers

Ulcers can be difficult to diagnose as early signs can easily be confused with colic. Many times horses with ulcers show mild, chronic, colic-like symptoms that resolve fairly quickly. Owners and trainers may notice that the horse seems sore after eating, denies feed entirely, or has colic-like symptoms such as upper lip movement, biting at its side, or pawing. If the ulcer is undiagnosed and is given banamine to treat the colic symptoms, ulcers can be exacerbated due to the administration of banamine.

Equine Ulcer Diagnostic Tools

There are several ways to diagnose ulcers. First, if ulcers get severe enough, they can cause the stomach to bleed, and can be tested in a quick blood test to check for a low red blood cell count or anemia. A small amount of dark blood present in the stool can detect bleeding gastic ulcers or the right dorsal colon, but usually it is a microscopic amount and it can be difficult to visualize. A fecal test to test for blood in the stool can be performed but it is not the most specific or reliable method.

The most definitive way to diagnose gastric ulcers is the use of a gastroscope to provide an internal scan. A small camera is inserted down the esophagus and into the stomach, which allows for a clear picture of the separation between the glandular bottom portion and the upper unprotected portion of the stomach. On the gastroscope, ulcers with ranging severity can appear to be a minor red irritation or actual holes, which are depressions of the lining of the stomach. With the gastroscope, you can also visualize the beginning of the small intestine, which is another common area for erosions to occur.

Hindgut ulcers can easily be identified by a non-invasive ultrasound of the colon. With an ultrasound, the veterinarian is able to determine if a specific area of the colon wall is thickened. Thickening of the wall is abnormal and is a primary sign of colonic ulcers. The drugs to treat hind gut ulcers differ from gastric ulcers but the treatment period is still four weeks or more.

Treatment of Equine Ulcers

If ulcers are diagnosed to be present, they are graded as to their location and severity. A treatment plan is determined according to these factors. The gold standard treatment is Omeprazole for four weeks – one tube a day for 28 days. The most common Omeprazole treatment is Gastrogard. Oral supplements, such as calcium, which help to neutralize the stomach acids and act as a buffer to protect the stomach lining, are also sometimes recommended.

If your horse is diagnosed with ulcers, it is important to avoid bute and banamine, if possible. The owner should be careful not to make any significant changes to the horse’s diet. Maintaining a consistent feeding schedule is important to avoid causing any major increases in acid production in the stomach.

Another tip to help keep the pH of the stomach neutral is to add one flake of alfalfa to the horse’s hay per day. It helps to lower the acidity of the stomach. Discuss changes to your horse’s diet with your veterinarian to make sure it will work with your schedule as alfalfa may increase your horse’s energy levels.

Ulcer Prevention

Another way to help prevent ulcers in the future is to prophylactically give Omeprazole a day or two before a stressor. If you know the horse is traveling or going to a show, start administering Omeprazole three to four days prior. Gastric medications can be given every day during the stressor time period, at the show, and then a day or two following the show. It is important to plan ahead and prepare preventative measures that can be very helpful with managing ulcer episodes.

The veterinarians at Palm Beach Equine Clinic are here to help with any concerns for your horse. If you suspect that your horse may have ulcers, or if you want to stay one step ahead and take preventative measures, contact PBEC at 561-793-1599 for more information.

Summertime is here and along with the summer months in Florida comes humidity and an increase in the fly population. Unfortunately for horse owners, an increase in the fly population creates many problems. One major problem that seems intensify every year is equine summer sores, or medically known as Habronemiasis. Equine summers sores are lesions on the skin caused by worm larvae from the horse’s stomach.

Easy Culprit: Flies

Healthcare Reminder: Equine Summer Sores

How does the stomach worm larvae end up as a skin lesion? One simple answer is from a fly. The stable fly is a host for these parasites. The worms in the horse’s stomach produce eggs that pass through the digestive tract, which end up in the horse’s manure. After that, the eggs then hatch to develop larvae that attach to the blades of grass.

Chain Reaction

The fly carries the larvae on its extremities and is attracted to mucous membranes or open wounds on the horse. Next, the larvae infect the open wound or a mucous membrane such as the eye or prepuce. This creates a type of allergic reaction within the immune system causing inflammation, discharge, and the production of granulation tissue infected with larvae. One way to tell if you are dealing with a summer sore is the granulation tissue contains small yellow rice like larvae within the skin and a mucopurulent discharge associated with the wound.

Summer Sore Prevention

The best way to avoid equine summer sores is to prevent them. Fly control, proper wound care, and most importantly an effective de-worming program. Habronema species are the source of summer sores. Please call Palm Beach Equine Clinic and discuss with one of our veterinarians a proper de-worming program.

Proper treatment of the lesion is extremely important. Delaying initial treatment may result in an increased cost. Delaying treatment may require surgical excision of the granulation tissue and possible skin grafting. Severe Habronemiasis of the male horse’s sheath may require reconstructive surgery of the prepuce and/or urethra.

Contact Palm Beach Equine Clinic to Treat Equine Summer Sores

At the first sign of an equine summer sore, contact your veterinarian at Palm Beach Equine Clinic at 561-793-1599.