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The Benefits of Biologics: Regenerative Medicine for the Equine Athlete

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.

Walking on Wire

Zeke was rescued from a life of neglect and was in extreme discomfort caused by a wire wrapped around his left front pastern.

In February of 2021, Baby Girl Horse Rescue and Veteran Therapy Ranch in Fellsmere, Florida, rescued six Belgian Draft Horses that were headed for slaughter after a life of neglect. Ezekiel, known as “Zeke”, was one of the gentle giants who rescue organizer Van DeMars described as still having spirit in his eyes despite his desperate condition. “When I found out about Zeke, I insisted on buying him even if it was only to give him some care and then have to put him down humanely,” DeMars reflected. “I just did not want him to have to make the long, hard trip past the border to die a scary death.”

Zeke was suffering from a severely swollen, actively infected, and draining wound on his left front leg. He was lame at the walk and in evident pain and discomfort. Once Zeke arrived at the rescue, their veterinarian Dr. Karie Vander Werf took radiographs that painted a grim picture. The radiographs showed a metal wire had been wrapped around Zeke’s pastern bone, deeply embedded through the soft tissue and into the bone. She then immediately referred Zeke to board-certified surgeon Dr. Weston Davis for surgery at Palm Beach Equine Clinic.

Once Zeke arrived at Palm Beach Equine Clinic, Dr. Weston Davis, assisted by Dr. Sidney Chanutin, took additional radiographs to thoroughly assess the location and depth of the wire. “The radiographs confirmed a metal object was circumferentially wrapped around the mid-pastern bone, embedded into the soft tissue and remodeled the bone itself,” Dr. Chanutin revealed. On February 24, Zeke was put under standing sedation, given a local nerve block, and the wire was carefully extracted by Dr. Davis.

Radiograph of Zeke by Palm Beach Equine Clinic showing wire deeply embedded into pastern bone.
Radiograph showing the wire wrapped and imbedded into the bone.
Posterior radiograph view of Zeke by Palm Beach Equine Clinic showing wire deeply embedded into pastern bone.
A posterior view of the pastern.

“Had the wire not been removed when it was, the infection would have continued to proliferate,” said Dr. Chanutin. “The infection and invasion of the wire into the soft tissue and pastern bone could have potentially cut Zeke’s life short.”

wire removal by Dr. Weston Davis. Palm Beach Equine Clinic Rescue Patient Success Story
Dr. Weston Davis removing the wire from Zeke’s leg.

While neither the rescue nor the veterinarians could tell with certainty how this had happened to Zeke, it was apparent by the location and way the wire was twisted that it was likely placed there intentionally. It was clear the wire had been embedded into Zeke’s pastern for months, based on the level of bone remodeling that had taken place.

Reflecting on how he felt dropping Zeke off for surgery, DeMars said, “I was afraid but was very confident in Dr. Davis. I knew that if anyone could get that wire out and give Zeke a chance to have a normal life, it would be him. Later that evening, I got a text of a picture of the wire and I was in shock that they had already gotten it out so fast. I was elated beyond belief.”

Wire removed from zekes leg post-surgery. Palm Beach Equine Clinic Rescue Patient Success Story
The picture Van DeMars received showing the cause of Zeke’s pain.

Remarkably, Zeke’s stay at the Palm Beach Equine Clinic hospital was less than 48 hours. He was then transferred to Dr. Vander Werf’s farm for aftercare, which included daily bandage changes, antibiotics, and wound care.

It only took a few weeks post-surgery for Zeke to finally experience pain-free days at Dr. Vander Werf’s facility. “He’s been a sweet boy through all of this, but only a day or two after the surgery, we really got to see his personality,” DeMars said. “He’s just a mischievous boy who even busted into Dr. Vander Werf’s feed room and is best friends with a little mini pony. We know he must have been in intense pain because he has become a completely different horse now.”

Zeke sneaking into the feed room. Palm Beach Equine Clinic Rescue Patient Success Story

In early April, Zeke was able to arrive at his new home of Baby Girl Horse Rescue and Veteran Therapy Ranch. The group of Belgian Draft Horses rescued alongside Zeke have come to be known as the “Titans.” They are destined to be part of the Titan Project, an endeavor to provide equine assisted therapy for veterans and first responders suffering from post-traumatic stress disorder and other related issues.

“Zeke is quite famous now, especially among the veterans,” explained DeMars. “People who suffer from post-traumatic stress disorder are able to derive strength through Zeke’s story and many have been reaching out through social media asking when he’s coming home so they can come see him. So, his future job is just to be groomed and taken care of. He’s going into retirement to be spoiled.”

The veterinary team at Palm Beach Equine Clinic is dedicated to protecting and providing the best possible outcome for every patient. Through swift action by the rescue and expert veterinary and surgical care, Zeke now has a new purpose and will live out his days in a safe, healthy environment. In the wake of Zeke’s immense suffering, he is now miraculously on the path to paying it forward by providing veterans and first responders the relief and support they need.

zeke in the sunrise at baby girl horse rescue

For more information or to support Zeke by donating to Baby Girl Horse Rescue and Veteran Therapy Ranch, go to https://www.facebook.com/Babygirlhorserescueranch.

Easy Breathing for Dickens

A performance evaluation led to uncovering a paranasal sinus cyst obstructing airflow through the horse’s right sinus.

Respiratory health can easily be overlooked. Unlike with a horse’s gaits, owners and riders do not typically pay close attention to a horse’s breathing for subtle irregularities or inconsistencies. Yet, respiratory function must be up to par for an equine athlete to pump the voluminous amounts of air in and out of their lungs required during exercise. When the horse’s respiratory system is not functioning up to par, the horse could have labored breathing, exercise intolerance, and prolonged recovery after exercise.

As rider Madison Aguilar was bringing Dickens – a 14-year-old Quarter Horse – back into a training program, she noticed some performance issues under saddle. She scheduled a performance evaluation with Dr. Meredith Mitchell to assess Dickens before moving forward with training and increasing his workload. As Dr. Mitchell was watching Dickens being ridden, she saw his breathing was exacerbated after only light work. She went up to him, simply held her hands over his nostrils, and noticed that there was no airflow coming out of his right nostril.

After taking digital radiographs (x-rays) of the horse’s head, Dr. Mitchell identified a paranasal sinus cyst responsible for Dickens’ breathing troubles.

Dickens Before Surgery radiography
Radiograph of Dickens used to identify a paranasal cyst.

To relieve Dickens, they scheduled surgery to remove the paranasal sinus cyst with board-certified equine surgeon Dr. Weston Davis. Once at the Equine Hospital, Dr. Davis used an endoscope to examine inside the horse’s nasal passages. They found two cystic structures in his right maxillary sinus and then proceeded with a standing maxillary flap surgery to remove the cysts.

Dickens surgery palm beach equine clinic paranasal sinus cysts

“We sent the cysts for pathology tests and luckily the results showed they were benign,” said Dr. Mitchell. “Reoccurrence of the cysts is unlikely, but we will follow up with radiographs six months post-surgery to make sure Dickens is still healthy, happy, and able to breathe easy.”

“I am so thankful to my vet for being the best at her job and the whole crew at Palm Beach Equine Clinic for making sure this boy was comfortable and recovering well during his time in the hospital.”

Madison Aguilar
Dickens success story post surgery

Dickens is now home and on the road to recovery with full, unobstructed breathing. Subtle and gradual changes in a horse’s health, behavior, and performance can be difficult to pinpoint. Routine performance exams and wellness checkups can be key to uncovering these subtle issues and taking action to address problems early on.

Whenever there is a question involving the health and well-being of your horse, do not hesitate to call your Palm Beach Equine veterinarian at 561-793-1599.

Show Jumper Returns to Top of Leader Board After Colic Surgery

In January of 2020, Palm Beach Equine Clinic veterinarian and board-certified surgeon Dr. Weston Davis performed colic surgery on Bull Run Jumpers Prince of Peace. Piloted by Kristen VanderVeen, “Prince” has proven he has fully recovered and is back in peak condition in August of 2020 by claiming the top spot in the $36,600 Traverse City Speed Classic CSI3* at the Great Lakes Equestrian Festival.

Congratulations to this fantastic pair from the entire PBEC Team!

Palm Beach Equine Clinic is incredibly proud to have been entrusted with the health and well-being of Prince and numerous other colic surgery patients who have gone on to make full recoveries, returning to training and competing as they were before the colic.

Each colic surgery case has its own specifics, and during Prince’s recovery, he particularly benefited from strategic veterinary use of the regenerative therapy RenoVo to strengthen the abdominal wall at the surgical incision. Dr. Davis adjusted Prince’s recovery plan as he returned to more intense exercise by using this regenerative medicine to provide some cellular scaffolding and growth factors to encourage proper tissue repair of the abdominal wall.

For more information on colic surgery, regenerative therapies, or to talk to Dr. Davis about your own horse’s needs, please call 561-793-1599 or fill out the form below.

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Bella Ciao: Back Out Front

Maurizio Sano, Bella Ciao, and groom Angel Mijangos at Gulfstream Park West. Photo courtesy of Alessandro Sano
Maurizio Sano, Bella Ciao, and groom Angel Mijangos at Gulfstream Park West. Photo courtesy of Alessandro Sano

Racehorse Bella Ciao Undergoes Surgical Repair

Trainers Alessandro and Antonio Sano reviewed a daunting x-ray on the morning of April 19, 2019. Their three-year-old Thoroughbred filly Bella Ciao, owned by Cairoli Racing Stable and Magic Stables LLC, had just finished a breeze in 49 seconds flat when she suffered a fracture in her right front leg.

She exited the track at Gulfstream Park West, her home racecourse in Miami Gardens, FL, with her racing fate hanging in the balance.

“She is a tough filly with a lot of heart, and she walked herself back to the barn where we had x-rays taken,” said Alessandro, who met with the track veterinarian right away to identify the problem. “When we saw it, we were nervous that she was headed to the breeding shed, and her career was over.”

Alessandro and his father, however, were not willing to give up on their special filly. They entrust Palm Beach Equine Clinic’s board-certified surgeon, Dr. Robert Brusie, with care of their entire string of racehorses, and quickly decided to send the x-rays for his review. Dr. Brusie quickly identified a condylar fracture and advised a surgical repair. Immediately after her diagnosis was confirmed, Bella Ciao made her way to the Hospital at Palm Beach Equine Clinic.

Identifying a Condylar Fracture

A condylar fracture is a repetitive strain injury that results in a fracture to the cannon bone above the fetlock. The fracture is a result of excessive strain and weight carried over the cannon bone during high-speed exercise. It emerges from the fetlock joint running laterally up or medially out the side of the cannon bone, essentially breaking off a corner of the bone.

“A condylar fracture is a disease of speed,” said Dr. Brusie. “A condylar fracture was once considered the death of racehorses. As time and science progressed, it came to be considered merely career-ending. Currently, veterinary medical sciences are so advanced that we have had great success with condylar fracture patients returning to full work.

“Luckily, with today’s advanced rehabilitation services, time, and help from mother nature, many horses can come back from an injury like this. My prognosis for Bella Ciao after surgery was very good,” said Dr. Brusie.


Dr. Brusie performed Bella Ciao’s surgery and inserted five screws to repair the fracture.

Digital radiographs show a condylar fracture to the right front leg, and the five screws that completed the surgery.

Digital radiographs show a condylar fracture to the right front leg, and the five screws that completed the surgery.

From left to right: Digital radiographs show the condylar fracture to the right front leg, and the five screws that completed the surgery.


“He does an excellent job with all of our horses. We wanted to give it a shot for Bella Ciao, and it paid off,” said Alessandro. He and his father, Antonio, have worked with Dr. Brusie on many horses, including a past Kentucky Derby runner and horses winning in excess of million-dollar purses. “He told us that she would be back to the track, so we followed his instructions perfectly.”

Back On Track

Dr. Brusie prescribed stall rest and hand walking for the first several months of Bella Ciao’s recovery. She slowly began jogging, and then breezing.

On October 27, 2019, she returned to the track in a $45,000 Allowance race. With Leonel Reyes up in the irons, Bella Ciao made her comeback in storybook fashion by winning that race and coming out fit, sound, and healthy. Now a four-year-old, Bella Ciao won again on April 30, 2020, and most recently placed third in a $60,000 race on June 27.

“While treatable, a condylar fracture is not an easy injury to come back from, but Dr. Brusie is one of the best surgeons in the country, and we trusted him,” said Alessandro, who has been working with Dr. Brusie since he and his father moved their business from Venezuela to the U.S. in 2010. “She recovered brilliantly, and we could not be happier with how she is going now. She is a special filly, and we are thrilled that we took this chance on her.”

Taking a Chance on Madison

Palm Beach Equine Clinic helps one mini donkey survive a roller coaster of health concerns

The popular veterinary adage, “if only they could just tell us how they feel,” never rang more true than in the case of an 11-year-old miniature donkey mare named Madison. Owned by Sariah Hopkins, “Madi” came to Palm Beach Equine Clinic by referral and was diagnosed with hyperlipemia, a common issue in miniature donkeys. Madi’s case, however, was never exactly how it seemed.

Hopkin’s describes Madi as the “center of attention.” Rescued from an animal hoarding situation by Safe Harbor Sanctuary in Nashville, TN, where Hopkins serves on the Board of Directors, Madi was officially adopted by Sariah and her husband Joel in 2015.

“She was one of 40 horses and donkeys being kept on four acres of land,” said Sariah, who relocated to Juno Beach, FL, with Madi in tow in 2018. “She has always had a super sweet, calm personality, but likes to kick up her heels. We’ve done behavioral health therapy work with foster children and she makes everyone who meets her fall in love. She is so engaging.”

After trading Tennessee for Florida, Madi didn’t adjust to her change in environment with ease. According to Sariah, a systematic decline in her health started while the mare tried to adjust to a new barn, environment, farrier, and life. “She was depressed,” said Sariah. “She wasn’t her bright-eyed self. She’s a donkey and she will eat anything so when she went off her grain and refused alfalfa, I called a local vet to pull fluids and run blood work.

“I reviewed the results with my vet in Tennessee who knows Madi and her history,” continued Sariah. “They were catastrophically bad, and she told me I needed to get Madi to a clinic immediately. I was referred to Palm Beach Equine Clinic by my friend Nataliya Boyko. Within minutes, I was on the phone with her vet, Dr. Bryan Dubynsky, and soon after we were on our way.”

Madison Miniature Donkey Palm Beach Equine Clinic Patient
Madison being treated by the team at Palm Beach Equine Clinic

Once Madison arrived at Palm Beach Equine Clinic, she was treated primarily by Dr. Abby Berzas and overseen by Dr. Dubynsky. They diagnosed her with hyperlipemia, and she remained at the clinic for two weeks.

Hyperlipemia is a common metabolic disease of ponies, miniature horses, and donkeys. In affected patients, an increase in serum triglyceride concentrations (hypertriglyceridemia) puts them at risk for liver failure, renal failure, and multiorgan dysfunction that can ultimately lead to death.

Genetically, donkeys are designed to live in harsh environments with poor-quality forage. As a result, they tend to put on weight and gain excess fat reserves when living on relatively lush pasture. Unfortunately, when they stop eating for any reason – usually stress induced –  hyperlipemia may develop due to a ‘negative energy balance’  where more energy is being used than is being taken in through eating. The essential organs of the body still require a food supply, so it uses the energy that has been stored as fat deposits. The result is that free fatty acids are circulated to the liver and converted to glucose for use by the body.

Madison Donkey Success Story Palm Beach Equine Clinic Abby Berzas success story equine hospital

However, donkeys are not able to efficiently turn off this fat release. The blood soon fills up with excess fat in circulation, causing them to become very sick and uncomfortable. This circulating fat is measured in the blood as triglycerides.

Madison’s case presented as a severe spike in triglycerides, which can be reduced by introducing sugars into the system. The sugar causes the body to release insulin and drive the triglycerides down.

“She responded well the first day, but we didn’t see the improvement that we would have liked or that she needed,” said Dr. Berzas. “We started more aggressive treatments the following day with insulin therapy and antibiotics. The dextrose caused a physiological increase in insulin, but it wasn’t enough. As soon as she had insulin therapy her triglyceride levels started coming down. They decreased significantly and she started eating again.”

Madison remained on insulin therapy for a week and was evaluated hourly by Palm Beach Equine Clinic veterinarians to monitor the possibility of hypoglycemic shock. When Madison was able to eat regularly and maintain low triglyceride levels without any help, she was discharged.

“I had access to Madi daily, and we made the most of her time in the hospital with long hand walks, grazing, and relaxing in her stall,” said Sariah. “I got updates from the clinic every two to three hours when I wasn’t there, and without any more clinical signs, she appeared to be improving.

Madison Miniature Donkey Palm Beach Equine Clinic Patient

“But, when I got her home she still was not herself,” continued Sariah, who spent hours sitting in Madi’s stall with her. She moved home to Sariah and Joel’s private farm while they did all they could to eliminate the stress that had supposedly led to Madi’s condition. “She was good for 24 to 48 hours and then would slide backwards again. One afternoon, I was sitting in her stall and she had a coughing fit that I was able to video. I sent it to [Dr. Berzas] and she came out to the farm to check on Madi.”

Dr. Berzas performed a thoracic ultrasound and spotted comet tails in her lungs, leading to one thing: pneumonia.

“We were wracking our brains to figure out what the original stressor might have been that led to the hyperlipemia, but Madi did not display any signs of pneumonia at the clinic and did not cough once,” said Dr. Berzas. Then, there it was! Donkeys are stoic, tough animals, and sometimes they don’t give us traditional clinical signs.”

While hyperlipemia was the result, pneumonia was the cause.

“Cortisol, also known as the ‘stress hormone’ has a vast array of effects within the body, and it is one of the first triggers for the body to recruit energy from the its peripheral stores,” explained Palm Beach Equine Clinic Internal Medicine Specialist Dr. Peter Heidmann. “It minimizes discomfort and increases blood pressure and metabolic rate, basically saying, ‘Now is not the time to conserve energy for the future. I need energy now in order to survive.’ In Madison’s case, the infection prompted the body to need more than average energy – it needed extra fuel to fight the infection.” 

The typical diagnostic procedure for pneumonia is a tracheal wash procedure, but after consulting with Dr. Heidmann, Dr. Berzas elected to try and mitigate any further stress on Madison by choosing a less invasive procedure. Instead, Dr. Berzas used a special stylette that allowed them to go through the nasal sinuses and cleanly aspirate back cellular fluid for analysis. This option is called a Bronchoalveolar Lavage (BAL), and is most typically used for diagnosing cell types in the lungs.

“After culturing her fluid aspirate, she went back on antibiotics and responded well,” said Dr. Berzas. “She also had nebulizer treatments that delivered antibiotics directly to the lungs, which is the best way to treat the infection.”

happy healthy Madison miniature donkey

One month after the pneumonia diagnosis, Sariah was proud to report that Madi had made a full recovery. “When we brought her in that first day, we frankly were getting ready to say goodbye,” said Sariah. “We were devastated, and Dr. Dubynsky agreed to try and save Madi. Thank goodness he did!”

Once the pneumonia was cleared, Madi’s routine returned to normal and the hyperlipemia was no longer an issue. Today, Madi is happily running Sariah and Joel’s farm.

“Palm Beach Equine Clinic treats some of the top sport horses in the world, but I feel that Madi – a very special donkey – received the same treatment. Dr. Berzas was 100% available to me, and she championed Madi. I could not be more thankful to her and the entire team of veterinarians and staff who rallied around our Madi.”

Sariah Hopkins

“When we have a case that’s particularly challenging to diagnose,” Dr. Berzas remarked, “it just reminds us of how fortunate we are to be part of a team of specialists. At Palm Beach Equine Clinic, we are able to tap into the knowledge and experience of our fellow veterinarians from different specialties, and really deliver that value for the patient.”

Madison, happy and healthy sunbathing.

Sariah chronicled Madi’s condition and recovery on her Facebook page, developing quite a fan base for the little donkey. Madi’s story is far from over, but now she’s telling it herself and can be followed on Facebook as @MadisonJoelleDonk.

Back From The Brink

Dr. Santiago Demierre Gives Peachy a Second Chance


When two-year-old Quarter Horse filly Peachy decided to jump out of her paddock for a night-time stroll this past November, she got herself into some creative “young horse” trouble. After tipping over a garbage can containing bailing wire, she became entangled in the wire and her attempts to kick free resulted in the wire penetrating the wall of her right hind hoof and looped through the sole. The more the filly kicked, the deeper the wire went until it pierced the opposite side of the hoof wall and protruded out the other side.

The first call owner Corey Chilcutt made was to the clinic, and on-call veterinarian Dr. Santiago Demierre responded immediately.

Palm Beach Equine Clinic veterinarian Dr. Santiago Demierre

Not So Peachy Anymore


peachy santiago demierre palm beach equine clinic success story puncture
The wire penetrating the wall of Peachy’s right hind hoof and looped through the sole.

“When I arrived, the two ends of wire that looped over the horse’s back had been cut down so it was only the wire penetrating the hoof,” said Dr. Demierre. “She was stressed and in a great deal of pain. I sedated the horse and blocked the foot so she would not feel any more pain.”

Once Peachy, who is in training to run barrels in Loxahatchee, FL, was comfortable, Dr. Demierre utilized portable radiograph technology to obtain x-ray images of the right hind foot and evaluate the injury. The images revealed that it was safe to remove the wire, and after disinfecting the area, Dr. Demierre removed the wire through the injury site.

peachy santiago demierre palm beach equine clinic success story puncture radiography wire
Dr. Demierre utilized portable radiograph technology to obtain x-ray images of the right hind foot and evaluate the injury.

“There were no fractures or synovial structures involved, but I did see on the radiograph that the coffin bone was compromised,” said Dr. Demierre. “There was a suspicious line through the coffin bone that could have led to chronic lameness, so the prognosis for performance was reserved. The prognosis for survival was very positive, and I told the owner there was a 50/50 chance she would return to training.”

Once Peachy’s hoof was free from the wire, Dr. Demierre soaked the foot in disinfectant, and began an aggressive course of antibiotic treatments, including regional distal limb perfusion and systemic antibiotics. Finally, the foot was wrapped while the treatments did their work.

Dr. Demierre returned to check on Peachy and continue the antibiotic treatments six times over the past two months. “I performed recheck radiographs of the hoof a month after the injury and there was no fracture where we saw the initial line that caused concern,” said Dr. Demierre. “The margins of the coffin bone had reabsorbed slightly, but overall the injury was healing well.”

peachy santiago demierre palm beach equine clinic success story puncture radiography
A view of Peachy’s healing hoof and therapeutic shoeing on January 11, 2020.
peachy santiago demierre palm beach equine clinic success story corrective therapeutic shoeing
Dr. Demierre worked with Chillcutt’s farrier, Juan Rivera, on a therapeutic shoeing plan.

Once the bandages were removed, Dr. Demierre worked with Chillcutt’s farrier, Juan Rivera, on a therapeutic shoeing plan. Rivera used a hospital plate with disinfectant on the injured hoof, and a bar shoe with a pour-in pad on the opposite hind hoof. At the first shoeing reset a month later, he transitioned the right hoof to a bar shoe with a pour-in pad.

Peachy’s recovery plan included stall rest until Dr. Demierre gave the green light for hand walking six weeks after the injury. At eight weeks, she was trotting on a lunge line, and earlier this month Peachy’s rider Kloey sat on her for the first time.

“The outcome was excellent,” said Dr. Demierre. “She is perfectly sound with no medication and will be back in normal shoes by the end of this month.”

peachy santiago demierre palm beach equine clinic success story
Peachy and Kloey back to work. Photo courtesy of Corey Chillcutt.

Chillcutt is hopeful that Peachy and Kloey will return to their training and will be running barrels in the future. “Dr. Demierre was amazing; his treatment plan was successful and Peachy was back to work much quicker than we ever thought. Words can’t describe the gratitude we have for Dr. Demierre, his technician Emma Sexton, and everyone at the clinic. Their dedication has been phenomenal.”

As of February 14, Peachy is back to her old self, according to Chillcutt, who noted, “She is happy to be back to work and she loves her job!”


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

When Margo Crowther of Fort Myers, FL, was looking to add a new addition to her string of barrel racing horses, she made one very important phone call. That call was to Palm Beach Equine Clinic. Dr. Weston Davis, board-certified surgeon and veterinarian at Palm Beach Equine Clinic, has been working with Crowther to keep her horses healthy, as well as performing career-saving procedures.

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

In 2016, Dr. Davis helped Crowther and her 2012 Quarter Horse mare Shes Packin Fame, or “Sissy,” return to the ring after what could have been a detrimental injury. Sissy suffered a rare slab fracture to the central tarsal bone in her left hock while competing in a barrel racing competition. After a diagnosis aided by Palm Beach Equine Clinic’s advanced diagnostic imaging equipment and a surgery performed by Dr. Davis, Shes Packin Fame not only returned to running barrels, but the mare was also back to winning the next year.

When Crowther found a new prospect named Grandiose Guy, or “Mater,” she turned to Dr. Davis to ensure her intended purchase would be a good fit. The Quarter Horse gelding was named the Barrel Futurities of America (BFA) Horse of the Year just after she purchased him, crowning him the top four-year-old in the country.

“When I was thinking about buying him, I called Dr. Davis and sent him videos of the horse working to review,” said Crowther, who started the purchase process late last year and chose to involve Dr. Davis in all aspects of the pre-purchase evaluation. “The horse was in Georgia, so he reviewed them from Palm Beach Equine Clinic in Wellington and gave me the stamp of approval. Once a pre-purchase was performed, I sent all the x-rays to Dr. Davis and he told me to move forward.

“I trust Dr. Davis and the team at Palm Beach Equine Clinic so much!” continued Crowther. “Barrel horses work hard and it’s so important to have a great relationship with the vet who oversees their care and knows them well in order to keep them happy and healthy.”

Regardless of breed or discipline, a pre-purchase exam involves certain steps that allow the potential owner and veterinarian to investigate the horse’s health and condition. The veterinarian gathers and interprets information by physically examining the horse’s body systems and conformation, as well as reviewing the health history. A lameness assessment is completed, including flexion tests, soft tissue structure palpation and movement evaluation. Diagnostic medical imaging tools, such as radiography, ultrasonography, endoscopy, magnetic resonance imaging, nuclear scintigraphy, or computed tomography, may be used to provide a more detailed and comprehensive profile of the horse.

Crowther purchased Mater and started running him at the beginning of last year, bringing him to the largest one-day rodeo, The American, in the Dallas Cowboys stadium in Texas in February. The competition had a $1 million payout and Mater and Crowther placed fifth.

“Mater” in the winner’s circle. Photo courtesy of Margo Crowther

“After so many runs, we brought him home from Texas and got him over to Dr. Davis for any maintenance work that needed to be done to keep him feeling his best,” said Crowther. “I am very picky about where I take my horses; there has to be good ground and I will not run their legs off. In conjunction with that, maintenance work with Dr. Davis is important. He performs flexion tests, utilizes the imaging at Palm Beach Equine Clinic if necessary, and makes recommendations about my horses’ health and overall well-being.”

Dr. Davis sent Mater home from Palm Beach Equine Clinic with a clean bill of health and Crowther gave the gelding a little time off before their next run. After returning to work, Mater headed to the National Barrel Horse Association (NBHA) Florida State Championships in Kissimmee.

Crowther’s diligence and Dr. Davis’ knowledge paid off when Mater won both his runs and clinched the open final at NBHA Florida State Championships. With more than 700 entries, Mater and Crowther topped them all and were crowned overall champions of the event.

“Palm Beach Equine Clinic and Dr. Davis have been a huge part of the success I have had with all of my horses,” said Crowther. “They are always there when I need them, whether I’m headed to the clinic in Wellington or they are coming to me in Fort Meyers. It’s nice to be able to know your vet will be there for you whenever you need them.”

The Road to Grand Prix Glory: Royale is Back in Action Thanks to Palm Beach Equine Clinic

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.

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

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.

Dr. Peter Heidmann Palm Beach Equine Clinic Veterinarian
Dr. Peter Heidmann of Palm Beach Equine Clinic.

“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!”

Success Story: Palm Beach Equine Clinic Patient in the Winner’s Circle

When Margo Crowther of Fort Myers, FL, was looking to add a new addition to her string of barrel racing horses, she made one very important phone call. That first call was to Palm Beach Equine Clinic (PBEC). Dr. Weston Davis, board-certified surgeon and veterinarian at PBEC, has been working with Crowther for several years and has helped maintain her horses and even performed some career-saving procedures.

In 2016, Dr. Davis helped Crowther and her 2012 Quarter Horse mare Shes Packin Fame or “Sissy” return to the ring after what could have been a detrimental injury. Sissy suffered a rare slab fracture to the central tarsal bone in her left hock while competing in a barrel racing competition. After a diagnosis aided by PBEC’s state-of-the-art diagnostic imaging equipment and a surgery performed by Dr. Davis, Shes Packin Fame not only returned to running barrels, but the five-year-old mare was also back to winning the next year. Click here to learn more about Sissy!

Crowther Meets “Mater”

This time, Crowther turned to Dr. Davis to ensure that her intended purchase of a new horse was a good fit. When she met Grandiose Guy, known to her as “Mater,” she had to have him. The Quarter Horse gelding was named the Barrel Futurities of America (BFA) Horse of the Year just after she purchased him in 2017, crowning him the top four-year-old in the country.

“When I was thinking about buying him, I called Dr. Davis and sent him videos of the horse working to review,” said Crowther, who started the purchase process late last year. “The horse was in Georgia, so he reviewed them from PBEC in Wellington and gave me the stamp of approval. Once a pre-purchase was performed, I sent all the x-rays to Dr. Davis and he told me to move forward.

“I trust Dr. Davis and the team at PBEC so much!” continued Crowther. “Barrel horses work hard and it’s so important to have a great relationship with the veterinarian who oversees their care and knows them well in order to keep them happy and healthy.”

Success Story: Diligent Pre-Purchase Practices Put “Mater” in the Winner’s Circle
Margo and Mater during one of their winning runs. Photo by Mike Rastelli

Crowther purchased Mater and started running him at the start of 2018, bringing him to the largest one-day rodeo, The American, in the Dallas Cowboys stadium in Texas in February. The competition had a $1 million payout and Mater and Crowther placed fifth.

“After so many runs, we brought him home from Texas and got him over to Dr. Davis for any maintenance work that needed to be done to keep him feeling his best,” said Crowther. “I am very picky about where I take my horses; there has to be good ground and I will not run their legs off. In conjunction with that, maintenance work with Dr. Davis is important. He performs flexion tests, utilizes the imaging at PBEC if necessary, and makes recommendations about my horses’ health and overall well-being.”

Dr. Davis sent Mater home from PBEC with a clean bill of health and Crowther gave the gelding a little time off before their next run. After returning to work, Mater headed to the National Barrel Horse Association (NBHA) Florida State Championships in Kissimmee in mid-June.

Success for Crowther and Mater

Crowther’s diligence and Dr. Davis’ knowledge paid off in full when Mater won both his runs and clinched the open final at NBHA Florida State Championships. With more than 700 entries, Mater and Crowther topped them all and were crowned overall champions of the event.

Mater being crowned National Barrel Horse Association (NBHA) Florida State Champion. Photo by Mike Rastelli
Mater being crowned National Barrel Horse Association (NBHA) Florida State Champion. Photo by Mike Rastelli

“PBEC and Dr. Davis have been a huge part of the success I have had with all of my horses,” said Crowther. “They are always there when I need them, whether I’m headed to the clinic or they are coming to me in Fort Meyers. It’s nice to be able to know your vet will be there for you whenever you need them.”

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