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Medical

Keeping Horses in the Game

Navigating Lameness Prevention and Treatment

Owners and riders have the responsibility of making sure their horses are healthy and sound. Horses are incredible athletes both in and out of the show ring, so it is important that they are cared for like any elite athlete. Non-equestrians do not equate performance horses to football players, marathon runners, or gymnasts, but horse owners and veterinarians know the same level of commitment is required to keep equine athletes in optimal health and fitness.

The goals of Sport Horse Medicine are to keep horses feeling and performing at their best, detect subtle changes, appropriately address underlying issues, and correctly diagnose and treat injuries to get horses back to optimum health. Despite being powerful and strong animals, horses are relatively fragile. One day they are competing in perfect form, and the next they might walk out of their stall lame. Thus begins the process of addressing the issue and determining a treatment plan.

Palm Beach Equine Clinic has a team of veterinarians who specialize in Sport Horse Medicine to keep equine athletes performing at their best.
Photo by Jump Media

Lameness can manifest itself in different ways, from subtle decreases in performance to severe and obvious signs of pain. Lameness is not a diagnosis or disease; it is the symptom of an underlying issue. Palm Beach Equine Clinic in Wellington, FL, has a team of veterinarians who specialize in Sport Horse Medicine and are skilled at diagnosing and treating the root causes of lameness. Pinpointing the underlying issue is the crucial first step in proper rehabilitation.

Understandably, practicing proactive prevention is the best approach to avoiding incidents of lameness. It is important to do what we can to prevent serious incidents such as falling, missteps, and accidents with other horses. Key to these efforts is detecting signs of lameness as early as possible so underlying issues do not exacerbate or cause longer-term lameness. Prevention techniques combined with proper training and rest, high-quality nutrition, and correct and balanced farrier work, help reduce usual wear-and-tear injuries.

Catching Lameness Early
Early recognition of the signs of lameness may help prevent more serious injuries from occurring. A firm understanding of what is “normal” for your horse is crucial to identifying subtle changes in behaviors, movement, or body conditions.

Once a day, do a hands-on leg check. During this exam, compare opposite legs to detect signs of heat, swelling, or sensitivity. While exercising the horse make sure you are aware of a shortness of stride, decrease in performance, reduced stamina, or changes in attitude. If you suspect a problem, give the horse a few days off. If the signs return when work is resumed ask your veterinarian to examine them. Remember that a mild problem can turn into a career-limiting condition if left untreated.

Scheduling routine performance evaluations with your veterinarian can also help catch signs of lameness early. Thorough evaluations often consist of:

• History from rider and trainer covering the how, what, when, and why of the perceived lameness
• Physical examination and limb palpation to detect swelling or soreness
• Lameness or motion examination, both in hand and under tack, to see how the horse moves and may be compensating
• Flexion testing to narrow down the problem area
• Diagnostic analgesia (nerve blocks) to pinpoint the specific area causing pain
• Isolation and confirmation of the problem area
• Diagnosing underlying issues through imaging such as a radiograph (x-ray), ultrasound, nuclear scintigraphy (bone scan), magnetic resonance imagining (MRI), or computed tomography (CT)
• Specific identification of the lameness or performance problem

Treatment Options
Even with preventative care, we cannot avoid all injuries. Therefore, it is important to work with your veterinarian to develop the best treatment plan for when an injury occurs. There are a wide range of traditional treatment methods including conservative treatment (rest, ice, compression), medical management (non-steroidal anti-inflammatory drugs, steroids), intra-articular medication (joint injections), soft tissue treatment (self-derived biologic therapies such as stem cells or pro-stride and shockwave, laser, and ultrasound), and as a last resort, surgery.

Veterinary practices like Palm Beach Equine Clinic also offer a holistic treatment approach through the use of Alternative Therapies. Often used in conjunction with traditional medicine, these therapies can be uniquely tailored to enhance a horse’s performance and overall health. Alternative Therapies include acupuncture and electro-acupuncture, veterinary medical manipulation (chiropractic adjustments), laser therapy, shockwave treatments, and Chinese herbal medicine.

Many causes of lameness are not intuitive, which makes them difficult to diagnose without the knowledgeable eye of an experienced Sport Horse Medicine veterinarian. At Palm Beach Equine Clinic, the goal is to get horses “back in the game” and keep them safe throughout their athletic careers.

Palm Beach Equine Clinic veterinarians and staff strive to be a vital part of the equine athlete’s support team and are committed to delivering comprehensive care specialized to the individual horse’s career, discipline, performance level, and training demands. Contact Palm Beach Equine Clinic today to make sure your horse is in optimal health.

On March 24, 2021, board-certified internal medicine specialist Dr. Peter Heidmann answered questions regarding Equine Herpesvirus (EHV) live on the Noelle Floyd Instagram page. Watch the video below or read these six main takeaways he discussed.

1. Equine Herpesvirus (EHV) can be present in any area where there are horses.

EHV can be found in horses in every country around the world. The virus can have varying consequences and not every horse may be symptomatic. The duration of their immunity, their capability to shed viral particles, and whether they continue to carry the virus are all variables unique to the individual horse.

2. There are multiple strains of EHV that lead to varying health defects.

Most horses, by two years old, have been exposed to EHV. Nearly every horse over five years old has had EHV in a mild respiratory form, in which they have likely suffered from symptoms such as a runny nose or cough. The disease becomes gravely serious when there is a neurological form of EHV-1 that is spreading rapidly among horses.

Over the last century, the primary focus of EHV disease control was related to reproduction.  EHV was a major cause of infectious abortions in mares.  Since the advent of effective vaccines that protect against EHV abortions, the concern has shifted to the rare but serious occurrences of neurologic disease caused by EHV-1.

Certain strains of EHV can have more propensity to cause neurological disease, while others do not. It is important to understand that both “neurologic” and “non-neurologic” strains can cause neuro symptoms, and that some horses infected with “non-neurologic” strains may also develop the neurologic form of the disease. Symptoms of mild neurologic disease can include ataxia or hind end weakness and irregular gaits. When horses suffer mild neurologic symptoms, most will make a full recovery. If they suffer from severe symptoms, it can be increasingly difficult to treat, and some cases can be fatal.

3. Vaccination is key.

There are currently no genetic explanations regarding whether a particular horse may be more likely to contract EHV-1. However, when a horse is stressed, whether it be from shipping, competing, or other causes, its immune system is more susceptible to illness. EHV-1 can live in the central nervous system, and during times of stress when endogenous corticoids are produced, the virus can start to replicate. This causes the horse to shed viral particles into the environment and explains why there are outbreaks of the disease. It does not take much for a stressed horse to start shedding viral particles into the environment and infecting non-stressed horses nearby.

Vaccinations can help horses generate additional antibodies and minimize the spread of disease. The vaccines available today are effective at preventing the respiratory and reproductive strains of EHV, but are not effective for the neurologic strain. It is just as important as ever to vaccinate because vaccines help to limit the spread of virus by decreasing the shedding of viral particles from each individual horse.

Immunization is recommended every six months at a minimum.  Most vaccine manufacturers suggest vaccinating against EHV as often as once every 90 days when travelling or competing.  It is recommended to work closely with your veterinarian to tailor a vaccination program for your horses’ specific requirements.

work with your veterinarian to develop a vaccination program for your horse

4. Surveillance is crucial to preventing a serious outbreak in the United States.

Due to the recent outbreak in Europe, medical surveillance has increased. There are now extra layers of protection in the process of importing horses. Imported horses have always been quarantined, but now horses are also receiving a nasal swab to look for the presence of EHV-1 in their nasal passages. There have been cases of EHV-1 in the U.S. recently. However, there is no evidence that these EHV-1 cases are related to the major outbreak in Europe, partially thanks to our increased level of surveillance on horses being brought into the country.

5. The handling of horses with fevers shifts dramatically when cases have been identified locally.

Veterinarians have significantly shifted how show horses with any symptoms are being handled. If a horse had presented with a fever or runny nose prior to the European EHV-1 outbreak in early 2021, it would typically have been treated by its own veterinarian and left to return to full health. What is happening now is that each horse with a fever becomes a possible candidate for being the index case of EHV-1. This changes veterinarians’ responsibilities everywhere because of the potential for the disease to spread among the population in respective local areas. Horses with fevers must therefore be strictly quarantined and tested.

The fastest and most accurate test in the world for diagnosing EHV-1 is a PCR test, which looks for the DNA of the infecting organism. The horse will test positive if it is actively shedding organisms. The biggest downside is that it typically takes 24 hours to produce results. Therefore, horses who have been tested are put under strict isolation until the test results come back. Often, by the time test results are ready, the horse’s symptoms have ceased. Yet that is the level of scrutiny necessary to prevent a serious outbreak.

palm beach equine clinic quarantine isolation stalls resized
PBEC offers on-site isolation facilities with individual air flow systems.

6. There are clusters of the disease reported all over the Unites States, although they are unrelated to the neurological strain of EHV-1 outbreak in Europe.

While this is routine from a veterinarian’s perspective, it is still serious and certainly worth our attention. A few isolated cases reported in the U.S. this March have been found to be due to the neurotropic form of the disease and some have been non-neurotropic. The concern is warranted, but cases are highly localized, mainly in areas with large equine populations. We see the disease cropping up because the virus may already be dormant in their bodies. To minimize the likelihood of outbreaks on the individual farm level, have a vaccination program with your veterinarian and if necessary take temperatures of horses twice daily to catch any viral infection early.


For up-to-date information on reported cases of EHV, horse owners can utilize the following resources:

No matter what life may bring, our pets are here for us.
And Palm Beach Equine Clinic is here for them.

Small Animal Veterinary Care Palm Beach Equine Clinic

In our commitment to the health, safety and wellbeing of our patients, clients and community, Palm Beach Equine Clinic is expanding to treat all four-legged members of your family.

Whether you are concerned for the health of yourself, your loved ones, or simply doing your part to flatten the curve, our team of veterinarians is here to help by prioritizing the the health of your animals.

Save yourself from the stress and risks associated with taking your pet to the veterinarian. Please contact Palm Beach Equine Clinic for your small animal veterinary needs. A team of Palm Beach Equine Clinic veterinarians is able to care for your pets through select small animal veterinary services during this unsettling time.

blood draw small animal

Here for the Health of All Barn Critters

Whether at Your Farm or at the Clinic

  • Vaccinations
  • Bloodwork & Fecal Testing
  • Select Medications (such as heartworm or flea and tick treatments)
  • Physical Exams
  • Acupuncture

Don’t hesitate to ask your Palm Beach Equine Clinic veterinarian about the care of your pets. We are here to support you and your animals, and can provide accommodations to safely tend to your pets.

Call Palm Beach Equine Clinic for questions regarding your pets at 561-793-1599.

Several regions across the U.S. have reached the peak of the winter show season, and with the increase in equine travel, as well as large populations of horses in close contact with one another, proper vaccination protocols are as important as ever.

Dr. Kathleen Timmins

Dr. Kathleen Timmins of Palm Beach Equine Clinic in Wellington, FL, is often asked why proper equine vaccination protocols are imperative for all horses, and her answer voices directly to the welfare of the horse.

“You could save your horse’s life!” she said. “It is really important from an infectious disease standpoint, but also for mosquito-borne diseases or rabies; these are diseases that are life-threatening for lack of a $25 vaccine.”

Vaccinations: When, What, and How

According to Dr. Timmins, recommended vaccination protocols vary by vaccine and by the location of the horse, but the core group of vaccines is relatively standardized. As a rule, horses should receive vaccines to prevent mosquito-borne diseases like Eastern Equine Encephalitis (EEE), Western Equine Encephalitis (WEE), and West Nile Virus twice a year. Equine Encephalitis is characterized by the swelling of the brain in an infected horse, while West Nile Virus infects the central nervous system and may cause signs of Encephalitis, including those ranging from fever to weakness and paralysis of the hind limbs.

“Vaccinations against mosquito-borne diseases become very important in south Florida because we have mosquitoes year-round,” said Dr. Timmins. “As you go further north, owners may sometimes choose to only vaccinate against those once a year.”

Included in the twice-a-year vaccination program is a Flu/Rhino dose. Flu vaccination prevents the illness in horses much the same way it does in humans, while the Rhino vaccine is key in helping to prevent the Equine Herpesvirus (Rhinopneumonitis). Equine herpesvirus type 1 (EHV-1) and Equine herpesvirus type 4 (EHV-4) most commonly result in respiratory disease in horses and can progress to neurological disease.

East and West Equine Encephalitis, West Nile, and Flu/Rhino can all be administered as a combination vaccine requiring only one injection.

In addition to vaccinations given twice a year, annual vaccinations include those to prevent Potomac horse fever, a potentially fatal illness that affects the digestive system and is caused by the intracellular bacterium Neorickettsia risticii; Strangles, a bacterial infection of the upper respiratory tract; and Tetanus, an acute, often fatal disease caused by the bacteria Clostridium tetani found in soil.

Much like the vaccinations administered to humans, the companies that produce the vaccines are in constant transition, adapting each vaccine to the most common strains to ensure the most accurate prevention of disease.

The Role of the Horse Show

To combat the rise of infectious disease outbreaks, many horse show organizers have taken a proactive step to reduce the spread of disease by developing vaccination requirements for the show grounds. This is a step towards preventing disease as an organized community, according to Dr. Timmins.

“No one wants sick horses,” she said. “All horse show organizers can do is put the requirements out there and hope that people comply and that they understand why vaccinations are so important.

“When a horse pops with a fever at a show everyone is alarmed,” continued Dr. Timmins. “If proper vaccination protocols are followed, it is easier for us to figure out why that horse has a fever and treat them quickly and appropriately.”

Negative Reactions

There are occasional cases of horses reacting negatively to certain vaccinations, making a regular schedule difficult. After receiving a vaccine intramuscularly, some horses experience local muscular swelling and soreness or signs including fever, anorexia, and lethargy. Severe reactions such as anaphylaxis can also occur in rare, extreme cases.

According to Dr. Timmins, there are procedures in place to help keep horses that suffer reactions on a systematic vaccination plan without threatening their health or competition schedules.

“What I will do first is break up the vaccinations so we can figure out which one is bothering the horse,” said Dr. Timmins. “Then sometimes all it takes is a change in the vaccine company because the particular horse is reacting to their preservative or their carrier. Veterinarians can also pretreat with a nonsteroidal anti-inflammatory drug to avoid really bad reactions. Finally, there is always an option to administer intranasal vaccines rather than using an injectable.

“Very few horses have severe reactions to vaccines and for the most part, the horses traveling to shows are part of a young and healthy populations,” continued Dr. Timmins.

As the winter horse show season continues throughout the U.S., horse health must be a priority and vaccinations are a simple way for the equine community to do their part.

“Vaccinations are an easy and relatively inexpensive way to prevent infectious disease outbreaks, and keep our horses healthy and safe,” she said. “There’s just no reason not to vaccinate.”

More About Dr. Timmins

Kathleen Timmins Palm Beach Equine Clinic Veterinarian

Dr. Kathleen A. Timmins is a 1993 graduate of the Ohio State University School of Veterinary Medicine. She completed her internship in equine medicine and surgery at the Illinois Equine Hospital near Chicago. Prior to coming to Florida, Dr. Timmins practiced in Aiken, South Carolina, where she met her husband, John, who plays polo professionally. Growing up in Central Ohio, Dr. Timmins began her relationship with horses as a child on the hunter/jumper circuit. She continues to ride and show as much as possible. She and her husband are enjoying parenthood with their daughter Schuyler.

Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. Make Palm Beach Equine Clinic a part of your team by calling 561-793-1599.

Regular, routine veterinary care is important to maintaining optimal equine health. Dental care, vaccinations, deworming, and annual physical examinations keep horses healthy and can identify problems early. It is very important that horse owners have a veterinarian who is familiar with their horses and provide routine care.

At Palm Beach Equine Clinic, every veterinarian values the importance of preventative equine medicine, and some have taken a specialty to treatments, including equine dentistry.

Equine Dentistry

equine dentistry dr. tyler davis palm beach equine clinic

Proper dental care is essential to the well-being and peak performance of every horse. Dental maintenance keeps horses working well, performing well, and most importantly, eating well.

It is important to get the horse’s teeth examined and regularly floated at least once a year and sometimes more frequently in older horses. The veterinarians of Palm Beach Equine Clinic are available to visit clients at their farms to perform thorough dental evaluations and “float” the teeth – a term that refers to the veterinarian wearing down the surface of the teeth, usually to remove sharp points or balance out the teeth in the mouth. During the routine examination, the veterinarian will also look for any other dental problems that the horse may have, such as a tooth abscess.
Regular dental care may help to prevent premature tooth loss and promote more complete utilization of feed. A horse with uneven teeth due to wear and tear is going to poorly grind up food creating issues with digestion. This could lead to colic, choke, or other serious complications. Sharp or uneven teeth can also cause pain due to the misfit of a bit on uneven teeth and contribute to poor performance or misbehavior. These problems can quickly be alleviated and prevented with proper care.

With Palm Beach Equine Clinic’s advanced technology, the veterinarians are able to perform more cutting-edge, specialized treatments beyond routine dentistry. Veterinarians are able to perform tooth extractions as needed for horses suffering from a tooth abscess or fracture. With the surgical staff at Palm Beach Equine Clinic, which includes three board-certified surgeons, dental surgeries, sinus surgeries, or similar procedures are easily performed at the clinic.

Preventative Equine Medicine

Along with dental care, Palm Beach Equine Clinic offers further preventative equine medicine, including worming protocols for parasite control and routine vaccinations.

Palm Beach Equine Clinic strongly suggests a fecal test to evaluate your horse’s internal parasite count on a routine basis. In Florida, the peak worm season is year-round due to the lack of frost. The effectiveness of different dewormer products can be measured using a simple fecal egg count reduction test, which involves performing a fecal test before and after deworming your horse. Equine tapeworms are also difficult to identify in fecal examinations. Deworming for tapeworms is strongly recommended annually with a product containing Praziquantel.

Establishing an effective deworming program for equine parasites has become an open topic for discussion on which method is most effective. Veterinarians have changed their views on worming in recent years, noting that minimal parasite load within the horse’s hind gut is actually helpful in producing a natural immunity; however, it is crucial to control the parasitic load.

Environmental management is imperative to equine parasite control. Due to the emergence of new resistant parasites, preventative measures in proper barn management should be added to routine rotational treatment with anthelmintic medications to properly control parasite exposure.

Protecting Your Horse from Infectious Diseases

Palm Beach Equine Clinic also stresses the importance of vaccinating horses against infectious diseases, especially with horses that travel. Highly contagious diseases such as Eastern Equine Encephalitis (EEE), the Equine Herpes Virus (EHV-1), and the West Nile Virus are just a few illnesses that often result in equine fatalities and should be taken very seriously.

The organisms that cause diarrhea are mostly bacteria –Salmonella and Clostridium difficile are among the most common
The organisms that cause diarrhea are mostly bacteria –Salmonella and Clostridium difficile are among the most common.

Routine vaccinations are imperative to protecting horses from disease and are also a requirement to attend many horse shows. Palm Beach Equine Clinic can prepare horses for travel, whether within the U.S. or going to or from Europe.

The best defense for horse owners is to maintain current equine vaccinations to protect their horses. Vaccinating at the proper time of the year is critical, and boosters should be given regularly. Consult with your veterinarian for further guidance on when and how frequently different vaccinations should be administered.

Whether it is a top-level show horse or a backyard pet friend, the veterinarians of Palm Beach Equine Clinic are here to help with all maintenance needs. For questions or more information, please call Palm Beach Equine Clinic at 561-793-1599.

This fall, the United States Equestrian Federation (USEF) unveiled its latest health rule requiring all horses entering a Federation-licensed competition be accompanied by documentation of Equine Influenza Virus (flu) and Equine Herpes Virus (rhinopneumonitis) vaccinations within six months of being stabled at the show. Now approaching a month of enforcement during the 2016 winter show season, the new vaccination requirements enacted by the USEF gave structure to requirements that were previously being developed and enforced on a show-by-show basis.

After Florida’s Equine Herpes (EHV) scare in February of 2013, horse show facilities began adopting vaccination requirements of their own, usually requiring EHV-1 and EHV-4 vaccines within 90 to 120 days of a horse’s arrival to the grounds.

Now, USEF specifically requires all licensed competitions comply with the same set of requirements while not increasing the workload for competition management. The six-month timeline also matches the operating procedures of international shows overseen by the FEI as well.

According to Palm Beach Equine Clinic’s own Dr. Richard Wheeler, the rule change simply makes sense.

“Most people regularly vaccinate their horses every six months anyway, so this rule should not present a disruption to current practices,” he said. “After the 2013 scare, competitions recognized the potential of closure due to infectious disease and started creating requirements which became inconsistent between shows.”

Whether directly or indirectly affected by rule change itself, an increase in awareness regarding equine infectious disease in recent years had minimized outbreaks, according to Dr. Wheeler.

“A good job is being done so far to keep a big problem away,” he added.

While efforts by the USEF, veterinarians, and horse owners alike have proved successful in keeping horses safe and healthy, Dr. Wheeler was quick to remind the equine community to not get complacent. He stresses the continuation of education and awareness.

“An increase in bio-security is the most significant benefit we’ve had as a result of these requirements,” he said. “This is the most protective measure that we have taken on as a community, and people are now cognizant of how disruptive bringing a sick horse to a show can be. We see people getting vets involved quickly and shows doing a good job of providing isolation. What’s been done in the past few years is a positive thing, but it’s important that we don’t let our guard down because we haven’t had an outbreak in a few years.”

Palm Beach Equine Clinic Dr. Richard Wheeler
Dr. Richard Wheeler of Palm Beach Equine Clinic.

In addition to abiding by the USEF’s six-month rule, Dr. Wheeler also suggests the individuals responsible for caring for horses continue their efforts past the gates of the facility.

“Horse shows are often condensed places and limiting the exposure of horses is difficult,” he said. “It’s important that we stay really aware, take temperatures regularly, identify sick horses, and isolate them immediately. It’s all key to prevent outbreaks.”

Thanks to regulations, always improving technology, educated veterinarians, and diligent horsemen and women, the equine community is becoming more guarded against infectious disease than ever before.

To read more about the USEF vaccination requirement, click here. The experts at Palm Beach Equine Clinic stand ready to answer any questions horse owners may have about vaccinations and the requirements needed for equestrian competitions.