Five Steps To Prevent Tendon Injuries In Your Horse

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Tendon injuries can mean lengthy time off, stall rest, etc. for your horse, so all of us want to do everything possible to prevent them from occurring. Here are five steps on how to prevent them:

1. Buy a horse with the best conformation possible. We all realize that there is no perfectly conformed horse and there are definitely cases where you have to give up a little of the conformation for a horse with a good brain or that is really good at its job, but ideally you buy as good a conformation as possible, especially for your particular discipline. Certain conformations are more prone to various injuries.  Horses that are very straight through their hind end are more prone to hock and high suspensory issues. Horses with long pasterns and underrun heels are more prone to suspensory issues in the front limbs and/or various other tendon issues. Horses that toe in put a lot of strain on the ligaments on the outside of their limbs. If you can buy a horse that minimizes these conformational faults, you are setting yourself up better for success.

2. Shoeing is key. Have a good farrier and keep your horse on a regular schedule. Again, horses that have conformational faults will put more strain on their ligaments at the end of a shoeing cycle when toes are long and heels are underrun due to greater leverage on these areas. So keeping them on a regular cycle is key. Also certain things can be done with trimming and shoeing to minimize stresses on various areas. So find a farrier you trust. Consult with your vet. And have the two of them work together.

3. Fitness. We all know what it’s like to be a weekend warrior and not exercise all week and then go out and overdo it on the weekend. Horses are no different. So don’t go out and expect to do a 50 mile endurance ride after not riding your horse for several weeks and expect him not to be sore. The more fit your horse is the less likely that he is to fatigue while you’re riding him. Injuries often happen when your horse is fatigued and not taking care of their body as well as they could. These tendons and ligaments also get tired and are more prone to injury at this time.

4. Terrain: Ride your horse on different types of terrain. Always riding on the same terrain makes tendons and ligaments accustomed to only that type of terrain. It makes sense to ride them on different types of ground.  Ride them on hard ground. Ride them on grass. Ride them in an arena. Ride them carefully over uneven ground. All these things will strengthen your horse’s ligaments and make them less prone to tearing.

5. Cross train your horse. This means ride them in an arena. Take them out on trail rides. Do trot sets. Ride them long and low. Ride them more collected. This will help strengthen your horse’s core and strengthen their hind end.  Also getting them to use their core will help strengthen their back and horses can get sore backs just like we can.

Ristocrat’s Return: Making The Most Of Time Off

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There it was, the news that horse owners dread to hear: the young, beautiful, talented warmblood that she bred had a suspensory tear. All the momentum of his promising career in dressage seemed to have ground to a halt, and now a new goal loomed. Roberta Falk was determined to pursue the best course of treatment for Ristocrat to put him back on the road to success.

The diagnosis was made through performing regional anesthesia (selectively blocking nerves in the lower leg to determine where the pain is) and ultrasound. The ultrasound examination also gave the information that Ristocrat’s injury was likely to benefit from regenerative treatment. It was decided to treat the tear with stem cells. Appointments were made, stem cells were harvested and processed, and then injected into the injured areas using ultrasound to guide the needles.

Regardless of other interventions, time and rest and controlled exercise (emphasis on controlled) are the basis of healing any soft tissue injury. Most horses spend 8-9 months, sometimes more, in a program of slowly increasing exercise before they are back to full work and allowed unrestricted turn out. Each animal is an individual, and every injury heals at its own speed, making the timing of changes to the program difficult. This timing is also key to keeping the progress going as efficiently as possible while avoiding further injury. The use of ultrasound to monitor the healing of these structures has vastly improved our ability to successfully guide rehabilitation in these injuries, improving outcomes from up to 50% success to up to 80% success.

Ristocrat had some challenges up his sleeve, though. Shortly after he returned home after his regenerative medicine therapy, his leg swelled up and was hot. Ultrasound of the leg confirmed that his body was having an exaggerated response to the biological therapies. Cold hosing, wrapping, and a few days of bute got things quieted down again. Fortunately, he was happy in his stall and enjoyed his hand walking, and when he was checked again the next time, significant healing was seen on ultrasound, and he graduated to the next level of exercise.

As he was asked incrementally to do more work, his muscles and joints were kept loose and limber with chiropractic adjustments. Little by little, more work was added at a pace dictated by the pace of his healing. He returned to full work, and was working well. He started showing, and he was doing well. After a short vacation, however, it was noted that he would skip off of that front leg at the trot in tight turns. After cantering, his gait was normal. Ultrasound examination of the suspensory showed some scar tissue at the old injury site. Shock wave was used along with exercise to break down the dense scar so that the ligament could stretch freely. The skipping has not returned.

Without ultrasound, determining the pacing of rehabilitation is difficult at best. Horses that heal more slowly need to progress through their rehabilitation program at a slower pace, and this cannot be determined by the horse’s soundness alone. Not all horses can be on the same schedule. Also, knowing the cause of a gait problem (injury vs. scar tissue) allows the correct course of action (rest vs exercise) to be determined. Ultrasound has helped Ristocrat get back to work efficiently and safely. Once again, the future is bright for this lovely sales prospect and his team.

What’s Wrong With My Horse’s Eye?

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Eye problems are more prevalent through the summer and fall. It is important to be aware that any eye problem should be considered serious and addressed in a timely manner. Certain eye conditions can progress quite rapidly (within 24 hours), becoming so serious that the horse will need to have the eye removed or will become blind. Most eye problems look the same to the owner: swollen, closed and tearing. The following problems are most commonly encountered, and they all have different treatments.

The most common problem is corneal ulcers. This problem usually involves one eye and tearing. Ulcers begin when the surface of the cornea is damaged. Most corneal ulcers do not threaten the overall health of the eye unless they become infected with certain types of bacteria or fungus which produce enzymes that cause further destruction of the cornea. Never treat an eye without first contacting a veterinarian. Some medications contain steroids such as hydrocortisone or dexamethasone. Steroids can cause further damage if given to horses with corneal damage.

Another problem is conjunctivitis. This presents typically with both eyes involved and includes mild eyelid swelling, tearing and inflamed, red-looking conjunctiva (white portion of the eye). This can be initiated by bacteria, dust, pollen and debris in the air.

A related problem and now more commonly found in Virginia is Eosinophilic Kerititis. This causes pain, severe purities and corneal ulceration. This syndrome is thought to have immune/allergic causes, so must be differentiated from more typical ulcers. Treatment is different and often complicated.

The last condition is anterior uveitis. Anterior uveitis is a term which means that the front portion of the eye has inflammation within it. This presents in many different ways but typically includes eyelid swelling, increased pain, tearing and a discoloration or white-to-bluish hue over the cornea. It can involve one eye or both. Treatment options range dramatically depending on the severity.

So as you can see (no pun intended!), many eye issues look the same, but are treated very differently. Early and proper therapy is crucial to a positive outcome!

Equine 911: When Do I Really Need To Call The Vet?

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When horses are sick or injured, it can be difficult to know what problems need a veterinarian’s care on an emergency basis, and which can wait until morning or later. Some situations, such as major bleeding, thrashing colic, or a horse that is down and can’t get up, clearly require veterinary intervention, but others are more subtle. In the less dramatic cases, there can be hesitation to call, both because of a reluctance to “bother” the veterinarian, and to avoid the expense of an emergency visit if one isn’t really needed. It is worth remembering that putting a call into the veterinarian isn’t a commitment to having someone come out, and a conversation with the veterinarian can often be very helpful in determining if one is needed. Below are 10 conditions that warrant calling for help.

1.       Signs of abdominal pain/discomfort: A horse that is stretching out as if to urinate every few moments, doesn’t want to eat, sulks in the back of the stall, is away from the herd, looks, bites, or kicks at his sides, spends too much time lying down, curls up his upper lip, or gets up and down frequently with or without rolling has colic. “Colic” is a generic term that means abdominal pain. There are many causes for colic, which may be anything from harmless to life threatening. A veterinarian can help to sort out how serious the situation is, and even in mild colic, early intervention is key to help prevent dangerous and costly complications.

2.       Severe lameness: Limping noticeably at the walk or refusing to bear weight on one leg may be as simple as a foot abscess or as serious as a broken bone or infected joint. Prompt evaluation and treatment of all of these conditions helps to provide the best care as soon as possible.

3.       Eye problems: Squinting, tearing, or cloudiness of the eye allsignal an eye problem. Problems with the eye can progress rapidly, so prompt treatment is key in successful treatment. Delay can lead to scarring of the eye, loss of vision, or even loss of the eye.

4.       Bleeding: Not all bleeding is an emergency, but it is best to consult a veterinarian if there is blood coming from a cut or out of the nose or other body orifice, as it may signal a serious condition.

5.       A wound near or over a joint: Any wound that is near or overlying a joint should be evaluated by a veterinarian as soon as reasonably possible. Especially on the legs, there is not much tissue between the skin surface and the joint capsules, so even relatively superficial appearing wounds can penetrate into a joint. The joint is the cartilage covered union between two bones that is filled with synovial fluid, which acts as a joint lubricant. Once bacteria gain entrance to a joint (or tendon sheath, which is a synovial fluid space surrounding tendons), the resulting infection causes damage quickly, leading to a very painful and difficult to treat condition. Once a horse has an infection in a joint or tendon sheath, which is characterized by severe lameness, the chances of curing the infection and returning the horse to soundness are dramatically reduced. This is definitely a case of, “an ounce of prevention is worth a pound of cure.”

6.       Choke: Horse “choke” isn’t really choking at all, it is blockage of the esophagus. Signs include retching, feed material coming out of the nose, excess salivation, coughing, and signs of colic. A horse with choke should be seen by a veterinarian to relive the blockage, and should not be allowed to attempt to eat anything while choked. In some cases, choke can lead to the horse aspirating feed material, leading to severe pneumonia.

7.       A mare having trouble foaling: If a mare is in labor and hasn’t made rapid progress (unlike cows, mares deliver in about 20 minutes), or if there is a red membrane covering the exiting foal, call the vet IMMEDIATELY. In the case of the red membrane (red bag delivery, caused by premature separation of the placenta associated with fescue consumption by the mare), cut or tear open the red bag first, allowing the foal to breathe.

8.       Reluctance to move: A horse that is planted in place and does not want to walk may have laminitis or myopathy (“tied up”), both of which can be very serious. Prompt attention of these conditions gives the best chance for a good outcome.

9.       Red or brown urine: Although normal horse urine turns red when it mixes with snow, horse urine should be yellow when it comes out of the horse. Bloody or brown urine can signal a serious condition.

10.   Sudden incoordination or other neurologic signs: Neurologic problems in horses can progress rapidly and are best addressed early in the course of the problem. Horses that are dizzy or suddenly incoordinated can be dangerous to themselves or their handlers. Early determination of the problem and aggressive treatment are usually key to resolving the problem.

Subcutaneous Emphysema Caused By A Skull Fracture

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Recently my horse Mocha fractured a small bone in the sinus region of her face causing subcutaneous emphysema, which means gas or air is trapped beneath the layer of skin. It is not a hot or hard swelling; it feels like it crackles and is crunchy to the touch, a sensation known as crepitus. I had never seen anything like this before, and called Dr. Julia Hecking right away. She asked me to look for a puncture wound that could be leaking air into the skin, however there was not a wound present.

Dr.Hecking thought it was best to take radiographs of her head to look for any fracture that may be causing air leakage. There was indeed a small fracture in her sinus region which explained her head being enlarged. However, we were unsure if that was causing the enlarged throat latch area and neck, or if there could be a secondary problem. We passed a scope through her nostril into her trachea and esophagus to make sure there were no tears or bleeding present. There were no tears or bleeding that she could see, however the scope the doctors use in the field is much shorter than the one we have at the hospital, so it’s hard to see the entire area. This is often the reason a doctor chooses to refer a horse into the hospital for a better look with a longer endoscope.

If you ever encounter this type of swelling in the head or neck region of one of your horses, it is important to call your veterinarian immediately, and keep the horse quiet and in a confined area until the vet arrives. He/she will appreciate knowing if your horse is eating, drinking, breathing normally, and if a fever is present.

After one week, the swelling is decreasing. Mocha continues to eat, drink, breathe and act normally with no indication of fever or discomfort, so we expect it to resolve on its own. Dr. Steve Trostle has seen similar cases and says it may be a few weeks until the swelling completely disappears.