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Here are a few things to remember as you and your horse prepare to travel to competitions. Prevent Stress to Keep Your Horse Healthy It’s important to realize that transport to shows, even if your horse seems like a calm traveller, puts stress on their bodies and immune system. Stress can play a large role in the development of gastric ulcers, so prevention is ideal. An in-depth article with the newest ulcer information will be coming soon, but here are some general management guidelines you can follow if you’re concerned about gastric ulcers in your horse: Increase turnout and decrease stall time to minimize stress Increase the amount of time feed is available using a hay net or slow feeder system Feed smaller meals more frequently throughout the day and overnight (ideally 4-6 meals daily) Feed hay before feeding grain – this will create more saliva, which is a buffer of stomach acid Feed more forage and less high concentrate grain Include up to 25% alfalfa in the diet – this can act as a buffer in the stomach Do not exercise on an empty stomach Avoid use of non-specific non-steroidal anti-inflammatory medications such as phenylbutazone (bute) or flunixin meglumine (banamine) unless directed by your veterinarian The respiratory system is another area vulnerable to stress while traveling. Horses have to stay stationary with their heads elevated for abnormally long periods of time and air quality may not be ideal while trailering. Signs of respiratory disease that you can watch out for include the following: Increased respiratory rate Increased respiratory effort Cough Nasal discharge Fever (>101.5F) Pack an Equine Emergency Kit While Traveling One way to be prepared for unexpected situations should they arise is to have an emergency kit with you while traveling. Some of the things we recommend you keep in such a kit: Stethoscope Digital thermometer (sold for people) or equine thermometer Supplies for a pressure bandage – a combine, brown gauze, vetrap, elastikon, white kling, and a non-stick telfa pad – to apply while waiting for a veterinarian Chlorhexidine Saline solution 3x3 gauze Furazone Exam gloves Triple antibiotic ointment Electrolytes Dose syringe to administer oral medications Stall card with all pertinent horse information (see our main Resources page) We also recommend consulting with your regular veterinarian on any prescription needs to have on hand in an emergency – for example, we often recommend having a tube of Banamine paste on hand in case of a colic episode to administer if your veterinarian gives you instructions to do so. Other supplies can be added based on the individual horse and horse owner. Stay Up to Date on Rules, Regulations and Paperwork Some competition organizations like USEF and USHJA require that your horse be microchipped. Those of you traveling out of state or out of country are aware of the paperwork that you should be carrying with your horse, but here is a reminder to keep an up-to-date Certificate of Veterinary Inspection or CVI (commonly known as a ‘health certificate’) and a negative Equine Infectious Anemia test (commonly known as a Coggins) on hand when you cross borders. CVIs must be issued by an accredited veterinarian within 30 days before crossing state lines, while an up-to-date EIA test done by a USDA-approved laboratory is required within six (6) or twelve (12) months dependent on the individual state. If you have any questions regarding your horse’s health prior to showing, please contact the clinic. Happy travels!

By Nora Grenager, VMD Published in Bay Area Equestrian Network December 2007 Introduction Colic. To some, it is a term that is unfortunately all together too familiar; to others, it is a word that causes fear with little understanding of what it is. While it is a situation we would all like to avoid, it is important to have a knowledge of what colic is, some of its causes, potential ways to minimize its occurrence, and how your veterinarian may deal with it. Causes Approximately 4 to 6% of horses in the United States will suffer from colic each year. This is a difficult statistic to interpret, because many mild episodes of colic likely go unnoticed. Of that percentage, only a very small amount require surgery. “Colic” is just a term that encompasses any abdominal pain – it is a clinical sign, not a specific disease. Horses have very extensive gastrointestinal tracts, and there are numerous possible causes of colic. There are many ways to categorize the causes of colic. One is to divide the causes into those that can be resolved by medical treatment alone versus those that require surgical intervention. Most horses with colic respond to medical treatment, and only a very small percentage have a cause that will not get better without surgery. A second useful way to categorize the causes of colic is based on whether the small intestine or large intestine is the source of the pain. This is beneficial because sometimes the veterinarian can differentiate between these two locations during the exam, and treatment and prognosis tend to depend on which part of the intestine is involved. A third way to categorize colic is based on whether it is a one-time occurrence or whether the horse has had multiple episodes of colic over time (i.e. it is a chronic situation). To list the specific causes of colic is beyond the scope of this article. Clinical Signs The clinical signs (a.k.a. “symptoms”) of colic vary from horse to horse, and can range from very mild to very severe. Some mild signs include a horse not being as interested in feed as normal, having decreased number of manure piles, or quietly laying down more than normal (or at an abnormal time, such as feeding time). A colicky horse may be looking at its side and showing evidence of having rolled (is covered in shavings). Moderate signs may include pawing, lifting the upper lip, looking at the flank, kicking at the belly, or stretching out. Severe signs can include repeated rolling or thrashing and sweating. Every horse is different, so knowing what behavior is normal for your horse is important so you can tell when something is amiss. Also, some horses are extremely stoic whereas others are very are more sensitive and quick to show signs of discomfort, which can make interpretation of signs tricky. It is therefore important to remember that the severity of colic signs you see may not always correlate very well with the severity of the underlying cause. What to Do While Waiting for the Vet If you are concerned that your horse is showing colic signs, you need to call your veterinarian immediately. If you are comfortable doing it, and the horse’s signs aren’t so severe as to prevent it, taking a heart rate and rectal temperature and evaluating the gums prior to calling your veterinarian may be helpful so you have more information for the phone call (ask your vet — (s)he may have a preference as to whether you do this or not). Next time your vet is out, have him or her show you how to take your horse’s heart rate and rectal temperature, and evaluate the gums. Normally a horse’s heart rate should be between 30 and 40 beats per minute. A normal rectal temperature is between 99°F and 101.5°F. The gums provide insight about how well hydrated the horse is and should be pink and moist. When you call your vet, (s)he may ask about the duration of colic signs, if the horse has colicked in the past, how uncomfortable the horse is, and if the horse is passing any manure. There are different opinions on whether to walk a horse while waiting for the vet to arrive. If the horse is rolling and extremely uncomfortable, walking may help keep it quiet. Walking may help alleviate some gas, which can be a cause of colic. A horse should not be forced to walk, and laying quietly is generally okay. Most veterinarians prefer that you do not administer any medications to a colicky horse unless they advise you to do so when you call. This is because a dose of Banamine or dipyrone (or whichever painkillers you have) can make evaluating the horse difficult for the vet. The horse may temporarily look better while the vet is there, only to become colicky again later; thus postponing necessary treatment by the vet and potentially making the situation worse. Situations in which the vet may advise you to administer medication are if it is going to be a long time prior to the vet seeing the horse, or if the horse is dangerously uncomfortable. What to Expect from the Vet Once the vet arrives, (s)he will likely examine the horse (take heart rate and respiratory rate, take the rectal temperature, evaluate the gums, and listen to the gastrointestinal sounds). If your horse is extremely uncomfortable, this exam may be brief and the vet will administer intravenous sedation/pain relief quickly. (S)he will then likely ask you a few more questions about duration of colic signs, any previous colic episodes, any recent changes in feed or management, or other medications recently given. The most common initial workup for a colicking horse is for the vet to perform includes abdominal palpation per rectum and passing a nasogastric tube. The horse will likely be sedated for these procedures. Abdominal palpation per rectum (a.k.a. “the rectal exam”) gives the vet information as to whether there is manure passing through, the appearance of that manure, and allows palpation of about the back third of the abdomen. Obviously horses are very large animals, and it is not possible to feel everything in the abdomen. However intestinal distention or impaction and some intestinal displacements can be palpated, so this is very informative. Sometimes this is not done if either the colic is very mild, or if the veterinarian does not feel safe doing the exam. There is obviously a degree of risk in standing directly behind a horse and performing a rectal exam, which is why at veterinary clinics this procedure is preferentially performed in the stocks. Passage of a nasogastric tube has two distinct purposes. First, horses cannot vomit, so if the stomach is very full due to an obstruction of the intestine, it can get very distended. This is not only extremely painful, but it is fatal if the stomach ruptures. The quantity and quality of the reflux is useful information; it can help differentiate between small intestinal and large intestinal causes of colic. A normal horse may have 1 to 2 liters of nasogastric reflux, versus a horse with a small intestinal obstruction can have upwards of 20 liters of reflux. Second, a nasogastric tube is an excellent way to administer fluids and electrolytes to help rehydrate the horse. Horses with colic generally have some degree of dehydration. Additionally, your vet may add either mineral oil or detergent or epsom salts to the fluid to help soften the bowel contents. If your horse becomes colicky again once the sedation and pain medications have worn off, or the initial colic is severe, your vet may recommend intravenous fluids and additional treatment. Depending on the horse’s condition, the vet’s preference, and the available facilities, this may be done at the farm or (s)he may advise taking your horse to a referral veterinary clinic. At the Clinic If your horse is referred to a veterinary clinic (or some vets may have resources to do some of this in the field), diagnostics such as abdominal ultrasound, abdominal radiographs, abdominocentesis (a.k.a., “the belly tap”), or gastroscopy may be performed. These are four different ways to evaluate different parts of the gastrointestinal tract and gather more information. While every attempt is made to determine the cause of colic, the horse’s level of pain is the single most important deciding factor as to whether surgery is necessary. If a horse is repeatedly uncomfortable in spite of adequate pain medication and hydration, the cause of the colic is very likely something that is not going to resolve without surgery. If surgery is indicated, the vet will discuss with you his or her thoughts on the possible causes, tell you about the surgical procedure, and talk about the costs. Possible Preventative Measures Colic can be frustrating because, in a lot of situations, a reason for the colic episode is not determined. Possible causes that often are discussed include weather change (so the horse is not drinking enough water), change in feed, poor dentition, and parasites. While it is probably not possible to prevent all episodes of colic, there are certainly some things owners can do to minimize the risk. Regular feeding schedules are very important for gastrointestinal health. If any feeding changes are to be made, they should be done slowly over a week or two. Horses were also designed to graze and therefore they are suited to more frequent smaller feedings when possible. It is important to make sure there is always access to fresh, clean water. Note how much water your horse drinks, and be cognizant of decreases if there is a weather change and try supplementing water in other ways at those times. For example, feeding a soupy mash or adding a few tablespoons of apple juice or Gatorade to the water to tempt the horse (obviously always have available both plain and flavored water). Horses living on sandy soil should be fed in feeders with rubber mats underneath to minimize the amount of sand they ingest. Additionally, horses in sandy areas should be on a preventive psyllium program to help clear them of sand they take in. Studies have shown that horses in California (in particular, Arabians) that eat alfalfa are more likely to have enteroliths (stones that form in the colon that can cause colic and have to be removed surgically). Therefore, while alfalfa is a great feed source, it may be recommended to not feed it for more than 50% of your horse’s diet. Routine deworming is important for many reasons, and can help decrease the incidence of some types of colic. Routine dental care is critical, not only in older horses, because poor dentition can increase risk of impaction colics. Conclusion Certainly there are numerous causes of colic, but some of these can be avoided with routine good horse care and by being well-informed. Being armed with a little more information about colic can hopefully help to decrease the preventable risks and make a colic event less scary.

By Timothy G. Eastman, DVM, DACVS, MPVM Published in Bay Area Equestrian Network December 2006 The word “colic” comes from the Greeks and means “abdominal pain”. Horses are notorious for colic and are predisposed to it when compared to other species. Signs of colic include but are not limited to: being “off feed,” depressed, looking/biting at the flanks, stretching as if to urinate, kicking at the abdomen, and rolling in pain. Most long-time horse owners have experienced at least a mild case of colic in their barns. Generally, a couple of injections and some laxatives will take care of most cases. If not, a repeat visit is required for further more aggressive treatment. There are many factors that predispose horses to colic. Equine species have simple stomachs unlike most other grazing animals and are unable to vomit. They evolved grazing over most of their day but are now fed several large meals at once, morning and night. Horses also experience much more stress than their mustang counterparts with their busy show and travel schedules. Most often horses with colic have an over accumulation of gas in their intestines (“gas colic”) or a mild impaction. The cause is oftentimes undetermined but can be triggered by a change in feed, dental abnormalities, environmental stress (“change in the weather”), or transportation to name a few. Certain regions have forms of colic unique to their area, for example enteroliths/intestinal stones in California, or “ileal” impactions in the South (the ileum is the last segment of the small intestine and prone to impactions in areas that feed coastal Bermuda grass hays). In over 95% of the cases of colic that equine veterinarians treat in the field, horses respond to medical management. Flunaximine (Banamine®) is often given because it controls pain, reduces fevers, decreases inflammation, and binds toxins sometimes released by bacteria. Dipyrone is a drug given to reduce spasms of the GI tract and to reduce fevers. Buscopan ® is a new drug to the USA but has been used over seas for many years and has become very popular for treating colic. It is a potent, short-acting drug that reduces spasms of the intestinal tract. It also facilitates rectal examination because it relaxes horse’s rectums. Horses with colic are frequently sedated because the tranquilizers we use are among the most potent pain killers available and begin to work very rapidly. Tranquilization also makes passing a stomach tube and performing a rectal exam easier, safer, and less stressful for the patient. Stomach tubes are passed up the nostril, down the esophagus and into the stomach to relieve gas pressure from the stomach, and to empty the stomach of feed and water that are not passing through in a normal time frame. A “twitch” is oftentimes placed in order to making the tubing process less stressful and reduce the chances of a bloody nose. While sometimes dramatic to witness the event, passing a stomach tube may be considered an important part of the management of a particular case of colic. Once the tube is passed and gas relieved, medication may be pumped down the tube. Mineral oil is very popular to use as a laxative. Other veterinarians prefer a detergent (“DSS”) to soften horses up and help eliminate gas. Epsom salts are sometimes given to soften up impactions. What drugs are given and by what route are the preference of the treating veterinarian and may vary greatly depending on the situation. Rectal exams can help determine the severity of a colic case. Some impactions may be felt, the portion of intestine involved can be determined, and the amount of gas in the intestine can often be evaluated. Performing a rectal examination is not without risks and whether or not it is indicated depends on the circumstances of the colic. Horses with colic pain are under stress and this stress can lead to fluids being shifted from their blood into their intestines. This is frequently why they become dehydrated and need fluids to prevent the colic from progressing and to help them get their intestines working in a normal fashion again. They also support the patient until the colic has passed. Fluids can be given via a stomach tube or by an IV catheter. Intravenous fluids are one of the most important therapies for more horses with more serious colic. Some combination of the above therapy will bring >95% of horses with abdominal pain through it just fine. However, sometimes the cause of the colic is such that fluids and medical therapy will not resolve the source. There are many causes of this more serious form of colic. The most common ones seen in Central California involving the large intestine are displacements, torsions (“twists”), and feed or enterolith impactions. Colics involving the small intestine in our area are typically more serious and may be from a fatty tumor that wraps around the intestine, or the small intestine being trapped and it’s blood supply cut off. These are the cases that often need surgery to physically relieve the obstruction or to mechanically replace the intestine back in its proper alignment. If a segment of the intestine has lost its blood supply for more than several hours, the affected portion may need to be removed and the healthy ends attached, or a bypass performed. Colic surgery is needed in these 5% or so of overall colic cases to give the best chance of success. The first obstacle to overcome with a horse during colic surgery is the ability to correct the problem. There are some instances when the exploratory reveals a hopeless situation. However, more than 80% of horses with successful colic surgeries will make it home. This is a substantial improvement over the past several decades and due to advances in anesthesia, surgical techniques, and aftercare. Abdominal pain caused from the small intestine tend to be more serious than ones caused by the large intestine and are typically more expensive to manage due to the drugs they require during surgery and aftercare. The vast majority of horses discharged from colic surgery will lead totally normal lives several months later. When trouble happens following colic surgery it can be from the inability of the intestine to regain normal function (“ileus” is the name for this), diarrhea, laminitis, and infections of the incision, etc. Huge advances have also been made in recent years with the management of these complications. Not everyone considers colic surgery a viable option for their horses due to previous experience, cost, or patient’s age etc. I think it is a good idea to make that determination periodically because the decision can often be hard to make in the middle of the night under stress. Medical insurance is actually very affordable and should be emphasized for family “pet” horses as much as in expensive performance horses. Care Credit® ((1-866-893-7864) is a company that offers a very reasonable payment plan for pet owners through many veterinarians. The age of patients undergoing colic surgery is less of a concern due to the same advances listed above. Many horses in their late twenties still undergo colic surgery on a regular basis. As a horse approaches his/her twilight years, when to draw the line with regards to whether or not a patient would get surgery for colic is an individual decision. Part of the job of your veterinarian is to assist you with guiding you through that decision process. In closing, most horses with colic will respond to simple medical management at the farm, if they do not, transportation to a hospital may be needed for further evaluation or treatment. Colic surgery has made huge advances over the past several decades for those rare cases that do not respond to simple medical therapy.

By Alexandra Eastman, DVM, MS Published in Bay Area Equestrian Network November 2007 It’s never too soon to start thinking about next year. Planning ahead can make breeding your mare less stressful and more fruitful. Many broodmare owners can run through breeding programs in their sleep, but for those new at the game, the following may be helpful in demystifying the process of breeding your mare. More than Two Months Before Breeding Discuss with your veterinarian the pros and cons of breeding your mare. There are many things to consider. How is your mare’s general health? Healthy mares that are not over or underweight tend to be most fertile. How old is your mare? Does she have any congenital problems that you would not want to pass on? Because of love they feel for their mare, many people overlook the consequences of breeding mares with undesirable heritable traits. Is she reproductively sound? A breeding soundness exam can help evaluate the reproductive health of your mare. If done early, it can help by identifying problems that may need treatment before you are trying to breed. During this time you may also want to research prospective stallions. You will want to establish a breeding contract ahead of time with the stallion owner. This is a time for you to familiarize yourself with the details of the contract. You may want to ask about the pregnancy rates of the stallion, the fees you will incur during the process, the collection days, and breeding season. Which stallion you choose may effect how your mare will be bred. Mares are bred by natural cover or by artificial insemination (AI). If your mare is to be bred by natural cover, you will probably transport your mare to the stallion for breeding. If she is to be bred by AI and the stallion ships well, it is possible for her to be bred with transported semen. Transported semen comes in one of two forms: cooled or frozen. There are advantages and disadvantages to each method. Pregnancy rates are highest in mares bred by live cover or artificially inseminated immediately after collection. However, transporting the mare to the stallion may not be practical or desirable. In most cases cooled semen has higher pregnancy rates than frozen semen but cooled semen must be ordered and shipped for each breeding. Depending on the collection schedule and shipping methods offered by the stallion owner, this can be difficult to orchestrate with the actual ovulation of the mare. Frozen semen is nice because it sits in the tank waiting for the mare but the conception rates are lower and the timing must be more precise so the mares need to be checked more frequently by a veterinarian. Breed registries have differing rules regarding AI and transported semen. If you intend to register your foal, you should check the rules of your specific breed association. Two Months Before Breeding Mares are seasonal breeders. They cycle, produce and release ova from follicles, during the months with the longest day length. During the winter they enter a period of diestrus and stop cycling. As mares begin to cycle in the early spring, they enter a period of transition. During this time the mares may show signs of being in heat but their cycles tend to be unpredictable making it difficult to achieve good pregnancy rates during this time. Without any intervention the ideal time to breed mares in the northern hemisphere is May through August. During this stretch of time, the mares are usually cycling consistently and are most fertile. The length of gestation is extremely variable but pregnancy usually lasts about 340 days. For many breeds the foals have an automatic birthday of January 1 st. Foals destined for age group competitions will have an advantage if they have an actual birth date early in the year. For owners hoping for birthdays early in the calendar year, May through August is usually considered too late to be acceptable breeding dates. The simplest and most effective method to get a mare to cycle earlier in the year, is to increase her “day length” 60 days before you want her to start cycling. For most mares this means adding light to their stall starting on December 1st. The most common method is to add light at the end of the day before dusk making the mare’s day length 15-16 hours/ day. This can be most easily achieved by placing the lights on timers to light the stall from around 4:30 pm to 10-11pm each day. Leaving the lights on all night or skipping days will negate the effect. The lights do not have to be overly bright. The rule of thumb is that you should be able to comfortably read a newspaper. One Month Before Breeding If possible, start teasing your mare to determine her heat cycle. Mares that are in estrus (heat) usually stand calmly, squat and wink the labia of the vulva in the presence of a stallion. They often raise their tail and urinate. Mares that are not in estrus tend to be more agitated in the presence of a stallion. They are restless and may lay their ears back, squeal and kick. Some mares will tease to geldings or other mares when they are in heat. Other mares will not overtly show signs of estrus even when teased with a stallion. Many mares with foals are so protective of the foals that they won’t show estrus behavior. Teasing is not always possible. Your veterinarian can determine the stage of estrus by examination of the ovaries, uterus and cervix of the mare. If your mare is to be bred with transported semen, contact your veterinarian to determine when they would like to start following your mare’s cycle. If your mare is going to travel to the stallion farm, contact the breeding manager or stallion owner to determine when they would like you to bring your mare. If your mare is to travel out of state, be sure to check with your veterinarian about the timing and requirements for an interstate health certificate and Coggins testing for the state in question. Desired Breeding Time Arrange for breeding either by your veterinarian or the stallion manager. The attending veterinarian will probably want to check your mare after breeding to ensure that she has ovulated and that she did not acquire any post breeding fluid within her uterus. Even with the use of drugs to induce ovulation, some mares do not ovulate when expected. If this is noted on a post-breeding exam, there may be a chance to order more semen. Many mares, especially older mares, will have difficulty clearing fluid from their uterus after breeding. If this happens, it can provide an inhospitable environment for the embryo and the pregnancy will be lost prior to implantation. Oxytocin with or without uterine lavage can greatly increase the chances of a viable pregnancy Pregnancy Exams Pregnancy can usually be diagnosed by ultrasound 14 days after ovulation. A fetal heartbeat can usually be detected ultrasonographically at day 24 or beyond. At the heartbeat check be sure to discuss with your veterinarian protocols for vaccination (most veterinarians recommend EHV-4 vaccination at 5, 7, and 9 months of gestation as well as core vaccinations 1 month prior to foaling). Specific recommendations may vary between veterinarians or by region. It is very nice when everything goes as planned. You find a stallion, your mare comes into heat, she is bred in a timely fashion and she takes the first time. This does happen sometimes. However, like it or not, mares are individuals and they don’t always come into heat when you expect them to, ovulate when they should, or they have trouble with post breeding fluid. Sometimes the semen misses the connecting flight or the stallion is collected Monday, Wednesday and Friday and they only ship FedEx and you really need the semen on Monday and you are out of luck. Generally the most effective tool in a successful breeding season is good communication. If you have all of your questions answered ahead of time by your veterinarian and by the stallion manager and you are kept up to date as the process unfolds you shouldn’t have too many surprises.

By Timothy G. Eastman, DVM, DACVS, MPVM Published in Bay Area Equestrian Network March 2008 The pastern joint, also known as the proximal interphalangeal joint, is a relatively common source of lameness in horses (Figure 1: Note the smooth borders of the bones along the front of the pastern joint of this normal horse). Degenerative joint disease/arthritis of this joint is commonly referred to as high ringbone. Low ringbone refers to the same type of degenerative joint disease of the coffin joint and is much less common. Horses afflicted with high ringbone are difficult to keep sound. The area is similar to the lower hock joints in that it is a “high-load/low motion” joint, meaning the joint is subjected to a lot of pressure but undergoes very little movement. Unlike the lower hock joints, the pastern joint does not respond consistently to intra-articular injections. The diagnosis of high ringbone is based on localizing the source of the lameness to the pastern joint with nerve and/or joint blocks. Lameness can be classified as minor and only apparent with extreme exercise or severe enough to cause lameness at a walk. Radiographs and ultrasound are useful in confirming the diagnosis and determining the severity of the disease. Radiographically you see new bony growth along the front and the sides of the joint (Figure 2: Compare the new bony growth along the front of this arthritic pastern joint to the normal one in Figure 1). These bony prominences can sometimes be seen and felt prior to radiographs during the physical examination. If the disease was traumatic in origin, ultrasound can be particularly useful in identifying any concurrent soft-tissue injuries complicating the prognosis. A complete series of radiographs is necessary to determine the severity of the disease as the sides of the joint can only be seen on oblique views. Quarter Horses are predisposed to ringbone due to the rotational forces they exert on their lower limbs during the sudden stopping and turning common in Western Performance. Treatment of ringbone can be divided into medical and surgical options. Medical management of ringbone is aimed at slowing down the progression of cartilage degeneration and reducing pain and inflammation associated with the condition. Helping to “ease the breakover” of the foot will decrease the forces subjected to the front of the joint and can be accomplished by a farrier “squaring” the toe and “rolling” the shoe. Like any lameness condition, there are many ways to shoe for the same problem. Anti-inflammatories like Phenylbutazone (“bute”) are used to decrease inflammation associated with acute flare-ups of the condition and to manage horses on a long-term basis. Many horses with ringbone can be sound enough for light use by giving bute before and after exercise. Oral joint supplements alone are unlikely to be sufficient to provide relief but are thought by some to slow down the progression of the disease. More aggressive joint supplementation would include Legend? and/or Adequan?. Legend is an intravenous form of hyaluronic acid which is important in lubrication of joints and is an essential component of joint fluid. Some horses with ringbone will be sound enough for athletic use with Legend therapy alone. Adequan is an intra-muscular injection and is thought to delay the progression of cartilage degeneration. Injecting the pastern joint is not rewarding as consistently as some other joints but should be attempted to evaluate an individual horse’s response. There is tremendous variability with regards to how long an individual horse will respond to pastern joint injections. If controlling the disease with anti-inflammatories, shoeing changes and joint therapy is not sufficient to allow pain free performance, surgically fusing the joint may be the only option to provide pain free performance. While this procedure involves a major surgery, it offers the possibility of complete return to work and relief from pain for many horses. Research has shown that 2 out of 3 horses with ringbone of the forelimbs and greater than 4 out of 5 horses with hindlimbs affected will be sound enough for athletic use with surgical fusion. This joint is fused with a combination of plates and screws (Figure 3). Typically horses are maintained in a cast for several weeks, then a bandage and stall rest for several months prior to returning to full work. As with any lameness condition, your veterinarian and farrier need to work together to provide your horse with the highest level of soundness possible and to help you determine the best course of action for your particular horse.

By Richard A.Mansmann, Sarah James, Anthony T.Blikslager, Kurtvom Orde Published in the Journal of Equine Veterinary Science (Purchase access to read the complete article) Abstract This study deals with the relationship between long toes in the hind feet and pain in the gluteal region in horses, and the remedial value of trimming/shoeing that moves the breakover point back at the toe. 77 client-owned horses were studied, 67 shod riding horses retrospectively and 10 barefoot broodmares prospectively. The 10 mares were evaluated twice, and 24 of the 67 riding horses were re-evaluated at the next shoeing, for a total of 111 observations. Each horse underwent gluteal palpation and lateral radiographs of both hind feet. Toe length was quantified as breakover distance (BD), the horizontal distance between the tip of the third phalanx and the dorsalmost point at which the wall/shoe was in contact with the ground. The BD was then shortened with trimming +/− shoeing to a length of ≤15mm (shod horses) or ≤20 mm (barefoot horses). The 24 riding horses were re-evaluated 4-6 weeks later and the 10 broodmares 1 week after trimming. The results showed that of the 67 riding horses, 75% were positive for gluteal pain at initial evaluation. The mean BD for the positive and negative horses was 24.2 ± 1.3 mm and 18.8 ± 2.0 mm, respectively (p = 0.04). At the next shoeing, the mean BD was 10.9 ± 2.3 mm and gluteal pain was improved in all 24 horses; 20 horses (83%) were negative and 4 horses (17%) were now only mildly positive. The 10 broodmares were all positive for gluteal pain initially. The mean BD before and after trimming was 23.7 ± 1.2 mm and 10.9 ± 1.1 mm, respectively. One week later, gluteal pain was improved in all 10 mares; 8 mares (80%) were negative, and the other 2 mares (20%) were only mildly positive. The conclusion is that excessive toe length in the hind feet may be accompanied by pain in the gluteal region and, in our experience, may be associated with gait or performance problems. Shortening the toe can alleviate this pain within days or weeks. Aiming for a BD of between 0 and 20 mm probably is appropriate for the average-size horse.

By Verena K. Affolter, Dominic Dawson, Keita Iyori, Koji Nishifuji, Thierry Olivry, Catherine A. Outerbridge, Anna C. Renier, Yu Hsuan Wang, Stephen D. White, and Laramie D. Winfield Published in the Equine Veterinary Journal (Purchase access to read the complete article) Abstract Hypothesis/Objectives: To describe the clinical, histological and immunological findings of an equine case of pemphigus vulgaris, including the demonstration of antidesmoglein (anti-Dsg) autoantibodies. Case Report: The diagnosis of pemphigus vulgaris was confirmed in a 9-year-old Welsh pony stallion with both direct and indirect immunofluorescence and immunoprecipitation studies, the latter identifying circulating anti-Dsg3 IgG. Treatment with immunosuppressive medications was initiated. Lesions were seen in the perineal area, sheath, mane, tail, eyelids, coronary bands and mucosa of the mouth and oesophagus. Initial corticosteroid treatment improved the clinical signs, but the onset of laminitis necessitated a reduction in dosage, which was associated with a recurrence of lesions and development of oral ulcers. A corneal ulcer developed after 60 days of treatment. Despite treatment with azathioprine, gold salts and dapsone, the disease progressed and the pony was euthanized. Postmortem examination showed additional lesions of the cardia of the stomach. Conclusions and Clinical Importance: Pemphigus vulgaris is rarely diagnosed in equids. We describe a case that was substantiated by the demonstration of anti-Dsg3 IgG. Response to treatment was poor, with the best response to high doses of prednisolone. Equine pemphigus vulgaris is likely to carry a poor prognosis and if there is no response to treatment, humane euthanasia is warranted.

By M. Aleman, P. H. Kass, J. E. Madigan, K. G. Magdesian, N. Pusterla, and L. S. Winfield Published in the Equine Veterinary Journal (Purchase access to read the complete article) Abstract Summary: Reasons for performing study There are currently few data available on the prognosis and outcome of recumbent horses. Objectives: To investigate the outcome of hospitalised horses that had been recumbent in the field or hospital and factors affecting their survival within the first 3 days of hospitalisation and survival after 3 days to hospital discharge. Study Design: Retrospective analysis of clinical records. Methods: Records of 148 horses admitted to the William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis from January 1995 to December 2010 with a history of recumbency or horses that became recumbent while hospitalised were evaluated. Exact logistic regression was used to assess the association between clinical parameters and survival within the first 3 days of hospitalisation and survival to hospital discharge after 3 days. Results: There were 109 nonsurvivors and 39 survivors. Multivariate analysis showed variables associated with an increased odds of death within the first 3 days of hospitalisation included duration of clinical signs prior to presentation, with horses showing clinical signs for over 24 h having increased odds of death (P = 0.043, odds ratio [OR] 4.16, 95% confidence interval [95% CI] 1.04–16.59), the presence of band neutrophils (P = 0.02, OR 7.94, 95% CI 1.39–45.46), the horse not using the sling (P = 0.031, OR 4.22, 95% confidence interval 1.14–15.68) and horses that were unable to stand after treatment (P<0.0001, OR 231.15, 95% CI 22.82–2341.33). Increasing cost was associated with lower odds of death (P = 0.017, OR 0.96, for each additional $100 billed, 95% CI 0.93–0.99). Conclusions: This study demonstrates that the duration of clinical signs, response to treatment and the ability of horses to use a sling are associated with survival to hospital discharge for recumbent horses.

Hemorrhage and blood loss–induced anemia associated with an acquired coagulation factor VIII inhibitor in a Thoroughbred mare By Laramie S. Winfield, DVM and Marjory B. Brooks, DVM Published in the Journal of the American Veterinary Medical Association (Purchase access to read the complete article) Abstract Case Description: A 23-year-old Thoroughbred mare was evaluated because of a coagulopathy causing hemoperitoneum, hematomas, and signs of blood loss–induced anemia. Clinical Findings: The mare had tachycardia, pallor, hypoperfusion, and a large mass in the right flank. The mass was further characterized ultrasonographically as an extensive hematoma in the body wall with associated hemoabdomen. Coagulation testing revealed persistent, specific prolongation of the activated partial thromboplastin time (> 100 seconds; reference interval, 24 to 44 seconds) attributable to severe factor VIII deficiency (12%; reference interval, 50% to 200%). On the basis of the horse’s age, lack of previous signs of a bleeding diathesis, and subsequent quantification of plasma factor VIII inhibitory activity (Bethesda assay titer, 2.7 Bethesda units/mL), acquired hemophilia A was diagnosed. The medical history did not reveal risk factors or underlying diseases; thus, the development of inhibitory antibodies against factor VIII was considered to be idiopathic. Treatment and Outcome: The mare was treated with 2 transfusions of fresh whole blood and fresh-frozen plasma. Immunosuppressive treatment consisting of dexamethasone and azathioprine was initiated. Factor VIII deficiency and signs of coagulopathy resolved, and the inhibitory antibody titer decreased. The mare remained healthy with no relapse for at least 1 year after treatment. Conclusions and Clinical Relevance: Horses may develop inhibitory antibodies against factor VIII that cause acquired hemophilia A. A treatment strategy combining transfusions of whole blood and fresh-frozen plasma and administration of immunosuppressive agents was effective and induced sustained remission for at least 1 year in the mare described here.

By Monica Aleman, Danika L. Bannasch, Carrie J. Finno, Steven R. Hollingsworth, John E. Madigan, Ron Ofri, and Laramie Winfield Published in the Equine Veterinary Journal (Purchase access to read the complete article) Abstract Objective: Neuroaxonal dystrophy (NAD) is a disease characterized by the sudden onset of neurologic signs in horses ranging from 4 to 36 months of age. Equine degenerative myeloencephalopathy (EDM), a disease that has been associated with low vitamin E concentrations, is considered a more advanced form of NAD. The objective of this report is to describe the electrophysiological features of NAD/EDM in American Quarter horses (QHs). Horses: Six NAD/EDM-affected QHs and six unaffected QHs were evaluated by ophthalmic examination and electroretinography. Five of the NAD/EDM-affected QH and five unaffected QHs were also evaluated by electroencephalography (EEG). Results: Ophthalmic examination, ERGs, and EEGs were unremarkable in NAD/EDM cases. Conclusions: Neuroaxonal dystrophy/EDM does not appear to cause clinical signs of ocular disease or functional ERG/EEG deficits in QHs.

Long-term Outcome of Standing Medial Patellar Ligament Splitting to Manage Horses Exhibiting Delayed Patellar Release: 64 Horses By Sarah J. James, Timothy G. Eastman, and Justin D. McCormick Published in the Journal of Equine Veterinary Science (Purchase access to read the complete article) Abstract A standing surgical technique for splitting the medial patellar ligament is described, and the long-term (average 4.5-years) efficacy of the procedure in horses exhibiting delayed patellar release is reported. Medical records of 64 horses that underwent a standing medial patellar ligament splitting surgery performed to treat delayed patellar release were analyzed retrospectively. Horses were sedated in standing stocks. A number 15 scalpel blade was used to percutaneously split the medial patellar ligament from just proximal to its insertion on the tibial tuberosity to its attachment on the parapatellar fibrocartilage, with the goal of inducing a localized desmitis and subsequent thickening of the ligament. Aftercare consisted of oral antibiotics, 14 days stall rest with hand walking, light exercise for 14 days, and full work at 4 weeks. Follow-up information was obtained through telephone calls to owners and/or clinical evaluation by a veterinarian. Results showed that 89% of horses benefitted from the procedure, with complete resolution in 58% of horses and improvement in 31% of horses. A total of 73% of horses were able to perform at the desired level following the procedure; 63% of horses showed signs of improvement or resolution within 30 to 60 days. Two horses had complications following the procedure: 1 horse had an incisional infection, and 1 had a medial patellar ligament rupture. This study shows that standing medial patellar ligament splitting is a successful, long-term surgical option for treatment of delayed patellar release. The procedure has few complications and allows rapid return to desired performance.