Latest from Horse & Hound in Vet-clinic

How to trot a horse up properly H&H subscribers

Horse & Hound — Tue, 07 Jul 2026 15:28:10 +0000

The aim of the trot-up is to allow the observer a clear view of the horse moving in a straight line and in balance, so that the gait can be assessed.

Horses are trotted up primarily to check for soundness. The trot is an even gait, with legs moving in diagonal pairs, so it is the easiest in which to spot lameness or uneven loading of the limbs. A horse may also be trotted up in-hand as part of a sale, to show off his movement.

FEI competitions for all disciplines will include a trot-up (otherwise known as the horse inspection) to check the horses are fit to compete. At three-day events, an initial trot-up takes place prior to competition. A second trot-up the morning after cross-country then follows to check the horses have recovered and are fit to continue to the final showjumping phase.

A trot-up in a straight line as part of a lameness examination allows the vet to make an initial assessment of the horse’s soundness. Further tests, such as flexion tests, lungeing and a ridden exam, may be necessary for the vet to gain more information.

At a pre-purchase exam, the vet is making a full assessment of the horse on behalf of a client. A trot-up is part of the examination, to identify any lameness issues that may prevent the horse being suitable for the buyer’s needs.

In all cases, a good, level surface that is not too loose, slippery or stony will help the horse trot confidently and offer the truest indication of his soundness.

A closer look

It is useful to know what the vet is looking for in these different trot-up circumstances.

As a spectator at a competition trot-up, it may be puzzling as to why some horses pass the trot-up while others are sent to an area called the holding box and occasionally eliminated.

The ground jury and veterinary delegate will assess each horse visually as he stands in front of them, before seeing him trot to evaluate his soundness. Any horse they have concerns about will be sent to the holding box for further assessment.

The vet in the holding box will be able to do a more thorough examination, including palpation and assessment of the horse’s limbs, to help identify any injuries — such as tendon or ligament injuries — which would prevent him from continuing in the competition.

A horse who has sustained a small overreach during the cross-country, for example, or who has pulled a shoe off, may appear slightly unlevel. After veterinary assessment, however, he may be deemed fit to complete a round of showjumping.

There may be horses competing that are poor movers, without having any specific injury that would be exacerbated by competition. At the second trot-up, on the final day, the ground jury will have benefited from seeing competitors at the first trot-up and in the dressage, so will have a clearer view of how each horse normally moves.

Taking the lead

Trotting up a horse correctly is an important skill to learn. The horse should be wearing a bridle for control and be led from the left side. Start by standing him up square so the vet or ground jury can examine him from all sides.

At an event trot-up, you will be expected to walk the horse for a few steps before trotting him away and then back towards the vet and ground jury. When examining a lame horse, or a horse for purchase, I ask to see him walked away and back and then trotted away and back. There is value in seeing the horse moving away and back towards you in both gaits.

The horse needs to be able to move his head freely without being held on a tight rein. The aim is to keep him moving in a straight line and at an even pace.

Stay by his shoulder and walk in a straight line by looking ahead, not at the horse. In trot, it is best to set off at a steady run with an even rhythm — remaining at his shoulder. If you run ahead or turn around to look at him, he may well back off and drag behind you.

It is important to keep the horse’s head and neck straight. If he curls towards you, this can make the gait look uneven and the right hindquarter can swing out and appear to drop away.

Experienced riders will have different ways of presenting a horse well, but I advise people to hold the reins in the right hand, as if you were riding one-handed, with your palm downwards and the reins separated by your hand. You can then place your arm across the horse’s chest so your hand is central, directly below the base of the neck.

With the reins in this position, you can encourage the horse to relax and take a contact with the bridle. He should then drop his head and lift over his shoulders and back, trotting with an even, powerful hindlimb gait.

If you are holding the reins together, in a fist, it is difficult to have much influence on a horse who sticks his head in the air and swings about. You can only apply downward force and he may react against this by putting his head up and hollowing through his back and neck, compromising the way he uses his body and hindlegs.

The horse needs to be able to trot in his own balance and rhythm, so find the pace or speed that suits him — which may mean adjusting your running speed. Don’t worry about your footsteps being in time with his. It’s great if they do match, but you may trip if your legs aren’t the same length as the horse’s and you try too hard.

Return to walk a few strides before the end of the straight and turn the horse away from you by moving his shoulder. This avoids being trodden on or tripped up, which can happen if you turn him towards you.

It is worth practising at home so both horse and rider learn to trot correctly. A horse who is poorly presented may look uneven, even if he isn’t.

Ref Horse & Hound; 17 October 2019

The lameness work-up: what it is and what it can achieve

Andrea Oakes — Thu, 16 Mar 2023 13:02:24 +0000

Poor performance or lameness with no obvious cause may call for an examination known as a work-up. Gil Riley MRCVS explains what’s involved

A lameness work-up is an investigation of the horse’s movement to diagnose injury or damage that is causing pain. The more accurate the diagnosis, the more finely tuned the resulting treatment plan can be. This, in turn, maximises the likelihood of a successful outcome and a return to athletic work in the shortest possible period of time.

A work-up may be performed because a reason for lameness is not apparent, or because performance is below par. There are many causes of loss of performance, including gastric ulcers, respiratory issues and temperament problems. By far the most common problem is orthopaedic pain, resulting from an abnormality somewhere in the musculoskeletal system.The aim of the work-up is to determine the root of this pain, using a sequential series of steps.

Where is the best place for a lameness work-up?

With so many unavoidable variables due to the individuality of every horse, it is important to standardise the procedure wherever possible.

A work-up is ideally performed at a veterinary clinic, where the vet will be familiar with how horses respond to the environment, the handlers and the facilities. These facilities will have been designed to allow the most obvious demonstration of lameness in the horse in the safest way — a small gravel lungeing ring, for example, that enables the horse to be seen moving on a hard surface with minimal risk of slipping.

Typically, one vet will use their experience and the examination results to lead them to the source of pain. A good lameness clinician needs to ensure they remain sufficiently objective to pinpoint the diagnosis. An advantage of bringing a horse to an equine hospital is that there may be more than one specialist, along with gait analysis systems and different imaging techniques that may be unavailable at home.

In certain cases, variations to the procedure may be necessary. A horse that has recently had its shoes removed may not be lunged on a hard surface, to avoid making him footsore, while the riding part would be omitted, of course, for an unbroken or miniature horse.

If the answer is found with the initial, static examination, or on the straight-line trot, the process ends there. It would be inappropriate to put the horse through unnecessary discomfort that would provide no further information.

If a horse will not tolerate nerve-blocking injections, we may opt to introduce imaging earlier than usual to minimise distress caused. This is not ideal, as it will take more time to reach the correct diagnosis, but it is a better alternative to risking injury to the horse, vet or handler.

Unravelling issues

Lameness in the limbs is most common, but pain in other areas can result in poor performance — especially back issues, such as impingement of the dorsal spinous processes (kissing spines) or spondylosis of the vertebrae. Such horses often exhibit no lameness on the straight-line trot or on the lunge, but show profound discomfort during ridden exercise under the weight of tack and rider. They may also resent palpation of the back, alerting the vet to the possibility of a problem in this area.

A work-up can also help to unravel a primary source of pain from secondary complications or compensatory lameness. An example would be hind limb suspensory pain — a common cause of lameness in dressage and event horses. Because it can develop insidiously, and in both limbs simultaneously, the rider may not realise anything is wrong in the early stages. The horse may adapt his movement to minimise pressure on the painful suspensories by moving his pelvis more, causing sacroiliac pain. When his suspensory ligaments are blocked out (numbed), the clinic rider is likely to report that he now moves more freely — but with a stiffness “higher up”. A subsequent nerve block of the sacroiliac area will then lead to further improvement.

Pain relief, such as phenylbutazone, should not be given for at least two days before the exam. Anything that makes lameness less obvious will make obtaining an accurate diagnosis more difficult.

What’s the verdict?

Eliminating possibilities to reach the correct diagnosis can take money and time.

While a definitive diagnosis is obtained in most cases, some may still evade an absolute answer — although a logical and well-supported suggestion can usually be made. Lamenesses that remain undiagnosed are usually suspected as being neurological in origin, emanating from the spinal cord or the associated spinal nerves and plexuses.

The emergence of gait analysis systems has been an exciting development in lameness investigation, particularly for horses that are unbroken or have become unrideable, or where lameness is so subtle that it is difficult for the vet to identify. These systems, however, should be regarded as another tool available to the vet, and just part of the process in uncovering the source of some lamenesses.

A lameness work-up: the process in detail

Part 1: historyThe horse’s background is explored thoroughly, from specifics of ownership and use to any previous lameness issues or suspicions. Other health conditions are also noted, along with the horse’s shoeing regime, the nature and onset date of the current lameness, details of any treatment and subsequent response.

Part 2: static examEach limb is palpated for swellings, heat, bony lumps or signs of traumatic injury, along with response to pressure. The feet are inspected, with attention paid to shoe fitting, the presence of a pulse and any pain upon use of the hoof testers.

The back and neck are palpated for areas of sensitivity or exaggerated pain reaction, and baited (carrot) stretch tests performed to assess neck manoeuvrability.

Part 3: dynamic examA. Straight-line trot: Unless severe lameness is already evident at walk, the horse is trotted away and back on a hard, level surface. As a two-time gait, trot allows direct comparison between sides. All but the mildest cases of lameness are usually apparent. Flexion tests may be performed at this stage. Any change in gait in the trot-away may point to a problem in a joint or an associated structure.

b. Hard-surface lunge: lungeing on a tight circle can provide vital information. Lameness that is particularly obvious on a hard surface may stem from a foot. Noting whether it worsens when the affected limb is on the inside or outside can help to pinpoint the pain source to a certain area of the foot.

c. Soft-surface lunge: lameness that is worse on the soft indicates that the problem is unlikely to be in the foot and may instead be in a soft tissue structure, such as a ligament or tendon. Further clues can be gained if it worsens in one direction.

d. Ridden exercise: the majority of lameness work-ups are brought to us by owners not because a horse looks wrong, but because he feels wrong.

An experienced rider can be invaluable in helping the vet determine the source of this abnormal movement, or lameness, by reporting, for instance, that the horse feels choppy on both front limbs, is not tracking up with a hindleg or resents pressure on his back.

Part 4: nerve blocksPossibly the most important tool in lameness diagnosis and often the cornerstone of the investigation. While “pain” cannot be imaged, the vet can narrow down the problem by progressively blocking out regions of the affected limb, or spine, before re-assessing movement. If an area is no longer painful, a horse’s gait will improve significantly — indeed, he may become sound. Such a response will categorically regionalise the source of pain.

Part 5: imagingWith the source of pain localised, imaging can be employed to assess the specific area — commonly radiography, ultrasonography, MRI (magnetic resonance imaging) and nuclear scintigraphy. Using information about the damage found, along with knowledge and experience of dealing with lameness, the vet may reach a diagnosis and formulate a treatment plan.

This feature was first published in Horse & Hound magazine; 9 January 2020

You might also be interested in:

Vet feeling a horses leg during a lameness examination (Image credit: Lucy Merrell)

Lameness in horses: what every owner needs to know

(Image credit: Lucy Merrell)

How blocking a horse’s nerve or joint can help locate a source of pain

(Image credit: Lucy Merrell)

Suspensory ligament injuries: what owners need to know

(Image credit: Lucy Merrell)

Kissing spines in horses: what all owners need to know

(Image credit: Lucy Merrell)

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Pelvic fractures in horses: all you need to know

Andrea Oakes — Fri, 13 Aug 2021 18:32:29 +0000

BEFORE discussing pelvic fractures in horses, you need to understand the anatomy of horse’s pelvis, which connects the spine to the hindlimbs. Many powerful muscles attach to this structure; during locomotion, massive forces generated by the hindlimb musculature are transmitted through the pelvis into the spine, propelling the horse forward.

The equine pelvis is formed of three zones: the ilium, pubis and ischium, with the left- and right-hand sides forming a mirror image of one another. The ilium extends upwards and in front of the hip joints on either side, to form broad, curved surfaces called the ilial wings – which end at the obvious bony prominences called the tuber coxae. The pubis and ischium extend behind the hip joint and form the floor of the pelvis, connecting left and right sides at the rigid central joint called the pubic symphysis. The ischium ends with the tuber ischii, the bony prominences positioned either side of the tail.

(Image credit: creditUnknown)

Types of pelvic fracture in horses

THE most common type of pelvic fracture seen in horses outside racing is of the tuber coxae. Due to its superficial position on the side of the pelvis, this bony prominence takes the majority of collisions with stable doors or fences, or if a horse slips and lands on concrete, for example. These fractures may be seen with skin wounds or contusions, and the fracture severity depends on the force and angle of the collision.

Similar to these are fractures of the tuber ischii, which forms the point of the buttock. Damage is typically sustained when the horse backs into a wall, or slips with his hindlimbs beneath him to land in a sitting position.

Stress fractures commonly occur within the pelvis, due to the repetitive stress of exercise. These are typically seen in racehorses, due to the repeated demands of the work performed, but also in equine athletes in other disciplines where high-intensity training is regularly undertaken.

Bone is constantly adapting, or remodelling, to ensure that it is strong enough to cope with the forces experienced during exercise. The way this material adapts without becoming too heavy is by a coupled process, where new bone production and resorption – the natural breaking down of old bone – work hand in hand.

Excessive repetitive stress can result in this balance being lost, however, which in turn can lead to a stress fracture. Stress fractures in the pelvis, like those of other bones, develop in predictable locations, the most common of which is within the ilial wing.

Signs of pelvic fractures in horses

SIGNS that a horse may have fractured his pelvis include moderate to severe lameness, usually evident at a walk. Some types of pelvic fracture may also lead to more specific changes in how the horse walks. If the tuber ischii is fractured, for example, the horse may be reluctant to bring the affected hindleg forward as this will tighten the muscles running over this area.

Swelling of the affected region may also be seen. This can range from obvious bleeding and distortion to more subtle signs of asymmetry. A crunching feeling, termed crepitus, is sometimes evident upon examination as the bone fragments rub against each other. Most often, any associated bleeding is self-limiting, but if one of the major vessels – for example, those running across the shaft of the ilium – is damaged, a fatal internal bleed can occur.

Diagnosis can often be made from the clinical features described. Sometimes, more information is gained by internal examination via the rectum. Attempts at diagnosing pelvic fractures with X-rays are often unrewarding, because the huge muscles surrounding most of the pelvis reduce what can be seen.

Ultrasound, while not often used to diagnose fractures, is very useful for pelvic fractures in the horse. Only the surface of the bone is visible, but any displacement of the fracture fragments or significant bleeding into the muscle can typically be seen.

Stress fractures, in particular, are difficult to identify, and can easily be missed or misdiagnosed as a “pulled muscle”. But it is important to diagnose a stress fracture as continued exercise may result in a much more severe or even life-threatening fracture.

Diagnosis often requires advanced imaging with nuclear scintigraphy (bone scan), which is a sensitive method of pinpointing the site of injury. A radioactive element called technetium-99m is injected into the area and binds to a molecule, which then attaches to the calcium-containing crystals where new bone is being formed. Radiation is emitted from this compound and an image of the bone activity can be seen with a special detector.

During a bone scan at the clinic, the camera is angled to get the best view of the ilial wing. (Image credit: creditUnknown)

Treatment of pelvic fractures in horses

IN the majority of cases, treatment of pelvic fractures in horses involves conservative management. Depending on the severity and location of the fracture, and the horse’s comfort level, he will typically be given a period of stable rest ranging from six weeks to three months, before walking exercise can be re-introduced.

When there is significant risk of the fracture displacing further and causing injury to important vessels, cross-ties are often used. This involves keeping the horse tied up in the stable, wearing a padded headcollar, to prevent him from lying down and incurring further injury. If this is necessary, the horse will need close monitoring and pain management. He must be allowed regular breaks to lower his head so that mucus can drain from his nostrils, to prevent lung infection.

Surgery is rarely used to treat pelvic fracture. The requirement for a lengthy period of general anaesthesia usually rules out surgical repair in adult horses, but this has been successful in foals.

Surgical intervention is usually only required to remove problematic fragments of bone that are painful or infected, or those involved with an open wound. Ilial wing fractures, for example, often produce a spike of bone that presses against the skin and requires removal.

The severity of a fracture often relates to whether or not the horse can bear weight, despite the injury. Involvement of the hip joint or disruption of the overall stability of the pelvis are key determinants in the prognosis. The pelvis is also close to several large and important vessels, which can be damaged during fracture.

Injuries to areas that are important for muscle attachment may not impact as much on weight-bearing, and are generally less severe. A common example of this is fracture of the tuber coxae. A horse with this injury is typically very lame for one to two days, before displaying a rapid improvement in comfort levels.

This injury is often referred to as a “knocked-down hip”, as the fractured tuber coxae ends up lower than normal on the affected side. Horses who sustain this fracture generally make a full return to athletic function, despite a permanent change to the shape of the pelvis.

Meet the vets

MATT SMITH MRCVS, a Royal College of Veterinary Surgeons (RCVS) specialist in equine surgery, is a surgeon and partner at Newmarket Equine Hospital (NEH). Matt Chesworth MRCVS, also based at NEH, is a European specialist in equine surgery. This referral hospital is one of the largest in Europe, treating a wide range of leisure and sport horses from throughout the UK. Contact: 01638 782020, newmarketequinehospital.com

Common ear problems in horses and how to deal with them

Andrea Oakes — Sat, 17 Jul 2021 08:03:11 +0000

From hearing and health issues to how they tell a horse’s feelings, Kieran O’Brien MRCVS delves into the outer ear of the horse

A HORSE has 10 muscles to control ear position and movement, enabling more manoeuvrability than in any other domesticated animal. Each ear is independently mobile and so they can be moved in different directions at the same time.

These adaptations, combined with highly sensitive hearing, allow what was originally a prey animal to be extremely responsive to approaches by other animals that signal threat – and to locate these threats very precisely.

The external ear, termed the pinna, comprises a funnel-shaped vertical tube (the vertical canal), made of cartilage with overlying skin. This is joined at the base via a right-angled bend to a short, horizontal tube, which in turn connects to the eardrum.

A thin coating of wax is produced by glands that line the canal. This wax not only serves to keep the ear surface moist and to trap small particles that may enter the ear, but also has antimicrobial activity against bacteria and fungi. A natural ear wax “escalator”, assisted by jaw movement, transports the wax along the canal to the outside.

Because a horse’s ears are vertically placed, there is the potential for rain or objects such as seeds, dust, pollen and insects to become lodged inside them. For this reason, the ears are lined with a dense coating of interlocking hairs that filter out everything except sound waves.

Accumulations of wax on the hairs below the ear can be snipped off with a pair of scissors, but clipping of the hair inside the ear for cosmetic purposes is strongly discouraged – the hair is there for a very good reason.

If the inside of the ears must be wiped, only a damp cloth should be used because liquid should not be allowed to run down into the ear.

Be vigilant, however, for any sign of ear irritation or discharge, or any abnormal growths on the ear surface, both externally and internally.

What can a horse’s ears tell you?

EAR position may indicate pain, fear, curiosity and anger. Horses use body language rather than vocalisation during their social interaction with other horses, and ear position is a key indicator of mood during these interactions – signalling aggression or submission.

A study of free-ranging ponies on the Isle of Rhum in Scotland found that 80% of aggressive encounters between animals consisted of threats with the head alone, by pinning the ears back and extending the neck. It is also assumed that when horses fight, the ears are held pinned back to protect them from injury.

Recent studies looked at the facial expressions, including ear position, of lame and non-lame horses when being ridden. It was found that the ears were behind the vertical in 43% of non-lame, but in 77% of lame horses. We are only now beginning to understand how horses signal their “wellness” via their facial expressions. Ear position may be a key element in this.

The drooping of one ear to the side and loss of motor control may indicate paralysis of the nerves controlling the ear muscles. This can occur due to damage to the facial nerve, infection in the guttural pouch or inner ear, and arthritis of the joint between the hyoid bones (that sit between the two halves of the lower jaw) and the skull.

Common ear problems in horses

ANY irritation in the ears can cause a horse to shake his head. Although headshaking behaviour is often attributed to ear mites, the prevalence of these in the UK is now low.

Where present, the mites cause irritation, ear rubbing and shaking of the head in random directions. This contrasts with the true equine headshaking syndrome, where there is no ear rubbing, the “shaking” action is almost solely a vertical “flip” of the head (mainly when ridden) and the irritation occurs in the nose, not the ears.

But the face and ears are common biting sites for midges. An allergic response to their saliva is triggered in horses suffering from sweet itch. In advanced cases, self-trauma will result as the horse tries to relieve the irritation caused by histamine release in the skin. The skin can be rubbed almost raw, which can cause bleeding sores, so protect this region with a fine-meshed face mask that covers the ears.

Blackflies can attack the skin on the inside of the horse’s ears and in the midline, in front of the udder or sheath. They suck blood and in doing so, can spread a papilloma virus that causes flat, scaly and initially circular white-grey zones in the ears.

Sometimes, these warty “aural plaques” proliferate and protrude from the skin. Some regress spontaneously, but others persist for life. They are rarely treated as they do not cause a clinical problem, and any treatment will usually result in a head-shy horse.

Thought to be caused by a cattle wart virus, probably spread by flies, sarcoids can develop anywhere on a horse’s body, including occasionally on the ears. They may look like an area of hairless, scaly skin or appear as growths that enlarge over time. Melanomas and squamous cell carcinomas can also occur in the ear area.

These tumours must be treated early when small, to ensure the treatment is effective and the horse does not become head-shy as a result. Topical chemotherapy may be successful, but some growths require removal; a surgical laser is often used on sarcoids and tumours, but this can be hazardous in the ear region due to the risk of damage to the cartilage underlying the skin.

A rare occurrence at a young age is an opening on the front margin of the ear flap that oozes a sticky fluid. Called a dentigerous cyst, this communicates with an abnormal area of dental tissue – sometimes an entire tooth – usually close by in the head. This developmental abnormality rarely causes any other symptoms and usually can be safely left untreated.

Why ears must be handled with care

HEAD-SHY horses are commonly encountered in veterinary work. While some animals will accept their ears being handled, others instinctively resent the touch. These horses must be desensitised by careful and skilful repetition, using behavioural techniques from a young age.

Any veterinary procedure involving the application of creams and other treatments to the ears must not be embarked upon lightly, because even with the greatest care, head-shyness can result.

Applying a twitch (a restraining device) to the ear is strongly discouraged. A study found that while a twitch applied to the upper lip lowers the heart rate and is calming, an ear twitch causes a rise in heart rate and blood cortisol level – indicating the horse is in pain.

This Vet Clinic feature was first published in 15 July issue of Horse & Hound magazine

The challenges associated with getting horses fit and how to solve them H&H Plus

Andrea Oakes — Mon, 12 Jul 2021 07:59:17 +0000

What could be behind a horse’s failure to develop or maintain fitness as expected? Andrea Oakes investigates

YOU prepared him methodically for the season, but your horse’s energy reserves seem unusually low. Or perhaps his fitness levels are not progressing, despite the fact that you’re following a training programme.

Before delving too deeply into the potential veterinary issues, performance horse consultant Peter “Spike” Milligan MRCVS advises first placing your training techniques under the microscope. Only then can a horse’s fitness – or lack of it – be objectively assessed.

“A competition horse needs to be just fit enough,” says Spike, a British Eventing youth performance squad vet. “Event horses at the lower levels are often too fit, which can compromise their soundness, appetite and condition, as well as their ability to achieve a good dressage score. Yet a slightly overweight, underfit eventer is at risk of injury.

“A good starting point is to understand the athletic demands at your horse’s level,” adds Spike. “You can then set measurable fitness parameters.”

To benchmark fitness levels, Spike suggests using a stopwatch and a horse heart-rate monitor.

“You can then assess fitness by speed of recovery, recording the time taken after a work period for the horse’s respiratory rate to return to 16 breaths per minute – or for his nostrils to stop flaring. If you do two six-furlong gallops, for example, the trend should be for the recovery time to shorten.

“Bear in mind that genetics play a part in a horse’s fitness capacity,” adds Spike. “A horse with more thoroughbred in his breeding will have greater innate fitness and an ability to maintain this. A warmblood, however, may have more power and endurance but less speed.

“Age also matters,” he adds. “The equine cardiorespiratory system is incredibly efficient; young Flat racing horses are on the track at two to three years, but they are still maturing skeletally. While older competition horses may be more at risk of developing an injury that rules out work, they tend to retain a natural degree of fitness. Their riders often know them well and know how to bring them to the required level. It’s all about understanding the horse you have.”

Using a heart rate monitor

While a phone app can tell you how fast a horse is moving, a heart rate monitor will tell you how hard he is working.

“A horse’s heart rate must rise above 180 beats per minute to reach the anaerobic zone,” says Spike. “He needs to work, otherwise you’re not achieving much.

“To push your horse’s heart rate up, you need to go further, faster or steeper. If you go steady, you’ll need to go that much further. The trick is to find the balance, maximising the effect of his training without undue wear and tear or increased injury risk.

“You may need to train a horse to gallop, as some warmbloods will only do a fast canter and never really raise their heart rate. But be careful that a buzzier thoroughbred type does not lull you into a false sense of security – he may be fine for up to six or seven minutes at his first long-format event, but he’ll run out of steam if you’ve not primed his anaerobic pathway and his body is not ready.”

Missing a beat

PROVIDED a training programme is progressive, is tailored to the individual and incorporates rest days, fitness should follow. If a horse remains under par, the areas examined first are usually the heart and lungs.

“While equine heart disease is relatively uncommon, we would check for a correct rhythm, with no murmurs, using a stethoscope on the horse at rest,” says Spike. “The most typical issue is atrial fibrillation, although horses with this irregular or abnormally fast heart rate tend to present with marked exercise intolerance and tire very quickly.

“The next step is to perform an electrocardiogram [ECG], in the stable or while the horse is ridden, to further examine the heart rhythm and electrical activity,” adds Spike. “A specialist can run a heart scan – an echocardiogram – to assess the structure of the heart.

“An irregular beat can occur when the heart enlarges. This is sometimes due to a problem, such as a leaky valve, but is also seen in very athletic horses with a bigger heart. Famously National Hunt horses Denman and Sprinter Sacre both suffered atrial fibrillation during their careers. This condition sometimes corrects itself, or may require medical treatment or even electrical cardioversion, where the horse’s heart is shocked back into normal rhythm under general anaesthesia.”

(Image credit: creditUnknown)

Lung and respiratory health is also key to performance.

“Low-grade inflammation in the lungs can be limiting,” explains Spike, referring to airway disease caused by challenges in a horse’s breathing environment. “This can be assessed with blood samples, or by sampling mucus in the lungs after exercise.

“Airway health tends to be under-appreciated,” he adds. “While minor airway issues can be managed with medication and treatment, it is vital to maintain a clean environment for the competition horse.

“Use only good-quality bedding and forage, and aim to reduce the respirable particles and chemical irritants a horse can breathe in, such as dust, cobwebs and ammonia. Vaccinating all yard horses against the equine herpes virus will also contribute to respiratory health.

“There may be a limitation in the airway that prevents air from entering and exiting the lungs correctly,” continues Spike, explaining that horses with these issues were previously termed roarers or whistlers.

“If noise is heard and considered a potential problem, your vet may recommend an endoscopy to examine the larynx and the back of the throat. This can be performed in the stable, but may be more revealing during exercise – termed an overground endoscopy.”

Delving deeper

“POOR performance is often due to orthopaedic problems, so a thorough lameness evaluation is an essential part of the process,” says Spike. “Blood testing can also reveal post-viral conditions that can lead to low white blood cell counts and anaemia.

“Check you’re feeding the right fuel,” he adds. “Different disciplines have specific requirements. An event horse needs a tailored diet for endurance, incorporating more oil and fibre, whereas those in dressage or showjumping need more heating food for quicker power.

“Ensure a constant supply of drinking water and consider feeding electrolytes for healthy muscle function. These should not be necessary every day, unless a horse is sweating hard.

“Diet is also linked to muscle function,” says Spike, explaining that muscle problems can lead to exercise intolerance.

“The condition exertional rhabdomyolysis, known as tying up, is seen in its most extreme form as acute muscle cramp, but can occur as more subtle but nevertheless performance-limiting muscle damage. Blood samples and muscle biopsies can reveal more. While close observation of muscle enzymes is key in racing, problems can be limiting at all levels with the competition horse, depending upon the individual.”

More in-depth diagnostics, such as blood lactate testing, are available but seldom necessary.

“The answers are usually to be found closer to home,” says Spike. “It is rare for a horse’s fitness levels not to improve with a planned, varied and progressive exercise programme that, ideally, is easily measurable.”

This exclusive veterinary feature is also available to read in Thursday 8 July’s Horse & Hound magazine

Summer allergies in horses and how to combat them

Andrea Oakes — Mon, 05 Jul 2021 11:10:38 +0000

Coughing, sneezing or a cluster of skin bumps could indicate a summer allergy, as Richard Hepburn FRCVS explains

THE summer months bring increased levels of specific allergens (a molecule capable of eliciting an allergic response), namely pollens, fungi and insects.

Pollen released from grasses and trees peaks from 5am to 10am. As intact pollen is too large to enter the small airways of the lung, it is deposited on the horse’s skin and in the upper respiratory tract, mouth and eyes. Rain and moist conditions can cause pollen to shatter, liberating much smaller particles that can enter the lung.

Fungi exist in a symbiotic relationship with many grasses, and within hay are already implicated in stable-associated asthma. These fungi are also present on different parts of the growing grass plant, and the release of their spores increases with humidity – leading to peak airborne fungal spore levels in the early morning. Levels also rise during warm and windy weather.

Fungal spores can travel a great distance; in summer, your horse is not only exposed to local fungi, as he is in winter in the stable, but to those from a wider area.

Consistently warm weather creates an increase in flying insects. As they feed on your horse, they produce chemicals in their saliva which act as allergens.

Insects vary in their chosen feeding location on the horse and preferred feeding time. Culicoides midges breed near standing water, but will travel up to half a mile to feed, following a carbon dioxide trail from exhaled breath. Most active at dawn and dusk, they are poor fliers and struggle with windy conditions, congregating near hedgerows and woodland. Different midge species feed on different parts of the horse; the more species present, the more widespread the lesions.

However, horseflies feed during the daytime on the flanks, sides of the chest and upper legs, tolerate windy conditions and breed on vegetation near water.

Understanding the allergic response

TO be allergic to something, a horse first has to become sensitised. When he is bitten by an insect or inhales pollen, a cellular response triggers the production of immunoglobulin E (IgE). This prompts the release of histamine, a chemical that increases blood flow and blood vessel permeability.

Accumulation of fluid follows, seen as skin wheals or airway oedema (swelling), leading to wheezing and the stimulation of nerve endings to cause itching, sneezing, coughing and narrowing of the airways – occurring within 15 minutes of allergen exposure.

Activation of a second inflammatory cell in the bloodstream, the basophil, leads to distant site allergic reactions. Mast cell stimulation also causes a later phase, typically four to six hours after exposure, which can last for days or weeks and is characterised by the deposition of fibrin (scar material) and remodelling of affected tissues.

Re-exposure to allergens causes the immune system to remodel, leading to a more aggressive and rapid memory response.

The most common problems

The main summer-associated allergic conditions are:

Equine pasture asthma (EPA)

Summer EPA worsens with increased turnout, especially during hot months. Signs of coughing during exercise, a high breathing rate during and after exercise, and poor performance typically begin in July, persisting until October. Many horses also show signs of breathing difficulty at rest, essentially having an asthma attack.

Mature horses are more at risk, reflecting prolonged recurrent allergen exposure. The specific cause of EPA has not been identified, but is likely to be high levels of pollens and mould spores, especially after crop harvesting.

Allergic rhinitis

Anecdotally, many owners report watery nasal discharge, sneezing and nose rubbing in their horses when the pollen count is high. Some horses also show signs of allergic conjunctivitis, with swollen eyes.

Insect bite hypersensitivity (IBH)

This is a hypersensitivity reaction to Culicoides midge species (termed sweet itch) and to other biting insects such as gnats, mosquitoes, stable and horseflies. Allergic reaction can be immediate (type one), causing urticarial wheals or hives, or delayed (type four), where itching and crusting develop a day or two after the bite. Often, horses exhibit both types of reaction.

What causes headshaking?

AN imbalance between types of T-lymphocytes (a component of the immune system) is found in allergic humans and dogs, due to genetic or environmental factors such as breed or diet, and leads to a magnified response to allergen contact. Defects in epithelial barriers (such as the nostril lining) may also contribute to human allergy, with reduced resistance found in those with chronic hay fever. Genetic variation in enzymes responsible for moderating the allergic response in the skin or respiratory tract has also been identified.

A certain cytokine (a small protein implicated in the body’s infection response) has been found in increased levels in the airways of horses with equine asthma. Similar mechanisms may mediate equine allergic disease, but it is not clear whether these changes are responsible for a horse being more likely to become allergic or have developed subsequent to him becoming allergic due to chronic low-level environmental exposure.

A recent study in the US showed that obese horses were more likely to have summer EPA. A more severe type of human asthma has emerged associated with obesity, with a poorer response to treatment. While human obesity is believed to promote a state of increased inflammation, the magnitude of its relevance to increasing the risk of allergic disease is unclear.

Management plan

DIAGNOSIS is usually based upon clinical signs, but if IBH skin lesions are unusual, a biopsy may exclude other diagnoses.

There are no definitive tests for sweet itch allergy. Blood sampling for IgE measurement or intradermal skin testing are insensitive, as it is unlikely that the test allergen will be specific to the midge species affecting an individual horse – although more detailed testing shows potential.

Intradermal skin testing can be more useful when IBH is part of a wider skin allergy problem. In EPA, airway endoscopy and sampling of airway fluid for cytology can be used to define the severity of disease and the likely duration of treatment.

Treating allergic disease depends on the severity of the clinical signs. If your horse has an allergic event, call your vet straight away. Human antihistamines are not particularly effective in horses, as their absorption from the gut is variable – meaning that a large number of tablets is needed and benefits are slow to materialise.

The mainstay of treatment is corticosteroid anti-inflammatories, given orally or by injection, on skin or inhaled into the respiratory tract. With EPA, bronchodilator drugs to relax the airways may be needed.

If your horse appears to have a summer allergic skin reaction, move him inside and hose him with cold water to help remove allergens and reduce development of skin swelling. Using colloidal oatmeal shampoo can reduce itching while you wait for the vet.

IBH-specific treatments, including allergen-specific immunotherapy and dietary manipulation using vitamin B3 and omega-3 fatty acids, have shown variable results. However, an Australian study showed that a plant extract emulsion spray significantly reduced clinical signs. Your vet can advise you about IBH management methods, such as sweet itch rugs and the fly repellent permethrin.

Management of horses with EPA is challenging, as it is difficult to remove the horse from the allergen source. An individual approach is required, based on an appropriate treatment plan, monitoring of airway health and corticosteroid treatment.

.This Vet Clinic feature is also available to read in Horse & Hound magazine, on sale date Thursday 1 July 2021

Grass sickness: how new research is shedding light on the disease

Andrea Oakes — Sun, 27 Jun 2021 11:00:17 +0000

A new approach to equine grass sickness research aims to shed light on the causes and risk factors of this disease. Andrea Oakes reports

CASES of equine grass sickness (EGS) typically peak during early summer months. While the causes of this often fatal disease are still unclear, more than 100 years after its discovery, a new biobank project aims to provide researchers with the information they need to make a breakthrough.

Dr Kathy Geyer, EGS research fellow at Moredun Research Institute, explains that the disease mainly affects horses that have access to grass – although there have been isolated cases in stabled horses.

“EGS has an extremely high mortality rate, with 80% of cases resulting in euthanasia on welfare grounds,” she says. “The clinical symptoms are non-specific [not due to any single known cause] and, without a reliable diagnostic test, diagnosis is challenging. As a result, many cases are mis- or undiagnosed, most likely leading to an underestimation of actual disease prevalence.

“What is evident is that EGS is a highly complex and enigmatic disease and therefore very challenging to work with,” adds Kathy. “Decades of research have led to various different hypotheses on the cause, but with a single causative agent yet to be confirmed, EGS is now thought to be of multifactorial origin.”

Locations of the 27 incidences of EGS that so far have been reported to the biobank project team in 2021 (Image credit: creditUnknown)

SAVING SAMPLES

SO what is the biobank – and how might it help?

“Progress in EGS research has been hampered by the lack of coherent sample collections,” says Kathy, saying that the Moredun Foundation and the Equine Grass Sickness Fund, with support from the British Horse Society, have launched the initiative.

“By collaborating with vets and owners, the biobank project aims to collect samples from EGS cases and co-grazer control horses that would otherwise be lost, so that horses have not died in vain. These samples will be available to any researcher working on EGS and will encourage an interdisciplinary approach in the search for the potential causes.”

These samples may be biological, such as blood, saliva or urine, or environment related, adds Kathy, and will be collected at no extra cost to the owner. Tissue samples are especially valuable. Since the course of EGS can be swift and frequently devastating, owners are encouraged to familiarise themselves with the project ahead of time – should the worst happen.

“There is just a small window of opportunity to collect the samples when grass sickness is suspected, so it would be helpful to think about and prepare for this in advance so these valuable samples are not lost,” she says.

“In addition to collecting samples, we are working with owners to encourage the completion of our case report questionnaire, which will give us valuable information about potential risk factors and general understanding of the disease.”

Many chronic EGS caseshave a tucked-up appearance and this recognisablestance. Sadly, few survive (Image credit: creditUnknown)

RISK FACTORS

HORSES can be affected by EGS at any time, but the spike in cases in spring and early summer is often followed by a second peak in autumn. Kathy explains that horses in eastern parts of the UK are at higher risk, with the north-east of Scotland having the highest incidence.

“There may be a weather-related aspect,” she says. “Vets and owners experienced with EGS are on high alert after a dry, but cool [around 10°C] spell lasting around 10 days, or periods with sunny days and intermittent ground frosts. Furthermore, younger horses appear to be at a higher risk, with a peak between two and seven years of age.

“The disease involves damage to the nerves in the digestive tract and other sites throughout the body, severely affecting the horse’s ability to swallow and impairing movement of gut contents,” she adds. “This can lead to complete paralysis of the digestive tract from the oesophagus downwards.

“Based on the underlying nerve damage and disease progression, there are three main forms of the disease: acute, subacute and chronic. Although euthanasia is generally the only option for acute or subacute EGS, under certain circumstances, treatment may be considered for chronic cases.

“With intensive and skilled care, around 50% of them survive,” Kathy says. “However, nursing a chronic case is physically, emotionally and financially demanding.”

For details about the biobank project and relevant downloads, visit: grasssickness.org.uk/biobank/biobank-for-horse-owners

This report can also be read in Horse & Hound magazine, on sale date 24 June 2021

What’s new in the veterinary world? How harmful is bute and findings on asthma H&H Plus

Andrea Oakes — Sat, 26 Jun 2021 08:00:03 +0000

Medicine side effects are under the spotlight, in the latest research from Peter Green MRCVS

RISKY BUSINESS

FOR years, equine vets and owners have been familiar with painkiller phenylbutazone (bute), but we now know it is not the harmless medicine it was once perceived to be – and should not be given long term or as a routine medication.

Bute is classed as a non-steroidal anti-inflammatory drug (NSAID) and other medicines in the same family have recently been developed to treat inflammation and pain – such as meloxicam and flunixin, which have fewer side effects.

Vets in Denmark studied horses given these NSAIDs when they were treated at the veterinary hospital in Copenhagen; those with no history of colic, low worm burdens and under treatment for issues such as lameness and respiratory problems received these as part of their therapy.

Within two days of starting their course, some horses developed thickening of the colon wall and, during the course of treatment, most showed signs of mild colic or diarrhoea. However, none of the control horses – which received no NSAIDs – showed any of these signs.

These findings show that even the newer, “kinder” NSAIDs are likely to cause some irritation or inflammation of the bowel. The Danish vets point out that the side effects were mild and that all the horses needed the pain relief the medicines provided. Withholding NSAIDs from horses in pain would be cruel, but we must be aware that using them to excess, or unnecessarily, can present real risks.

BREATHING SPACE

VETS in Canada have reviewed all published evidence on the use of glucocorticoids (also known as corticosteroids, or GCs) in horses with equine asthma.

Medicines like prednisolone and dexamethasone are the mainstay of therapy for many equine asthma patients. There are long-standing suspicions, however, that these drugs are occasionally associated with serious side effects, such as severe laminitis and immunosuppression. Some powerful GCs, like triamcinolone, are usually only used for injection into joints because of the risk of such side effects.

The vets confirmed that there are risks of side effects with GCs given by mouth, or by injection into the muscle or bloodstream. The risk of laminitis seems to be greatest in patients that have suffered laminitis before, or if the patient is particularly stressed. However, they concluded that there is no risk of laminitis if the GCs are given by inhalation, using nebulised preparations.

One rather quirky finding was that powerful GCs like triamcinolone have a positive effect on lung function, even when they are injected into joints. The vets suggest that some sport horses that appear to perform more effectively after their joints are injected are actually improving because their lungs – not their joints – are working better.

Summer colic casebook: the dangers during warmer months

Andrea Oakes — Sat, 05 Jun 2021 14:00:38 +0000

Colic can occur at any time, but what are the dangers during warmer months? Andrea Oakes investigates

WE’RE familiar with the risk of impaction colic in winter, when the move to an indoor lifestyle – together with a drier diet, possibly less exercise and often less inclination to drink – can combine to bring a horse’s intestinal movement to a grinding halt.

But colic in horses still occur in summer, when lush grass and sudden management changes can cause abdominal upsets. Since risks from issues such as internal parasites and dental problems are ever-present, vigilance is required year-round to keep the digestive system running smoothly.

One seasonal danger is sand ingestion, which typically occurs before spring grass comes through or later in summer when pasture is poor. A grazing horse may swallow the sandy soil that is pulled up with the grass roots or splashed onto the grassy leaves by heavy rain after a dry spell.

Sand can also be swallowed during sand paddock turnout, usually with hay that is fed from, or falls to, the floor. The gradual accumulation of a large amount in the gut may cause subtle signs, or none at all, but some horses can develop potentially life-threatening sand colic.

SHIFTING SANDS

IRISH Sport Horse mare Joules was found sweating and exhausted in her stable one morning last autumn, rolling relentlessly in an attempt to relieve pain.

A clinical examination revealed fairly normal gut sounds, but rectal palpation suggested displacement of the colon and the presence of abdominal gas – enough for the attending vet, Chloe Marsden MRCVS, to recommend immediate referral to the Bell Equine hospital. Surgery was required to remove a huge amount of sand from Joules’ large intestine – enough to fill nearly three buckets.

“Most sand colics can be treated medically, with oral laxatives, but not in Joules’ case,” says surgeon Evita Busschers MRCVS. “We suspected an impaction, based on our clinical examination findings. A radiograph [X-ray] of the abdomen can confirm a more specific diagnosis of sand colic, but she was in too much discomfort to X-ray. Exploratory surgery was the only option.”

The large colon is eased out during sand colic surgery to flush out any sludgy sediment (Image credit: creditUnknown)

While a small amount of ingested sand may pass harmlessly through a horse’s system, if swallowed in larger quantities, it sinks like a sludgy sediment to the bottom of the colon. Its abrasive nature can then irritate the delicate gut wall and cause a colitis-type inflammation or, as with Joules, it can “silt up” the narrower parts of the colon – typically the pelvic flexure.

“The process can take weeks or even months, causing partial or total blockage,” explains Evita. “Food can’t move around easily and gas builds up, putting the bowel at risk of a twist or torsion.

“The biggest risk with surgery, aside from the general anaesthetic, is rupture of the colon,” she says, describing how the bowel must be lifted out through an incision along the horse’s abdomen and onto a tray. “A colon full of sand is so heavy. Sadly, the chances of a catastrophic tear are quite high.

“Once the colon has been manoeuvred and opened, the sand is flushed out with a large volume of water using a surgical hose pipe. The gut is then sutured, the area is rinsed to reduce the chance of abdominal contamination and the colon is replaced.

“The interior lining of the bowel renews itself within five to seven days, so any abrasion usually heals quickly once the inflammatory component – in this case the sand – is removed,” adds Evita. “Depending on how much sand we’ve been able to remove, we may feed psyllium [a laxative] for some time afterwards to encourage any remainder to pass out with the droppings.”

ON HOME TURF

SIGNS of sand accumulation include chronic diarrhoea, weight loss or a milder colic due to low-grade, grumbling pain, but there may be few clues.

“Looking back, Joules was napping in an unusual way at a cross-country schooling session the week before, and her coat was a bit dull,” says her owner, Jordan Harvey. “But she was otherwise well.

“At the start of summer, I had moved her to a new yard, from clay soil onto sandy soil. She was turned out every day, but there was less grass available.”

A belly band helps support the site of the surgical incision (Image credit: creditUnknown)

During a prolonged recovery, Joules suffered nasogastric reflux – a pooling of fluids in the stomach – requiring removal every three hours by nasogastric tube. A secondary gastric impaction then had to be broken down by lavage with further fluids, including Coca-Cola, and once back at home she needed treatment for an infection at the surgical site.

“Gradually, the wound healed and she became stronger and healthier,” says Jordan, who has moved Joules back to the original yard and hopes to jump her again soon. “I had no idea she had eaten so much sand. I’m so grateful to my own vet and to the hospital team; without it all coming together, she might not have pulled through.”

Happy and healthy, Joules is back in work with Jordan (Image credit: Jordan Harvey)

Could it be sand?

(Image credit: creditUnknown)

“THE old test for sand in the digestive system involved mixing droppings with water in a suspended plastic glove”, says Karen Coumbe MRCVS. “The theory is that, over time, any sand present will sink down into the fingers, but that is rarely convincing.

“Researchers in Finland recently published studies that described the test as “moderately accurate”, but noted that while a positive test is usually correct, it does not reveal the severity of the condition. Neither does a negative result rule out the problem. The glove test may be a useful diagnostic tool if you are worried about horses grazing on very sandy soil, but it is far better to consult your vet, who may recommend X-rays, ultrasound and rectal examination to provide a clearer picture.

“Horses in Finland reportedly suffer from sand colic, highlighting that the condition is not confined to hot, dusty environments. Another recent piece of research from there – a retrospective study of more than 1,000 cases – revealed that daily nasogastric tubing with psyllium and/or magnesium sulphate (Epsom salts) for three to seven days is more effective for removing large accumulations of sand from the colon than feeding psyllium for at least 10 days.

“Medical management with oral laxatives is the preferred treatment in all but the worst cases, where fluids tend to wash over the accumulated sand rather than flushing it through the system. Horses at high risk or with a history of sand-eating may benefit from a psyllium feed supplement. If turnout in a sand paddock or on sparse, unhealthy pasture is unavoidable, feed hay from a low-level manger rather than from the floor.”

Common culprits for summer colics

SUMMER digestive disorders are often down to one of three factors…

Sudden changes

A flush of grass growth can trigger a reaction in the gut and create gassy colic, which can cause the colon to displace or, even worse, to twist – a particular problem with mares who have recently foaled and have extra space in the abdomen.

Impaction colic is not just a winter worry, so try to avoid dietary disturbances such as stabling ponies on straw bedding for a week at camp, or adding electrolytes to drinking water without realising that the horse does not like the taste.

Grass sickness

A potential killer, and most common between April and July, equine grass sickness (EGS) is a degenerative disease of the nervous system that results in impaired motility of the gut.

Internal parasites

Modern de-wormers have reduced colic risk, but anthelmintic resistance is increasing. Encysted small redworm – also called strongyles or cyathostomins – are a particular threat, lying dormant in the gut lining before emerging en masse to cause diarrhoea, colic and often death.

Targeted de-worming is a must and poo-picking, however tedious, is beneficial.

This feature is also available to read in Horse & Hound magazine, on sale Thursday 3 June 2021

The healthy athlete: how to keep competition horses infection-free H&H Plus

Andrea Oakes — Mon, 31 May 2021 08:00:57 +0000

From grassroots to championships, keeping competitors infection-free requires a robust routine. Lesley Barwise-Munro MRCVS explains

TRAVELLING to and staying away at shows again is an exciting prospect. To ensure a healthy, infection-free season, however, we must undertake thorough preparation to protect our competition horses from a variety of potential health threats.

The outbreak of the equine herpes virus-1 (EHV-1) paralytic strain this year in Europe was an extreme example, highlighting the risk of rapid spread of an infectious disease at a show.

Biosecurity – the term for the good hygiene practices that prevent disease transmission – must start at home. This means every yard should have an isolation system for newly purchased horses and short-stay visitors. Ideally, each incoming horse should undergo testing for strangles, equine influenza (flu) and EHV, prior to integration.

Currently, there is a health declaration form to complete for all competitions, to certify that horses arriving at a competition have no known signs of illness and have not had contact with any infectious diseases. This relies on the honesty and vigilance of owners in observing their horses in the run-up to the show, which should include temperature-taking at least once a day for a week or so in advance.

Cleaning and disinfecting the lorry or trailer after a show is a good biosecurity measure (Image credit: creditUnknown)

International eventer Oliver Townend is a great advocate of biosecurity. Having recently travelled two horses to the Kentucky five-star in the US – Cooley Master Class and eventual winner Ballaghmor Class (pictured in action at Badminton, left) – the Townend team quite rightly prides itself on effective quarantine and preparation of horses for top-level competition.

At home, Oliver runs a barn system where horses are stabled in small groups, so meticulous biosecurity measures can be applied and any health issues can be swiftly dealt with. Each barn has its own equipment, which is regularly disinfected, and grooms have a high standard of hygiene.

“We are incredibly careful about the isolation of our horses,” he explains. “Visitors and any grooms other than the horses’ own have minimum contact with them, both at the yard and away. Temperatures are taken daily at home, and at least twice a day when away at competitions – and for 48 hours upon return.”

(Image credit: creditUnknown)

TRIP HAZARDS

WHILE international competition brings its own challenges, any kind of gathering of horses from different yards will increase the risk of infection spread.

Make sure that your horse’s vaccinations comply with the requirements of your registered discipline. Plan ahead, as FEI rules stipulate that a horse should not be vaccinated for flu within seven days prior to entering the competition stables.

Flu and EHV vaccinations will help to protect against these diseases. While there is no specific vaccination against the EHV-1 paralytic form, it is thought there is some protection for vaccinated horses through herd immunity.

Keep the lorry well ventilated. It is advisable not to share transport with horses from different yards and, if possible, to travel to competitions daily to avoid the risk of cross-infection with others in show stabling.

Infection is not only transmitted directly, through horse-to-horse contact, but also indirectly, on hands, tack or other equipment. While viral particles and bacteria can live in an environment for several days, they can be killed with disinfectant.

Where an overnight stay is necessary, stringent hygiene measures are recommended. If your horse is the first into new temporary stabling, on grass, and the shavings bales provided are unopened, this should be fine in terms of biosecurity. Used bedding can be a disease transmission risk, however, in terms of nasal discharge or coughed aerosol droplets, so take your own if it is feasible to pack some in the lorry.

A horse can lick or nuzzle anywhere, so treat the stable surfaces with an approved disinfectant such as Virkon. Prevent nose-to-nose contact with neighbours, either through or over the top of stable walls – secure some waterproof material with cable-ties, in the absence of anything specifically designed.

Use your own equipment, and clean your hands regularly with antibacterial gel. Since communal hose pipes potentially harbour infection, take a supply of water with you. If you must use a shared hose pipe, disinfect the end regularly.

Ballaghmor Class (Image credit: creditUnknown)

WORK:FEED RATIOS

ADDITIONAL health issues can crop up. To reduce the risk of the muscle condition exertional rhabdomyolysis (known as tying up, or azoturia), make a work plan right up to the day of travel – and during the away stay.

There are sometimes “easy days” at shows, but maintain a horse’s work and dietary balance. Follow a proper warm-up and cool-down routine to assist muscle recovery and repair.

“We kept the two horses that were travelling to Kentucky as fit as possible, right up to the point of setting off, knowing that they had to go into quarantine where the work level and feed would be reduced,” Oliver reports.

Some horses do not like a change of water, so encourage a poor drinker to stay hydrated to avoid impaction colic.

Biosecurity measures should continue at home, where thorough disinfecting of all equipment – including the lorry or trailer – is recommended. Isolate a returning competitor for a minimum of two weeks, where possible, monitoring for a raised temperature or signs of sickness, to lessen the risk of infecting other horses.

Prevent nose-to-nose contact with other horses at show stabling (Image credit: creditUnknown)

Bust stress to boost immunity

SOME horses travel well, while others become stressed by the experience. Stress is thought to have some impact on the immune system, making a horse more susceptible to infectious disease. By maintaining his routine and minimising the effects of stress, the better the chances that he will compete to his full potential.

In the run-up to a show, gradually introduce the haylage a horse will be eating while away. This may mean changing from a big bale to smaller, more convenient bales Or, as the Townend team does, take small bales with you made from the same haylage as the big bales.

(Image credit: creditUnknown)

Oliver helps protect his horses from the effects of stress by feeding probiotics prior to travelling and competing, which are thought to maintain healthy gut function, and veterinary-prescribed omeprazole to guard against gastric ulcers – which can also be triggered by stress. Electrolytes, given under veterinary guidance and always with free access to fresh water, are particularly beneficial in hot weather or when horses are working hard, to replace salts lost through sweat.

Horses arriving at a venue after a long trip, especially in the summer heat, can be more vulnerable to infection. Reduce journey stress by setting off in good time, and allow for some recovery time upon arrival. Hand-grazing is good for gut function, as well as enabling any fluid that has collected in the airways during travel to drain from the nostrils, but does pose an infection risk. It is imperative to find clean grass, which can be difficult at competition centres that have a high turnover of shows.

The vet

LESLEY BARWISE-MUNRO MRCVS, from Alnorthumbria Veterinary Group in Northumberland, attended the London and Rio Olympics – and hopes to travel to Tokyo – as an FEI treating vet. 01670 897597, alnorthumbriavets.co.uk

You can also read this feature in the 27 May issue of Horse & Hound magazine.

How bridle pressure affects a horse’s performance H&H Plus

Andrea Oakes — Sun, 23 May 2021 14:00:32 +0000

Research is proving that bridle pressure can inhibit a horse’s performance, but what’s key to a perfect fit? Dr Rachel Murray MRCVS explains

RECENT developments in technology are enabling us to understand more about the effects of the bridle. Investigations using under-bridle pressure mats are revealing that bridle design and fit can significantly affect a horse’s movement pattern – and therefore his ability to perform.

The nature of equine anatomy means that certain areas of the head are vulnerable to pressure. The better the design and fit of the bridle, the lower the pressure in these areas and the fewer the locations where pressure points can be seen.

At the sites where pressure does occur, this is unlikely to be continuous and will vary depending on the point in the stride. Additionally, depending

on the position of the horse’s head, the location of maximal pressure can vary.

When a horse’s head is more vertical, for example, greater pressure tends to occur at the top edge of the noseband (nearest the eyes). Pressure is more likely to occur under the bottom edge when the head is more horizontal.

Pressures are usually higher during faster paces, or when movement is more extravagant, meaning that good bridle fit and design are especially important for the performance horse. However, pressure points can occur with any horse, whatever his job, so the bridle must be fitted and checked as carefully as the saddle.

VITAL ADJUSTMENTS

THE more stable a bridle is on a horse’s head, the less likely he is to experience pressure points at the front and back of the headpiece, or rubs at the corners of his mouth as the bit moves.

Some “give” is needed in the noseband, however, as the head moves. Since the noseband is attached over the top of the head, it can act as a fixed unit; this can then create pressure points on the poll and also underneath the horizontal fitting, particularly if done up tightly.

A shaped, more narrow headpiece would provide a better fit against the ears (Image credit: creditUnknown)

It is important that the noseband is not too tight or fastened with the horizontal part too high. There should be space between the noseband and the facial crest. Side rings, such as those typically seen on a drop or crank noseband, allow the noseband to move better with the horse’s head and can help reduce pressure under both the noseband and headpiece.

Pressure points are likely to occur under buckles or metal fittings, particularly if these are located over the higher-risk locations. These fastenings should be positioned carefully and padded where possible. Stiff material or hard edges can also create pressure points and are better avoided. A rolled or narrow noseband strap under the headpiece can localise pressure over the poll, so needs to be carefully checked.

This headpiece design, with a browband of sufficient length, allows more room (Image credit: creditUnknown)

A number of higher-risk locations involve the headpiece: at the front, where it pushes against the base of the ears; at the back, where it impacts against the wings of the atlas; and underneath, on the top of the poll.

Additional risk areas are situated underneath or close to the browband attachments (pressure points can occur here when the horse swallows, or moves his tongue or jaw); under the noseband, on either side of the nasal bone; and over the jawbones on the underside of the chin.

FACING FACTS

THE fit of a bridle is affected by a horse’s conformation. Few horses have a symmetrical head, so the shape and fit on one side may need to be different to the other.

The distance between the corner of the mouth and the facial crest can vary. A horse with a long mouth and a low facial crest will have a very short distance to accommodate a noseband, so a wide noseband can create real problems – especially if he has thick skin, which can become bunched up between the bit and the noseband and cause rubs or pinching.

Careful selection of the noseband width and shape, choosing a design that narrows at the sides, for example, is critical if there is limited space.

Generally, a wider headpiece over the top of the head reduces pressures over the midline of the poll, although the distance between the back of the ears and the wings of the atlas can vary between horses. If the atlas is positioned close to the back of the ears, there is very little space.

The padded cavesson is positioned well between the bit and the facial crest, but the unpadded flash strap may cause pressure points (Image credit: creditUnknown)

For horses with this type of anatomy, narrowing of the headpiece at the sides may reduce pressure points at the front and back and improve both comfort and performance. This is particularly important if the horse has a large crest, which can cause the bridle to fly forward over the ears, or is ridden in a curb bit with long shanks – where the headpiece is more likely to be pushed against the back of the ears.

The height of the browband and cheekpiece buckles needs to be assessed relative to the bony prominences below the ears. The browband should be long enough, and the headpiece of sufficient length that the browband does not sit too high.

The padding on a noseband should be wide enough under the jaw or over the nose to limit pressure points on these bony edges. If a horse has a wide jaw, the length of the padding should be assessed in relation to his shape and size. Some horses have a longer distance over the top of the nose to the mouth, while others have a bigger chin; where possible, consider the individual and tailor the bridle shape and size to his conformation.

When a bitless bridle is used, the positioning and shape of a bridle over the horse’s nose is even more important, as pressures created at this location may be much greater than with a standard noseband.

SPOTTING THE SIGNS

STUDIES have shown that high pressures under the bridle reduce the quality of a horse’s movement, both limb flexion and stride pattern. By selecting bridle fit and design to suit the anatomy of the individual, these pressures can be avoided and performance will be improved.

Signs of discomfort range from a dislike of being tacked up or handled around the ears and an unwillingness to go forwards, to head tossing or ear drooping on one side during ridden exercise. More obvious indications include white hairs at pressure points, rubbing on the corners of the mouth or the cheeks, or a swelling or indentation over the nasal or jawbones.

Extra padding is not necessarily the answer, since this can make the bridle more unstable and lead to problems elsewhere. Consulting a Society of Master Saddlers-trained bridle-fitter will be worthwhile if problems persist.

Identifying pressure zones

(Image credit: creditUnknown)

THE head comprises large areas where there is limited soft tissue covering the bone, leading to anatomical prominences and moving parts with little padding. The shape and location of these can create pressure points under the bridle.

The numerous nerves and blood vessels that run over and around the bony prominences are at risk of irritation or injury, if the shape and fit of the bridle is not optimal.

Key areas of interference include:

● The edges of the nasal bone.

● Under the mandible (lower jaw).

● Bony enlargements around the roots of the teeth – a particular problem in the young horse.

● The facial crest – the bone that sits under the cheekpiece and above the noseband.

● The temporomandibular joint and hyoid apparatus, which move with the jaw and tongue motion.

● The skull, which is quite pointed at the poll.

● Behind the ears; while this area does have muscle coverage, space is limited by the bony side wings of the atlas (the first neck vertebra).

You can also read this feature in the 20 May issue of Horse & Hound magazine.

At the cutting edge: equine eyelid surgery

Andrea Oakes — Mon, 17 May 2021 08:00:05 +0000

A clever surgical technique can restore full function to the eyelid after growth removal, as Andrea Oakes discovers

SKIN masses, such as melanomas, sarcoids and squamous cell carcinomas, can be particularly troublesome when they appear in close proximity to the eye. Left untreated, a mass may grow and interfere with eyelid function or vision. Yet treatment can result in damage to the thin skin of the eyelid, inhibiting its ability to protect the eyeball and to keep it bathed in lubricating tears.

While nine-year-old Irish Draught/thoroughbred mare Rosie appeared unbothered by a cluster of ulcerated masses developing at the outer corner of her left eye, vets at Pool House Equine Clinic in Staffordshire felt that these growths were best removed.

“Treatments such as chemotherapy and radiotherapy are sometimes possible, depending on the nature of the mass, but in this case surgical excision was the favoured option,” says equine surgeon Marco Marcatili. “To preserve the eyelid anatomy and function, and to create a good cosmetic outcome, we planned a reconstructive technique called sliding ‘Z’ dermoplasty.”

DIGGING DEEP

ULTRASONOGRAPHY of Rosie’s eye revealed that the masses penetrated about a centimetre into the deeper tissue layers.

To minimise the likelihood of recurrence after excision, it would be necessary to remove

a significant amount of surrounding tissue during surgery. The aim of “sliding flap” reconstruction is to reconfigure what is left of the healthy tissue, to create less distortion of the skin and a neater scar.

The sliding “Z” flap is just one of a number of flap shape variations, explains Marco. Two triangular areas of skin adjacent to the surgical site are separated from the underlying tissue and removed. The remaining skin flaps are advanced (manoeuvred) into a zig-zag pattern, and the edges are then stitched together with absorbable suture material.

“The surgery is performed with the horse under general anaesthetic, as opposed to standing and sedated, because the surgical instruments are so close to the eye,” adds Marco, explaining that the slightest movement could result in injury.

“We always use ultrasound before surgery to evaluate the full extent of the mass and to plan the excision. Afterwards, the mass is sent to the lab for pathology.”

SEAMLESS REPAIR

FOLLOWING an uneventful recovery from the anaesthetic, Rosie was nursed at the hospital and given antibiotics and anti-inflammatories. Once it was clear that the site was healing without complication, she was allowed home.

“This technique can be very useful to close high-tension wounds following tissue removal,” says Marco, adding that lab tests identified the growths as sarcoids. “All surgery carries some risk, but we usually find that the eye area heals well and fast.”

Six months later, Rosie’s owner, Ellie-Mae Morson, reports that the surgical scar is barely visible.

“She had to wear a fly mask for a few weeks, to protect the area, but after a short time in the stable she could go back out to grass,” says Ellie, who regularly feels along the scar line for any signs of sarcoid reappearance. “Now the hair has grown back, you would hardly know it had happened.”

The sliding “z” flap: how it works

The periocular region (around the eye) is clipped and cleaned, and marked with incision lines.

(Image credit: creditUnknown)

The masses are excised in their entirety, leaving an area devoid of skin.

(Image credit: creditUnknown)

Adjacent triangles of skin are removed to let the remaining flaps be drawn across into place.

(Image credit: creditUnknown)

Suturing completes the reconstruction. Note the tension-relieving incisions behind the site.

(Image credit: creditUnknown)

The eyelid is fully functioning and already beginning to heal, just 48 hours after surgery.

(Image credit: creditUnknown)

You can also read this feature in the 13 May issue of Horse & Hound magazine.

Back conformation and saddle fit: what’s new in the veterinary world? H&H Plus

Peter Green MRCVS — Wed, 12 May 2021 14:00:36 +0000

Peter Green MRCVS reports on back conformation and saddle fit

SETTING THE PACE

A MUTATION in the gene labelled DMRT3, known as the “gait-keeper gene”, gives horses the ability to pace or tolt, rather than trot. This mutation is found in Icelandic horses (pictured) and other breeds with this ability.

Swedish geneticists studied pedigree Icelandic horses, which are rigorously scored for their conformation and for the quality of these “lateral” gaits. They analysed the DNA of 177 performance-tested horses and discovered a genomic region strongly linked to the conformation of the withers, back and croup.

The scientists found two opposite forms, or haplotypes, of this genetic code. Horses with one haplotype had higher withers, a flatter back and a lower, more muscled croup – creating an “uphill” conformation. Horses with the opposite haplotype had a more level or even a “downhill” conformation.

When the quality of the pace and tolt of the individual Icelandic horses was compared with the genetic type, there was a strong correlation with the genetics. The more favourable haplotype, producing the uphill conformation, was associated with much better pacing and tolting. This means that Icelandic horses can be genetically screened to find out how good their lateral gaits will be.

FIT FOR PURPOSE

SADDLE-FITTING is a skilled job but it is subjective, with some differences of opinion among saddlers.

Electronic pressure mats, sometimes used to identify areas of unacceptable pressure beneath the saddle, have the added advantage of generating data while the horse is worked.

Swiss scientists compared the results of manual saddle-fitting with pressure mat data in 196 healthy riding horses, with no known history of back problems, and with the saddle currently being used by the riders. All were assessed by an experienced saddle-fitter and then by an under-saddle electronic mat as the horses were ridden. The saddles were English patterns: dressage, showjumping or general purpose (GP).

Only 10% of the horse’s saddles were deemed a “perfect” fit by both saddle-fitter and pressure mat. Almost a third of the horses were found to have painful backs. Problems varied with saddle type: dressage saddles tended to have panels that were too steep on the back of the horse and not symmetrical, the waists of the showjumping saddles were generally too narrow, and the GP models tended to be badly balanced.

There was good correlation between the assessment made by the professional saddle-fitter and by the pressure mat. It was also clear that sheepskin numnahs were better than other pads in spreading pressure, and that there was only poor correlation between the detected back pain and the worst-fitting saddles.

Back pain in horses is complicated. Although correct saddle fit is essential, it is only one part of the problem.

You can also read this feature in the 13 May issue of Horse & Hound magazine.

How to help keep your horse happy and healthy while in transit H&H Plus

Andrea Oakes — Sun, 09 May 2021 08:00:40 +0000

Planning a road trip? Keep your horse happy and healthy during the journey, with expert advice from Liz Brown MRCVS

Q. Should I worry about shipping fever on a UK journey?

A. SHIPPING FEVER, or pleuropneumonia, is an infection which may occur after travelling. Bacteria present in the lungs can multiply and cause pneumonia, inflammation and secretion of fluid into the surrounding cavity, known as the pleural space.

Contributing factors during travel are dehydration and a prolonged head-up position, both of which reduce drainage of mucus from the lungs. Additional risk factors include recent fast exercise or viral infection, exercise-induced pulmonary haemorrhage, or exposure to inhaled particles.

While shipping fever can occur after a shorter trip, longer journeys represent an increased risk. Keep a horse well hydrated, make sure he does not overheat and untie him periodically to allow him to lower his head.

Initial signs include a high temperature, lethargy and appetite loss, and may progress to laboured breathing or an unsteady gait. A delay in veterinary treatment can result in more severe disease, which may have a poor prognosis for survival.

Q. How tiring is travel?

A. TRAVELLING requires muscular effort for the horse to balance and stabilise. Studies have found evidence of muscle fatigue after longer journeys, which may affect performance. An overnight stay before the competition will allow time for muscle recovery and rehydration.

A study of horses on an eight-hour trip showed that the frequency of stress-related behaviours was greatest in the first hour of the journey and that balance-related behaviours were most common in the final hour.

A smoother ride, on a motorway, for example, will be less arduous than travelling on twisty roads with changes of speed and direction. A lorry journey may be less taxing than travelling in a trailer.

Remember, too, that a seasoned traveller will find the journey less mentally and physically tiring than a less experienced horse.

Q. Are rest breaks recommended?

A. IF your journey is longer than three to four hours, schedule a stop to allow the horse to rest and drink. Untie him, so he can drop his head. If there is a safe place to unload, a short walk and a graze are beneficial.

Animal welfare regulations state that no horse may be transported on a journey in excess of eight hours, except in an approved vehicle where the limit is 24 hours – provided that water and feed are provided at eight-hour intervals.

Q. Which way should a horse face while in transit?

A. STUDIES have shown that horses have lower heart rates when facing backwards. They seem to find the experience less stressful and can engage the muscles of the hindlegs and quarters to buffer braking. When facing forwards, they tend to hold their heads higher.

Some horses find it harder to balance in a trailer. A larger horse may prefer to travel without the partition so he can stand diagonally.

Floor mats can be slippery and may not afford the horse sufficient grip. A layer of shavings can make him feel more secure.

Q. Can travel affect soundness?

A. TRAVELLING places different stresses on a horse’s limbs or body as he maintains balance. When he is positioned diagonally, these stresses may be uneven and could aggravate a pre-existing condition. Horses travelling in a herringbone pattern for long periods have been observed to appear stiffer on the right hind leg afterwards; this limb may experience more loading during repeated stabilisation.

Allow a horse time to recover after a long journey, to prevent secondary injuries. When travelling abroad, he may need a day or two of light stretching before returning to normal work.

A high head position can put extra stresses on the neck. A horse travelling with his head positioned over a locker, or a longer horse who cannot stretch his neck forward, may look stiff after unloading. Any degree of arthritis present in the cervical facet joints may aggravate this problem.

Q. How can I help my stressy horse cope?

A. FIRST consider why he gets stressed. Does he have room to stand comfortably and balance? Try widening the partitions or placing him in a different orientation or vehicle, maybe with a companion.

Accustom him to the trailer or lorry with short journeys. Drive carefully; if you are towing a trailer, you may not realise that your horse’s ride is a lot rougher than yours is in the car.

Q. Why is ventilation vital?

A. VENTILATION should be sufficient to provide good airflow. Keep the windows open, as long as the horse’s face is not exposed to a continuous draught and particles of hay or dust are not blowing into his eyes.

Take care not to over-rug. Muscles create heat while horses travel; several horses in transit together can generate considerable warmth. A warm horse will lose heat and fluid through sweat.

(Image credit: creditUnknown)

Q. How can I keep a horse hydrated?

A. AIM to minimise fluid loss through sweating by keeping the horse cool, and stop regularly to offer him water. He may be more inclined to drink if you give him time to rest and eat first, while you take a break, offering him a bucket before you set off again. Gastric ulceration can make a horse reluctant to drink, an important consideration when travelling long distances.

Allow a horse time at the end of a competition to rest, eat and drink, before loading him up. Give him free access to water once at home to replace any fluid losses.

Q. Should I provide hay?

A. HORSES benefit from eating hay or haylage during a journey. Travel can be a risk factor for gastric ulceration; chewing encourages saliva production, which helps neutralise stomach acid, and fibre in the stomach will reduce acid splashing.

A horse with a respiratory allergy may need to avoid eating hay on the way to a competition, however, if it triggers coughing. It is advisable not to feed a horse from a haynet at head height if he has had upper respiratory tract surgery, in case he inhales food particles.

(Image credit: creditUnknown)

Q. Travel boots or bandages – what’s best?

A. BOTH provide protection from knocks or treads. Legs can swell slightly on long trips, so it is important bandages are not too tight and are applied over a sufficient layer of padding. Boots must fit well so there is no danger of them slipping down.

An over-tight tail bandage can constrict the blood supply, resulting in discomfort that can be mistaken for colic – along with the growth of white hair or, in extreme cases, complete loss of the tail. A tail guard is easier to apply but may slip.

This feature can also be read in this week’s Horse & Hound magazine, on sale Thursday 6 May

How different grazing systems can help you control your horse’s weight H&H Plus

Andrea Oakes — Sun, 02 May 2021 08:00:13 +0000

Could moving away from conventional grazing systems help weight management? Dr Tamzin Furtado reports

WITH equine obesity at alarming levels in the UK, managing weight is becoming an important part of everyday horse care. Traditionally, weight management is achieved through stabling, grazing muzzle use, increased exercise or the use of “starvation paddocks”, but some owners are seeking methods which do not restrict their horses’ access to the “three Fs”: friends, forage and freedom.

A survey of UK owners conducted last summer explored the use of alternative grazing systems, not just for keeping weight under control but also for reasons such as the management of arthritis and behavioural issues related to stress. Each option aimed to provide enriched turnout areas, where horses can live in groups and access a range of low-calorie forages.

It is important to note that no one system was a panacea for every owner; all have their pros and cons, highlighting that any changes should be considered on an individual level. These innovative ideas provide food for thought, however, for welfare-friendly weight control.

ON THE MOVE

TRACK systems allow horses access to a track created around the outside of a paddock. Resources such as water, hay and shelter are placed at different points, to encourage the horses to move in order to access them.

Tracks may cross multiple fields and are sometimes dotted with features, including hedgerows for foraging, different terrains (sandpits, streams or steps, for example) and enrichment such as scratching posts, herb gardens and flavoured water stations. The centre section can either be cut as hay or left as standing forage for winter, or managed with Equicentral principles (discussed later).

The upside is that the horses are encouraged to keep moving around the track to access their resources, while the footfall and lack of space means grass growth is limited – making this ideal for overweight horses. Horses are living in an enriched environment, usually as a herd, which can reduce stress levels.

However, track systems are not without their issues. Because of heavy footfall over a limited area, tracks which are not surfaced can become very muddy; as a result, many owners remove their tracks entirely for the winter months. Surfacing is ideal, but is clearly expensive and may require planning permission.

The reduced space can also be a problem in terms of herd dynamics, with careful attention required to ensure that the herd is cohesive – particularly when introducing new horses.

When creating grass tracks to manage obese animals, it can be difficult to limit the grazing enough to reduce their weight. Some users resort to using grazing muzzles or strip grazing the track to keep grass levels low.

Some horses may not suit some aspects of track life; certain ponies reportedly do not move more but instead simply wait at the hay feeder. Others escape onto the centre section, and some may find the concept of a track itself confusing. Tracks should never be designed in complicated shapes like spirals or zig-zags.

HDRWDJ Young stallion horses embracing in peaceful in the summer corral (Image credit: Alamy Stock Photo)

IMPROVING PASTURE

THE Equicentral system, developed by Equiculture, is a philosophy based around improving soil health in order to then maximise grass health and biodiversity, and thus produce healthy horses. The principles translate the science of regenerative agriculture in a way that can be used by horse owners.

The system proposes that horses are going to spend time “loafing” – hanging out, resting and sleeping – so we should allow them to do so in an area set up for this to let paddocks rest. The heart of the system is therefore a surfaced, non-mud area such as a stable yard or arena, where all the required resources are placed.

Leading off from this, horses have access to very lightly grazed paddocks that are rotated regularly – think maybe one week, rather than a season. Grass is never allowed to drop below 5cm in length, meaning that horses purportedly graze on the fibrous, stalky sections rather than carbohydrate-rich, stressed grass.

Horses always have access to come back to the loafing area at their choosing, but do not always have access to the field; thus, they follow a pattern of grazing for a while before returning to the yard area to drink and rest.

The Equicentral principles are based on modern sustainable farming methods. Some users suggested that they were surprised by how the grazing of “healthy” grasses led to better management of weight. Moreover, horses whose weight was a concern could also be easily kept in the loafing area, if necessary, rather than allowed out to grass – meaning that multiple horses with different dietary needs could still be managed as a cohesive herd.

The survey found that commitment was required, however, as it would take time (and possible re-seeding) before traditional horse pastures would transform into the diverse grasses which are preferable. In addition, some horses may not learn to self-regulate their intake, so the system needs careful implementation for each individual.

Some owners combined both ideas, using a surfaced, grass-free track as the loafing area, while managing the centre area to allow light grazing. This allowed them a flexible option for managing diverse horses.

The final option – woodland and moorland turnout – simply involved using non-traditional areas where horses have access to relatively low-calorie forage, due to the general lack of grass in woodland areas and the lack of improved grass species, such as rye grasses, in moorlands.

In fact, some woodland areas provided almost grass-free turnout areas, where horses could instead forage the trees and plants and eat the hay supplied. Both environments nevertheless provide enriched spaces, where horses can wander, browse and spend time in a herd.

The survey found that woodlands and moorlands were of limited use in winter, given that both are prone to becoming muddy and waterlogged. It’s also necessary to check regularly for hazards such as splintered logs or poisonous plants.

Woodlands were reportedly more useful for weight reduction than moorland areas, and may be of particular interest to readers given the number of yards that have small patches of woodland areas fenced off from horses.

E6TB45 Black and chestnut horses eating hay (Image credit: Alamy Stock Photo)

A HEALTHY BALANCE

NO one grazing method may suit every situation; continual monitoring and adjustments are necessary to optimise equine health and wellbeing.

Even if none of these options is possible, however, the principles of trying to incorporate low-calorie forage, herd living, freedom of choice and enrichment are key and worthy of consideration.

The survey

THE project, which prompted 758 responses, was a collaboration between the University of Liverpool and the Blue Cross, British Horse Society, British Equine Veterinary Association, The Donkey Sanctuary, The Horse Trust, Redwings and World Horse Welfare. Read the report at: bit.ly/3cqpyBM

This feature can also be read in this week’s Horse & Hound magazine, on sale Thursday 29 April

Keeping a veteran active for longer

Stephanie Bateman — Mon, 26 Apr 2021 08:00:02 +0000

With advances in medicine, our horses are staying healthy well into their twilight years. Stephanie Bateman discovers how to keep our veterans sound and active for longer

LONG gone are the days when we’d retire our horses in their early teens. Nowadays, it’s not unheard of to see horses in their twenties still enjoying an active life.

“Keeping a horse sound into old age is a product of a huge number of factors, but most importantly, it’s about delaying the onset and severity of wear and tear,” says Newmarket Equine Hospital surgeon Matt Chesworth.

One of the main issues facing older horses who have lived an active life is osteoarthritis.

“Horses have a few common sites for developing osteoarthritis which become more significant as the horse ages,” explains Matt. “These include the lowest joints within the hocks, the coffin joints, and pastern joints, but arthritis can ultimately develop in any joint.”

Equine joints, like human joints, have fairly limited means of repairing damage.

“Damage to the surface of the joint, or joint capsule, and the resulting inflammation can lead to further damage and cartilage loss,” says Matt. “Enzymes produced when a joint is inflamed can affect normal cartilage as well as the injured area, so reducing inflammation minimises the speed of deterioration as well as providing pain relief.”

(Image credit: creditUnknown)

One method which may provide pain relief is joint injections, often involving a single or a combination of medications injected into the joints.

“Often corticosteroids are our treatment of choice due to fairly consistent results; however, other treatments are available which can be used in cases where either corticosteroids have shown a poor response or there is concern over laminitis risk,” says Matt. “Examples include hyaluronan, a normal substance found in joints, interleukin receptor antagonist protein [IRAP] derived from the horse’s own blood, or more recently a polyacrylamide hydrogel.”

The length of time a joint injection lasts depends on the severity of disease but can be from six months to a few years. Other pain control options include non-steroidal anti-inflammatories (NSAIDS) such as low levels of phenylbutazone (bute).

“If you aren’t competing, a maintenance level of pain relief can help keep the horse comfortable and active, but it’s important to discuss with your vet first,” adds Matt. “Joint supplements are another option to help ensure the optimum environment for joint repair and maintenance.”

MAINTENANCE MATTERS

TO help maintain healthy joints, Matt advises ensuring the horse’s feet are in good balance with regular visits from the farrier.

“Long toes, for example, can significantly increase the forces through the deep digital flexor tendon and therefore the navicular bone,” he explains. “Your farrier will also notice if the horse is less comfortable when being shod, which may indicate arthritis.”

The type of surface you ride on is important, too.

“Excessive work on hard ground should be avoided as this can lead to increased forces and vibration through the joints, increasing the wear and tear,” says Matt. “Similarly, overly soft or uneven surfaces can lead to increased strain on tendons and ligaments. Regularly feel your horse’s legs so you pick up any swelling or heat early.”

When it comes to fitness, older horses require a bit more time to build them up.

“Veterans require longer getting fit, so take a more gradual approach,” suggests Matt. “Strength is very important in avoiding over-stressing joints and old injuries, so keeping them in a low level of consistent work will help keep them strong, as well as giving them plenty of turnout to prevent muscle wastage and stiffness.”

Other considerations include dental health.

“Dental care becomes increasingly important as the horse ages,” Matt says. “Horses have hypsodont teeth which are constantly erupting. This means that regular checks every six to twelve months are important to avoid overgrowths. Also monitor for signs of disease such as facial swelling, discharge from the nostrils, bad breath and quidding [dropping food]. Poor dental condition can reduce the protein intake and therefore their muscle mass.”

Pituitary pars intermedia dysfunction (PPID, commonly called equine Cushing’s disease) is also associated with veterans.

“Signs include increased hair length, increased drinking, loss of top-line and a

pot-bellied appearance, and laminitic symptoms,” says Matt. “It can be diagnosed with a simple blood test.”

Older horses can also be more prone to heart abnormalities such as murmurs.

“These are often picked up when your horse has their annual vaccination as the vet will listen to their heart,” says Matt. “Murmurs are often due to leaking valves and vary in type and severity. Your vet will be able to advise if your horse is still safe to ride.”

BODY WORKS

(Image credit: creditUnknown)

KEEPING our veterans in good physical condition plays a big role in their longevity.

“In an ideal world, a veteran horse would have been well looked after and had regular physio treatments throughout its life,” says veterinary physiotherapist Hayley Marsh. “The best chance you can give a veteran is to be on top of all the physical issues as soon as they arise through regular physio sessions.”

When it comes to daily maintenance, Hayley suggests longer warm-ups as well as longer cool-downs, and the use of blankets to help warm up muscles.

“Know your horse and when he feels stiff,” she says. “If he feels stiff, don’t ask anything of him until he’s loosened up. Make sure he has more breaks during a session; his recovery rate might not be as good as when he was younger.”

When treating, Hayley spends longer warming older horses up and is more conscious of the range of movements she puts them through.

“I’ll be looking at making sure the muscles are still functional, supple and flexible and I give the owners low level exercises to increase the muscle the horse is carrying,” she explains. “If a horse isn’t well muscled, it puts more strain on the joints which could increase the rate of arthritis setting in. I’d also be careful about a veteran horse’s weight; you don’t want them carrying extra weight on their joints.

“All horses should work over their backs properly and have a strong core, too,” says Hayley. “I advise carrot stretches, polework, long and low work and backing up to build and maintain the core.”

ENSURING our veterans are getting what they need from their diet is essential,

as independent equine nutritionist Donna Case explains.

“When feeding the harder-working veteran, their diet should provide an appropriate level of energy – calories – to help maintain an ideal body condition score [BCS],” she says. “They also require quality protein to support muscle repair and development as well as a balanced level of vitamins and minerals.”

Many horses will drop weight during the colder months, but if you notice a sudden loss of condition, an increase in forage or higher calorie hard feed may be required.

“Speak to your vet in the first instance to rule out possible underlying health factors,” says Donna. “Consider your horse’s clinical history, too, as this will have a massive bearing on suitable diets. A history of EMS [equine metabolic syndrome], PPID [equine Cushing’s disease], laminitis or ulcers will all have an effect on feed that is suitable. Speak to your own vet or a nutritionist to discuss a suitable diet.”

When it comes to supplements for older horses, Donna recommends a high-quality joint supplement and a gut balancer.

“When looking at joint supplements the key ingredients include glucosamine, chondroitin, HA [hyaluronic acid] and MSM [methylsulfonylmethane],” says Donna. “The digestive tract tends to become less efficient with age, so finding a high-quality probiotic and prebiotic gut balancer can help to support a healthy hindgut microbiome.”

“She’s still in work four days a week”

(Image credit: creditUnknown)

KARLEY HUBBARD owns 25-year-old Irish Draught/thoroughbred event mare Sadlers Symphony (Jazz).

“We bought Jazz in 2008 as my first event horse,” tells Karley. “Although she’s hot-headed, opinionated and hates dressage, she gives you everything cross-country. She’s taken me up the levels, achieving our first British Eventing [BE] point, and numerous top-10 placings, including the Pony Club Eventing Championships and the BE100 under-18 finals.

“Back in February 2017, aged 21, Jazz degloved her right hind down to the cannon bone. Six-months post injury, I was back on board and in June 2018, we were back out eventing, achieving a double clear and third place.

“Although she’s dropped down the levels now and is enjoying a quieter life, Jazz is still in work four days a week. We’ll hack, school, use polework and groundwork and she’s jumped once or twice a month to keep our eye in. I ensure we have long and slow warm-ups and cool-downs, she’s turned out every day for as long as possible and we keep a constant eye on her condition.

“She’s fed Emerald Green Grass-tastic and grass nuts, and in the winter months we add full-fat linseed to maintain condition. She is not on any supplements.

“She has a six-monthly MOT including a physio and dental check, and all being well we’ll be back out eventing this year at 90cm.”

This feature is also available to read in this Thursday’s H&H magazine (22 April, 2021)

Hunting emergencies: equine and human injuries and dangers and how to deal with them H&H Plus

Stephanie Bateman — Sun, 25 Apr 2021 14:00:40 +0000

As thrilling and exciting as hunting is, it isn’t without its risks and accidents can happen. Stephanie Bateman investigates the most common hunting emergencies

THE unpredictable demands of hunting can unfortunately result in injury to both horse and rider, so knowing the risks and how to deal with situations when they arise will put you in a better position should the worst happen.

Three Counties Equine Hospital vet Andrew Harrison MRCVS outlines the most common horse injuries and how to deal with them.

Horse emergencies

Blackthorns

DFKWWM blackthorn, prunus spinosa (Image credit: Alamy Stock Photo)

JUMPING hedges can result in blackthorns penetrating joints and tendon sheaths.

Action: if you have had a big jumping day, always thoroughly check joints after hunting, particularly the knees, for thorns. Often you can easily pull them out, but if a thorn is stuck in, don’t try to remove it as it might break – the tip then breaks off and remains in the joint (or tendon sheath). Even after removal, if you suspect that the joint has been penetrated, it will need immediate veterinary intervention.

Quite commonly, horses with blackthorns will pull up sound from hunting and load sound thanks to adrenaline, but an hour or two later will be hopping lame. There will be heat and swelling around the joint and the horse will markedly resent joint flexion.

With blackthorn penetrations, time is of the essence as an aggressive septic arthritis develops rapidly, requiring urgent arthroscopic flush and debridement (removal) of any foreign material. Get your vet out immediately or take your horse straight to the vets.

Strike injuries and overreaches

GALLOPING with the rest of the field can run the risk of strike injuries from other horses to your horse’s legs, or of your horse overreaching and striking into himself. There are many structures at the back of the leg that can be affected, including tendons, tendon sheaths and ligaments.

Action: because of the location of most overreach and strike injuries, bleeding can be quite severe, so the first port of call is to stem any bleeding with pressure. Once home, clean the wound and bandage the leg. If the wound is deep and requires stitching, or your horse is showing a significant level of lameness, call your vet – don’t leave it overnight.

Tendon injuries

Ultrasound of suspensory ligament (Image credit: creditUnknown)

GALLOPING and jumping over uneven and holding going can result in damage to the tendons and ligaments that can take months to heal.

Action: ensure your horse is fit enough for hunting with a suitable fitness programme before the season starts. If you suspect your horse has injured a tendon out hunting, keep them as immobile as possible, transport them home immediately and call the vet. Tendon injuries require box rest, non-steroidal anti-inflammatory drugs such as phenylbutazone (bute) and regular ice therapy. Prevention is better than cure, so don’t gallop through really deep ground and be wary of jumping out of heavy ground.

Flesh wounds

(Image credit: creditUnknown)

PASSING through gates or by trees at speed or getting kicked by another horse can result in flesh wounds.

Action: some wounds may bleed and look bad, but be of no serious concern and may just require cleaning and bandaging or possibly a stitch or two by a vet. It’s the small, seemingly innocuous wounds close to joints and tendon sheaths that cause the biggest problems. If you are concerned, call your vet.

For wounds that are bleeding profusely, the key is stemming the flow. Remove your stock or tie and wrap it just above the bleeding to help stem the flow. Keep layering up with the bandaging and eventually it will stop. Always seek veterinary advice if your horse has lost a lot of blood or you can’t stop the bleeding. It’s also worth checking that your horse’s tetanus vaccination is up to date.

Some kick injuries aren’t obvious, particularly if they affect the bone where there is little or no covering tissue. If your horse is very lame, he may require an X-ray to rule out a fracture.

(Image credit: creditUnknown)

Getting stuck

IT’S not uncommon to hear of horses getting stuck while out hunting, such as when jumping hanging gates but not quite making it all the way over, or falling into a ditch after jumping a hedge with a ditch behind, or when riding through a deep bog.

Action: working safely around horses that are recumbent or entrapped is very important. Avoid the “kick zone” or “head-butting zone” – never approach a horse from the leg side if they are lying on their side; approach from the spine side.

If a horse is properly trapped, they tend not to struggle, but once they sense a bit of freedom they are likely to scramble to escape, so keep out of the way at that point. People are keen to get stuck in to such situations but it can be very dangerous. It’s better to wait for the emergency services, who are trained and have the equipment to deal with trapped horses. They will request the attendance of a vet to sedate the horse to protect themselves and their staff.

First-aid essentials

As part of your first-aid bag, consider including a major bleed control kit, which includes a tourniquet plus advanced ChitoGauze packing and bandages. In partnership with the Daniel Baird Foundation, Midlands Air Ambulance Charity offers bleed control kits. Visit midlandsairambulance.com for contact details.

Travelling home

(Image credit: creditUnknown)

For horses with injuries on the hunting field, borrow a trailer or request a horse ambulance to get them home. The shallower ramp angle to that of a horsebox can help get them loaded more easily and they will have more support when travelling.

Rider emergencies

EQUESTRIAN-related incidents are sadly among the top four reasons the advanced clinical teams on board Midlands Air Ambulance Charity helicopters are called out. This is either because of the remote location of the incident or because of the traumatic nature of their injuries. It is imperative that those with the patient provide support before the pre-hospital emergency specialists even arrive on the scene.

Dr Katie White is a pre-hospital emergency medicine specialist and flight doctor with Midlands Air Ambulance Charity. She provides some tips for assisting at an incident.

Fractures of the forearm

WRIST fractures are common following falls from horses. A person is likely to have a fracture if the area is tender, swelling or deformed in any way.

Action: if a fracture is suspected, support the affected arm with a sling or improvise to make a splint to help keep the arm still until you can get it X-rayed. Remove any jewellery from the affected side as the fingers and hand may swell up. Consider paracetamol as a painkiller and note when any medication was given. An ice pack may help.

Occasionally bones are badly broken – the arm may look to be obviously deformed, there may be bone sticking out and the injured person may complain of numbness or tingling, which could indicate serious injury. In this case, seek medical advice immediately and do not give the casualty anything to eat or drink as they may require an operation.

Concussion

THIS can result from being kicked by a horse or from a fall. Riding hats are important in helping to prevent head injuries, but they can still occur.

Action: concussion is an injury to the brain that results in impairment of its function. Loss of consciousness doesn’t occur in the majority of concussions.

Riders with concussion may appear dazed, may be slow to get up, show signs of poor balance or coordination and may be confused. Some of the symptoms they may complain of include headache, dizziness, fatigue and nausea. All concussions should be considered serious and medical advice should be sought.

Open wounds

AN open wound can result from contact with barbed wire or branches while jumping or following falls.

Action: remove debris from the wound, then wash it with clean water and pat dry with a clean towel if available before covering it. Seek medical advice if the wound is large and might need stitches or gluing. Also, check the person’s tetanus vaccination is up to date as otherwise further treatment such as antibiotics may be required to prevent infection.

In the following days, signs the wound is becoming infected include feeling feverish and unwell, and redness, swelling, worsening pain and pus from the wound. If this occurs, you should seek medical attention urgently.

Major bleeding

BLEEDING can be common from small wounds, however, occasionally major blood loss can occur. This can be life-threatening as a person can bleed out within minutes if a major artery is punctured, so get immediate help.

Action: expose the wound so you can see the injury. If it is a bleed from the torso, use a clean cloth and put pressure on it. If it is a limb injury, use a tourniquet or alternative such as a belt or stock to help stem the bleeding, fixing the tourniquet tightly above the bleed. You then need to pack the wound with clean cloth before bandaging the packing into place.

Calling for help

If you or someone you are with needs medical attention and you require an ambulance, first call 999.

Tell the ambulance service where you are using the What3words app location, as this makes it much easier for them to locate you quickly. The ambulance service will decide if the patient needs the rapid response and advanced care of air ambulance crews.

If the air ambulance is on its way, ensure horses are cleared away from the area so they do not get spooked by the loud noise and downdraft of the helicopter landing. It is also important people keep clear of the area, and must not approach the helicopter while the rotors are still running.

While waiting for help, reassure the patient that help is on its way, keep them talking and keep them warm. Being cold can cause shivering, which can increase pain from broken bones due to muscle movement. Also, hypothermia decreases the blood’s ability to clot, which can result in worsening haemorrhage in trauma patients.

To find out more about Midlands Air Ambulance Charity, visit midlandsairambulance.com and follow the service on social media.

This feature is also available to read in this Thursday’s H&H magazine (22 April, 2021)

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The effects of fire on horses: what are the implications and can they return to health? H&H Plus

Andrea Oakes — Sun, 25 Apr 2021 08:00:06 +0000

We hope it never happens, but if your horse was caught in a fire, what would be the implications and how would we restore them to health? Andrea Oakes investigates

ONE of the most heartbreaking aspects of a yard fire is that a horse lucky enough to be freed from a burning stable will often refuse to leave it, or will try to run back to it, in the mistaken belief that his stable is a place of safety. The chaos and confusion as the flames take hold is something we hope never to witness.

Hope is not a strategy, however, when it comes to keeping horses safe. Instead, prevention and planning will minimise risk and offer the best chance of avoiding a catastrophe.

According to Jim Green, who brings years of firefighting experience to his role as director of the British Animal Rescue and Trauma Care Association (BARTA), the typical yard set-up presents a perfect storm for an inferno.

“Most have an abundance of combustible materials, such as wood, forage and bedding, but lack smoke detectors, fire alarms or sprinkler systems – unlike at commercial premises,” Jim explains. “By the time someone realises that fire has broken out, it’s often too late. The usual advice with a building fire is to get out and shut the door; with stables, it can be difficult to contain the flames.”

The facts are frightening – a fire involving dry materials, such as straw and shavings, can double in size every 60 seconds.

“Products of combustion are nasty,” says Jim. “Hot air rises, and when horses are scared they lift their heads and their respiration rate increases. In an enclosed space, they are at risk from toxic and often superheated smoke, as well as the physical effects of radiant heat.

“Other building materials will contribute; the felt under a tiled roof can melt and drip onto the animals below, for example, causing burns,” he adds. “Smoke from materials such as rubber and felt will also create huge toxicity.”

Causes can range from spontaneous muck heap combustion to arson, but most stable fires are due to electrical faults. Jim cautions against overloading sockets and advises regular appliance safety testing, with checks to ensure that cabling has not been attacked by rats or squirrels.

“A key preventive measure is sensible yard organisation,” he adds. “Vehicles contain fuel and sometimes gas canisters, so park them well away from forage and bedding stores. Split up anything with the potential to catch fire, and keep the yard tidy to avoid a build-up of dust and other materials.”

A PRE-REHEARSED evacuation plan can be a life-saver.

“Get to know your local fire and rescue service and invite them to assess your yard,” says Patrick Pollock FRCVS, who has worked with BARTA to share veterinary expertise. “Practise, to see how quickly you can get the horses out. Is there a headcollar for each of them, and where is it? Where will the horses go when they’re out of their stalls – are there separate paddocks for mares, geldings and youngsters, if they can’t mix, or fields that are better if the wind is carrying smoke in a certain direction?

“Horses may be traumatised,” he adds. “Work out how to move them away from the blue lights and the sirens, and the people in firefighting gear who already smell like a bonfire from the previous call-out.”

Professor Debbie Archer FRCVS, who has helped BARTA produce training materials, says: “Mistakes are often made, such as letting the horses out before checking that the yard gate is closed, or not shutting stable doors to stop them running back inside. But planning will help – knowing the location of the water supply, for example, and identifying more than one escape route.”

Should the worst happen, burns will require immediate first aid.

“Take any rugs off and start cooling the area with tepid water,” says Debbie, explaining that the recommended formula is 10 minutes at 10°C. “Keep the site clean and apply a water-based antiseptic cream, but nothing oily.

“The severity of injuries is not always apparent, especially the effects of smoke inhalation,” she says, adding that rescued horses may need supplementary oxygen and supportive therapy. “Any horses involved should be checked over by a vet, even if they appear unscathed.”

SADLY, where injury to the skin and lungs is extensive, the prognosis is poor.

“A badly burnt horse is extremely difficult to deal with,” says Patrick. “A large surface area means a heavy loss of fluids but, if a horse won’t eat because his muzzle is burnt, it can be difficult to find a suitable site to insert a catheter. Kidney failure can then result due to substantial fluid shifts.

“Inhaling huge doses of hot air or noxious chemicals will scorch the delicate lung tissue and the small airways,” he adds. “An affected horse will struggle to breathe as oedema [foam] and sloughs of mucosa [cavity lining] build up in his nasal passages.

“As with humans, the severity of equine burns is calculated as a proportion of total body area. Beyond a certain point, euthanasia is advised. The skin may never function properly again, even with grafts, and development of a tumour called a burn carcinoma is common.”

While the knowledge base for treating equine burns is limited, encouraging results have been achieved with innovative dressings and medical-grade honey. When eight-month-old filly Cinders was subjected to a suspected acid attack in 2018, she underwent pioneering surgery at Rainbow Equine Hospital using the skin of tilapia fish.

“You can’t expect horses to lie between clean sheets and not allow their wounds to become dirty,” says David Rendle MRCVS, who worked with a vet from California to treat severe burns to Cinders’ face. “The fish skin offered potential for a cost-effective alternative to conventional dressings, which can be exorbitantly expensive.

“We can’t draw too many conclusions from one case, but the experience gained in using the fish skin and performing grafts was undoubtedly useful,” he adds. “Thankfully, we don’t see these injuries often. In 20 years, I’ve only treated two horses with potentially life-threatening burns. I won’t forget either of them, though; they present a veterinary challenge and a real ethical dilemma.”

“You think they will come out”

(Image credit: creditUnknown)

FIVE horses lost their lives when fire swept through the Rothenberger family dressage yard in Germany two years ago. Among the survivors was Sanneke Rothenberger’s Oldenburg gelding Sankt Anton (Toni).

“When Toni came out, his rug had caught fire,” recalls Sanneke, who suffered smoke poisoning during the rescue. “Thank goodness he was wearing it; the top had burnt down to the wool padding, but the flames did not reach his back. But he had lost a lot of hair on his ears and neck, and he was kept in hospital for three days.”

While Toni’s skin healed and an initial cough died down, Sanneke was worried about his demeanour.

“He is normally a very fresh horse who comes out to work with his ears pricked, she says. “I was riding him and he would do his job, but it took a few months before we saw his character come back.”

Toni made a successful return to competition last year and is back on the path to grand prix, but Sanneke will never forget the struggle to free the horses trapped by fire.

“You think that when you open their doors they will come out, but they don’t,” she says. “They react quite differently. Luckily, our stables had outside doors and we were able to get most of them out like that – I can’t imagine how we would have done it otherwise.”

This feature is also available to read in this Thursday’s H&H magazine (22 April, 2021)

A guide to box rest — how to navigate this testing time

Andrea Oakes — Sat, 24 Apr 2021 08:00:37 +0000

When a horse has to stay in the stable for a prolonged period of time, all kinds of problems can ensue. Gil Riley MRCVS advises on how to manage box rest

MANY conditions or injuries sustained by horses, as with humans, can require a period of rest for weeks or even months. However, unlike with humans, we are unable to advise our horses to take things easy and that’s why stable (box) rest is such an important part of many a horse’s recuperation.

The duration and nature of the box rest will be individually tailored for each horse and will be dependent on the condition or injury sustained as well as their speed of response to the rehabilitation programme.

One of the most common reasons for box resting a horse or pony is laminitis. It’s vital that laminitis patients are totally confined to the stable on a deep bed of shavings so that the inflamed laminae are not put under any unnecessary strain while they are repairing.

A failure to do this can result in the pedal bone, ordinarily supported by the laminae, rotating or even sinking (foundering) and thus greatly increasing the seriousness of the original condition. A horse with laminitis must remain completely boxed for at least three weeks after first contracting the condition, after which gradually increasing turnout can be introduced if the horse’s condition has resolved.

Most horses post-surgery also require box rest as a fundamental part of the recuperation programme. All horses that have had colic surgery will be put on box rest to prevent the stitches in the body wall being excessively taxed. This minimises the likelihood of herniation of the intestine through the wound in the muscle layers along the midline of the belly.

Strict box rest in both laminitis and colic cases also requires rigorous control of the diet. In laminitics, a low-calorie diet or weight loss programme is a must. In colic cases, a major surgery can be followed by a period of at least 24 hours of starvation. This is then followed by a bran mash and then a high-fibre diet fed little and often. Restricted diets can be hard with horses with reduced gut motility or gastric ulcers, so its’s best to ask your vet how to feed a horse on box rest.

Unlike laminitis cases, colic surgeries can often benefit from a short walk out several times during the day to allow a pick of grass and to ease any fluid that may be collecting along the site of the incision – the midline along the belly – which is prone to fluid gathering under the effect of gravity.

Depending on the reason for box rest, your vet may allow some periods of hand-grazing (Image credit: creditUnknown)

A HORSE’S recovery from injuries of the superficial digital flexor tendon – check ligament or suspensory ligament (all structures running down the back of the cannon) – necessitates a prolonged period of box rest. Animals which are recovering from any form of fracture repair, especially those of the limb, will also need this.

An important part of the repair of these structures is, after a short initial period of complete box confinement to allow the injury or repair to settle, that they should be exposed to a measured workload in the form of walking out on a hard, flat surface.

This usually means around 10 minutes twice daily, increasing to 30 minutes twice daily over a period of six to eight weeks. Box rest, in association with walking out, gives structures the space to repair through the laying down of collagen fibres (or in the case of fractures, bone).

The walking out also provides gentle work to encourage the tissues of repair to be laid down in alignment with the direction of load, so they are best able to withstand the stresses and strains of work when exercise is resumed.

If your vet has advised a walking programme, you must continue with shoeing as the hard surface can quickly cause the horn to crack and foot soreness to develop.

Less common but still often requiring a period of box rest are eye injuries. Keeping the horse out of sunlight is vital as this can exacerbate discomfort, cause unhelpful squinting, tear streaming and potentially further injury through the horse rubbing the eye in an attempt to alleviate the accompanying irritation. The last thing an injured eye needs is further trauma.

IT is vital that box rest is what it suggests; rest in a stable. An agitated horse running around its stable is not a resting horse and this must be prevented, else the whole treatment plan is in jeopardy.

Some common problems with box rest can include…

Boredom

(Image credit: creditUnknown)

SOME horses will tolerate box rest well. These are generally older horses of a more settled temperament; younger horses of the more hot-blooded breeds tend to be the worst patients.

The stress of box confinement can lead to the horse’s behaviour becoming very unpredictable. Such horses can develop stereotypies to relieve their stress (crib-biting, swaying, box-walking) and these may not disappear once the horse no longer requires confinement.

For such horses, it is vital to experiment with stress-relieving measures. Is the horse better if it is confined to a stable where it can see other horses in the field? Is it better when a companion is kept in the stable next door to keep it company? Keeping other horses in as company, possibly on a rota, can really help.

Some distraction measures can be very useful, such as boredom balls, dangling licks or toys, and mirrors can relieve the monotony for some horses.

Spending as much time as possible grooming the patient will go down very well, as long as it is safe, you are not on your own and appropriate safety precautions – such as tying the horse up and wearing a hat – are taken.

Food intake can be a good distraction, so small, regular hay nets and frequent low-calorie feeds throughout the day are advised. Double netting the hay is a good idea, as the horse will have to work that bit harder for its food to keep its stomach satisfied.

In those horses that are bedded on straw, a continual trickle feed of hay can also ensure the horse does not gorge on its straw bed and risk developing an impaction colic. All of this requires a dedicated owner or a supportive livery yard.

There are various daily calmers on the market and some owners find these helpful. Most are based on either magnesium or L-tryptophan; this amino acid is the precursor of serotonin (the calming, feel-good hormone in the horse’s brain). While the effects of calmers can be inconsistent, if they seem to work, by all means feed them.

In the more fractious animals, it may be necessary to discuss the use of oral sedatives with your vet.

These are also from one of two groups, acepromazine (ACP) and detomidine. The effects of the ACP sedatives tend to be mild but can be very effective in all but the most agitated animals. The detomidine-based sedatives are generally very effective and safe, even if used on a daily basis longer term, but they are more expensive.

Oral sedation can be especially helpful when the horses are on a walking-out programme as many patients will be fine in the box but are prone to explode once walked outside. It should also be noted that the cost of daily sedative over a period of months in some horses can really mount up.

Respiratory issues

PROLONGED confinement in the stable can result in issues with dust, especially in those animals that have a history of respiratory sensitivity or allergies. Signs can include nasal discharge, persistent coughing and airway inflammation.

Use dust-free bedding and make sure the stable is mucked out several times a day so there is minimal ammonia in the environment. Also, choose a dust-free forage such as a good-quality haylage or soaked hay.

Provide as much ventilation as possible. Moving to an outdoor stable or one at the end of the barn can help with the ventilation. If the ventilation in the stable is sufficient, spiders should not be able to weave their webs so if cobwebs are on view, maybe it’s not the best stable for a prolonged period of rest.

Colic

ASIDE from impaction colics as a result of eating the bedding, prolonged box rest is associated with a greater incidence of colic. This may be due to the change of management with the horse being confined to the stable rather than out in the field.

However, should pain-management with non-steroidal anti-inflammatory drugs be concurrent, then these can interfere in gut movement and impaction colics or displacement colics (where the colon or caecum of the large intestine moves out of position within the abdomen) can result.

Such colics are best prevented by limiting the pain relief to the minimum necessary, ensuring a consistent, regular supply of roughage and of clean, fresh water, and those regular short spells out in-hand.

No two recovery plans are the same, and while box resting a horse can involve intensive effort on behalf of the owner, its frequent role in achieving the very best recovery for the horse means it is a vital component in many successful rehabilitations.

Plan of attack

(Image credit: creditUnknown)

The programme for box rest patients is never a one size fits all. Consider some of these options…

Outside pen. If the horse will not settle on box rest it may be possible to revert to a stable-sized area outside (pictured). A sturdily fenced off patch in the corner of a field, within a very short walking distance of the stable to which it will go in at night, can work well.
Rehabilitation centres. A more recent development in the UK is the growth of rehabilitation centres which are willing to work alongside your vet in achieving the very best recovery for your horse. Such units are staffed with competent handlers and facilities that allow the recuperating patient to be managed in a safer, professional environment.
Horse-walkers allow for the walking-out exercise to be performed without a handler exposed on the end of the lead rope and within range of those extendable forelegs. The diameter of the walker should be at least twenty metres as smaller circles can create continual torque on the limbs and joints, sometimes leading to soft tissue injuries.
A swimming pool will allow a full-body exercise without the weight bearing down on injured limbs, while water treadmill exercise encourages particular engagement of the back and sacroiliac area.
Sending your horse to one of these centres will often be covered on your insurance policy but, even if your horse is not insured, the cost of providing the necessary care at the home stable (bedding, fuel back and forth to the yard etc) may not work out much less expensive than it being performed by the professionals.

This feature is also available to read in this Thursday’s H&H magazine (22 April, 2021)

Tipping the balance: why the levels of equine obesity are escalating H&H Plus

Horse & Hound — Fri, 23 Apr 2021 11:00:27 +0000

Even forage and pasture can contribute to an excess of sugar and starch, triggering a cascade of health problems. David Rendle FRCVS offers dietary advice

HORSES evolved on pastures that were high in fibre and low in sugar and starch. As a result, they have adapted to meet most of their energy requirements by fermenting grasses and other plants to release the energy contained within the plants’ fibrous structure.

By harnessing the ability of bacteria to ferment fibre, horses are able to satisfy their nutritional needs through the ingestion of forage alone. With domestication, however, it has become commonplace to increase their energy intake through supplementation with feeds high in sugars and starches.

Feeding energy-dense cereals was more convenient and practical than large volumes of forage, particularly when horses worked long hours, under heavy loads, in urban environments. These days, only horses performing extreme levels of exercise require supplementary feeds high in sugar and starch.

Escalating levels of equine obesity demonstrate we are failing to balance energy requirements with feed. It is estimated that around 50% of horses in the UK are very overweight or obese.

When a horse’s energy intake exceeds what he requires to remain healthy and to exercise, the surplus is converted to fat. In addition to providing a means of storing energy, fat produces “signalling molecules” that alter the metabolism – with the most notable change being a reduction in the responsiveness to insulin.

More insulin must then be produced to compensate, increasing the risk of laminitis. This combination of obesity, reduction in sensitivity to insulin and an increased laminitis risk has become known as equine metabolic syndrome (EMS).

Obesity is associated with many other health problems, including orthopaedic disease, accelerated ageing, developmental problems in youngstock, colic and poor performance. Feeding excess sugar and starch can disrupt normal bacterial fermentation in the large intestine, resulting in combinations of colitis, laminitis and the systemic disorder endotoxaemia. Starches also increase the production of acid in the stomach, increasing the risk of gastric ulcers.

Weighing hay (Image credit: creditUnknown)

PASTURE PERILS

THE simplest means of reducing a horse’s energy intake is to feed him solely forage, with an additional vitamin and mineral balancer. In favourable conditions, however, 30% of the weight of some grasses may be sugars and starches – meaning that their energy content is similar to that of some cereal-based feeds. While eliminating cereal-based feed is a good start to reducing sugar intake, for most horses this is not enough to prevent weight gain.

The sugar and starch content of grass varies dramatically, so consideration must be given to the quantity and type of grazing or forage that is being fed. Levels of sugar and starch in grass are at their highest:

In pastures of cultivated (rather than native) grass species, such as ryegrasses, which were developed to maximise production in the livestock industry. While grass should be kept healthy, fertilisers will increase volume.
During conditions of plant growth, when sunny weather combines with sufficient moisture. Grass seed heads are high in starch and the total sugar and starch content will reduce once the grass has shed seed and becomes woody.
In sunny but cold or frosty weather.
Later in the day, meaning that turnout in the morning is preferable to turnout in the evening. The sunnier the weather, the more rapidly sugar levels will increase; in bright conditions, levels may peak by midday. Grass in full sun is likely to have a higher sugar content than grass in shade.
On heavily grazed pasture or freshly cut hay stubble. Although there will be less grass available, what remains can have a very high sugar content. Restricting the intake of healthy, steadily growing native grass is preferable to using overgrazed or stressed pasture.

While these factors are worthy of consideration, ultimately the only means of reducing energy intake to an appropriate level in a horse that is obese is to limit his access to pasture.

Alfalfa can be used if you need to give feed to administer medication (Image credit: creditUnknown)

When pasture access is restricted, there is likely to be a requirement to feed forage in the form of hay or haylage. The aim is to feed forage with less than 10% sugar and starch after water is removed – that is, less than 10% of dry matter.

Haylage is often perceived to be more energy dense, yet it typically has a lower sugar and starch content as the sugar is fermented after the forage is wrapped. Hay is typically around 90% dry matter (10% water) and haylage around 60% dry matter (40% water). When comparing by weight, more haylage has to be fed to provide the same nutrient content.

The type of grass used and the manner in which it is preserved will have a significant influence on both the water and energy content of the resulting forage, hence the value of forage analysis. This is relatively inexpensive and well worth doing, allowing you to make informed decisions around how much forage to feed rather than just guessing. For maximum benefit, feed the same forage consistently rather than changing sources or batches.

Sugar levels in hay can vary by up to 100% and will be determined by the factors that affect the sugar content of grass when it is cut. Hay that cures slowly in mild conditions, rather than drying out rapidly in very hot weather, will have lower levels as some of the sugar will be broken down. Soaking hay prior to feeding is another effective way of reducing sugar content.

THE BOTTOM LINE

RESTRICTING a horse’s energy intake can appear complicated, but the fundamentals are very simple. Most horses only need fresh or preserved grass to provide their energy requirements; cereal-based feeds are rarely necessary.

Remember that fruit, vegetables, molasses and grains are all high in sugar and starch and are best avoided other than as an occasional treat. If you need to give feed to administer medication, use grass, alfalfa cubes or chaff rather than cereal-based mixes or cubes.

In sunny conditions, most horses given unlimited access to grass will eat more than is good for them; some form of pasture restriction is necessary. While little can be done to control the levels of sugar and starch in pasture, understanding the variables will allow better management of your horse’s energy intake.

Sugar levels in hay and haylage will also vary markedly, so forage analysis can be very helpful in assessing requirements. It is well worth seeking professional advice that is relevant to your particular situation.

Simple science: sugar and starch

(Image credit: creditUnknown)

CARBOHYDRATES are one of the three main classes of foods, along with proteins and fats, and provide a horse’s primary source of energy.

Carbohydrates may form part of the structure of grass (termed structural carbohydrates), or are stored by the grass as sugar or starch. These non-structural carbohydrates can be digested easily and absorbed rapidly. Glucose, fructose and galactose are the simplest sugars and the building blocks for other carbohydrates. Starches are chains of simple sugars that are broken up easily and also readily digested.

Most sugars and starches are absorbed in the small intestine. Food and water move through the small intestine in around 45 minutes; any excess sugars and starches, along with structural carbohydrates and proteins, pass through it to reach the large intestine.

Structural carbohydrates, commonly termed “fibre”, are fermented in the large intestine by bacteria. The resultant volatile fatty acids produced can be absorbed by the horse and also provide him with energy. Sugars absorbed from the small intestine should provide a relatively small proportion of the horse’s energy requirements; far more should come from the fermentation of fibre in the large intestine.

This feature is also available to read in this Thursday’s H&H magazine (22 April, 2021)

Ataxia explained: why a horse might become weak, wobbly or unable to stand H&H Plus

Andrea Oakes — Sun, 18 Apr 2021 08:00:35 +0000

Why might a horse become weak, wobbly or unable to stand? Dr Philip Ivens MRCVS discusses potential causes

ATAXIA refers to incoordination, which can affect one or more of the limbs and also the neck and body. While this complex condition can result from problems with the vestibular apparatus in the inner ear, or in a part of the brain called the cerebellum, ataxia often arises due to an issue in the spinal cord.

Spinal ataxia occurs when there is a lack of information coming up the horse’s spinal cord to tell his brain where his body parts are in space, and the state of muscle contraction at any one time. Ataxia is therefore not painful for the horse; rather, he has no sense of the position and movement of affected areas.

The hallmark of ataxia is inconsistency. Most orthopaedic lamenesses are consistently repeatable in any one gait, or on a particular surface, but with ataxia the gait changes all the time. A leg might swing out to the side or under the body; a joint might overflex, or a foot scuff or drag.

If he trips, an ataxic horse may be slow to correct himself and potentially fall. His trunk, neck or both might sway. He may tread on himself, or struggle to turn – or instead of crossing his legs underneath as he does turn, he stays rooted to the spot, pivoting while his legs eventually catch up.

A grading system can document the severity of the problem, starting with a zero for normal strength and coordination. Grade one applies to a horse who walks normally in a straight line, but shows a slight deficit when walking on tight circles or with his head extended. He may also sway when pulled by the tail.

A mild increase in muscle tone or weakness in all four limbs, with ataxia at all times – especially during the manipulations mentioned – is graded two, while grade three denotes a more marked increase in stiffness and obvious ataxia, with a tendency to buckle and fall while being circled vigorously, backed up or swayed. A grade four case will spontaneously trip, stumble and fall; at grade five, the horse is recumbent and unable to stand.

(Image credit: creditUnknown)

SIGNAL PROBLEMS

CERTAIN developmental conditions present at birth can cause ataxia. These include abnormal underdevelopment of the cerebellum, called cerebellar abiotrophy, and abnormal formation of the first and second cervical vertebrae, termed atlantoaxial malformation.

The degenerative condition cervical vertebral malformation (CVM), or wobblers syndrome, leads to compression of the spinal cord and inhibits its ability to carry messages to the brain. And synovial cysts, vertebral fracture and different types of tumour – melanoma, plasma cell myeloma and lymphoma – can press on the nerves and spinal cord.

Infectious disease can result in ataxia: viruses, such as the equine herpes virus-1 (EHV-1, see box), which is endemic in the UK, and the exotic disease West Nile virus, which is becoming established in central Europe and likely to come to the UK at some point. Bacterial meningitis, diseases caused by protozoa – seen mainly in north America – and parasitic causes have also been documented.

Ataxia can be caused by a long list of toxins, the most common of which in the UK is severe nettle rash. Heavy metals such as lead and arsenic may be to blame, or certain therapeutic drugs if used inappropriately – ionophores, for example, such as monensin, found in cattle and poultry feed.

Reaching a diagnosis begins with consideration of the horse’s age and breed and a thorough examination of his history. Has he fallen, for example, or are there stinging nettles in his field?

A routine examination will assess factors such as heart rate, respiratory rate and temperature, to identify any other physical abnormalities that may contribute to or be part of the neurological problem. For example, it is possible for a horse with a foot abscess to look ataxic or for primary muscle disease to cause weakness and similar signs. Perhaps other body systems are involved, such as the skin. If fever is present, an infectious cause becomes more likely.

A neurological examination then follows, comprising tests to identify the part of the nervous system that is affected. This process, neurolocalisation, is a key part of pinpointing the cause and is used to determine whether the spinal cord alone is involved, or if the brain and the peripheral nerves are also implicated. The disease may be focal – centred in one location – or multifocal, affecting multiple places.

Based on these findings, auxiliary diagnostic tests may include a blood cell count, with serum biochemistry, to look for signs of inflammation and other body system involvement. Diagnostic imaging is becoming increasingly helpful; the quality of X-rays of the neck has improved, while advanced techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) are feasible for at least part of the top of the neck.

Sampling the cerebral spinal fluid, either at the atlanto-occipital joint (just behind the ears) or in the lumbosacral area (behind the saddle), is possible and in some cases helpful.

Cerebral spinal fluid is collected under general anaesthesia (Image credit: creditUnknown)

The yellowing of fluid is seen in cases of EHM (see box, below) (Image credit: creditUnknown)

Radio-opaque dye detects narrowing of the spinal cord (Image credit: creditUnknown)

RECOVERY CHANCES

THE prognosis for ataxia is variable, depending on the diagnosis. Stinging nettle-induced ataxia can resolve quickly and fully once the horse is removed from the nettles, sedated and provided with appropriate anti-inflammatories. Sadly, many conditions affecting the spinal cord have a guarded to poor prognosis, due in part to a horse’s size and the safety concerns regarding him and his handlers.

Treatments, including surgery, are improving all the time. When compared with humans and

small animals such as dogs, however, the number of affected horses that can be sufficiently improved to be considered safe is still relatively small.

Repeated neurological examination and diagnostic tests can aid and guide decision-making, ensuring that equine welfare is always put first.

Suspended animation

(Image credit: creditUnknown)

DISTRESSING images and footage of horses affected by the recent outbreak of EHV-1 in Europe illustrate the neurological effects of this highly contagious disease. The paralytic form, termed equine herpes myeloencephalopathy (EHM), can cause progressive ataxia with marked incoordination of the hind- and occasionally forelimbs, weakness of the bladder and tail, and recumbency.

The virus enters the bloodstream in the immune cells – white blood cells called lymphocytes and monocytes – and is carried around the body. This disseminates the infection to secondary sites, where the virus can replicate in the endothelial cells lining the small blood vessels, which results in infection, inflammation and blood clots. This compromises the spinal blood supply and causes the neurons (nerve cells) to swell and bleed. The extent and location of the neurological lesions determines the nature and severity of the clinical signs.

Modern treatments are available but can be very expensive when dosed for an average-sized 500kg horse. While medications can help, many horses with EHM will die or be euthanased due to complications – often within 48 hours of showing the first clinical signs.

Horses cope poorly with extended time lying down, mainly due to their size, so those that are recumbent are prone to problems including bacterial pneumonia, bacterial cystitis and myopathy (muscle disease). Suspending a horse in a sling during recovery (pictured, above), where possible, can lessen the chance of these complications.

This feature is also available to read in this Thursday’s H&H magazine (15 April, 2021)

Taking care of the workers: how riding establishments manage their horses H&H Plus

Andrea Oakes — Sun, 11 Apr 2021 08:00:25 +0000

Rebecca Hamilton-Fletcher MRCVS discusses the welfare rules surrounding horses for hire

RIDING establishments are an integral and much-loved part of British equestrianism. Many of us started our equestrian “journey” at the local riding school, and these establishments play a vital role in ensuring that riding remains accessible to all.

Even at the best of times, however, managing a riding establishment involves immense hard work with minimal financial return. Covid-19 has added to this somewhat precarious existence.

As restrictions are lifted, establishments that have survived are preparing for a busy summer. How do these businesses routinely manage the health and welfare of their animals?

STRICT STANDARDS

A RIDING establishment (RE) is any business that hires out horses for riding or instruction in riding, or both. In addition to riding schools, REs include operations such as trekking centres and polo schools, and those offering hunter hirelings and beach donkeys. A raft of legislation in place is underpinned by the Animal Welfare Act 2006, to protect the welfare of the animals used and the health and safety of clients and employees.

All REs are required to be licensed. This involves a rigorous annual inspection which must be carried out by a trained and listed veterinary inspector, often with a local authority inspector.

Strict minimum standards must be met for a licence to be issued or renewed. Any animals deemed not suitable – those that are unsound, for example – will not be included on the licence at this stage. In England, where additional regulations mandate extra criteria be met, a star rating system rewards REs of a particularly high standard.

Inspection of the horses is welfare-driven and focuses on those areas most at risk, especially given that many REs favour older animals. Any judgements made are always in the context of the animal’s role; will he be hunting twice a week, or is he a Riding for the Disabled Association pony and only ever required to walk steadily around the school?

Health records must be kept for every horse or pony, detailing the routine monitoring of his weight and condition score, along with dentistry, worming, farriery and tack checks, and any health problems or non-routine veterinary treatment.

The veterinary inspection concentrates on key areas:

General condition: is the animal in optimum condition for his workload? Many traditional REs use native pony types, prone to gaining excess weight.

Appearance and demeanour: a “happy” animal speaks volumes.

Musculoskeletal system: it is important to differentiate between a degree of initial stiffness, which may be acceptable, and obvious lameness. A good overall standard of footcare is also required.

Back health: any evidence of a sore back warrants careful assessment of both the saddle fit and the RE’s policy for horse:rider bodyweight ratios.

Eyes and heart: cataracts and other visual issues are common findings within an older equine population. Most animals seem to work normally with a degree of visual impairment, but rider safety is paramount. It may be necessary to impose restrictions, such as no roadwork. Heart murmurs are generally less of a concern in an otherwise healthy animal, but require careful monitoring.

Coat and skin: ideally an animal has a well-groomed, healthy coat, with no sign of abrasions or galls.

Tack: this should be clean and well maintained. Horses are inspected tacked up, with attention paid to correct fit, safety and general wear and tear.

(Image credit: creditUnknown)

COMPLEX CHALLENGES

WHILE much of this may appear straightforward to the individual horse owner, the many variables within an RE’s remit add further complexity to the management challenges – and also to the workload of the animals involved.

Varying levels of fitness may be required, for example. The frequency of work comes into play, as a balance is maintained between keeping a horse fit enough for irregular hours or seasonal work, without him being overly fresh at any one time.

Contingency plans must be in place to provide cover for ill or injured horses, or during unseasonal weather. In addition, provisions must be made for riders of varying size, weight and fitness, and also individual expectations, experience, ability, coordination and balance.

Rider variables are challenging to cater for. Preliminary work has shown that a heavier rider can induce temporary lameness in a horse, together with behavioural indications of musculoskeletal pain, when compared with a lighter rider. This may be further compounded by inadequately fitting tack.

The vast majority of RE horses have just one saddle, which is expected to suffice for all riders. This is obviously far from ideal, given the potential welfare implications. RE managers increasingly use horse:rider bodyweight ratios when allocating rides, but this needs to be managed sensitively. There is still a lack of scientific evidence on which to base guidelines.

(Image credit: creditUnknown)

The extra challenges created by lockdown have added to the demands of running an RE. The sudden requirement to lay off fit horses has meant reducing hard feed, increasing forage and making good use of turnout where possible, all the while keeping them ready to return to work at short notice.

Where winter turnout has been restricted, some proprietors have used horse walkers and arena turnout to manage the inevitable age-related stiffness in older horses. Those with turnout have handled and groomed horses daily to prevent them from becoming “herd feral”.

On the plus side, many have seen this as an opportunity to spring-clean their premises and carry out maintenance and renovations. It will have been time well spent once their gates are open to the general public once again.

Managing the multi-horse yard

(Image credit: creditUnknown)

RIDING establishment licensing requirements include multiple protocols and extensive record-keeping. Once in place, these systems are an incredibly helpful management tool which can benefit any yard with multiple horses and owners.

A similar plan for a private yard might include:

Health care

A vaccination programme to promote herd immunity.
Parasite control, based on targeted de-worming.
Regular farriery and dental assessments.

Nutrition

Wall charts detailing individual feeding plans.
Regular recording of bodyweight and condition score.
Robustly labelled feed containers.

Biosecurity

Assessment and screening of new arrivals: appropriate isolation for diseases such as strangles, de-worming and careful herd integration.
Monitoring of usual residents: regular temperature taking, recording of unusual behaviour such as reduced appetite or droppings, and close inspection on return from competition.
Suspected disease outbreak: immediate isolation, twice-daily temperature taking, strict hygiene measures and veterinary involvement.

Yard maintenance

Ongoing cleaning, fencing repair and pasture management.

Health and safety

Emergency contact numbers and fire procedures on display.
Well-equipped first-aid supplies.
Suitable containment of prescription-only medicines.

This feature is also available to read in this Thursday’s H&H magazine (8 April, 2021)

Inside the stifle: explaining injuries in horses within this joint H&H Plus

Andrea Oakes — Fri, 02 Apr 2021 08:00:20 +0000

How significant are soft tissue injuries within this complex joint? Matt Smith MRCVS explains

THE stifle is a hard-working joint with a large range of motion, which connects the horse’s thigh and crus (lower limb) regions.

It actually comprises two joints. The femoropatellar joint is located at the front of the stifle, between the ridges at the bottom of the femur and the patellar (the equivalent of our kneecap). The femorotibial joint sits between the bottom of the femur and the top of the tibia, and is divided into medial (inside) and lateral (outside) compartments.

Unlike in most joints, where the opposing cartilage surfaces fit into each other to create a smooth, gliding surface, the femorotibial joint features smooth discs of tissue called menisci, which sit between the ball-shaped ends of the femur and the plateau at the top of the tibia.

A complex array of ligaments supports the stifle and provides stability. On the inside and outside are the collateral ligaments. The patellar ligaments connect the patellar to the tibia, at the front, forming a functional extension of the quadricep muscles. In the centre, the criss-crossed cruciate ligaments connect the bottom of the femur and the top of the tibia.

Tissue injuries

STIFLE injuries are quite common and the soft tissue structures are frequently involved. The range of issues is similar to those seen in the human knee, with meniscal injuries occurring more often than damage to the cruciate and collateral ligaments.

Injury usually follows trauma to the joint. Lameness, often severe, is usually the first clue. While this can improve with rest, moderate lameness typically persists.

Fluid swelling of the stifle joints will be apparent when the lame leg is examined. In the most severe injuries, there may be instability of the joint and obvious swelling around the stifle as a result of internal bleeding. Localising the cause of lameness to the stifle may be possible from examination, but nerve blocks may be necessary.

(Image credit: creditUnknown)

Ultrasound is generally more useful than X-ray for further investigations, but there are pros and cons with each technique. Fragments of bone that have pulled away from the attachment sites of the menisci and stifle ligaments can be seen with X-ray, as can other abnormalities such as reactive changes within the joints.

While ultrasound is very effective for imaging the menisci and collateral ligaments, significant portions of the menisci between the joint surfaces are not visible. Views of the cruciate ligaments are also limited.

More advanced imaging techniques may be needed to establish a diagnosis. Arthroscopy (keyhole surgery) is often used, as this allows direct examination of the interior of the joints and offers the best treatment in many cases.

Experience with computed tomography (CT) and magnetic resonance imaging (MRI) is developing in the investigation of stifle injuries, as both allow thorough evaluation of the bone and soft tissues. It is likely that these techniques will become more commonly used, but they add significant expense.

(Image credit: creditUnknown)

Treatment options

MUCH of what we know about soft tissue injuries in the stifle has come from observations during diagnostic investigation of lame horses using arthroscopy.

Injuries of the meniscus most frequently occur within the medial femorotibial joint. In people, the entirety of the upper surface of the menisci can be evaluated with arthroscopy, by applying traction to the knee and pulling the joint surfaces apart to give space to look around with the arthroscope. This is not possible in the horse, however, meaning that portions of the meniscus, particularly towards the centre of the joint, cannot be seen. Injuries in this location are also inaccessible for arthroscopic treatment.

In the majority of cases, arthroscopic surgery involves removal, or “debridement”, of torn and disrupted portions of soft tissue. Partial meniscectomy (removal of the meniscus) can be performed or, with cruciate ligament injuries, torn ligament fibres removed.

During arthroscopic surgery, the cartilage surfaces are also evaluated for any additional damage or signs of degenerative (arthritic) change. The information obtained provides the best guide for the horse’s chances of recovery from injury.

Intra-articular medications may be used as an adjunct to arthroscopic treatment, or, with mild injuries, as the primary treatment. Anti-inflammatory injections are commonly used, typically corticosteroids such as triamcinolone (similar to cortisone, often used in people).

Your vet may recommend alternative intra-articular medications; examples include hyaluronic acid, which is both anti-inflammatory and viscoelastic (shock absorbing), or polyacrylamide gel, which is thought to form a cushion-like membrane after injection. Stem cells have also been researched for treatment of meniscal injuries, and may improve healing.

Following treatment, an effective rehabilitation programme will help the horse back into work.

(Image credit: creditUnknown)

Meniscal tears most frequently occur in the medial femorotibial joint. The left scan shows a tear before treatment, and the right following debridement (removal) of torn tissue (Image credit: creditUnknown)

The prognosis

MANY horses can make a return to full competitive soundness following arthroscopic surgical treatment. The prognosis depends upon the extent of the injury. With meniscal injuries, approximately two-thirds of horses with minor tears recover fully. This falls to closer to 50% with moderately severe tears; in the worst injuries, very few can resume work.

Injuries of the cranial cruciate ligament treated by arthroscopic surgical debridement generally have a fair prognosis, with approximately half of horses reported with this injury resuming a competitive career.

Sadly, horses who sustain a complete rupture of either of the cruciate ligaments are unable to work again. In the most severe soft tissue injuries, stability of the joint may never completely return and arthritis is likely to develop, with associated persistent lameness.

The vet

MATT SMITH MRCVS is a surgeon and partner at Newmarket Equine Hospital (NEH). This referral hospital is one of the largest in Europe, treating a wide range of leisure and sport horses from all over the UK. Matt is a Royal College of Veterinary Surgeons (RCVS) specialist in equine surgery and has a particular interest in orthopaedic problems. 01638 782020, newmarketequinehospital.com

This feature is also available to read in this Thursday’s H&H magazine (1 April, 2021)

Focus on fluids: how to rehydrate a sick horse H&H Plus

Karen Coumbe — Sat, 27 Mar 2021 09:00:03 +0000

What’s involved in rehydrating a sick horse or restoring the body’s natural fluid balance? Karen Coumbe MRCVS explains the importance of fluid therapy

Horses can be surprisingly reluctant to drink when you want them to.

Different methods have been developed to encourage them, from adding apple juice to the bucket or warming the water, to feeding supplementary salt or soaked hay and wet feed to up the water intake. Such tactics can help, but not when a horse is seriously unwell.

The amount of water a healthy horse needs to drink daily will vary, depending on factors including his age, environment, nutritional status, workload and temperament. Certainly, some will only want to drink out of their own buckets containing their usual tap water, in their own stable, so it is worth trying to accustom a horse to change before it is required.

On average, a healthy 500kg thoroughbred will drink approximately 12 to 40 litres of water per day. With one big bucket holding 10 litres, that means a lot of fluid to administer to any sick horse who is unable to drink – especially if he is losing additional fluids from bleeding, for example, or diarrhoea.

Fluid therapy can be life-saving for the sick horse and is crucial for treating conditions such as dehydration, shock and serious inflammatory responses.

In many colic cases, intravenous fluids are essential during surgery – or sometimes instead of surgery – as well as post-operatively. Fluids help to support a horse suffering from post-operative ileus (reduced or absent gut motility), which is an unfortunate complication of some colic surgery cases.

If the intestines are not functioning properly, quantities of fluid can pool in the stomach and elsewhere. Since horses cannot vomit, this results in the challenge of nasogastric reflux and the need to pass a nasogastric (stomach) tube to decompress the stomach and remove trapped fluid.

Catheter or tube?

(Image credit: creditUnknown)

Intravenous (IV) fluids work by rapidly boosting the circulatory system volume, hopefully helping recovery. Different fluids options are available, including whole blood, plasma and various types of saline.

A vet will administer IV fluids to a horse via an IV catheter, which is typically inserted into the jugular vein on the neck. Complications can arise, including venous injury with thrombosis or infection, causing a blockage. This is more likely to happen if a sharp-ended hypodermic needle is used to access the vein. It is better to use a purpose-designed catheter.

There is also a risk that air can enter and cause an embolism or blockage elsewhere in the horse’s circulation. More likely is that the catheter will come loose and slip out of the vein, resulting in fluid leakage and bleeding. It is essential that the horse is carefully monitored.

In some cases, it is simpler to administer fluids by the enteral (oral) route. This removes the need for sterile fluids and catheters, carries a low risk of infection and costs less.

In very sick patients, however, blood is diverted away from the gastrointestinal tract to the vital organs, limiting the absorption of fluids by this route. Serious colic cases will not tolerate fluids by mouth, and nasogastric intubation is not ideal for recumbent horses.

There are also potential complications with this method, including the rare chance that

a stomach tube may be misdirected so that fluids enter the lungs. A more common problem is that passing a stomach tube causes a nosebleed.

The general rule is that, ideally, a horse should drink water of his own accord. If he will not, fluids by stomach tube are the next best choice, in most cases, before IV fluids are considered.

Liquid assets

(Image credit: creditUnknown)

Whereas a human will receive tiny 250 to 500ml bags of intravenous sterile fluids, administered slowly, a horse will be given several huge five-litre bags. These larger bags are efficient and, when needs must, can be set up to hang from a beam in a stable or barn (pictured).

We are fortunate in this country that such large bags of sterile life-saving fluid are available for equine veterinary use. In some countries, only smaller bags can be obtained, making IV drip administration more difficult.

Recent studies have shown, however, that excessive fluid therapy might be more harmful than once thought. Strategies are being investigated to reduce fluid doses to optimise the level that is beneficial, which will also reduce costs.

This feature is also available to read in the Thursday 25 March issue of Horse & Hound magazine

The dangers of overreach and strike injuries H&H Plus

Andrea Oakes — Wed, 17 Mar 2021 16:05:59 +0000

Sharp contact between a horse’s hind hoof and foreleg can cause a significant injury, as Dr David Stack MRCVS explains

OVERREACH and strike wounds – known as interference injuries – are often self-inflicted. An overreach typically occurs when a horse steps on the heels of a forelimb with a hind foot, while a strike wound can result from the edge of the hoof or shoe making sharp contact with the fetlock or pastern region.

Similar incidents can occur when there is contact between the limbs of two horses moving in close proximity. Injuries can range from minor grazes and bruises that can be managed with routine first aid, to issues requiring veterinary attention. Some can be severe, leading to referral, hospitalisation and even surgery.

Injury can happen at any time in any horse moving actively – often at moments when the gait becomes uncoordinated, due to a lapse of concentration or a loss of fine motor control due to fatigue. Fatigue-related interference injuries can also occur in heavy ground, where horses tire quickly.

We often see interference issues with wobbler syndrome, where a horse loses the ability to know where his limbs are in space (a sense known as proprioception). This can cause an irregular and uncoordinated stride, leading to frequent overreach injuries.

Strikes or sharp, glancing blows from any other limb tend to result in lacerations, often in a horizontal plane, on the sides or back of the pastern or fetlock. Overreach injuries typically cause irregular skin tears that can penetrate other tissues of the heel, even ripping the coronary band.

Either type of injury can have serious consequences, irrespective of the size of the wound. Like other prey species, horses have very little muscle, fat or loose, connective tissue below the carpus (knee) or tarsus (hock). This evolutionary characteristic improves the speed and efficiency with which a horse moves, by reducing the weight of the lower limb, but leaves vital tissues vulnerable to trauma.

The joints and bones are relatively unprotected, as are the ligaments and cartilage and the cushioning, fluid-filled bursae. Nerves, blood vessels, tendons and tendon sheaths are also at risk.

What’s the damage

IF your horse sustains a strike or overreach injury, contact your vet. Even seemingly innocuous injuries can have serious consequences, including infection of the synovial (joint) fluid.

Wounds that are bleeding profusely should be bandaged carefully but snugly, with direct pressure over the wound. A pressure bandage should not be left in place for more than two to three hours, but can be replaced if blood flow continues.

All other wounds should be rinsed liberally with fresh tap water for five to 10 minutes, and then a clean, dry bandage applied. Avoid touching the site with ungloved fingers and remember that a poultice is not a suitable dressing for a wound.

If the skin is lacerated completely, but nothing deeper, the wound requires cleaning and suturing (stitching). Fresh wounds in the pastern and fetlock regions should be sutured wherever possible, as they are prone to the development of pink granulation tissue known as proud flesh.

The horse is likely to be sedated, and will be nerve-blocked and given pain relief, before suturing. He may then need stable rest for two to three weeks, with bandaging, to minimise movement at the wound site.

Your vet will check that your horse’s vaccination status against tetanus is current and will probably prescribe some pain medications such as phenylbutazone (known as bute). Antimicrobials are administered on a case-by-case basis and may not be necessary.

Surgical solutions

DEEPER wounds require careful veterinary assessment to establish whether any underlying structures have been involved. Investigation may include techniques such as X-rays, ultrasound scanning and synovial fluid sampling, ideally performed in a clinic setting.

Injuries to joints, tendons and synovial structures such as the digital flexor tendon sheath are the most serious and, unfortunately, are common. Those involving the cartilages of the foot and the coronary band are next in terms of severity, while other significant injuries, such as pedal and navicular bone fracture, are seen less often. In extreme cases, the whole heel including the hoof wall can be torn off or avulsed (pulled away). Thankfully, such catastrophic injuries are rare.

Wounds that involve synovial structures are potentially life-threatening, requiring hospitalisation and often surgery. Endoscopic (keyhole) surgery is performed under general anaesthesia to flush the joint or sheath, remove debris and address tendon or cartilage damage, before the wound is cleaned and closed.

Rehabilitation may be lengthy, depending on the severity of the injury and the resulting damage. Injuries of the deeper structures of the foot may need antimicrobials and anti-inflammatories.

Overreaches often result in ragged wounds with deeper ripping and bruising of the tissues. As the tissues are crushed by the weight of the hindquarters and hindlimb bearing down on the heel, these wounds are more prone to infection and potential “breakdown” of any surgical repair.

Infections of the cartilages of the foot can be slow to resolve and frustrating to treat. Overreach injuries that involve the heel bulbs and extend to the coronary band may benefit from a rigid foot cast following wound debridement and suturing, to limit movement.

Injuries to the coronary band can create ongoing issues as the new hoof wall grows from the damaged site, requiring careful farriery.

Reducing the risk

PREVENTION may be impossible, but certain measures will mitigate the risk of interference injuries or reduce their severity if they do occur.

Overreach boots will absorb some of the traumatic energy involved and may offer a degree of protection, as will tendon boots – especially those that extend below the fetlock. Consider the difference between getting stepped on by your horse while wearing sturdy leather boots, compared to flip-flops.

However, the force involved in an interference injury means that a hind hoof may slice right through the boot material. There is also the potential for boots to slip, rub or interfere with a horse’s action, so choose and use them with care.

Good farriery can address gait issues, to minimise interference risk. Hind shoes set further back on the foot and bevelled leading edges of the shoe can also help lessen the damage should an overreach occur.

About the author

Dr David Stack MRCVS is a European board specialist in equine surgery and senior lecturer in the University of Liverpool’s Philip Leverhulme Equine Hospital in Leahurst, where he leads the equine orthopaedic surgery and sports medicine service. Contact: 0151 794 6041, liverpool.ac.uk/equine

Also published in H&H magazine, on sale Thursday 18 March

Modern breeding methods: what are they and which one is right for your mare?

Andrea Oakes — Sun, 14 Mar 2021 09:00:50 +0000

Modern reproductive methods may offer a better chance of breeding success, but what do the abbreviations mean – and which is right for your mare? Dr Charles Cooke MRCVS explains

Breeding has always been based on decisions, from which stallion to use to the method of breeding and where to foal the mare. Recently, these decisions have become more numerous, with the emergence of a range of modern assisted reproductive technologies.

Careful planning remains a must, whichever method is chosen, so that you and your vet can maximise the chances of success. Certain questions still need to be asked beforehand. Is the mare healthy? Does she have any conditions that might prevent her from carrying the pregnancy and foaling? Consideration must also be given to when you want the foal to be born, and the logistics of using your chosen stallion.

You may also wonder if you can still breed from your mare while she is competing, or whether it will take several years for her to produce the multiple foals you are hoping for. While much will depend upon your mare’s age, health and breeding history, assisted reproductive technologies may broaden your options, as long as you are not intending to breed a racehorse as natural cover remains the requirement in the thoroughbred racing industry.

Modern assisted reproductive technologies offer solutions for sport horse and pony breeders, and benefits to the horseworld in general. They allow us to ensure the welfare of breeding horses, by using surrogates when a mare cannot carry her own foal, and preserve bloodlines to maintain a wide genetic pool, supporting the recovery of rare breeds.

Technology can also help to preserve the genes of stallions that would otherwise be lost. When a stallion has been critically injured, becomes ill or dies, it is possible to harvest and freeze semen using a process called epididymal sperm extraction. This technique can also be used after a stallion has been castrated.

Mare preparation

Any breeding process requires the mare to be managed with care. This usually involves pre-breeding health tests, including a swab for contagious equine metritis (CEM) and blood samples for equine viral arteritis (EVA) and equine infectious anemia (EIA), along with an understanding of her reproductive cycle.

For most mares, there is a transition from the winter quiescent (inactive) state to a regular 21-day oestrus cycle in March/April, in response to increasing daylight hours. Part of the pre-breeding assessment is to check where the mare is in her cycle, so she can be bred at precisely the right time.

The safety of the mare, handler and vet is paramount, so using stocks and occasionally sedation for examination is advisable.

Artificial insemination (AI)

(Image credit: Arnd Bronkhorst/www.arnd.nl)

Artificial insemination (AI), the most commonly used assisted reproductive technology in equine breeding, involves a series of ultrasound examinations and medications to ensure the mare is inseminated close to ovulation (pictured, above). Fresh semen must be used within three hours, but it can also be supplied chilled or frozen. Your choice will dictate how the mare is managed.

Chilled semen is viable for 24 to 48 hours after collection, so must be ordered and couriered following careful monitoring of the mare. Ovulatory drugs help to ensure the follicle ovulates – releases a mature egg – within the correct time frame.

Frozen semen must be stored appropriately (pictured, above right) and can be used when needed over a time period of many years. Increased veterinary input is needed with frozen semen, to time the insemination for the best pregnancy rates. The aim is to inseminate the mare within six to eight hours of ovulation, so repeated ultrasounds, possibly overnight, are required.

Frozen semen doses vary from a single 0.5ml straw to the more usual four to eight straws. The use of the deep intrauterine insemination (DUI) technique is essential for a lower volume, to deposit the sperm at the tip of the uterus – next to the Fallopian tube – where the oocyte (egg) will be waiting.

With appropriate veterinary management before and after insemination, pregnancy rates for chilled and frozen AI are similar – which increases stallion choice.

Advantages: AI opens up a worldwide stallion market. However, if you are considering a non-UK stallion, it is advisable to use an experienced semen agent, due to the new Brexit regulations.

Embryo transfer (ET)

Embryo transfer (ET) involves inseminating a donor mare, then “flushing” her uterus seven to eight days later to collect the embryo. This is transferred into the uterus of the recipient, or surrogate, mare who then carries the pregnancy.

The reproductive cycles of the donor and recipient must be synchronised, so that the embryo remains in similar conditions. It is recommended that two or more synchronised recipients are ready, to ensure the “best fit” with the donor mare at the time of transfer. However, you don’t necessarily need your own recipient mares, as the embryo can be chilled and couriered promptly to a mare at another location.

Advantages: ET can be repeated multiple times during the season, increasing the number of foals a mare can produce per year. It is worth considering for a competition mare, to avoid interrupting her career, or for a mare with fertility issues or an injury that would prevent her from carrying her own pregnancy.

Intracytoplasmic sperm injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is used in conjunction with Ovum pick-up (below). In this lab-based technique, a single sperm is injected into the matured oocyte, which is held in specialised fluid medium and incubated to encourage the development of an embryo. This can take up to nine days.

Not all of the oocytes will develop into an embryo, but those that do can be transferred immediately into recipient mares or frozen for future use.

Advantages: ICSI is an efficient way of using semen, as a single straw can be used multiple times. The technique is advantageous for sub-fertile stallions or where semen stocks are limited, perhaps because a stallion has died.

OVUM pick-up (OPU)

OVUM pick-up (OPU) is the collection of oocytes from the ovarian follicles of the mare.

The collection process is performed with the mare standing, under sedation with epidural anaesthesia. An internal ultrasound probe is used to visualise the ovary, so that a guided needle can then aspirate (draw) the fluid and oocyte from the follicle. The process continues until 15 to 20 follicles have been aspirated.

The fluid is examined under a microscope. The tiny oocytes are collected, processed and incubated to allow them to mature. Suitable ones are fertilised by intracytoplasmic sperm injections, and the resulting embryo is transferred into a recipient mare.

While OPU is a more involved technique, it is generally well tolerated by the mare and can be repeated in three to four weeks, as long as sufficient follicles develop. It can also be performed outside the usual breeding season. Embryos can then be frozen and stored, exported internationally, or thawed to allow foals to be born at a particular time of the year.

Advantages: OPU is useful for mares with fertility problems – for example, those unable to conceive, maintain or carry a pregnancy, or where ET has been unsuccessful or is not appropriate. As a single-day procedure, involving minimal medication, it is ideal for the busy competition mare.

Meet the veterinary expert

DR CHARLES COOKE is a Royal College of Veterinary Surgeons advanced practitioner in equine stud medicine and a director at Equine Reproductive Services (UK), a North Yorkshire-based first-opinion and referral practice offering specialist advice to vets and owners. With a passion for all aspects of equine reproduction and fertility, Charles deals with a varied caseload of thoroughbred, sport and leisure horses.01653 668190, equinereproductiveservices.co.uk

Also published in H&H 11 March 2021

Group turnout for horses: what are the pros and cons? H&H Plus

Andrea Oakes — Sat, 06 Mar 2021 09:00:44 +0000

How can we maximise the benefits of field time, while minimising risk? Kieran O’Brien MRCVS offers advice for trouble-free turnout

Horses in their natural state are free-ranging, social animals. While separate confinement in a stable is necessary if they are to be individually fed and managed, maximum turnout, where possible, should be provided.

Turnout reduces the risk of colic, respiratory diseases and the development of stereotypical behaviour, while supporting muscle and joint health. Grazing in groups allows coordinated patterns of movement, social experience and mutual grooming, all of which are vitally important for the welfare of animals ill-adapted to a solitary life.

There are negative aspects, however, the most significant being increased risk of injury. In a survey of 652 UK owners, 40% reported that their horses had suffered a traumatic injury in the previous year – 62% of which occurred while at grass. Results showed that horses grazed in a large group or recently introduced to the herd were most vulnerable. Kicks or incidents with field fencing were the most common causes of injury.

Other hazards at grass include exposure to biting flies and intestinal parasites, and obesity and laminitis due to excessive grass intake – all of which can be avoided with careful planning.

(Image credit: creditUnknown)

Taking sides

Interaction across a fence – often with a mare on one side and a gelding on the other – is probably the most common cause of fence-related injuries.

One horse typically strikes out through the fence. It is safer to separate such groups by placing a strand of electric wire along the top of the fence or, better still, a strand near the top on each side. Horses will then come close to the fence but will not lean over.

Alternatively, a separate, single-strand electric fence can be erected on one side, parallel to the main fence. This also stops hungry horses leaning through the fence to access grass on the other side.

Sheep fencing is especially dangerous and should only be used with an additional safeguard.

A gate between fields is another contact point. Although useful for “pre-exposure” of a new horse to others, a gate should be “sheeted” to prevent limb injury if a horse kicks through it. Attach plastic stockboard sheets with strong cable ties, ensuring they overlap by at least 15cm.

Shock tactics

(Image credit: creditUnknown)

Electric fences allow paddocks to be divided cheaply and safely. They can be used to separate horses and thus prevent kicking, to limit the grazing area for weight and laminitis control, and to restrict space for horses being rehabilitated from injury.

With a little thought, electric fencing can be made as safe as possible. Otherwise, injuries can occur – and may be very severe. Apart from stake wounds from the plastic posts, most injuries happen when the horse becomes entangled in the fencing.

An electric fence should have two properties: it should hurt when touched, and should break easily if a horse runs or kicks through it or rolls into it.

Horses will only respect an electric fence if it gives them a suffifficiently severe shock when they touch it. Manufacturers of the energisers, which power the fence, say that a weak or absent shock is in 90% of cases due to failure to earth (ground) the fence properly. The earth stake should be as long as possible and pushed its whole length into the ground.

A good tip is to pour a bucket of water over the stake when it is in the ground to ensure good contact, and to keep it wet. The fence must be regularly checked for contact with vegetation, which reduces the strength of the pulse.

Choose an energiser with the highest output you can afford. Two rechargeable batteries (one in use, and one charged and ready when required) are the minimum needed.

There is no need for the fence to be strong; the risk of an electric shock is what deters the horse, and it is not intended that the fence restrains the horse physically. If he runs through it, the fence should break rather than be dragged and eventually become wrapped around the horse’s legs.

It is generally agreed that plain metal electrified wire should not be used with horses,

as it is virtually unbreakable. It follows that, except in very windy sites where there may be no alternative, electric fence rope – which is extremely strong – may also be inappropriate. The thin plastic string breaks most easily; concerns about its visibility are overstated.

One has to question why, except in the case of small ponies, more than one strand of fencing is required. Using two or three strands presents more opportunities for the fence to fail to break, or to wrap around the horse’s legs if he goes through it.

Breakpoints are easy to make using two cable ties. This method works well for the narrow tape and rope, but experiment to see how tight the cable ties must be for your fence to slide through the breakpoint when force is applied.

Safety first

In any group of horses, there is a social hierarchy enforced mostly by threat – using often quite subtle body language, rather than violence. Kick injuries are common when new arrivals join the group, or when lower-ranking horses fail to respond to threats.

Sometimes, a horse simply cannot get out of the way quickly enough.

Lower leg wounds and overreaches from a forelimb being struck by a hindleg can be prevented by putting boots on the horse before turnout.

Tendon boots do not prevent tendon overstrain injuries but, if they contain a rigid band at the back, will protect the tendons from being struck into. Soft neoprene boots provide some protection against brushing but little else.

Loss of shoes can be prevented by shoeing the horse “tighter”, so the shoe does not protrude beyond the heels at the back, and by shortening the usual shoeing interval by a minimum of a week.

Another option is to turn the horse out in overreach boots (choose one size larger than normal, so they reach the ground), or to wrap the forefeet with duct tape to cover any part of the shoes extending beyond the heels.

Rounded fencing (Image credit: creditUnknown)

Turnout tips

Take the following steps to help to keep horses out of trouble:

● Keep the group size as small as possible (pairs of horses are a ideal) and the composition stable. Avoid moving horses between groups.

● Aim for a large age spread within the group. There is more aggression when horses of a similar age, such as yearlings, are kept together.

● Turn out a newcomer on his own fifirst, so that he can familiarise himself with the paddock layout. Then slowly add the others, one at a time, starting with the less dominant.

● If possible, remove the hind shoes when first introducing horses to each other. Turnout rugs may offer protection from kicks and blows.

● Identify the aggressive repeat offffenders and graze them separately, preferably with a much lower ranking horse who knows to keep out of the way.

● Check there are no places where lower-ranking horses can become trapped and bullied. Rounding offff paddock corners will help.

● Keep the sexes apart. There is far less kicking when geldings are kept separate from mares.

Also published in H&H 4 March 2021

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Calling the vet out of hours: what you need to know H&H Plus

Andrea Oakes — Sun, 28 Feb 2021 09:00:50 +0000

Andrea Oakes discovers what happens when illness or injury occurs “out of hours”

Accidents tend to happen at the most inopportune moments as horses owners are only too aware, and sickness rarely saves itself for a convenient time. Thankfully, if disaster strikes at night or over the weekend, veterinary help is usually just a phone call away.

But who answers these out-of-hours emergency requests and drives to the scene if hands-on treatment is required?

In the UK, the Royal College of Veterinary Surgeons (RCVS) requires that veterinary practices make provision for 24-hour emergency cover. The majority achieve this by running a rota within the existing team, or with neighbouring practices, meaning that the on-call vet often works the day before their night-time shift — and will most likely be back at work the following morning.

As an owner, the promise of round-the-clock care is reassuring. Yet vets in equine-only practices can expect the heaviest workload in the veterinary world, ahead of colleagues in mixed, small and farm animal practices. A 2019 RCVS survey revealed that full-time equine vets work an average of 50.5 hours per week – with on average an additional 25.5 hours per week on call.

Certainly, it is debatable whether a horse will receive the best possible care if the vet has been working both night and day.

Welfare concerns

What happens out of hours to keep our equine vets so busy?

“Colic accounts for roughly one in three visits,” explains Professor Tim Mair MRCVS of Bell Equine. “We helped with a University of Nottingham study, which also revealed that wounds account for a further 20% of call-outs, and lameness for another 11%.

“These tally with our own out-of-hours statistics,” adds Tim. “After these are recurrent airway obstruction, choke, foaling and post-foaling visits and painful eyes, with recumbency, neurological issues, foal problems and diarrhoea largely accounting for the remainder.

“It’s not really the case that horses are more likely to develop certain illnesses in the hours of darkness,” Tim explains, adding that serious colic is sometimes not discovered until the following morning. “More tend to be stabled at night, however, and being fed only hay or eating straw bedding leaves a horse more prone to impaction colic.

“Horses who are unobserved at night may also break into feed stores,” he adds. “Gorging on sugar beet can result in choke, while a glut of concentrates can cause grain overload.”

It’s clear that certain issues require urgent attention, whatever the hour. A delay in the diagnosis and treatment of surgical colic, for example, can significantly lower a horse’s chance of survival while a major bleed or a foaling difficulty represents a life-or-death situation.

Balancing immediate equine welfare needs with the ongoing mental health and work-life balance of our vets on call is not easy, but an emerging solution is the evolution of new equine emergency services clinics.

“These are integrated with regular veterinary practices, but respond solely to out-of-hours emergency calls,” explains Tim. “This relieves the demands on vets in the regular host practices, who then don’t need to cover both day- and night-time work. Those attending out-of-hours calls are fresh, not tired, and can become more skilful in treating emergency cases.”

Earlier this year, the RCVS approved a new category in its practice standards scheme, to ensure that these “ambulatory” (outpatient) clinics provide the most appropriate and up-to- date service.

“It is incredibly tough to work all night and all day,” explains Tim, who adds that long working hours with irregular nightshift patterns are a proven cause of ill health. “These new clinics can help lighten this load, improving the welfare of both the vets and their patients.”

Open all hours

According to Ian Bellis MRCVS of Equicall, a dedicated out-of-hours service, the key to success is a solid relationship with the daytime practice, and skilled equine vets who are accustomed to equine emergency care.

“In a crisis, an owner wants someone there promptly,” says Ian, who set up the pioneering service in 2018 with James Hopkins MRCVS. “It’s nice if they know the vet but, in a large practice, this is not always possible with an urgent daytime call-out. A quick and effective veterinary response is most important.

“We work closely with multiple equine practices, carrying out emergency work for nights, weekends and bank holidays,” he adds. “An owner will still call their regular practice, but one of our team will respond.”

Equicall’s busy workload is dominated by colic cases.

“It is amazing how sensitive some horses are to things such as changes in climate and moisture levels in the grass,” says James. “But we’re called to a range of emergencies. We do at night what a daytime vet would do; for a joint wound, for example, we’d arrange X-rays and if necessary, refer the horse to the closest hospital.

“A good handover to the daytime team is essential; all case details should be itemised and communicated by email or phone.”

Without traffic priority, vets cannot provide a true “blue light service”. They will triage cases to prioritise the most urgent, however, and attend emergencies as promptly as possible.

“We would encourage all owners to phone their practice if they are worried, whatever the hour,” says Ian, adding that in two years Equicall has seen 2,500 emergencies and handled 4,000 advice calls. “Sometimes, a brief chat with a vet is enough.”

Emergency measures

Be prepared for an out-of-hours visit by:

● Knowing the postcode of your yard or field, ideally making sure that the premises are signposted clearly from the road.

● Maintaining a well-stocked first-aid kit for basic treatment such as bandaging.

● Checking your horse’s passport is easily accessible.

● Keeping your trailer and towing vehicle or lorry in good repair or identifying a reliable 24-hour equine transport service and keeping contact details handy, in case urgent hospital treatment is necessary.

● Taking extra care when handling a horse who is in pain to prevent personal injury.

● Where possible, providing lighting, hot water, soap and a clean towel for the visiting vet. Remember your masks, with current Covid security, and minimise numbers of people.

● Thinking ahead about whether you would want your horse to undergo surgery for serious colic, for instance. Indecision can waste valuable time, jeopardising the chances of a successful outcome. It may be too late to change your mind once you’ve ruled surgery out.

● Considering insurance exclusions, upfront hospital costs and any necessary permissions in advance, briefing anyone left in charge of your horse in your absence.

Can it wait?

“A veterinary emergency is usually obvious, such as profuse bleeding that won’t stop, difficulty in breathing or any obvious or suspected fracture,” says H&H vet Karen Coumbe MRCVS.

“But other problems may require immediate attention. Continuous diarrhoea can cause dangerous dehydration, for example, while eye injury or ulceration can lead to permanent loss of vision.

“If in doubt, call and ask for professional advice,” she advises. “Be ready with the basics, such as the frequency and duration of any signs of pain, the horse’s temperature, pulse and respiratory rate, or the location and appearance of a wound or swelling. Sending an image or a video is often useful, particularly with lameness or wounds.”

This feature was also published in H&H magazine, 25 February 2021

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How to keep a horse in harness in good health H&H Plus

Andrea Oakes — Sun, 21 Feb 2021 15:00:45 +0000

What does it take to keep a harness horse in good health? Driving vet Rosie Mould MRCVS offers her advice

From a fun outing with a pony and trap to the four-in-hand championships at international FEI level, driving encompasses a huge variety of activities.

Any type of horse or pony can learn to pull a carriage, as long as he is confident and well trained enough to go forwards with a wheeled “creature” chasing him. The sport offers a second career for riding ponies who have been outgrown, an alternative for ponies not compatible with small children and a shared experience for families and friends.

Just as the ridden horse should carry weight on the hindlimbs to free up the forelimbs for movement, the driving horse should push with his powerful hindquarters – rather than pull – and use his shoulders and bodyweight to propel the carriage forwards. Once momentum is achieved, the effort required to keep the carriage rolling will depend upon the surface, the gradient and the requirement for twisting and turning.

The horse’s level of training will then come into play, along with the skill of the driver and the “backstepper” (the passenger positioned in the rear of the carriage), to reduce the load and produce a smooth ride.

Instead of carrying a rider of, say, 70kg, the horse must in effect push the weight of the vehicle and its passengers – which represents quite a difference in effort. As a result, driving can exert pressures on hindlimb function that differ in their intensity and occurrence from those on ridden horses.

Wear and tear

Training for any driving competition requires a methodical approach to fitness. As it takes several years to develop a high-level competition driving horse, much like in any other discipline, various orthopaedic “wear and tear” challenges can be encountered along the way.

If the horse has to negotiate obstacles, it is important to give him the best chance of cornering securely at speed to reduce the risk of self-injury, so pay attention to shoeing and the type and tting of any studs or pin nails used. But self-injury is relatively rare and overreaches unusual. Leg injuries more often occur during accidents or are occasionally caused by the other horse in a pair or a team.

Joint pain, sacroiliac joint issues, hock problems and, in particular, hindlimb tendon sheath injuries and in ammation are all common. Addressing and diagnosing these at the outset will almost always produce a better long-term result.

Those horses who perform in the S-shaped outline often seen in driving, where neck flexion comes mainly from the poll and not from the lower neck as well, tend to suffer more, as their hindlimb muscle structure does not support their activity. An occasional stride of lameness turns into an “every stride” issue, or a single “unlevel” comment from one dressage judge becomes the opinion of all three.

Some lamenesses, particularly in the hindlimb, are difficult to see and might only manifest themselves while the horse is in the carriage. I sometimes get onto the carriage in the backstep position while the horse is working to identify the issue.

As veterinary expertise increases and with the use of lameness detectors, it is now often possible to diagnose problems earlier and o er orthopaedic treatments more speedily. An equine physiotherapist qualified with the Association of Chartered Physiotherapists in Animal Therapy will help with this, particularly if they see a patient regularly, as they can detect changes quickly and bring them to an owner’s attention.

Whether you’re driving a horse for leisure or competition, harness must be well fitted and maintained to prevent rubbing or bruising.

Driving bridles and bits are chunkier and heavier, especially in pairs and teams where the bits incorporate more metal to avoid trapping the coupled reins that cross over between horses. Driving saddles look more like rollers, but require the same attention to detail as a riding saddle to ensure that they are comfortable and do not put pressure on the spine. A double girth is used, so there are more buckles, and usually a crupper that ts under the tail.

(Image credit: creditUnknown)

Athletic demands

The competition driving horse is not only pushing extraordinary weight around a dressage arena and demonstrating accuracy and speed around a cones course, but also must complete a marathon – the most strenuous part of which is a section of up to 9km that includes up to eight timed obstacles. The marathon lasts for between 60 and 90 minutes and incorporates a 10-minute halt, with vet checks en route and at the finish.

Surface and gradient can have a profound e ect on the effort required; hard ground is often preferred to soft, while sand, mud, water and hills all make additional demands. A low-grade lameness or poor shoeing can be sufficient to make that extra effort impossible, while a subtle respiratory condition such as equine asthma may only become symptomatic under athletic stress.

Accidents do happen, sadly. Usually, the faster the pace, the more disastrous. Horses can be trapped if the carriage overturns; once freed, however, it is amazing how many seem to stand up relatively unscathed.

Injury can also occur if a horse is accidentally turned into a post, or a pair is “split” with one going either side of it. Remember that a driving horse’s sight is limited by blinkers; these must be fitted correctly to allow a sufficient range of vision. A positive spin-off is that blinkers afford good eye protection.

Shoulders tend to receive the worst of the damage in collisions, although modern harness is well padded over crucial places and will provide some protection. Most drivers use protective boots in the faster phases, to reduce the risk of traumatic injuries to the lower limbs.

As with any equine athlete, meticulous preparation and appropriate competition aftercare will go a long way in helping the driving horse cope with the rigours of the sport.

(Image credit: creditUnknown)

Dual disciplines

Many driving horses are also ridden, switching happily between the disciplines.

When introducing a horse to a completely new activity, however, bear in mind that established riding and driving animals are very different. Riding horses usually have better developed shoulder and forearm muscles, whereas driving horses tend to develop the medial (inner) thigh muscles – which can only add power to the ridden capacity. A horse who has only ever been driven will lack muscle across the withers and back, so this area must be developed gradually with “long and low” work, through a mixture of riding and lungeing.

A programme of static and active exercises, including stretching, polework and circles, will further help the driving horse adapt to being under saddle. He may already be familiar with lateral work, such as leg-yielding and shoulder-in, as part of his dressage and cones training, so this can be built on for ridden dressage. Remember, too, that a driving horse will be used to blinkers and may not be familiar with what happens behind him, even if he has been ridden before. He’ll also have undergone some voice training.

Generally, it is the inflection of the voice, rather than the actual words used, that gives the command. The universal continental expression for “slow down” or “halt” is a rolled “rrrrrr” sound, so be careful what you ask for. Once verbal communication is established, it is easy to combine this with the ridden aids and then to drop the speaking altogether to remain within ridden competition rules.

Ref: 18 February 2021

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Why equine viral arteritis could cause havoc for UK horse breeders

Karen Coumbe — Mon, 15 Feb 2021 08:48:50 +0000

Equine viral arteritis may be rare in the UK, but we cannot afford to be complacent, warns Karen Coumbe MRCVS

WITH vague signs and the ability to spread undetected via silent “shedder” stallions, the infectious disease equine viral arteritis (EVA) has the potential to cause havoc within the UK breeding industry.

EVA is caused by the equine arteritis virus and is found virtually worldwide, including in mainland Europe where there is high horse population immunity and low-grade signs of the disease.

Evidence suggests the global incidence of EVA is increasing. While the UK has remained relatively unaffected, this means our equine population has little or no immunity and would be highly vulnerable to infection when or if the virus recurs here again.

EVA is unusual in that it is spread by both respiratory and venereal routes. The disease is rarely life-threatening to healthy adult horses, but can result in abortion in broodmares and, infrequently, death in young foals.

The most serious issue is that some stallions are apparently healthy carriers of infection, shedding the virus in their semen. Mares mated with or inseminated by such shedder stallions may become infected and spread the disease to others by the respiratory route.

The disease can be transmitted by all forms of artificial insemination (AI); neither chilling nor freezing will destroy the virus, which is preserved in the semen. Antibiotics commonly used in semen extenders have no effect on its survival. The consequences of an outbreak could be devastating, both for individual studs and the wider equine industry.

How the equine arteritis virus spreads

Through venereal contact between mare and stallion
From stallion to mare at AI, through infected semen
Via droplets from the respiratory tract, spread by coughing and snorting, through any close contact, such as in yards, turnout or at shows
Through contact with aborted foetuses, or fluids and placentas of mares who aborted due to EVA, or during foaling

High-risk situations

MECHANISMS are in place to prevent the introduction of equine viral arteritis to the UK via semen imports.

Any semen imported should be certified by an official vet from the country of origin, to confirm that the stallion is free from infections – including EVA.

In the UK, only vets and certified AI technicians are allowed to inseminate mares. It is their responsibility to notice the lack of certification, whether paper or electronic, to acknowledge this is an illegal import that should be rejected, and to report the infringement appropriately.

The British horse industry must do all it can to protect itself from any further outbreaks. EVA is classified here as an exotic notifiable disease, which means that a case must be reported to the authorities if it is identified in stallions, or mares that have been bred or inseminated in the past 14 days.

High-risk situations for spread of the disease include any import and also the covering or insemination of mares, and when they are later foaling down, or whenever there is movement of horses between premises.

As horses which have EVA and are capable of passing on the disease do not necessarily show clinical signs, control and prevention is based upon blood testing to identify carriers.

Owners and breeders need to be aware of the potential risks of EVA. Equally, vets must remain vigilant. The disease should be considered a possibility until it can be ruled out by diagnostic testing of any suspects.

It would seem that most of the recent EVA infections in the UK have been carrier stallions, first detected by routine serological (blood) testing conducted for international trade, pre-purchase or pre-breeding purposes, and not identified through investigation of clinical disease.

Be cautious, however, and monitor your inseminated mare for signs of illness, which is one way the disease has previously been detected.

Physical clues include fever, lethargy and depression, conjunctivitis (pink eye), nasal discharge, nettle rash-type skin lesions and swelling of the eye socket, lower limbs, scrotum or udder.

All of these signs are vague, so lab tests are required to confirm the diagnosis. Proper investigations can identify the presence and level of antibodies by testing blood, and can also screen for the actual virus in blood, semen and other samples.

When a mare aborts her foal, or if a newborn foal’s death could be EVA-related, the mare’s clinical history and blood samples should be sent to the lab along with samples from both the placenta and the dead foal.

Prevention via vaccination

There are reliable, readily available tests to control equine viral arteritis. The main method of prevention is vaccination, particularly for stallions, accompanied by blood tests on all horses prior to breeding to confirm that they are free from infection.

Semen can be tested to ensure it is safe for insemination, and also to identify whether a stallion is shedding the virus. More than one EVA outbreak, such as that in South Africa, has been caused by semen sent from Europe that subsequently was reported to be infected.

In the UK, the vaccine is used to protect stallions but not mares. The timing of the vaccine is crucial, so it should be administered under strict veterinary guidance. A blood test must be taken beforehand to show that the stallion has no antibodies, because post-vaccination tests cannot distinguish whether antibodies present are from infection or immunisation.

It is vital for breeding, sale and potential export purposes that any such blood test results are received and properly documented in the horse’s passport before vaccination – and that the vaccination is administered every six months.

Certainly, no mare or stallion should be used for breeding until there is a definite clear lab test signalling that it is safe to go ahead. A test is likely to cost less than £50 and can save a huge amount of hassle.

Even if a stallion is destined for competition and not breeding, it is still wise to arrange a basic blood test before purchase and importation – and to double-check the horse after arrival.

Treatment for equine viral arteritis

THERE is currently no treatment for EVA. While some people have suggested that anti-testosterone medication can reduce shedder status in stallions, this is unreliable and not recommended.

The problem will be eliminated if the horse is castrated, as only stallions are persistent shedders. Otherwise, such horses must be isolated under Government movement restriction orders and managed extremely carefully. Some are re-exported.

Currently, the UK Government publishes details of restricted infected horses on its website. The same website has a review of the 2019 UK outbreak, which reveals the capacity for spread of infection by respiratory means, rather than just through covering, and the relatively large number of horses involved.

The review also highlights the importance of making sure that horses coming from countries where EVA commonly occurs (Spain, for example, in the 2019 outbreak), into countries such as the UK, where it is not routinely present, should be properly tested as negative before importation and retested after arrival. Quarantine is also an important factor to consider, along with being aware of where your horses have travelled, so that any spread of infection can be tracked.

The health of all of our horses is put at risk if these vital checks are ignored. Insist on clean certificates for all breeding horses at the start of every breeding season, be extra vigilant and consider quarantine with new arrivals – especially those that are imported. This is a serious equine disease, which has the potential to be a major impediment to international horse travel.

Detailed Codes of Practice for 2021 can be found at the Horserace Betting Levy Board (HBLB) website: codes.hblb.org.uk

H&H 11 February 2021

Home alone: how to best keep your horse happy while stabled H&H Plus

Andrea Oakes — Sat, 06 Feb 2021 15:00:42 +0000

Can enriching a horse’s stable environment help him cope with indoor life? Andrea Oakes

We know that a lifestyle spent largely indoors, and alone, is a long way from what’s natural and healthy for horses. If a stabled horse looks happy and seems well, however, can we assume that he is satisfied with his surroundings?

According to equine behaviour expert Dr Orla Doherty MRCVS, a horse’s outward appearance may not be as revealing as we imagine.

“He may seem absolutely fine – looking over the stable door, apparently interested, with a shiny coat,” she says. “But we should ask ourselves, ‘What must it be like for him?’ Horses have a very high motivational drive to carry out certain behaviours, so denying them the opportunity to do so will have a big impact.”

Horses have evolved to do three things in particular: to eat, move and socialise.

“A horse would naturally spend at least 60% of his day grazing, rising to 90% on sparse pasture,” Orla says. “It is well established in scientific research that a horse would not voluntarily ‘fast’ for more than three to four hours. While we can satisfy his nutritional requirements in concentrated feed, we cannot bypass his instinct to be chewing and swallowing – yet many stabled horses finish their forage by late evening and are not fed again until the next morning.

“Naturally, a horse would be in almost continual locomotion, grazing and stepping forwards, adds Orla. “He would move in a group and engage in interactions such as mutual grooming, but by stabling a horse we prevent these social behaviours. Ideally, a window or a low wall will allow nose-to-nose interaction; simply seeing a neighbouring horse from 12ft away is not thought to be of much value.”

Toy story

Stable mirrors and toys can never be a substitute for natural means of behaviour fulfilment, says Orla, but they have their place – if used wisely.

“A horse displaying behaviour towards another will trigger an appropriate response, to get both safely through the interaction,” she says. “A mirror reflects the behaviour back. While this is not of the same value as another horse interacting, it does provide visible movement and makes that environment more interesting.

“Toys such as feed-dispensing balls have some value; pushing them around encourages locomotion, and the slow release of food brings a horse closer to his natural feeding habits,” she adds. “But a device that dispenses a highly palatable treat, such as pellets, or withholds the reward component, can give rise to frustration and arousal which may be misdirected elsewhere.

“A slow-release forage feeder is best. If possible, provide late-night forage, double-netted or in a small-holed haynet, to keep the horse busy for some hours, so he is not fasting until breakfast.”

Company is always desirable, ideally of the equine variety.

“The further away from equine we move, the less satisfactory the interaction,” explains Orla, explaining that even a donkey has a slightly different behavioural repertoire. “But see what works.

If we remove opportunities for a horse to be interactive, or active, we should do our utmost to enrich his environment.”

Introvert or extrovert?

Horses unable to indulge their natural instincts react in one of two ways.

“Some deal with frustration in an active or extrovert fashion, such as trying to find things to chew or lick,” says Orla, explaining that response is largely determined by genetic make-up. “These horses are more likely to develop stereotypic behaviours, such as crib- biting or wind-sucking.

“Others have a more introverted method of coping. A recognised psychological condition called ‘learned helplessness’ can result, where the horse stops trying to alleviate stress and shuts down. He still experiences anxiety, though, even though we may not notice. This horse is more prone to gastric ulceration.

“Health risks don’t stop there. Short-term frustration leads to a surge of adrenaline, while continually elevated stress levels prompt the release of the natural hormone cortisol.

“While cortisol is helpful for the ‘fight or flight’ response, without the corresponding ‘escape’ from danger it can dampen or suppress a horse’s immune system. He will then be more likely to pick up infection and may lose condition as his body continues to break down energy reserves in preparation for flight.”

Ref: 4 February 2021

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Buying the less-than-perfect horse: pre-purchase vetting decisions

Andrea Oakes — Thu, 28 Jan 2021 15:00:21 +0000

A pre-purchase examination can throw up a number of issues to consider before buying a horse, but the vet can help the potential purchaser weigh up the results...

Few horses tick all the boxes when it comes to health and temperament; a degree of compromise must usually be made.

Experts agree that a five-stage pre-purchase examination (PPE) is a sound investment before buying, rather than the shortened two-stage exam, but how does a vet assess a horse with an obvious or suspected problem? And how does a potential purchaser weigh up the findings to make their decision?

Lesley Barwise-Munro MRCVS and Malcolm Morley MRCVS discuss three typical scenarios…

Safe and sound?

This horse has a good competition record, but doubts have been raised about his behaviour. Is it the vet’s responsibility to protect a buyer from being over-horsed?

“The PPE centres around a veterinary check list, but at the same time observations are usually made about the horse’s behaviour and suitability to protect the buyer,” says Lesley. “What is considered acceptable is very much driven by the level and experience of the buyer, the prospective rider and the horse’s future job.

“Being head shy, bargy or sharp in terms of threatening to kick can be revealed during the early stages of the PPE. The vet must try to ascertain if the horse is just a worrier and slowly settles, or if he has a temperament issue that could affect suitability – before describing what has happened and alerting the buyers to see if the issue concerned them when they tried him.

“A horse with a tendency to nap may not produce this on the day of the exam. As a buyer, it is always worth asking to ride the horse away from others when you try him, and, if possible, hacking him out alone.

“As the PPE progresses, a vet will get a feel for a horse in terms of his manner and behaviour. Watching the horse over the stable door while filling in the initial paperwork may reveal any abnormal behavioural traits such as weaving, box walking or wind sucking.

“Keep in mind that an experienced handler or rider presenting a horse for sale can disguise issues. Blood sampling at PPE is a safeguard to fall back on if it is suspected that drug administration has been used to modify behaviour. Remember, too, that you may not be able to ride a horse in the same way as a professional and produce the same results at home; support from a good trainer is worth putting in place.

“Ultimately, the vet can only advise about temperament, so that at least any potential naughtiness is flagged up.”

Wonky, but otherwise wonderful

He seems sound and sensible but this horse has is noticeably asymmetrical. What should a potential buyer consider?

Lesley explains: “As part of a PPE, the horse should be stood on a firm, level surface so that the vet can carry out a distant appraisal of his overall conformation – from the front, side and behind.

“The hind feet should be together as he is viewed from behind, so the vet can assess pelvic symmetry by looking for height differences of the tuber sacrale (or TS, the bony prominences at the top of the hindquarters). Palpation of the TS helps confirm levelness or identify any small differences. Viewing from behind also allows assessment of muscle symmetry, highlighting any swellings and whether one hind limb is rotated more than the other.

“From the front, the shape of both sides of the neck, the shoulder muscling, front limb rotation (toe in or toe out) and the size and shape of the front feet are assessed, and the fetlocks and knees checked for being an equal height from the ground.

“Why is symmetry so important? The relationship between conformation – especially of the lower limbs – and lameness is well recognised. Horses come in all shapes, sizes and types, so conformation will vary, but certain conformation faults produce predictable problems.

“Since biomechanical efficiency of movement is thought to stem from good, symmetrical conformation, correct movement will create the least amount of abnormal strain. The more degrees away from “perfect” conformation, the greater the strain or “torque” in the affected parts of the body.

“This is all proportional to the level of work that the new horse will be expected to do. The higher the level of performance in each discipline, the more emphasis is put on being as close to the “gold standard” symmetrical conformation as possible. While it is important to recognise desirable conformational traits in horses suited to a particular discipline, however, a vet must also learn to overlook a minor fault that has little clinical relevance.

“After a visual assessment of the conformation and any lumps or bumps, the vet will watch the horse move to evaluate the impact of any limb deviations or asymmetries. Where one forelimb “toes in” more than the other, for example, that leg will have a different flight path and land on the outside of the foot – causing uneven loading which transmits through all related joints. Good farriery may rectify the problem, allowing the foot to land flat and protect the coffin joint, navicular apparatus, fetlock joints and related soft tissue structures in that leg.

“A difference in TI heights is the most common pelvic asymmetry detected at PPE. This is often presumed to be subluxation (partial dislocation) of the sacroiliac (SI) joint, but it may also be caused by asymmetrical muscle forces acting on the pelvis, rather than direct SI ligament injury. Only a few of these horses actually have pathology of the SI ligament or SI joint laxity.

“Studies have revealed, however, that TS height asymmetries of more than 1cm are often associated with poor performance and should be scrutinised carefully for SI pain on palpation, hindlimb lameness and back stiffness.

“As with any other asymmetries, this abnormality, if detected, must be carefully interpreted. Is it likely to affect the horse’s performance for the purpose for which he is being purchased? The vet should give an opinion of whether the horse is currently sound in all aspects of the PPE and likely to stand up to his intended job, as well as discussing any implications for resale value.”

Maintained on medication

The occasional joint injection keeps this horse performing at his best. Is he a wise buy?

“It is not uncommon that an older schoolmaster horse who has had a successful competition career is not entirely sound without medication, such as regular phenylbutazone (known as “bute”) or joint injections,” says Malcolm. “As part of the PPE, the seller signs a form declaring whether the horse has received any medication within the last 30 days. While we would prefer to examine the unmedicated horse, it is not necessarily a problem if he has received something – provided that the seller declares this and the potential purchaser is made aware.

“Some buyers feel that it’s not worth investing in a PPE with a horse on medication as they know it will “fail”, but this is missing the point of the exam. The PPE is designed to do so much more; by looking at the bigger picture, the vet can offer a balanced opinion of the horse’s suitability for intended use. What’s important is to use a vet who knows you and your values, and vice versa.

“Many of these schoolmasters still have so much to offer. Consider the implications, such as ongoing costs and potential insurance issues, but don’t rule out buying a horse that requires medication if he seems otherwise suitable.”

The vets

LESLEY BARWISE-MUNRO MRCVS oversees a busy caseload of performance and leisure horses at Alnorthumbria Veterinary Group, Northumberland.

MALCOLM MORLEY MRCVS, of Stable Close Equine Practice, Hampshire, has chaired the British Equestrian Veterinary Association (BEVA) PPE committee.

Ref: 28 January 2021

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New findings revolutionise how bone fractures in horses heal and can be prevented H&H Plus

Horse & Hound — Sat, 23 Jan 2021 09:00:47 +0000

New insights into how bone forms, adapts and heals are revolutionising fracture prevention and repair, explains Patrick Pollock FRCVS

The ability to repair and prevent bone fractures in horses, which can come about as a result of a single trauma or as a result of ongoing microtrauma through inappropriate training, is a topic of great interest among the veternary community and horse owners alike, with exciting new insights available.

Bone is a substance that changes throughout life, in a process called remodelling. This allows the bones of foals and young horses to grow and change shape, and in adult horses enables the repair of damage and prevents bones from becoming brittle.

The amount of remodelling is affected by the horse’s age, the type of exercise he does and the surface on which he works. Research in thoroughbreds discovered that if horses undergo controlled exercise early in life, the bone “learns” to model in a way that protects it from injury in later life.

Interval training with short bursts of high-intensity exercise is more likely to result in healthy, strong bone, than low-intensity, endurance-type work. Exercise causes tiny areas of damage, leading to “stress remodelling”, where the bone adapts to the forces placed on it. This process, called an adaptive response, is critical to bone health.

Why bone fractures occur in horses

We now know that the die is cast for a fracture long before the bone actually fails. Inappropriate training before the adaptive bone response is complete leads to too much strain on the bone. This results in “fatigue injury”, microscopic damage to the bone.

If training continues, the osteoblasts lay down too much new bone, causing the bone in those parts of the skeleton placed under excessive strain to become more dense than normal. In horses, extra new bone tends to be laid down at the joints, such as around the condyles (rounded ends) of the fetlock and in the front part of the limb bones. This dense bone, called sclerotic bone, is actually quite brittle.

The advent of magnetic resonance imaging (MRI) has enabled us to see the true extent of pathological changes within the bone prior to fracture. Abnormally modelled bone with fatigue injury appears inflamed and contains excessive amounts of oedema (fluid). Stress fractures may even be visible before the horse is lame and before radiographs (X-rays) can detect the injury.

It appears certain humans may be predisposed to the development of stress fractures; genetic markers exist to identify these people, allowing them to be monitored. Recent work at the University of Edinburgh suggests this may also be the case in horses. And it would be exciting to be able to identify horses at risk of developing stress fractures through something as simple as a blood test.

We do still see fractures that come about as a result of trauma, such as a kick or a fall, and some performance horses do slip through the net and present with a fracture. Thanks to a better understanding of how to train horses to encourage the adaptive response, however, along with our ability to detect signs of bone microdamage before a fracture occurs, the number of sport horses suffering fractures is at an all-time low.

How healing occurs in bones

In contrast to soft tissues, such as tendon, ligament or skin, bone is one of the few body tissues able to heal without a fibrous scar.

Unlike the scar left after a skin wound heals, which never gains the same degree of strength and can be thought of as a fibrous “patch”, new bone laid down during fracture healing is just as strong as the original. Healing is so effective that it is often impossible to determine where the previous fracture was.

Bone healing is affected by two main factors: the size of the gap between the fractured ends of the bone and the strain across the fracture site. Strain relates to stability: a certain amount is good, keeping bone ends together, but too much interferes with healing.

To understand the healing processes, it can help to think about skin wounds. Where possible, we will close the wound and realign the edges of the skin to enable primary intention healing. Where the skin is lost, secondary intention healing occurs – the wound fills with a blood clot and then granulation tissue (proud flesh) and is eventually covered with new skin cells resulting in a larger scar.

When the gap between fractured bone ends is less than 0.01mm and the strain across the site is less than 2%, structures (cutting cones) develop across the fracture. These generate cavities that fill with bone produced by osteoblasts. This re-establishes bridges of osteons across the fracture line, which then remodel into normal lamellar bone.

As a result of this primary healing, there is no formation of a periosteal callus (lump) at the site. This is important in articular fractures, involving joints, which are common in horses, as the presence of a fracture gap then callus formation can potentiate the development of osteoarthritis.

Secondary bone healing occurs when the ends of the fractured bones are near enough to heal but not perfectly opposed, or when there is motion at the fracture site. This process involves the classical stages of injury: haemorrhage, inflammation and scar formation.

In bone, the “scar” is a soft callus made of cartilage; this then undergoes mineralisation and remodelling so that, unlike skin, the tissue becomes normal without any permanent scarring. Secondary bone healing is less of an issue in certain situations, such as fractures of the non-weight-bearing splint bones on either side of the cannons in the lower limb.

Because we now understand how bone is formed, how it adapts and responds to stress and activity and how it heals, we have never been so well prepared to identify and treat potential fractures before they occur – or to repair the damage when they do.

Understanding how bone forms

From the huge bones of the pelvis and femur to the tiny structures within the ear, each of the horse’s 205 bones performs a critical role – and each adapts in direct response to the forces and strains applied to it.

How does this remarkable, adaptable material form?

● Bone largely consists of a protein called collagen, which forms a framework for the mineral calcium phosphate. This combination makes bone strong yet flexible enough to withstand stress.

● Three types of cell are constantly at work within the bone: osteoclasts, which break down old bone through a process called resorption; osteoblasts, which make new bone, and mature bone cells called osteocytes, which basically tell the other two what to do.

● These groups of cells work together to form osteons, cylindrical structures surrounding a central canal that contains the bone’s blood supply. Osteons are aligned parallel to the long axis of the bone.

● The long bones of the skeleton have an outer layer of compact bone called the cortex. This is covered by the periosteum, a dense layer of vascular tissue which carries both nerves and the blood supply, and is important in bone healing. The medullary cavity in the centre of these bones stores the spongy marrow, where stem cells are produced.

Ref: 21 January 2021

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Horse & Hound — Thu, 14 Jan 2021 15:00:22 +0000

Antibiotics should only be used when there is no alternative, or we will be powerless to fight infection in the future, warns David Rendle MRCVS

Antibiotics – more correctly termed antimicrobials – have revolutionised the way we treat infectious disease, thanks to their ability to slow down or destroy the growth of bacteria.

However, no one can escape the increasing discussion in the media around resistant bacteria and concerns that antimicrobials are no longer working.

For decades, there has been a tendency to use antimicrobials “just in case” there might be infection, or because infection could develop. The emphasis is now on using antimicrobials only when there is no alternative.

In a number of European countries, antimicrobial use in animals has been restricted to ensure the most important treatments are reserved for humans. Farmers have reduced antimicrobial use dramatically and the equine industry is now under pressure to do the same.

If we cannot demonstrate an ability to decrease our dependence on these medications, there is the possibility that the UK Government could step in to prohibit the use of certain antimicrobials in horses.

Taking action

Every horse owner has a responsibility to support their vet and to work with them to balance their horse’s immediate requirements with the need to preserve the effectiveness of antimicrobials. We’ve compiled 10 essential tips to consider…

1. Trust his immune system.

Antimicrobials are only necessary if your horse’s immune system cannot cope. Not every infection needs antimicrobials: minor wounds will heal, and foot abscesses will clear up if they can drain.

2. Don’t kill the good guys.

Your horse needs bacteria, so don’t destroy them unless you have to. Not only does he digest his food courtesy of billions of bacteria in his large intestine, but bacteria on his skin and in his respiratory tract provide essential protection against others.

Antimicrobials kill bacteria indiscriminately and can cause diarrhoea or other infections by removing the “friendly” bacteria.

3. Understand the issues.

Vets often feel under pressure to prescribe antimicrobials. Let your vet know you are aware of the issues and that you don’t want them used unless they are absolutely necessary. If your horse does require antimicrobials, check with your vet which class they propose to use. Work with them to avoid the use of highest-priority critically important antimicrobials (HP-CIAs), which are essential in human medicine and should not be used in animals unless there is absolutely no alternative.

Liquid antimicrobials issued in bottles will be either enrofloxacin or doxycycline hyclate. While these liquid preparations may be easier to administer to horses, there are more appropriate alternatives for both and these should be avoided where possible.

4 Pinpoint the problem.

Get a proper diagnosis, rather than using antimicrobials because your horse might have a bacterial infection. A cough is more likely to be an allergy, for example, while a temperature may well mean a virus – neither of which will benefit from antimicrobials.

5. Invest in tests.

Without testing, your vet must make an informed guess as to which antimicrobial is the most likely to be effective – and won’t always be right. Ask if any tests are available to guide selection. Culture and sensitivity testing can be used to grow the bacteria in a laboratory and to identify the most effective antimicrobials.

Your vet may not initially discuss testing because of the additional cost. Think of it as money well spent; testing is less expensive than the antimicrobials, and ensures that funds are not wasted on ineffective treatment.

6. Help the medicine down.

Under-dosing increases the risk of resistant bacteria developing. If your horse is not finishing the food that contains the treatment, or if some of the liquid that should go into his mouth ends up on the floor, ask your vet for an alternative. There are antimicrobials specially formulated for horses, which are much easier and safer to give.

7. See the bigger picture.

Ask yourself whether you are acting responsibly by keeping antimicrobials and using them without veterinary guidance. There is still a concern that many yards stockpile antimicrobials, and it has been suggested that some use them in the mistaken belief that they might improve performance, rather than to treat life-threatening disease.

This has major implications. Locally, you are increasing the risk of resistant infections developing on your yard and affecting the horses and people within in it. Globally, you are hastening the development of antimicrobial resistance – which already kills 12,000 people in the UK annually.

8. Guard against infection.

Take measures to prevent bacterial infection developing. Vaccinate against respiratory viruses such as influenza and herpes to reduce the risk of bacterial pneumonia, and maintain regular dental checks to help prevent dental infection.

At the yard, good housing and air hygiene will lessen the likelihood of equine asthma and secondary respiratory infection. Keep stables, gates and fencing in good repair to prevent unnecessary injuries, and try to avoid turning horses out in overly wet, muddy conditions for long periods, to keep mud fever at bay.

9. Administer with care.

Follow the instructions with any antimicrobials. Dose your horse with the correct amount, as advised by your vet, and always complete the course. If this isn’t possible, speak to your vet and discuss an alternative, and dispose of any unused antimicrobials responsibly. Store medicines in the fridge, where instructed, and otherwise in a cool, dry place.

10. Practise biosecurity.

If a horse does develop an infection, take adequate biosecurity measures to prevent the spread of bacteria. Wear gloves, wash your hands after treating the horse, dip your boots in a disinfectant bath and dispose of infected dressings appropriately. Resistant bacteria present a threat to you and your staff, as well as to all horses at the yard.

Understanding bone fractures

Antimicrobial resistance presents a huge human health issue that scientists predict will soon overtake cancer as a cause of death. By 2050, it is estimated that every year 10 million people worldwide will lose their lives as a result of bacterial infections that can no longer be treated. Healthy people already die when minor injuries or surgical incisions become infected with untreatable bacteria. Virtually all of the multi-resistant bacteria that worry doctors have been identified in our domestic animals. Equine hospitals mirror the situation in human hospitals, with potentially fatal complications associated with resistant bacteria becoming more common, causing horses to be euthanased.

It is unlikely that new antimicrobial classes will be made available for horses, so we have to use the current options more responsibly and sparingly. Other means of preventing and controlling infection, such as medical grade honey or medicinal maggots, are becoming increasingly important.

Ref: 14 January 2021

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Horse & Hound — Fri, 08 Jan 2021 12:00:45 +0000

A diseased or damaged molar that is beyond repair is best removed, but how? Neil Townsend MRCVS explains

Dental extraction can appear daunting to an owner. When performed by a suitably qualified and skilled clinician, however, with the correct equipment, it can be a routine procedure. Often, the patient does not have to stay in hospital, and time off following extraction is minimal.

The most common reason for removal of a molar (cheek) tooth is infection of its roots, termed apical infection.

Signs of infection can vary, dependent upon which tooth is involved. Generally, infection of mandibular (lower) cheek teeth creates a swelling on the bottom of the jaw, which may burst out into a draining tract (a surface wound). Apical infection of the front maxillary (upper) cheek teeth usually causes swelling in front of the facial crest – the bony ridge either side of the face. Because the back maxillary teeth have their roots within the sinuses, infection typically causes nasal discharge.

Teeth may become apically infected or require extraction as a result of fracture, advanced dental caries (decay), periodontal (gum) disease or a blood or lymphatic-borne tooth infection. Signs may be subtle, ranging from ‘quidding’, or spitting out, of long fibre in the case of infection, to tenderness over a facial swelling. Occasionally, a ‘dead’ tooth with open pulps (the soft, central area) is only identified during routine dental examination.

A detailed oral exam under sedation can give clues as to which tooth is involved, by identifying fractures, open pulps, dental caries and periodontal disease. This will also provide vital information about the infected tooth, notably the integrity of its crown and whether the tooth is already mobile.

Radiography (X-rays) are used examine the roots of the cheek teeth and the surrounding structures. A marker can be placed over any facial swelling beforehand, to see which tooth sits beneath it. Similarly, a probe placed into a draining tract will often go directly to the affected tooth.

Advanced imaging such as computed tomography (CT) can be useful in cases where radiography and oral examination fails to reach a diagnosis.

Extraction of cheek teeth should only be performed by a veterinary surgeon, unless a tooth is so loose that can be manipulated by the fingers – as is sometimes seen in geriatrics. A qualified equine dental technician (EDT) may then perform the procedure.

Extraction methods

Oral extraction is usually the preferred starting technique where a portion of the tooth is present within the mouth. This is performed under sedation with a regional nerve block in place, along with local anaesthetic.

Right-angled elevators are used to separate the gingiva (gum) from around the tooth, and molar spreaders are placed between the affected tooth and those adjacent to it. These tools are gradually manipulated before being replaced with thicker instruments. Forceps are then secured to the tooth, which is further loosened by ‘wiggling’ until it can be lifted from its socket with a tool called a fulcrum.

Maxillary teeth fractured in the midline can be extracted orally – through the mouth – in many different ways. Each case should be considered individually; some clinicians prefer to loosen and remove the halves separately, while others glue the broken tooth together with dental resin and extract it in one piece.

Oral extraction most commonly fails due to further fracture of the tooth, usually due to pre-existing disease within it. A small portion of the tooth that is left may be loosened with right-angled picks and removed with forceps.

For teeth that are fractured below the gumline, a favoured technique is minimally-invasive transbuccal extraction (MTE). This must only be performed by vets with relevant further qualifications, in a clinic setting, using standing sedation and local anaesthesia.

A keyhole incision is made in the cheek and a small sleeve is passed through the skin into the mouth. Straight elevators are placed through the sleeve and guided around the tooth with the aid of an oral endoscope, to loosen the remaining tooth portion.

A hole is drilled into the tooth and a threaded pin is screwed into it, so that a slotted hammer used on the end of the pin can pull the tooth from its socket. The sleeve is removed and the incision is closed with skin staples.

Following the loosening of a tooth, a small pin can be inserted through the bone in order to push the remaining portion of the tooth into the mouth. Intra-oral division, where the tooth is divided into pieces with a rotating burr, may also be useful in selected cases.

After an oral or MTE extraction, the empty socket is usually ‘packed’ to prevent food accumulation. The packing material – gauze swabs, or dental putty – must be changed every one to two weeks until the socket has healed.

A draining tract may require daily cleaning until dry, while any skin staples are usually removed at the first packing change. Most horses can begin work again two weeks after extraction.

Potential problems

Ccomplications following these techniques are rare.

The most common is failure of the socket to heal adequately. If every fragment of tooth has been removed, this is usually due to a portion of dead socket bone, known as sequestrum, which may not become evident until three to four weeks post-extraction.

Recent research has shown this to be more common following mandibular extractions. Treatment involves removal of the sequestered portions of the socket with right-angled picks.

Extraction is generally more difficult the further back in the mouth the teeth are, as the space between them decreases. This is a particular issue in small ponies or miniature horses, since it is almost impossible to reach a hand to the back of the mouth.

Horses have ‘hypsodont’ teeth, meaning that they continue to erupt. A molar in a young horse can measure up to 10-12cm, which may be too long to pull into the mouth in its entirety. Cutting it into two may be necessary to allow delivery into the mouth.

Chronically diseased teeth can present challenges in addition to the risk of fracture; some lay down abnormal cementum (the surface layer) around their roots, becoming mushroom-shaped and extremely difficult to extract.

Of all the extraction methods, oral extraction has the lowest reported complication rate, of around 10%, dependent on study, compared with around 15%-25% for MTE. Both rates compare favourably to those for more complex surgical extractions or repulsions, however, performed under general anaesthesia. With these, complication rates can be as high as 60%.

Provided the tooth is removed successfully, and the socket heals without complication, an owner can expect the horse to recover fully with no further issues.

‘Fermenting food was visibly bubbling’

This eight-year-old thoroughbred gelding had a left-sided mandibular swelling, which was initially treated with oral antibiotics and anti-inflammatories. The swelling resolved but four months later burst out from the bottom of his jaw.

The gelding underwent a thorough oral examination at the equine clinic. All appeared normal at first glance, but, on closer examination, one of the tooth pulps contained fermenting food material that was visibly ‘bubbling’. Radiography was performed with a probe in the draining tract, revealing communication with the tooth roots and chronic infection.

With a mandibular nerve block in place and local anaesthetic injected around the tooth, the affected molar was successfully removed by oral extraction in around 40 minutes. The draining tract was cleaned, the socket was packed with a dental putty plug and the patient was allowed home.

The horse was back in work a fortnight later, and, by six weeks the socket was 80% healed. After three months, the mandibular swelling was barely noticeable.

Ref: 7 January 2021

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Horse & Hound — Thu, 31 Dec 2020 15:00:33 +0000

How can we ensure competition horses enjoy their side of the partnership, asks Professor Madeleine Campbell MRCVS

Famous examples of horse-human partnerships have filled the pages of Horse & Hound this year. All of us involved in the equestrian world feel an intuitive “bond” between ourselves and our horses, which is very difficult to define but undoubtedly special. The reality is that however strongly we feel that bond, the partnership between a horse and a human is always, unavoidably, an unequal one.

Domesticated horses are dependent upon humans: both in a legal sense, because they are our property, and in an everyday sense in that they rely upon us for food, shelter, exercise and health care. We have it within our power to make horses’ lives miserable or enjoyable, and that power brings with it an enormous responsibility – a responsibility not only to treat horses as well as possible, but also to strive to understand better what horses need, in order to improve our treatment of them.

Behavioural clues

The recent World Horse Welfare conference was based around the question: “The horse-human partnership – what’s in it for the horses?” Set against the background of increasing societal interest in animal ethics, welfare and equestrian sport, this is a particularly timely question in relation to competition horses.

So, what’s in it for the competition horse? The simple answer is that well looked-after equine athletes benefit from outstanding veterinary care, careful management and – very often – a happy retirement.

If the majority of competition horses can and do enjoy those benefits, then, in theory, all of them could. Every responsible person working within the equine industry holds that ambition, and those who do not deliver upon it should be dealt with appropriately by regulators and the law.

But we need to extend the way in which we think about welfare, beyond solely considering how we meet veterinary and everyday needs. We should be asking ourselves: “How we can more holistically improve the welfare of horses in training and in competition, both through minimising negative welfare impacts and maximising positive impacts?”

We need to be able to understand, for example, which of two possible training methods is better for the welfare of the horse, and what the comparative effects of alternative items of tack and equipment are. To do that, we need some understanding of how the horse feels.

Fortunately, over the past decade, this has become a lot easier thanks to the developments in the field of equine ethology and of various equine welfare assessment tools.

Ethology is the study of animal behaviour. A major development in the past decade has been the systematic investigation of equine facial expressions as a reflection of a horse’s emotional state.

Several studies have elucidated the facial expressions of horses that are associated with pain – including stiffly backwards ears and strained nostrils – and have developed an objective horse grimace scale.

More recently, and very relevant to the fact that we are trying to maximise positive welfare states as well as minimise negative ones, objective studies have demonstrated equine facial expressions associated with positive emotions.

As an example, eye wrinkle expression can indicate both negative and positive, with the angle between the line through the eyeball and the highest skin wrinkle above the eye decreasing during positive states.

Proof positive

It is unlikely that this news will come as a surprise to those of us who spend our lives around horses. The value of having the evidence base proved in this way, however, is twofold, enabling us to promote good equine welfare through increasing our own awareness and educating those for whom such behavioural indicators are not perhaps so obvious. It also provides us with objective criteria with which to test the effect of actions on our equine partners.

Research has shown that it is not only facial expressions that are relevant to understanding and safeguarding the welfare of horses being used for competition, but a whole range of other behaviours.

We now have access to a ridden horse ethogram which relates 24 ridden behaviours to pain. Once we understand and can interpret facial expressions and general behaviours, we can use that knowledge to understand how equipment and training techniques may have a negative or positive welfare impact.

The potential of equine ethology to improve the welfare of competition horses is complemented by recent developments of equine welfare assessment tools. These provide an objective means of assessing the welfare impacts of management methods.

One such work has established how we can use a welfare model known as the five domains to assess the impact of transportation. This will help us answer at an individual horse level questions such as whether it is better to travel a horse home immediately after a competition so he can rest in his own stable that night, or to stay overnight at the venue and travel the next day.

Another interesting area of work is the development of an animal welfare assessment grid (AWAG), a cloud-based technological tool which can be used by anyone in the field. Previously, this has been used to assess the welfare of zoo animals kept in an unnatural environment.

Work to adapt the AWAG specifically for use in horses is ongoing and is the subject of current grant applications.

Finding a balance

Oour partnership with competition horses is unavoidably unequal. Nonetheless, this relationship can be mutually advantageous and enjoyable if we strive constantly to provide welfare-enhancing experiences and minimise negative ones.

By applying the research into equine ethology, equine welfare assessment tools and equine cognition, those responsible for competition horses can do this, by making objective, evidence-based decisions about equipment, methods and management.

Going into 2021 and beyond, as members of the equine industry we must strive not only to apply our current knowledge to enhance welfare, but also to work together to assess aspects of horses’ lives which we may not previously have considered.

Facing facts

An area of research which is of direct relevance to the welfare of competition horses relates to our understanding of equine cognition, which is the ability to learn from experience – specifically, the effect our own emotional state can have upon that of our horses.

Evidence suggests that horses can read and remember human emotions. Research has shown that not only can a horse identify between an angry human face and a happy one, but also that he may recall the previous facial expression of a person when he meets them again – and adapt his behaviour accordingly.

Horses tend to view negative events with their left eye, processing this potentially threatening stimuli in the right hemisphere of the brain. In studies led by Professor Karen McComb and Dr Leanne Proops, horses spent more time studying a person’s face with their left eye if they had previously seen a photo of them looking angry (pictured). Ideally, such findings will make us all think more carefully about what we project when we interact with horses in our care.

Grazing horses alongside livestock: what are the pros and cons? H&H Plus

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The importance of water in winter — why your horse could be more dehydrated now than in the summer H&H Plus

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5 warning signs your horse might be tying-up, causes and how to manage it

How a squeeze can save a dummy foal’s life

Andrea Oakes — Mon, 28 Dec 2020 09:00:48 +0000

For foals who fail to wake fully at birth, an innovative veterinary technique could be the answer. Kelly Harrison-Tait MRCVS explains

The majority of foals born are fit, healthy and ready for the world, but sometimes things aren’t quite right. One condition that can affect a newborn foal is neonatal maladjustment syndrome, also known as being a “dummy foal”. A procedure that can help in this situation is the Madigan squeeze.

Traditionally, oxygen deprivation to the brain is thought to be the reason for this neonatal maladjustment syndrome, resulting in brain damage and inadequate blood supply to the nerve cells. Oxygen deprivation can result from the placenta coming away abruptly from the uterus before foaling, prolonged labour, prematurity, sepsis and swelling of the brain, among other causes.

Another, newer consideration is failure of the foal’s mental state to evolve from somnolence within the uterus to consciousness at birth, which normally occurs as the foal travels through the birth canal. The squeezing effect of the canal halts the release of neurosteroids. These keep the foal in a state of unconsciousness in the uterus; if no signal is received to stop their production they continue to be emitted, preventing the foal from becoming fully conscious as he emerges.

Slow to respond

A dummy foal will often be slow to follow the expected patterns of behaviour, not standing or drinking within the normal time-frame, for example. He may be lethargic and “forget” to lie down or stand up, needing assistance or reminding.

The foal is typically unable to interact fully both with his dam and his environment. When going to feed, he may struggle to locate the udder or fully latch on – this can lead to failure of passive transfer, a process where the foal receives essential antibodies from the mare. If he does not ingest enough colostrum before his gastrointestinal tract stops being able to absorb these large proteins, he is at increased risk of sepsis and other life-threatening illnesses.

Failure to spot the signs and initiate treatment can mean that a dummy foal develops a dangerously low body temperature (hypothermia) or blood sugar levels (hypoglycaemia), which can ultimately lead to death.

Foals are born with very little energy storage in the form of fat, so intervention to ensure that the affected foal receives adequate colostrum can be essential. Care must always be taken if bottle-feeding a foal, because aspiration pneumonia can result if any fluid, such as milk, enters the lungs. Due to their often poor suck reflex, dummy foals need to be fed with extra caution.

It is important to seek veterinary advice, as stomach-tubing the colostrum is often considered safer. An intravenous drip may also be necessary, containing warm fluids, glucose and other neuro-protective agents such as thiamine and vitamin C.

Most foals recover well within one to five days, with correct care and if closely monitored, and begin to behave as expected.

The Madigan squeeze

The Madigan squeeze is a procedure that can be used on a foal displaying dummy signs in an effort to recreate the natural transition to consciousness.

A rope is secured around the foal by looping it around the chest several times. Tension is then applied to mimic the pressures implemented by the birth canal during the foal’s journey from the uterus to the outside world, and at the same time the foal is helped to lie down.

The rope is held for 20 minutes, the duration that the mare would be in second-stage labour. During this time, the foal becomes somnolent and lies asleep within the rope.

At the point the rope is released, the foal awakens, and, if the procedure has been successful, displays normal consciousness –usually going straight to the dam to drink. With these foals who have responded well to the technique, the prognosis is excellent as the sedative effect from the neurosteroids has been switched off.

The Madigan squeeze will not work on those who have suffered from hypoxic injury to the brain, unfortunately, although attempting the method will do no harm. The only caveat is that the foal is first checked carefully for evidence of rib fractures; if injury is detected, it is not safe to squeeze the foal.

“He was so floppy”

Miniature Shetland colt Gizmo weighed just 9.5kg when he was born on a snowy night in the Scottish Borders in late March. While the mare, Fern, appeared to foal without issue, owner Charlotte Mills soon sensed that something was wrong.

“Although Gizmo seemed physically perfect, he was so floppy that he couldn’t stand,” she recalls. “He was unresponsive and was getting cold, so we took him indoors and put him in front of the fire.”

Gizmo was referred by Charlotte’s local veterinary practice to the Dick Vet Equine Hospital, where he arrived early the next morning after a short lorry journey spent sitting on Charlotte’s lap. Now nearly 12 hours old, he had yet to stand or nurse from his dam.

“Examination revealed that Gizmo was hypothermic, with a poor suckle reflex, a drowsy demeanour and physical evidence of immaturity,” says Rachel Jago MRCVS, who confirms that the tiny foal was diagnosed with neonatal maladjustment syndrome.

“He was admitted to the foaling intensive care unit, under the care of the specialist medical team, and wrapped in a Bair Hugger warming blanket to maintain his core temperature.

“He was fed the dam’s colostrum every two hours, via a nasogastric tube, together with intravenous fluids and antimicrobial therapy,” adds Rachel. “The Madigan foal squeeze technique was performed and his demeanour improved.”

After 36 hours of round-the-clock care, Gizmo was up on his feet and able to suckle unassisted. Three days later, he and Fern could return home.

“Gizmo is still small, even for a mini Shetland, but he’s lovely,” says Charlotte, whose husband Douglas bred him. “He’s happy and healthy, like a little bison.”

Glazed and lifeless

“It was as if the lights were on but no-one was home,” says international showjumper Jay Halim of the glazed, lifeless look his warmblood colt foal Herbie (pictured top) developed during his first 12 hours. “He had arrived a little earlier than expected, but he had seemed bright and normal at first and was suckling well. As the day progressed, he went downhill.”

While Herbie would go to the udder, he wouldn’t drink. Jay had tried milking the mare and offering the foal a bottle, but Aled Thomas MRCVS, a stud vet at Bourton Vale Equine Clinic, recognised dummy foal syndrome and advised that Herbie should be transferred to the clinic.

“Herbie was initially managed with an indwelling stomach tube, so that we could feed him the mare’s milk and ensure that his hydration and energy levels were maintained,” explains Aled. “We later performed the Madigan foal squeeze technique, which was so successful that he was able to suckle almost immediately.”

Eight months later, Herbie has been paired up for turnout with another uncastrated colt.

“You wouldn’t know he’d ever had a problem,” says Jay. “He’s a cheeky monkey, but everyone loves Herbie.”

Ref: Horse & Hound; 24 December 2020

Grazing horses alongside livestock: what are the pros and cons? H&H Plus

Horse & Hound — Mon, 21 Dec 2020 12:00:00 +0000

It worked for our horses’ wild ancestors, but is it wise to co-graze equines and livestock today? Peter Green MRCVS discusses pros and cons

In the UK we tend to keep horses and farm livestock apart from each other. Horses belonging to farmers may be turned out with the cattle or sheep, but, on the whole, equines are managed separately.

Of course, this is artificial. Think of the plains of Africa where antelopes, zebras, elephants, giraffes, rhinos and others all graze and browse. In pre-Ice Age Britain, wild horses grazed with bison, deer, woolly rhinos and wild cattle called aurochs.

There are pros and cons to modern mixed grazing. The big winner when you turn cattle and horses out together is worm control. Because cattle don’t support the same nematode worms as horses but will ingest their eggs as they graze, worm burdens in horses grazed with cattle are lower and the requirement for wormers is reduced.

In one recent study in France, young horses grazed with cattle had 50% fewer worm eggs in their droppings than those grazed alone. And it works both ways, because the cattle also have fewer worms.

Another plus is the pasture itself. Horses have incisor teeth in both upper and lower jaws, while cattle and sheep only have lower incisors. They graze in different ways and have different preferences. Horses tend to be more picky and will overgraze some patches and leave others, while both cattle and sheep are less discriminating.

This is especially useful when mixed grazing is used on marginal land or heathland, but it also has a benefit on lowland grass pastures. Native ponies such as Exmoors are brilliant for conservation grazing, and their impact is increased when combined with cattle.

Infection risk

When it comes to external parasites, there may be both positive and negative impacts when livestock and horses graze together.

If the farm animals, especially sheep, are not treated for ticks, a horse’s exposure to these pests may be increased and the risks of tick-borne infections like Lyme disease may therefore go up. The same may be true for tabanids (horse flies), which are more prevalent around cattle and may therefore bite both horses (and people) in the vicinity. However, if the cattle are treated with fly repellents as part of routine farm husbandry, the horses will benefit from the herd effect of the repellents.

Fungal skin infections such as ringworm are common in housed cattle, especially youngstock, and horses can be infected if they are turned out with them in the spring. The fungal spores are passed from one to another when the cattle rub on gateposts, water troughs and trees. Yet ringworm is not a serious problem and is usually self-limiting, especially in the open air with exposure to sunlight.

Owners are sometimes afraid that their horses will contract sarcoid skin tumours from cattle, because it is known that sarcoids are caused by the bovine papilloma virus. Flies have been proposed as a vector that spreads sarcoids from cattle to horses. In fact, this has not been established.

Bovine papilloma virus is very common in the rural environment and we now know that there is a strong genetic susceptibility in horses to developing sarcoids. Grazing with cattle does not appear to increase the risk.

Another factor to consider is the pasture fencing. Cattle are almost always fenced in with wire stock fencing and barbed wire; their thick skin requires some hefty barriers, or they may push through them. Large-aperture wire stock fencing and barbed wire, especially, can be hazardous to horses, as equine vets will testify.

On balance, however, and with good management, the mixed grazing of cattle or sheep and horses can benefit both the animals and the pasture.

Pig tales

Horses will usually tolerate cattle and sheep, but most seem to hate pigs.

There is much discussion about the reasons for the widespread aversion to pigs, but no solid scientific explanation based on reliable research. Is it the smell, the behaviour or the noises that pigs make? Is there a deep-seated inherited dread of pigs that goes back to those pre-Ice Age times when horses, bison and deer were roaming together and lived in fear of aggressive wild boar? Who knows?

Some horses will freak out on first meeting donkeys, llamas and alpacas. With a patient approach, however, these animals can learn to become grazing companions.

Ref: Horse & Hound; 17 December 2020

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The latest veterinary developments: light shed on viruses and foal deaths H&H Plus

Karen Coumbe — Thu, 17 Dec 2020 12:00:34 +0000

We find out what’s new in the veterinary world as species-hopping infections come under the spotlight

Going viral

In the current climate of Covid-19 infection, there has been increased awareness of the unusual property of some infections suddenly to skip between species. C19 itself is known to be a virus that came originally from a wild animal, probably a bat, and then jumped species, acquiring the ability to infect humans.

Over generations, most pathogens develop to live in a kind of balance with their host. After all, the virus or the bacterium would not survive and persist if it killed every infected host animal. This host-pathogen balance means that the majority of infections are specific to one host, having evolved together for a very long time. Just occasionally, however, an infection that has been present in one species for ages hops to another.

Molluscum contagiosum (MC) is a human skin infection caused by a virus in the pox-virus family. Most common in children under 10, the infection causes inflamed spots or nodules and can spread widely on the body, limbs and face. It almost always clears up after a few weeks and treatment is rarely necessary.

Research has revealed that an MC virus has been isolated from a horse in Tanzania, East Africa, and that genetic sequencing of the virus shows close similarity with human MC. Whether or not this horse acquired the infection from a person is not clear, but it illustrates that such viruses can affect species other than their primary host.

Virologists recently discovered a cluster of horses in Brazil infected with vaccinia, the virus used in human smallpox vaccination. It seems that the vaccinia virus spread from vaccinated humans and is now circulating in a limited area from horse to horse.

Abortion link

Psittacosis, a bacterial infection of birds, has a worldwide distribution and is caused by Chlamydia psittaci.

Human doctors are well aware of psittacosis because it is easily passed from pet birds to people, causing a serious disease with clinical signs that include fever, pneumonia and profound weakness. In Europe, wild birds such as feral pigeons are often infected with a less virulent form of the disease than that carried by wild parrots elsewhere in the world.

Vets in Australia were puzzled recently by two cases of unexplained late abortion in mares on a stud in Victoria. The usual causes were ruled out and foetal tissues were examined in the laboratory for evidence of unusual pathogens. Surprisingly, C. psittaci DNA was discovered in both cases.

A month later, on another stud 75km away, a weak foal was born which died after 24 hours. Tissues from this foal also revealed C. psittaci DNA. The lab scientists were able to sequence the bacterial DNA from these foals; when they compared the strain with other known strains of psittacosis, they discovered that it was exactly the same as that harboured by the wild parrots of Victoria.

These cases confirm what we have come to realise through the C19 epidemic: occasionally, and inexplicably, bacterial and viral pathogens can jump from one species to another. Thankfully, scientific work has so far enabled us to spot and to combat such occurrences.

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The importance of water in winter — why your horse could be more dehydrated now than in the summer H&H Plus

Horse & Hound — Tue, 15 Dec 2020 13:00:14 +0000

Whether he’s indoors or out this winter, a horse’s health can soon suffer if his water intake drops – as Rebecca Hamilton-Fletcher MRCVS explains

Often referred to as ‘the forgotten nutrient’, water is essential for all life. Without it, dehydration occurs and most physiological functions, including digestion and growth, rapidly become compromised.

Most people are conscious of the need to drink plenty during the summer months, as our own increased thirst is directly related to the hot, sticky conditions. In contrast, during the winter months we naturally drink less. It is easy to assume that our horse’s needs will be similar.

Whereas most horses are out in summer eating grass, however, with its high water content, during the winter many are stabled. Their grass intake is supplemented or even fully replaced by a forage hay diet, which has a relatively high dry matter content. Drinking enough water to compensate for this unnaturally dry diet becomes vital.

Various factors will affect a horse’s water requirements during winter.

Points to consider include the horse’s management. Is he at grass, or predominantly stabled and on a dry forage diet? What is his workload — is he hunting twice a week, or only hacking out occasionally?

Temperature will play its part. A clipped-out horse is less likely to lose fluids through sweat while working than one who is fully coated. Being over-rugged, especially given that our winters are getting warmer, will increase thirst.

A horse’s age can significantly increase his water requirements. Equine veterans may already have compromised digestive capabilities, while those suffering concurrent clinical conditions such as pituitary pars intermedia dysfunction (PPID), or Cushing’s, may be influenced by an excessive endocrine-driven thirst.

Given adequate water, under natural conditions most equines appear to self-regulate their winter water needs. This balance is only really upset when we interfere, by feeding an overly dry diet, perhaps, or by clipping and over-rugging.

Dehydration can occur relatively quickly during the summer months and is usually related to a sudden increase in water loss, such as excessive sweating. In winter, dehydration is often insidious and is more likely to be caused by inadequate water intake.

An affected horse may be depressed, lethargic and easily fatigued, with a dull coat, sunken eyeballs and a tucked-up appearance. His droppings may be infrequent, small and hard in texture, and his urinary output may decrease and become darker in colour.

Additional signs include dry mucous membranes, reduced salivation and a loss of appetite. The horse may become uncomfortable, with visible muscle tremors, a subnormal temperature and an increased heart rate. The skin on his neck may not return to normal following a pinch test, although this is not considered a reliable indicator.

Impaction danger

By far the most common winter veterinary issue is impaction colic, or constipation.

Representing approximately 10% of all colics, impactions occur when water is reabsorbed in the large intestine from an already relatively dry ingesta (food intake). This slows the passage of the food, allowing even more time for further water to be reabsorbed. Gradually, things grind to a halt, with the blockage usually building up at the narrow U-bend of the hindgut known as the pelvic flexure.

Symptoms can be subtle at first and are often missed. If the issue is caught early enough, stomach-tubing fluids, electrolytes and possibly liquid paraffin may be sufficient. Often, however, by the time the vet is called the blockage is pushing right back into the pelvis. It can then take several days of intravenous fluids and medical analgesia until everything is moving again.

While other factors can contribute towards impactions, including poor hay quality, inadequate trickle feeding, a lack of exercise, intestinal parasitism and compromised dentistry, the most significant is insufficient water intake. These colics often begin after a sudden, sharp cold spell, when feed, exercise and water may suddenly become compromised and the horse is unable to adapt quickly enough.

The equine urinary tract appears to be surprisingly resilient to dehydration, and incidences of renal or bladder stones are uncommon. Other factors, such as excessive dietary calcium (leading to a calcium carbonate-rich alkaline urine), are usually involved. Attention should always be paid to urinary output, however. Any signs of dark, concentrated urine, perhaps with blood, and accompanied by low-grade abdominal pain, warrant veterinary investigation.

Beating the freeze

So how can we ensure adequate water intake in winter?

Freezing over of water is one of the biggest challenges. Ice must be regularly broken and removed in its entirety, and containers will need topping up much more frequently. Electrically heated automatic drinkers and buckets are available, but they are expensive and the electrics must be impeccably maintained. A horse’s sensitive muzzle will easily sense any stray voltage in the water, which will put him off drinking very quickly.

Research by the University of Pennsylvania, USA, found that horses drank up to 40% more if the water was warm, and less if offered chilly water. When presented with both options, however, horses would choose the chilly water. It thus follows that horses will drink more during cold weather if the water is heated, but only if no other source of water is available.

They also found that stabled horses do most of their drinking within a few minutes of eating their hard feed, and within an hour or two of consuming their hay. They should therefore always have access to at least two buckets of water at feed-time – preferably warm water, if prone to impactions, or if there has been a recent drop in ambient temperature.

Additional ways to increase water intake include feeding soaked hay or haylage instead of dry forage, making hard feeds sloppy by adding water and increasing the amount of time spent at grass. Ensure that all horses turned out have plenty of safe access to shared water containers, so that even the most submissive are not discouraged from drinking.

If your horse is working hard or has additional needs, ask your vet about adding salt and/or electrolytes to his feed. These can also be added to his water, although plain water must also be made available in case he dislikes the taste.

Since several diseases use water as a vector for infection transmission, biosecurity is especially relevant where horses are sharing buckets or troughs.

Just one drop of infected nasal discharge contains sufficient Strep equi bacteria to infect 2,000 horses with strangles. In winter, this source of infection can last for several days on inanimate objects, such as buckets, and up to a month in water. The EHV-1 equine herpes virus can remain stable and infectious in water for up to three weeks, while the equine flu virus is only slightly less durable.

Containers must be regularly cleaned or disinfected, especially if shared, and filled with clean, fresh water. Horses can be selective and will be reluctant to drink if the water provided is dirty, unpalatable or foul-smelling.

Crunching the numbers

85% – moisture content of summer grass; dry hay contains just 10%

4 litres – the water required to digest every kg of dry matter ingested

40 litres – the water a 500kg horse, eating 10kg of dry matter daily, needs for digestion alone

10 litres – average water bucket capacity

5 minutes – the time an average horse spends drinking per day

Winter watering methods

Buckets

PROS: allow intake to be monitored

CONS: capacity is limited; can be kicked over or broken; labour intensive; freeze easily

Trough

PROS: good capacity

CONS: individual intake cannot be measured; difficult to keep clean; can freeze over; infection transmission risk if shared

Automatic drinker:

PROS: a constant supply; rarely freezes if pipes are lagged

CONS: cannot assess intake; risk of unnoticed mechanical failure

Ref: Horse & Hound; 10 December 2020

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The effects of heavy falls on horses H&H Plus

Horse & Hound — Mon, 07 Dec 2020 12:00:50 +0000

A hefty fall can leave a horse winded, but how do we know if he has suffered internal injury, asks Gil Riley MRCVS

After a heavy fall, it is important to establish what, if any, injuries the horse has sustained.

If he can’t stand, he may be winded – a spasm of the diaphragm as a result of sudden force applied to the abdomen – or have a broken limb or an injury to the spine or head. A horse who is merely winded should be back on his feet within 10 to 15 minutes. If he stays down, the likelihood is that much more serious damage has occurred.

A thorough examination should identify any architectural changes to the horse’s external anatomy. Failure to bear weight on a leg could indicate a broken bone or torn muscles in the proximal (upper) limb; moving the limb may result in crepitus, a grating sound or unpleasant sensation produced by friction between bone and cartilage in a joint or the fractured parts of a bone. Injury to the pelvic musculature or the pelvis itself can render a horse very reluctant to walk or weight-bear on one or more limbs.

The challenge is to ascertain whether any damage is superficial or deep, so any vets in attendance must be allowed time and space to examine the animal thoroughly. If serious injury is present, it can take considerable time to gather sufficient clinical evidence to be able to reach an accurate diagnosis.

Bumps and bruises

Falling on heavy ground can cause bruises – ruptures of the small blood vessels (capillaries) underneath the skin. If the ground is hard, damage may be greater, with abrasion to the skin.

A deeper bruise presents as a fluid-filled lump (haematoma), where underlying tissues have bled or oozed serum to create a “balloon” under the skin. The damaged blood vessels bleed until there is sufficient pressure from fluid accumulation within the haematoma to halt the bleeding and allow clotting. If there is major disruption of deeper tissues, there may be torn muscles as well as bruising. Always try to keep the horse calm, since excitement will increase blood pressure and lead to more bleeding.

While a haematoma is developing, it may be possible to control the bleeding and minimise swelling by applying direct pressure and ice to the site – as long as it is in an accessible area where the horse will tolerate it. Cold should be applied for no more than 20 minutes at a time, and only for as long as the area feels warm and soft. Later, after the haematoma has stabilised, warm packs can increase circulation and stimulate healing.

Haematomas are often sterile swellings, so there is little pain or inflammation. Most resolve, if given enough time, so are best left alone. No attempt should be made to drain a haematoma until the damaged vessels have sealed, as opening it up may allow bleeding to resume. If it continues to grow, however, then surgery to ligate (tie) the vessel responsible may sometimes be necessary.

Once a haematoma is “mature”, usually around two weeks after forming, careful drainage with a sterile needle can be considered to minimise long-term scarring or to speed up healing.

If it has developed a subcutaneous pocket, where the skin is no longer attached to the underlying tissue, it may refill with serum. There is also the risk that bacteria is introduced, converting a sterile pool of serum into a painful abscess.

A blood test helps identify the severity of any internal or external haemorrhage by measuring the haematocrit, the level of red blood cells in circulation. Results must be carefully interpreted, however, as horses have large reserves of blood in the spleen and may not appear obviously anaemic, especially in the early stages as everything stabilises.

High levels of muscle enzymes measured in a blood test, proteins found mainly in muscle tissue, will indicate muscle damage. Very high levels are associated with bruising and trauma to the muscles of the hindquarters or back, where most of the muscle tissue is found.

Difficult diagnosis

Ruptures of internal organs such as the spleen or intestine, or the diaphragm (the muscular curtain that separates the chest cavity, or thorax, from the abdomen), are rare.

More commonly, fracture of one or more ribs can cause penetration of the space around the lungs, called the pleural cavity. The resulting pneumothorax (collapsed lung), usually evident because the horse is struggling for breath, can sometimes be resolved with rapid surgical intervention.

While many limb fractures are untreatable and result in euthanasia, some may be corrected. Most can be identified using radiography (X-ray), but nuclear scintigraphy may be required to diagnose hairline distortions in the bone (stress fractures), or fractures within large amounts of muscular tissue impenetrable to X-rays or even ultrasound (in the femur or hip, for example, in the larger horse).

Examination of the pelvis is difficult due to its musculature; the only palpable areas are the points of the hip (tuber coxae) and the tuber sacrale at the highest extremity of the back. Impact with the ground can result in a piece of the tuber coxa breaking off. Since the tuber coxae serve as the origin of some of the gluteals, the largest muscles of the hindquarters, recovery may be prolonged and lameness long term.

After a fall, swimming can be a useful addition to box rest and walking out, as it allows the horse to recuperate without weight bearing and to achieve mobility of damaged muscles and joints. Physiotherapy can help return elasticity to tissues and mobilise scar tissue, minimising the formation of constrictions and adhesions and breaking down those already present.

Up and over

Rearing and toppling over backwards can cause skull fractures. In the case of the basisphenoid bone, at the base of the skull, this can lead to a catastrophic cerebral haemorrhage and rapid death. Blood emerging from the ear after a bad fall is invariably a serious sign, indicating a fracture of important bones in the skull.

Sitting down

If the hindlegs are underneath, the tuber ischii – the point of the pelvis nearest to the tail and an anchor for muscles in this region – can suffer bruising or fracture. Profound hindlimb lameness on that side can develop and the muscles of the tail head will start to atrophy, or waste, within days.

Lameness resulting from trauma to the region can resolve, but requires recuperation of four to six months.

Falling onto belly

Falling with one or both hindlimbs stretched out behind classically leads to rupture of the peroneus tertius – a tendinous structure that runs from the lower end of the femur and over the front of the hock, inserting in the upper front of the cannon bone. This muscle ensures that as the stifle flexes, the hock flexes also, so an affected horse may appear normal at walk but will trot with a profound lameness.

Full recovery is possible after a minimum of three months’ box rest and the introduction of a walking-out programme.

The splits

This typically happens on slippery or icy ground (below) and causes extreme forces to be applied to the muscles on the inside of the thigh and limb. Common injuries sustained are to the adductor muscles of the femur and the collateral ligaments of the hock.

Recovery is dependent on rest and physiotherapy. Where ligament damage involves the hock, an arthroscopy (keyhole) procedure to debride damaged ligament tissue can be beneficial before recovery can begin.

Ref: Horse & Hound; 3 December 2020

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Hindgut issues: how significant are they? H&H Plus

Horse & Hound — Fri, 27 Nov 2020 09:00:36 +0000

How significant are hindgut issues? Tim Mair FRCVS discusses the horse’s engine: the large intestine

The horse is a hindgut fermenter, meaning that the large intestine is the site of digestion (fermentation) of ingested fibre. This is where food is converted into energy, which fuels bodily functions such as movement and helps the horse to maintain body heat.

The population of bacteria and other micro-organisms present in the hindgut is responsible for this fibre fermentation. Any major upset in this microbial community – termed dysbiosis – can result in “intestinal upsets”, causing diarrhoea, colic and weight loss.

Conditions affecting the large intestine, sometimes referred to as “hindgut issues”, are often a topic of debate. While scientific evidence regarding the prevalence and significance of certain problems may be lacking, many disorders in this section of the digestive tract are recognised and understood.

Blocked pipes

The hindgut comprises the caecum, large colon, small colon and rectum. The caecum is a large, blind-ended sac that occupies much of the right side of the horse’s abdomen and functions as a “fermentation vat”. Here, fibrous food material is stored and fermented for several days before passing into the large colon.

Impaction of the caecum with feed material can occur in mares after foaling and in horses who are hospitalised or undergoing surgery and treated with nonsteroidal anti-inflammatory drugs. Signs typically include low-grade colic along with a reduction or cessation of the quantity of faeces being passed.

If an impaction is not recognised or treated, rupture of the caecum can sometimes occur. Since this is usually fatal, it is important to monitor the quantity of faeces passed by these at-risk horses and to feed them a laxative diet such as bran mashes and grass.

From the caecum, food passes into the large colon – a wide, tubular structure measuring up to 3.7 metres in length. The function of the large colon is to continue the fermentation and digestion of fibre, producing volatile fatty acids which are then absorbed into the bloodstream, and to absorb water.

The large colon has a number of U-shaped bends, or flexures. Its convoluted course and a relative lack of any anchoring ligaments make it susceptible to displacements and twists, which are common causes of colic.

Impactions can also occur at the flexure sites where the diameter of the colon narrows, especially the pelvic flexure. Colonic impactions are most commonly seen in horses that are suddenly exposed to management changes, such as alterations to diet or exercise.

Clinical signs are similar to those for caecal impactions. While colonic impactions are usually easier to treat, it can still be intensive and costly, so prevention – that is, feeding at-risk horses a laxative diet – is always the goal.

The final phase

The small colon and rectum, the final parts of the hindgut, are involved with further absorption of water. This is where faecal balls are produced.

Impactions of the small colon and rectum can occur but are fortunately rare. Mild dysfunction of the small colon can be associated with the passage of “faecal water”, whereby horses pass normal, formed faecal balls followed by a volume of malodorous liquid. The precise cause is often uncertain, but it can be associated with age-related damage to the wall of the small colon and rectum, or dysbiosis.

Colitis is defined as inflammation of the colon. Since one of its major functions is the absorption of water, damage to the wall of the colon of the adult horse, caused by inflammation, frequently results in diarrhoea.

The hindgut is not fully developed in foals before weaning; in this age group, diarrhoea is more commonly due to inflammation of the small intestine – termed enteritis.

Mild diarrhoea can occur for many reasons, including a change of diet, stress and access to fresh grass. In these instances, it is usually self-limiting and of little significance.

On occasion, however, colitis can be life-threatening. These cases are often associated with overgrowth by certain species of bacteria, such as Salmonella and Clostridium species, which can invade into the lining of the caecum and large colon, and may produce toxins that damage the large intestinal wall. Some of these diseases can be contagious to other horses and to people.

Another important cause of colitis is larval cyathostominosis, which occurs due to damage to the large intestine by migrating larval stages of the small redworm. Severe colitis can be fatal rapidly unless intensive treatment is instituted early; for this reason, prompt veterinary advice should be sought for any horse who develops watery diarrhoea.

More chronic forms of colitis also occur sporadically. These inflammatory bowel diseases are similar in some respects to those seen in humans, such as Crohn’s disease. In horses, however, they are more common in the small intestine than the large intestine and are usually associated with progressive weight loss. If the large intestine is involved, then chronic diarrhoea ensues.

Some inflammatory bowel diseases can result in increased intestinal permeability. In these cases, the term “protein-losing enteropathy” is more appropriate than the poorly defined and controversial “leaky gut syndrome”, which suggests that the lining of the intestine leaks plasma proteins due to inflammation or ulceration.

Are ulcers to blame?

Ulceration of the stomach, termed gastric ulceration, is a common condition in performance horses. The associated clinical signs can be varied and vague. A horse may become picky with short feeds, eating a little and then walking away. Other signs include grumpiness, loss of weight or coat lustre, decreased exercise tolerance or performance, and sensitivity when the girth is tightened or the abdomen brushed.

Diagnosis of gastric ulceration has become commonplace since the introduction of endoscopes. But what about ulceration of the small intestine or hindgut? Many people believe that ulceration of the hindgut can produce symptoms similar to those of gastric ulceration, but there is currently no easy way to diagnose this problem in the live horse.

Right dorsal colitis causes severe damage to a defined area of the large colon and is usually associated with long-term administration of phenylbutazone. The diagnosis of this condition is often uncertain, unless it is confirmed by surgical exploration and biopsy.

Clinical signs may support a tentative diagnosis but, of course, the reality is that ulceration and damage to other areas of the hindgut could present the same signs – including colic, weight loss, faecal consistency variation and irregular appetite, as well as behavioural issues relating to chronic abdominal discomfort.

Ref: Horse & Hound; 26 November 2020

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Mud: how to tackle it and help prevent the health issues it can bring horses

Helen Triggs — Sun, 22 Nov 2020 09:00:52 +0000

Mud is an inevitable part of winter. Helen Triggs checks out how to minimise the damage with advice from some industry experts on the perils of mud and how to navigate your way through winter with your horse as safely as possible

No one likes mud – it’s cold, wet, sticky and gets everywhere. Even worse, it can cause injuries and medical complications for the horse. But while winter’s ever-present hazard is unavoidable, there are strategies to take away some of the pain.

In most situations, mud is more of an inconvenience than a serious problem. If your horse has even a generous amount of dried mud on his coat, it may be unsightly but it often won’t do any harm. Unless infection takes a hold, the horse’s coat and feathers are his best protection. But for those whose season covers the colder months, they have to confront the elements head-on.

Dealing with sweaty, muddy horses and tack is all in a day’s work for Beaufort hunt groom Margaret Hopkins.

“Last winter was a nightmare,” she says. “We put pig oil on the legs and tummy, and petroleum jelly under the boots and in the heels before we go hunting. We keep horse-washing to a minimum because it strips the horses’ natural oils, leaving them more susceptible to bacterial and fungal infections.

“In summer washing is fine as they soon dry off, but leaving a horse cold and wet too long puts stress on their immune system. However, if they are soaking wet and plastered with mud, we’ll wash them off with a medicated shampoo, to combat bacterial and fungal skin disorders, and make sure they’re scraped and towelled dry before they go to their stables. My rule is that if they arrive home wet, they are washed off, but if they are dry, the mud is brushed off.

“We then bandage all round and use Thermatex rugs to wick away the wet. Horses that are likely to break out in a sweat will have their rugs changed until they are dry. A solarium is on my wish list!”

Horse owners often debate whether to clip out horses’ legs, as the coat does provide some protection but makes it hard to dry and treat sore skin.

Showing and dressage star Louise Bell says, “With horses prone to mud fever I clip the hair on the legs but with a blade that leaves a bit of coat on. I always wash off, but legs must be dried as they are more prone to mud fever.”

David Sheerin, general manager of Wellington Riding, tends to leave the hairier school horses’ legs unclipped.

“They come in to dry and then are brushed off. We’d rather sacrifice looking clean over causing skin infections.”

If not treated, mud fever can lead to long-term conditions such as vasculitis. The key is constant inspection of the horse’s legs for early signs of soreness and scabs, treating the infection and then allowing the skin’s natural barrier to heal. There are a variety of remedies for mud fever, properly named pastern dermatitis, as horses tend to respond differently. The best prevention is to bring the horse in from the field for some time every day to allow the legs to dry out and to be inspected.

Janet Littlewood MRCVS, a specialist in equine dermatology, acknowledges mud fever is a massive problem. Mud can cause surface damage to the skin of the legs, and even the body, which allows bacterial organisms such as Dermatophilus or Staphylococcus to take hold and cause infection.

“If the mud fever is chronic, it can be difficult to deal with and other bugs get in on the act,” says Janet. “Dermatophilus spores are extremely persistent in the environment and can last in the soil for over a year. UV skin damage on unpigmented skin and age can also be contributory factors that increase the riskof infection.

“It’s important to keep limbs dry and clean. Once scabs appear they must be removed with a disinfectant in an area which can be cleaned afterwards to avoid recontamination. A residual disinfectant spray or mousse can also be applied to the lower limbs to help prevent reinfection.”

Janet recommends drying legs with paper towels rather than fabric towels which, if not hot-washed, can harbour infection.

Muddy fields and going can also have implications for the horse’s feet. For example, if your horse has pads or packing in his shoes, sloppy mud can get in and accumulate underneath, so in winter it may be best to avoid these if possible.

“When the ground gets poached we see a lot more overreaches and lost shoes as the horse can’t move his front legs quickly enough out of the way of the hindlegs,” says Team GBR farrier Andrew Bowyer. “Often we have to be more conservative when fitting the shoes.

“If it’s really wet, the horn of the foot gets soft and shoes can pull off a bit more often. If the shoe does come off, clean the foot and apply a wet or dry poultice secured with duct tape and cohesive bandage until the farrier comes.

“In wet weather the feet absorb a lot of moisture. In my opinion, a shavings bed is best at wicking away the moisture,” adds Andrew.

If dealing with muddy horses is time-consuming, their caked tack, rugs and boots are equally a chore, especially for horses hunting several times a week.

“Once we’ve cleaned off the mud from the tack, we towel-dry the leather – there’s no point in putting saddle soap on wet leather as it won’t absorb,” recommends Margaret Hopkins. “We use cotton webbing girths and brush them off when they are dry.”

Anna Millward of Shires Equestrian says, “Avoid using pressure washers or stiff brushes to remove mud from rugs as this will break down the coating on the fabric. Let the rug dry thoroughly and use a soft brush or gentle hose to remove the mud.”

Hose mud off boots, including fastenings, and let them dry naturally.

As with all problems, prevention is better than cure. To prevent mud in the winter, you need to prepare your fields in the summer. However, this is often only remembered in the autumn, as you stand on the opposite side of a muddy gateway to your horse, realising he isn’t going to walk through it unless you fetch him.

The best solution is a non-slip concrete in the gateway or around the water trough. A cheaper solution is to remove the top soil and lay a ground membrane. Put down a layer of stone topped off with smaller stone or tarmac planings. You could also use a plastic grid system where the grass grows through and makes the area resistant to poaching.

Mud isn’t pleasant, but with careful management and preparation it needn’t bog you down.

Ref: Horse & Hound; 19 November 2020

Why winter warm-ups matter H&H Plus

Horse & Hound — Fri, 20 Nov 2020 09:00:27 +0000

Easing horses into exercise in colder weather will help them stay injury-free and perform at their peak, explains Dr Susanna Ballinger MRCVS, who investigates the biology behind warming up and how to provide the best post-workout care, too

Warming up before work is important year-round, whatever the weather, and in simple terms it raises the horse’s body temperature to allow safe, injury-free exercise.

In winter, when shorter daylight hours can restrict riding time, it may be tempting to condense this vital phase.

Yet a combination of colder weather and longer periods of stabling, often with little or no field turnout, means that many horses require more careful preparation at this time of year.

Basic biology

How exactly does a warm-up ready a horse for harder work?

When movement commences, muscles contract. Chemical energy converts to mechanical energy for this contraction, which in turn causes an increase in muscle temperature. Heat then dissipates throughout the body and the horse’s overall temperature rises.

As a result of rising body temperature, blood vessels widen – a process known as vasodilation – to facilitate an increase in blood flow to all organs, including muscles. A higher rate of blood flow also increases oxygen delivery to muscles, promoting aerobic metabolism.

If there is insufficient oxygen in the blood to allow muscles to produce energy to exercise aerobically, anaerobic metabolism kicks in. This leads to a potential build-up of lactic acid which causes fatigue, muscle damage and, in severe cases, rhabdomyolysis, or “tying up”.

Oxygen is carried in red blood cells, up to a third of which are stored in the horse’s spleen. At the start of exercise, during a controlled warm-up programme, the spleen releases these into general circulation. This “splurge” of red cells increases the oxygen-carrying capacity of the blood, preparing the horse for exercise by ensuring a greater supply of oxygen to all organs and muscles.

As the warm-up intensifies, the rising heart rate increases blood flow around the whole body. The increased body temperature improves elasticity within tissues, including muscles, ligaments and tendons. This flexibility allows more efficient contractility, the ability of muscle to shorten, helping prevent injury.

Warming up also promotes a steadily increased airflow into the lungs. Inhalation of cold air can cause irritation and constriction of the airways, leading to respiratory problems including coughing. This is particularly evident in horses with pre-existing respiratory conditions. While you cannot warm the air as it enters the lungs, starting slowly and gradually increasing the intensity of the programme reduces the likelihood of a problem arising.

An established warm-up routine used at home and prior to competition will prepare athletes – both human and equine – mentally, for the work ahead.

Stepping it up

There are two warm-up phases:

• Passive warm-up is more relevant in colder weather and involves increasing the

horse’s body temperature by external means, with rugs and heat pads, or by using a solarium. This warms the muscles, but usually only along the topline and back.

A massage pad will boost blood flow but only to the area of application, with a small increase in temperature in the muscles being massaged.

Unclipped horses with a thick haircoat over their quarters should not need an exercise rug during warm-up, even in colder weather. If they are clipped out, however, keep their muscles warm, ideally with a well-fitting exercise rug of an appropriate weight for the climatic conditions. Remove the rug once the horse is warmed up to prevent the detrimental effects of increased sweating.

• Active warm-up in colder weather should start with a generalised session which includes initial walking exercise, progressing to a period of controlled, faster (trotting or cantering) exercise. The overall warm-up duration will depend on the planned activity, the horse’s fitness level and the external temperature.

At least 10 minutes of walk is usually recommended. If the horse is older, arthritic and stiff, or has had a previous injury, it may be prudent to walk for longer, gradually introducing bending and stretching before increasing the intensity of work.

This should be a relaxed phase with the horse moving forwards freely in a manner it is comfortable with, ideally in a long and low posture. As the warm-up period progresses and, if appropriate for the individual, flexing and stretching within the walk can be included.

Monitor the horse’s respiratory and heart rate during this time to ensure that you are not stepping up the work too quickly.

Walking can be undertaken on a horse-walker or treadmill, in-hand or ridden. The risk with lungeing is that the horse will have a hooley and set off at canter, rather than walk, potentially sustaining injury by using muscles before they have warmed up sufficiently.

With the walking completed, five to 10 minutes of trot or slow canter exercise can commence.

The horse should be comfortable in the pace chosen; some find trot more difficult

than canter, but both paces will achieve the desired physiological changes of increased body temperature.

Finish with a short period of activity-specific exercise. This may involve some gymnastic jumping work over small fences, beginning to bend and flex in a collected form for dressage, or a gradual increase in faster work if galloping is intended. The horse should now be ready for work.

Management plan

Be prepared to tailor or adapt your warm-up for the individual and the weather conditions. Remember, too, that a horse’s management routine will affect its ability to cope with exercise in the season ahead.

Forage will help maintain body temperature, especially in colder weather as it is used to generate body heat, so provide a plentiful supply.

Hydration is also key to performance and recovery, yet most horses have reduced turnout and less access to moisture-rich grass in winter. Encourage a horse to drink by taking the chill off the water, and consider feeding haylage as it has a higher moisture content than dry hay.

Exercise after-care

Build time into your session for a cool down. Controlled walking not only promotes physical cooling and a decrease in heart and respiratory rates, but maintains circulation to remove lactic acid from the muscles.

Cool a hot, sweaty horse by walking it for 10 to 15 minutes post-training, until its skin has dried and its nostrils have stopped flaring. Use a sweat sheet or exercise rug in cold weather for this phase, just as you would put on an extra layer immediately after your own exercise session.

After cooling, a horse should be washed down with warm water and either rugged appropriately or stood under heat lamps or in a solarium to prevent chilling. Replace the regular rugs only once the horse is completely dry.

About the vet, Dr Susanna Ballinger

Susanna is an RCVS advanced practitioner in equine practice and clinical director at Ballinger Equine, the award-winning first-opinion ambulatory equine practice. Providing 24/7,365-day veterinary care and top-quality diagnostic imaging in the field throughout eastern England. Ballinger Equine also undertakes pre-purchase examinations across the UK and Europe.

Ref: Horse & Hound; 19 November 2020

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The health impact of behaviours such as crib-biting and weaving

Horse & Hound — Mon, 16 Nov 2020 12:00:44 +0000

Horses who crib-bite, weave and so on are often frowned upon in the equestrian world. But do some behaviours have greater effects on health than others? Professor Debra Archer FRCVS investigates

Many owners want to know how to stop cribbing and other undesirable equine behaviours such as wind-sucking, box-walking, weaving and other traits typically described as stable vices. But as these stereotypic behaviours develop to help some individuals cope with a life where they cannot forage, move around or interact with other horses as nature has designed them to do, is preventing a horse from expressing the behaviours that help it cope the best action to take?

Why it shouldn’t be described as a vice

A “vice” is a behaviour, habit or other negative trait that a person has. But animals don’t have that level of thinking; they aren’t doing these behaviours deliberately.

One study estimated that around 2.7 million horses worldwide display some form of stereotypic behaviour. These horses don’t need punishment, just a better understanding of why they are doing this and, ideally, methods for preventing these behaviours from developing in the first place.

Stereotypic behaviours include crib-biting, wind-sucking, weaving and box-walking. These are common, developing in around one-fifth to one-third of all horses. Their cause is complex and considered to be a combination of genetics and management.

Stereotypies are not seen in wild horses and are generally considered to be a coping strategy that some domestic horses develop. The behaviour helps these horses to adapt to a life in which they cannot feed, roam and interact with other horses, as they have evolved to do in the wild.

Stereotypies can be a cause of major concern and frustration to some horse owners and carers. In addition, they can reduce the financial value of these horses and can make them more difficult to sell or rehome. But how do they affect a horse’s health, and what can we do to help?

Crib-biting and wind-sucking have been studied most in terms of effects on horse health. These so-called “oral stereotypies” involve complex linking between the brain and gut, something we do not yet fully understand. Therefore, it is not surprising that most health effects in these horses relate to the mouth and gastrointestinal tract.

Some horses may crib-bite or wind-suck only occasionally, usually around feeding time or at other specific times, such as when tied up. Other horses perform this behaviour almost constantly and it is likely that the severity of crib-biting and wind-sucking behaviour is more significant to health than simply the fact that a horse displays these behaviours.

Crib-biting can affect both the teeth and skull. It can cause increased wear on the incisor teeth, although there is no current evidence that this causes specific dental issues. Horses that crib-bite or wind-suck, especially youngsters, can fracture the front (incisor) part of their jaw if they are startled and suddenly pull back while their teeth are grasping a fixed object. Fortunately, these types of fractures are usually relatively simple to repair and have a good prognosis.

Interestingly, there is some evidence from the USA and Japan that crib-biting or wind-sucking may be associated with arthritis of one of the joints within the horse’s skull. This condition, temporohyoid osteoarthropathy (THO), is relatively uncommon in horses. But when researchers looked at the clinical records of horses with THO, those affected were eight to 12 times more likely to be a crib-biter or wind-sucker.

Affected horses display head tilting or head shaking, ataxia (where they cannot coordinate their legs or balance properly), paralysis of the eyelid on the affected side and drooping of the muzzle. Diagnosis is based on endoscopy of the guttural pouch, X-rays or ideally computed tomography, and a horse may require medical treatment or surgery.

In horses in whom unusual signs related to the head such as head-tilt or head shaking develop, it is worth investigating THO as a potential cause of such signs, particularly in a horse that crib-bites or wind-sucks.

A chance of colic

Several studies have shown that crib-biting and wind-sucking are associated with an increased chance of colic. Importantly, a study performed at the University of Liverpool’s equine hospital showed that the frequency and duration of crib-biting behaviour was hugely important; the more often and longer the horses performed this behaviour, the more likely they were to have suffered from colic before.

Crib-biting and wind-sucking don’t increase the risk of all forms of colic, but these horses are more likely to develop large colon impactions and epiploic foramen entrapment, in which the small intestine becomes stuck through a natural opening within the abdomen. Surgical techniques have been developed to close the epiploic foramen in horses that develop this type of colic, as it can recur.

Gas colic, gastric ulcers and weight loss have also been associated with these behaviours. These might also be related to the severity of the behaviour; a horse that is crib-biting or wind-sucking for long periods of time during the day is likely to swallow a reasonable amount of air or spend less time eating.

The link between gastric ulceration and crib-biting or wind-sucking is not fully understood but both are associated with diet, particularly the need for forage to be available for large parts of the day such as through increased pasture access and small-holed haynets to encourage trickle feeding.

Despite the fact that abnormal hoof wear and issues relating to strain on joints and tendons and muscle fatigue are stated as problems in horses that box-walk or weave, there is actually very little scientific evidence to back this up.

It would seem possible that repetitive abnormal movements that occur with these “locomotor” stereotypies could result in musculo-skeletal issues developing, but further research is needed in this area.

Should we stop undesirable behaviours like cribbing?

This is a controversial topic and in general, the answer is no. This should be a last resort where management changes fail to make a difference and where the horse’s health is genuinely being negatively affected.

Studies have shown that physically preventing horses from performing stereotypic behaviours causes increased stress and they find other ways to cope – for example, weaving inside the stable itself if bars have been fitted to the stable door. Some described methods are barbaric and are simply not acceptable in terms of horse welfare.

The focus should be on trying to find ways to help these horses cope better – for instance, increased access to forage and turnout, interaction with other horses, fitting of stable mirrors so the horse can see his reflection, a change in type of stabling or in location on the yard so the horse isn’t in isolation on its own. These changes may not stop horses from cribbing or demonstrating other behaviours, such as wind-sucking, but it would seem logical that reducing the duration of time for which horses display these signs would benefit their health and welfare.

What does the future hold?

In humans, a huge amount of research is being done to explore how genetics affect development of different diseases and how genes affect our behaviour. This work is expensive to perform, but rapid improvements in technology and reduced costs of performing genetic studies are allowing us to understand more about the role of genetics in disease and behaviour in animals.

This ultimately may lead to better understanding of the genes that are associated with stereotypic behaviours in horses. This could allow horses, particularly youngstock, that are more likely to develop these behaviours to be identified, managed and monitored more carefully. In addition, it could allow drugs to be developed to help reduce the severity of stereotypic behaviours if these behaviours have already become established.

For the moment, the main focus must be on preventing these behaviours from developing in the first place, rather than wondering how to stop cribbing and other undesirable behaviours once they are established. Optimal management of youngstock, particularly around weaning and introduction to training, is critical.

Once established, these behaviours are frustrating to manage and can have various negative effects on health. Yards where large numbers of horses develop or display stereotypic behaviours must consider different ways of management to ensure sufficient access to forage, pasture exercise and social contact with other horses.

Ref Horse & Hound; 12 November 2020

How to bring a horse back to exercise safely after injury H&H Plus

Horse & Hound — Mon, 16 Nov 2020 09:00:36 +0000

Many horses will have had a season out of work due to the cancellation of the majority of competitions. Laura Fitzharris MRCVS advises on how we can bring them back to their job safely

The best way to return a horse to exercise after a period of rest is an age-old topic. With the recent lockdown situation many horses have had a prolonged holiday, but with the competition season back up and running there are factors we must consider when returning them to work. The principles discussed are similar for horses that have had a holiday over the winter period or are returning to training following treatment for an injury.

The first thing to consider is what effect a period of rest has on a horse’s body. In all cases, a reduction in exercise level will result in a loss of muscle mass which can occur after even a few weeks of reduced activity.

The amount of muscle loss is often horse-dependent and will vary based on age, body condition before the rest period and what activity the horse has been undertaking during the rest period, such as field turnout or strict box rest.

Rebuilding the muscle relies on the correct exercise and conditioning programme combined with an appropriate diet.

Monitoring fitness

Many riders go by feel, knowledge and experience to monitor fitness levels. Heart-rate response to exercise is one of the primary measures used by veterinary surgeons, traditionally measured using an electrocardiogram (ECG). The recent increase in availability of equine heart-rate monitors has made this method widely accessible.

Generally, as a horse’s fitness level increases, the heart-rate response to the same level of exercise should decrease. An additional tool is the measurement of blood lactate level, which increases in response to strenuous exercise.

Basic training

Generally, in terms of basic training, a minimum of two weeks should be undertaken before the intensity level is stepped up. For example, two weeks of walking should be performed before introducing trot, with two weeks of trotting undertaken before introducing canter for two weeks.

The duration of exercise should also be monitored. In most cases, basic fitness work is done while out hacking and interspersed with light schooling work. After this initial six-week programme of basic fitness, more specific training can be gradually introduced, such as lateral work or jumping exercises.

How to prevent injuries

There are four basic principles. Firstly, at least 15 minutes of walking should be undertaken before starting any faster exercise. This time is crucial to allow the soft tissue structures time to warm up and reduce the likelihood of a strain injury. It is particularly important when having a lesson or schooling, as the temptation is to start trotting quite quickly. A short hack or putting the horse on the walker before the lesson will help to prevent soft tissue injuries.

A second consideration is how quickly the exercise level is increased each week. As a rule, the increase in exercise duration should not be by more than 10% each week. This will allow the muscles, tendons and ligaments to adapt to the training stimulus. An increase of about five minutes per day each week is generally sufficient. If a horse is pushed too hard too soon, then overload injuries can occur.

Thirdly, training the horse for the job it is asked to do is key. The gradual introduction of jumping exercises before going out to showjumping competitions will allow the horse’s body to adapt and prevent overload injuries.

The final consideration is rest and recovery days. Any human athlete will tell you that good recovery is an important part of training. Traditionally, horses are not given many rest days. However, studies have shown that the muscle recovery time and the replenishment of glycogen (energy) stores is actually twice as long in horses compared to humans. As such, it is really important to schedule some recovery time into your horse’s training plan. This can be in the form of a day off, or a lighter exercise load such as hacking or horse-walker exercise, and will allow the horse’s body to adapt to the training stimulus.

Specific training

When reintroducing more specific training, factoring in a warm-up and a cool-down period is key. Working the horse in a long and low outline is advised to warm up, stretch and loosen the horse, before trying more collected exercise.

The addition of breaks during the schooling session itself, where the horse is returned to a long and low outline for a few minutes, can be beneficial. Finally, an active recovery period at the end of the session is recommended.

A further consideration is the surface on which the horse is exercised. Where possible, quality surface with good footing (not too firm or too deep) is ideal for training and competition. A hard surface may predispose to bony injuries, whereas a soft surface may cause soft tissue injuries.

Complementary exercises

All horses can benefit from complementary athletic exercises to increase muscle strength and improve range of motion. Traditional exercises include hill training and raised pole exercises. The use of training aids such as the Equiband or Pessoa can help the horse to work through from behind and build up the topline. These training aids should be gradually introduced by an experienced user to allow the horse to adapt.

Recently, the use of water treadmills has gained in popularity. Preliminary research has shown an increase in the flexion (bending) of the legs during the swing (flight) phase of the stride and increased range of motion of the back during water treadmill exercise. However, further research is required.

Finally, horse “yoga” in the form of carrot stretching exercises on the ground has the effect of increasing the size and strength of the topline and epaxial muscles in the back, in particular the multifidus muscle.

Nutrition

Some types of horses, such as natives, may gain weight during a rest period while others, such as thoroughbreds, may lose it. For the majority of horses, a diet composed mainly of roughage (grass and hay or haylage) along with a feed balancer is appropriate for maintaining condition during a period of rest and light exercise.

When more intense exercise is re-introduced, the diet needs to be adjusted accordingly. In most cases this means the addition of concentrate feed. It is important that the feeding is in line with the exercise being undertaken and the body condition of the horse.

Speaking to your vet or consulting with a nutritionist can help you develop an individual feeding plan.

Take-home messages

Ensure the horse does at least 15 minutes’ walking before increased speed to allow the soft tissues to warm up.
Gradually increase exercise duration each week.
Use complementary athletic exercises such as carrot stretches and raised poles to improve strength.
Train the horse for the job it is asked to do.

Ref Horse & Hound; 12 November 2020

Caring for a horse after colic surgery

Andrea Oakes — Sun, 15 Nov 2020 09:00:16 +0000

What’s involved in caring for a horse after a colic operation? Andrea Oakes follows the process from hospital to home

In roughly one in 10 cases of colic in horses, wherever a gastrointestinal obstruction cannot be treated by medical means, then surgery may be a necessity.

The decision to operate is never taken lightly, however, since opening up a horse’s abdomen to investigate the many metres of intestines is not without risk. Sections may be displaced, distended or in some cases dying, due to obstruction of the blood supply, calling for resection (removal) of these diseased areas. Then there’s the challenge of anaesthetising such a large animal during the procedure and returning him safely to his feet.

“A horse undergoing colic surgery may already be tired and sick, increasing the risk of cardiac arrest, myopathy (muscle disease) or bone fracture as he comes round from general anaesthesia,” says Rosie Olley MRCVS, a Bell Equine clinician. “Yet anaesthesia and surgery techniques continue to evolve – and horses tend to be more robust than we are. After his first shaky steps in the recovery room, it’s not uncommon to see a patient alert and neighing at the other horses once back at the clinic stables.”

While surgery can save a horse’s life, there are usually a few hurdles to clear before he can leave hospital.

Making ends meet

Within hours, the internal healing process begins – even after extensive surgical repair.

“Colic can mean a lot of things, from a hind gut twisted and distended with gas to a more complex issue such as entrapment or strangulation of the small intestine,” says Rosie. “Often, we have to ‘replumb’ the intestines, removing a length of the gut and sewing the ends of healthy intestine together. Almost instantly, the body starts to form a natural seal until these dissolvable stitches become redundant. The site heals quickly – usually within two to three days.”

However, while the intestine has to heal, so as not to leak, it must also work.

“The gut on either side of the join must learn to communicate, to move food along the intestines in a coordinated manner,” Rosie explains. “Until this peristalsis returns, a horse who has undergone small intestine surgery will not even be allowed water – generally for 12 to 24 hours – and will instead receive fluids through an intravenous drip.

“Depending on the location, the intestine can be narrowed where it has been replumbed and must stretch to allow food through,” adds Rosie. “It’s harmful to starve the gut completely for too long, since many of the cells in the gut receive nutrition from the food within the intestine.”

Patients are fed as soon as there is evidence of returning gut function (such as improved gut sounds or passing of droppings), starting with handfuls of grass and fibre pellets and building up to short periods of grazing and small amounts of hay. This is typically within 48 hours.

“A common and potentially fatal complication is post-operative reflux, and ileus, where fluid builds up in the intestines,” says Rosie. “A nasogastric tube is inserted to drain the fluid, which can amount to six to eight litres every four hours. We must then control the horse’s hydration levels, until his system starts working normally.”

Team approach

The whole team delivers care during this critical period, in particular the nurses and the vets who live on-site.

“We’re there to keep an eye on the patient,” explains Bell Equine head nurse Ruth Gravenell, a registered veterinary nurse. “We administrate medication and pain relief, monitor food and fluid intake, check faecal output and do any tubing – to give fluids or remove them due to reflux. We’ll take the horse for ultrasound scanning to assess intestinal function or for blood tests to check inflammatory markers.

“These cases are potentially high-maintenance and require round-the-clock monitoring,” adds Ruth, explaining that up to half will colic again at some stage during recovery. “We also attend to any specific needs, using ice boots with a horse prone to laminitis, for example, or controlling arthritis with extra pain relief.

“An important part of our role is pain scoring, so we’ll take time to watch the patient and note any signs of discomfort,” she continues. “We also monitor the surgical incision, which usually follows the linea alba, the natural ‘seam’ along the horse’s midline. Any infection can delay healing, so we change the dressing daily and fit a belly-band for support, as the incision is on the underside of the abdomen and gravity is not our friend.”

Grooming the patient or leading him out for some sun on his back helps introduce normality to his life.

“Grazing in-hand is the best thing, as biting and chewing grass helps prevent ileus, and these outings two or three times a day keep a horse’s mind active,” explains Ruth. “It’s all part of nursing him back to health.”

Managing pain

Pain management is a vital part of post-operative care. The hospital team uses a pain-scoring system to identify discomfort that may not be immediately apparent.

“We observe a horse for 10 minutes, during a quiet part of the day, before trying to interact with him and judging how he responds,” says student veterinary nurse Claire Tottman. “We evaluate certain points, including appetite, respiratory and heart rate, evidence of ‘pain face’ (tension in the nostrils or facial muscles, for example) and signs such as tooth grinding, scoring each from zero to four. This creates an overall pain picture; a higher-than-expected total indicates a need to reassess pain relief.

“While different breeds, types and ages have a different approach to pain, a usually stoical cob who goes off his food – but shows no other clues – would be a cause for concern.”

Ready to leave hospital

Once a horse can cope without constant supervision, his care can continue at home.

“Most have finished medication by the time they’re discharged, which could be anywhere from around five days to many weeks,” says Ruth.

All patients leave with detailed instructions about aftercare. This normally starts with eight weeks of box rest, wearing the belly-band, to allow the abdominal incision to heal fully and to reduce risk of hernia.

“We expect a patient to fluctuate a little in his recovery,” she adds, citing recurring colic and surgical site infection (termed SSI, which occurs in around 25% of cases) as the most common complications. “Owners tend to know their horses best, however, when it comes to spotting subtle signs. We encourage them to contact us with any concerns or to discuss any management issues with our ambulatory vets during follow-up visits.

“After colic surgery, there’s often no reason why a horse can’t return to what he was doing – even high-level competition,” Ruth concludes. “But it’s a slow process, so be prepared to give him time.”

Nursing the convalescent – what to expect

Once the horse is back at home, be prepared to:

Provide an enclosed area for eight weeks of box rest, with fresh water and ad-lib forage.
Walk the horse out to graze for 15 minutes, three times daily.
Watch for colic signs, such as pawing and rolling, or appetite loss. Monitor the amount of droppings produced and the horse’s general demeanour.
Check the incision for excess discharge, swelling or pain that could signal SSI. If infection develops, frequent dressing changes and cleaning of the incision may be necessary – your vet will advise you.
Fit the belly-band, if used, carefully, for full abdominal support. Re-adjust it regularly if the horse has lost weight or muscle and check for rubbing, especially over the back, withers and chest.
Vaccinate as normal, but consult your vet before de-worming.
Follow up with small-paddock rest before a return to exercise under veterinary supervision.

Ref Horse & Hound; 12 November 2020

An essential guide to equine dental care

Andrea Oakes — Sat, 14 Nov 2020 09:00:42 +0000

Dental check-ups should be a regular feature in your horse’s basic health care routine. Andrea Oakes looks at problems that can arise in the mouth

When it comes to equine dentistry, the days of a quick “once over” with a rusty rasp are long gone. Regular and detailed dental check-ups are now the norm for the well-cared for horse, allowing skilled practitioners to detect developing issues before they become real problems.

Since a comfortable mouth is a mainstay of good condition, behaviour and performance, it makes sense to start this routine care in a horse’s early years. When is it best to begin?

“Up until the age of five, a horse’s adult teeth are erupting and shedding their ‘caps’ – the remnants of the deciduous, or baby, teeth,” says Dr Kieran Rowley, an RCVS advanced veterinary practitioner in equine dentistry.

“We would generally recommend a first examination at around two to three years of age, provided that specific issues have not already become apparent.

“A check-up every six months is a good idea with the young horse, so that we can monitor the development of the mouth,” he adds. “We can also deal with any troublesome wolf teeth that may interfere with bitting and require extraction.”

Ideally, routine care will then be ongoing. A preventative approach is a must, explains Kieran, since horses can be surprisingly stoical when it comes to tooth problems.

“As a prey animal, a horse tends to hide pain – so an issue is usually quite advanced once outward signs become apparent to his owner,” he says. “For the adult horse we advise an examination every year, as an absolute minimum, and in some cases more often. This comprises an extra-oral exam, to check facial symmetry and the movement of the jaw and the temporomandibular joints that connect it to the skull, along with an intra-oral examination, inside the mouth, frequently using a gag, a bright head torch, mirrors and small instruments called picks.

“The vet or equine dental technician will be looking for periodontal [gum] disease and tooth problems including holes, gaps, fractures and misalignments, known as malocclusions,” says Kieran, who adds that observations should be noted and records maintained. “It may be necessary to rasp any sharp points and edges. Other issues that cannot be dealt with at the time can be booked in, while more complex problems may be referred to an equine veterinary dental specialist.”

The anatomy of the equine jaw

A horse’s routine requirements will be influenced by his lifestyle, age and dental history.

“Different feedstuffs require different amounts of chewing,” says Kieran, explaining that the anatomy of the equine jaw and the lateral chewing motion naturally create sharpened points. “In theory, a largely grass kept horse will develop sharp points at a slower rate than a horse eating a lot of concentrates. Other factors such as breed and mouth conformation do come into play, however, so more frequent examinations may be necessary.

“Horses doing a lot of collected work with more rein contact, especially in dressage, can also benefit from treatment every six months,” he adds, explaining that “mouthing” or fussiness with the bit, often caused by sharp points pressing on the tongue or inner cheeks, can lead to a deterioration in performance and loss of marks. “Other cases requiring twice-yearly examination include horses who’ve had a molar removed, to prevent overgrowth of the opposite tooth into the empty space, and older horses approaching their twenties and beyond.”

Despite the best care, problems can still arise – especially in the ageing mouth.

“From late teens, abnormal gaps called diastema can form between the horse’s teeth, resulting in painful periodontal disease,” says Kieran. “It’s important to be vigilant with a horse of any age, however, for behaviour that may signal tooth pain.

“Signs range from resisting the bit or contact to becoming unusually head shy,” he adds. “The horse may tilt his head or display abnormal jaw movement when eating, or struggle to bite harder foods, such as carrots. Look out for packing of food in the cheeks, like hamster pouches, facial swelling, bad breath, nasal discharge, usually from a single nostril, or ‘quidding’, where the horse drops unchewed food as he eats. Signs may be so subtle, however, that you don’t notice until the horse loses weight.

“Any of these issues warrants a check-up, but certain situations require emergency treatment. These include a recently fractured incisor tooth, which we can often save with a simple technique called pulp capping, or a badly swollen face that might indicate a tooth root abscess.”

Modern treatment techniques include swift and effective extraction methods, fillings and endodontics – the term for root canal work. Yet perhaps the biggest advance in equine health, believes Kieran, has been a greater understanding of what can go wrong and the ability to identify these issues during routine examination.

“Correct and regular care can prevent long-term problems or loss of teeth, potentially extending a horse’s active years and easing the ageing process,” he says. “It’s a huge advantage to pick conditions up in the early stages.”

Avoiding erosion

Thankfully, there’s no requirement for twice-daily brushing of a horse’s teeth. Where food tends to become stuck between gappy incisors, however, Kieran suggests removing it gently two or three times a week with a toothbrush or a soft pick.

“Another measure to prevent decay is to be selective with the treats,” Kieran adds. “Something natural is best. Avoid mints that are sugary or chewy, as these can stick to the teeth and potentially cause erosion.”

Who’s qualified?

How can you make sure your horse is in safe hands? Neil Townsend, an RCVS specialist in equine dentistry, answers some frequently asked questions…

Who should I entrust with caring for my horse’s teeth?

“Either a vet or a suitably qualified equine dental technician (EDT). These are the only people sufficiently trained and legally allowed to diagnose and treat equine teeth, and both groups must hold indemnity insurance and undergo regular professional development training.

“All equine vets are highly trained in dental care and are qualified to carry out any procedure in a horse’s mouth, but some have a special interest in dentistry and go on to pass EDT exams or to become advanced practitioners or specialists. Qualified EDTs have undergone training and examination to become a member of the British Association of Equine Dental Technicians (BAEDT) or the Worldwide Association of Equine Dentistry (WWAED).”

For basic work, is it worth considering an unqualified EDT – or someone sometimes incorrectly termed an equine dentist?

“By law, anyone can use a hand rasp to file sharp points in a horse’s mouth. Yet a so-called ‘equine dentist’ has had no regulated training and has no recognised qualifications, while an unqualified EDT has not met the rigorous BAEDT or WWAED standards. Neither group can use motorised equipment or diagnose or treat issues in a horse’s mouth, and in neither case can you be confident that your horse is receiving quality care with appropriate protection should anything go wrong.”

What about more complex treatment?

“Only a vet can diagnose issues, administer sedation if required, or treat problems such as fractured teeth or diastemata. A qualified EDT will be keen to work with your horse’s vet, carrying out routine examination and corrective rasping but referring any abnormalities for further veterinary evaluation and treatment.”

Ref Horse & Hound; 12 November 2020

The fetlock: Everything you need to know about this complex joint H&H Plus

Horse & Hound — Thu, 12 Nov 2020 12:00:35 +0000

Laura Fitzharris MRCVS and Evita Busschers MRCVS delve into the details of this complex joint and the injuries that can happen in this area

The fetlock is a high-motion joint with a similar structure in both the forelimbs and the hindlimbs. The fetlock joint is the articulation between the cannon bone (third metacarpal and metatarsal bone in the forelimb and hindlimb respectively) and the long pastern bone (first phalanx), with two sesamoid bones located at the back of the joint.

There are several soft tissue structures associated with the fetlock; the joint is stabilised by collateral ligaments, located on the inside and the outside of the joint. The suspensory ligament originates at the back of the cannon bone, passing down the back of the leg before dividing into two branches which attach to the sesamoid bones.

The sesamoidean ligaments are located lower down at the back of the fetlock and pastern, and consist of five separate ligaments that attach the sesamoid bones to each other as well as to the cannon and long pastern bone.

This crucial combination of the suspensory ligament, the sesamoid bones and the sesamoidean ligaments is called the suspensory apparatus, and this structure supports the majority of the high load on the fetlock joint during the stance phase (when the leg or foot is on the ground during the weight-bearing part of the stride).

The flexor tendons are located at the back of the limb and they provide some additional support to the fetlock joint.

The fetlock is a hinge joint, meaning that the movement is predominantly in one direction – either flexion, during the swing phase of the stride when the leg is in the air, or extension, during the stance phase of the stride when the horse is weight-bearing. There is minimal twisting or side-to-side motion of the fetlock.

The high range of motion and intense loading during canter, gallop, turning and jumping make the fetlock joint susceptible to injury.

An improvement in the lameness

Fetlock injuries typically present as an unusual swelling, involving the soft tissues or joint itself. In some cases, careful physical examinations can point to the fetlock being the problem. In other cases, diagnostic anaesthesia is required, where local anaesthetic is injected into the leg to numb part of the limb. If the area where the pain is localised is desensitised, an improvement in the lameness is seen.

Once the fetlock joint has been identified as the source of the problem, further investigation in the form of diagnostic imaging can be undertaken.

Radiographs (X-rays) allow assessment of the bony structures and are often the first line of investigation. Ultrasound examination looks at the soft tissue structures, such as the tendons and ligaments. Portable X-ray and ultrasound machines mean that these can be performed out on the yard in certain situations.

In other cases, further examination in the form of either an MRI or CT scan is required to provide more detailed information in 3D, and is undertaken at specialist equine hospitals.

Injuries to the fetlock can be divided into three main areas: the soft tissues, the bones and the joint. Most injuries can be caused by a single “overload” incident which is acute in onset, or by a repetitive strain injury which is a chronic change. It is possible that multiple injuries occur in the same traumatic incident since all these structures are closely related.

Soft tissue damage can consist of injury to the suspensory ligament, sesamoidean ligaments and collateral ligaments, which is known as desmitis. Injury to these ligaments can occur in any horse, but increased athletic function puts the horse at higher risk.

Soft tissue damage can often be diagnosed with ultrasound examination, but sometimes more advanced imaging such as MRI is required.

Treatment usually involves a prolonged period of box rest and controlled exercise rehabilitation to allow healing of the damaged tissues. With some injuries, regenerative medicine can be used in addition. The prognosis depends on the severity of the injury, but some horses can return to full athletic function.

Acute single overload

Injuries to the bones mainly consist of subchondral bone damage (such as bruising of the bone close to the joint) or a fracture, resulting in either small fragments within the joint or a major fracture of the cannon bone, long pastern bone or sesamoid bones.

It is well recognised that chronic changes in the subchondral bone due to repetitive injury can change the mechanics of the bone, resulting in decreased ability of the bone to endure the forces during exercise, which can then lead to a fracture. Alternatively, a fracture can also occur due to an acute single overload.

Major fractures might require surgical fixation with screws or sometimes even a plate, and are most often seen in horses doing hard and fast exercise, such as racehorses and high-level event horses.

Smaller fragments within the joint can be the result of a fracture or a developmental disorder called osteochondritis dissecans. The first is the result of trauma, whereas the second is a disorder that is caused by abnormal development of the bone and cartilage. Fragments can be removed during arthroscopic surgery (surgery of the joint). The prognosis after fragment removal depends on how much of the joint surface is affected and the degree of joint damage that has occurred, but is often good.

Changes in the joint can happen as a consequence of another injury (such as a fracture within the joint or a soft tissue injury surrounding the joint).

Changes often start with inflammation, causing an increase in the amount of joint fluid known as synovitis. This can cause lameness and does not have to be associated with changes of the bones or soft tissues (primary synovitis). This is most often seen in young horses when the exercise level is increased, and is treated with an adjustment to the training routine and anti-inflammatory medication.

Osteoarthritis occurs when there is damage to the cartilage and bone, and is common in the fetlock joint of older horses. Osteoarthritis is a progressive, degenerative disease.

The cartilage damage cannot be reversed, but often the pain can be managed, and the disease progression slowed by adapting exercise and providing anti-inflammatory medication. There are several additional medications available to modify the disease or decrease the clinical signs associated with it.

Treating a field injury

Jack is a 12-year-old Irish Sport Horse gelding used for general riding club activities. One day Jack returned from the field lame on his right hind limb with swelling surrounding his fetlock joint.

Radiographs showed several smaller fragments within the joints and an ultrasound examination showed damage to one of the sesamoidean ligaments. It was suspected that Jack had had an acute traumatic event whereby the foot stayed on the ground while the body and limb turned, resulting in a twist at the level of the fetlock joint.

Jack had surgery to remove the fragments and underwent a period of box rest and a controlled exercise rehabilitation programme, with repeated clinical and ultrasonographical examinations every three months.

Following nine months of rest and controlled exercise rehabilitation program (and lots of hard work by his owner) Jack was sound and returned to full work.

Ref Horse & Hound; 12 November 2020

How does veterinary telemedicine work? H&H Plus

Stephanie Bateman — Wed, 11 Nov 2020 15:00:49 +0000

During lockdown, vets turned to telemedicine, but how does it work and is there a future for it post-Covid? Stephanie Bateman investigates

Remote vetting, or telemedicine, is the provision of veterinary care without the vet being present. Instead, the consultation is held on the phone, via video call, or through text message or email.

Telemedicine isn’t new – since the development of mobile phone technology, owners have been communicating with vets in this way, sending photographs, videos and updates remotely. And it works well for non emergency enquiries such as skin problems and minor wound ailments, as well as follow-up consultations, particularly for owners living in remote locations. But for more serious conditions and emergencies, the vet must attend.

However, there is a grey area and this applies to the remote prescribing of certain medications. Under normal circumstances, the Royal College of Veterinary Surgeons (RCVS) states that every horse must undergo an examination by a vet before prescription medication can be given, including antibiotics and phenylbutazone (bute). But when Covid-19 hit, the RCVS decided that this rule should be lifted temporarily to allow the remote prescribing of such medicines.

So how have vets found remote vetting and where do they see it heading in the future?

Patrick Pollock, senior lecturer and head of equine surgery at the Royal (Dick) School of Veterinary Studies, works with developing countries, helping working equines and donkeys. And for this, he uses telemedicine.

“I hold telemedicine clinics in which I FaceTime a vet at the scene who may ask our opinion on a condition,” says Patrick. “We then offer advice on treatment and follow it up a few days or weeks later. I also provide telemedicine in the form of a consultation service, reporting on X-rays and images that vets send me.”

He admits to not having done as much vet-to-client telemedicine in the UK.

“We started using it on remote islands in Scotland and it has been gradually rolled out to other clients,” he says. “The main problem is that the RCVS legislation states that a horse must be considered ‘under my care’ to offer remote treatment, so I need to have seen it in person at least once in the past six months.”

Rules were relaxed during lockdown so that vets could continue to provide a service, but Patrick saw its flaws.

“If in any doubt, I see the horse in person,” he says. “If it doesn’t feel right, it usually isn’t, and I don’t ever want to wonder if I made the right decision or if things would have ended differently if I’d seen the horse earlier.”

Vet and H&H columnist Karen Coumbe agrees that telemedicine has its limitations.

“We tried to use telemedicine during lockdown, but I found it less useful than I’d hoped,” she says. “Few people seem able to provide sufficiently clear videos and images, so you end up examining the horse anyway.”

No hands on

Another with mixed views is Liz Somerville, practice manager and director of Loch Leven Equine Practice in Scotland.

“We’ve always followed up cases remotely, with clients sending in videos and photos, so it had already started before Covid-19,” says Liz. “For those clients you know well and have a good relationship with, it has its place. The main frustration for some of our vets during lockdown was that they were so used to doing a physical exam and getting hands on, but couldn’t. We also found many owners preferred for their horse to been seen in person.”

Telemedicine also raised logistical issues. “We had to have specific vets on emergency calls and put another vet on video consults, because stopping while on the road to do a video consult didn’t work,” adds Liz.

Deciding what to charge for remote vetting was also challenging. “We have always offered free advice, especially when the client just wants some reassurance or the vet is following up a case that doesn’t need a visit. But if a tele-consultation is being used as a replacement for a visit, as a profession we need to charge properly for this,” says Liz. “The most important bit is then making sure the client feels they are getting value for money.”

Jack Wallace, director at Walnut Hill Equine Veterinary Practice in Warwickshire, is another vet who agrees.

“We have a very good level of trust with our clients, so a proportion of our work would include some remote vetting, for which we do not charge,” he says.

Jack runs a busy practice with six vets. “The utilisation of telemedicine for following up cases has enabled us to keep up with demand,” he says. “As long as we have a good rapport with the client, have seen a photo or video and have examined the horse recently, then we feel there can be a place for prescribing some drugs remotely. Generally, coronavirus has not been a difficult transition for us.”

The advent of telemedicine and relaxation of the prescription rules has, at times, been accompanied by financial savings for clients.

“An example would be the avoidance of paying for a call-out fee for a vet to have a look at a small wound that isn’t near a joint and requires basic cleaning and medication,” explains Jack.

“A video consultation can be a useful tool that combines a coronavirus-safe approach, reduced cost to the client and no impact on the welfare of the horse. But the relaxation of these rules is unlikely to remain for the long term and while there can be some financial benefits to clients, there are also limitations.

“There are some cases that definitely require a visit in person, such as colic, wounds near joints and problems with eyes,” says Jack. “One downside to telemedicine is that we are constantly on our phones and the expectations are high. Can you text your doctor at 10pm at night and expect a reply from his personal mobile? Probably not.”

There’s an app for that

One thing that has come to light with the increased use of telemedicine is the need for an equine-specific telemedicine app.

“There are several good apps for small animal practice, but what I wanted was an equine-specific app – one where clients can book and pay for the appointment up front, then call the vet via video,” says Liz Somerville. “It is then recorded and the vet makes clinical notes on the app. There has been a huge amount of development through lockdown, but it needs a bit more work.”

Jack Wallace agrees: “Having an app would be useful so that vets aren’t being bombarded 24/7.”

Patrick Pollock has tested Vidtu, an app for remote conferencing and telemedicine. It enables mobile screen and file share, camera and chat over a secure encrypted network.

“You pay a fee to access it and it has been developed for low bandwidth areas,” he says. “It works well and is great for recording the consultation, covering yourself against litigation.”

Ref Horse & Hound; 12 November 2020

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An experienced rider can be invaluable in helping the vet determine the source of this abnormal movement, or lameness, by reporting, for instance, that the horse feels choppy on both front limbs, is not tracking up with a hindleg or resents pressure on his back.

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This exclusive veterinary feature is also available to read in Thursday 8 July’s Horse & Hound magazine

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Summer allergies in horses and how to combat them

Understanding the allergic response

The most common problems

What causes headshaking?

Management plan

Management of horses with EPA is challenging, as it is difficult to remove the horse from the allergen source. An individual approach is required, based on an appropriate treatment plan, monitoring of airway health and corticosteroid treatment.

.This Vet Clinic feature is also available to read in Horse & Hound magazine, on sale date Thursday 1 July 2021

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Grass sickness: how new research is shedding light on the disease

SAVING SAMPLES

RISK FACTORS

“With intensive and skilled care, around 50% of them survive,” Kathy says. “However, nursing a chronic case is physically, emotionally and financially demanding.”

For details about the biobank project and relevant downloads, visit: grasssickness.org.uk/biobank/biobank-for-horse-owners

This report can also be read in Horse & Hound magazine, on sale date 24 June 2021

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What’s new in the veterinary world? How harmful is bute and findings on asthma *H&H Plus*

RISKY BUSINESS

BREATHING SPACE

FURTHER READING

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Summer colic casebook: the dangers during warmer months

SHIFTING SANDS

ON HOME TURF

Could it be sand?

Common culprits for summer colics

Modern de-wormers have reduced colic risk, but anthelmintic resistance is increasing. Encysted small redworm – also called strongyles or cyathostomins – are a particular threat, lying dormant in the gut lining before emerging en masse to cause diarrhoea, colic and often death.

Targeted de-worming is a must and poo-picking, however tedious, is beneficial.

This feature is also available to read in Horse & Hound magazine, on sale Thursday 3 June 2021

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The healthy athlete: how to keep competition horses infection-free *H&H Plus*

TRIP HAZARDS

WORK:FEED RATIOS

Bust stress to boost immunity

The vet

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How bridle pressure affects a horse’s performance *H&H Plus*

VITAL ADJUSTMENTS

FACING FACTS

SPOTTING THE SIGNS

Identifying pressure zones

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At the cutting edge: equine eyelid surgery

DIGGING DEEP

SEAMLESS REPAIR

The sliding “z” flap: how it works

Adjacent triangles of skin are removed to let the remaining flaps be drawn across into place.

How to trot a horse up properly H&H subscribers

The challenges associated with getting horses fit and how to solve them H&H Plus

What’s new in the veterinary world? How harmful is bute and findings on asthma H&H Plus

The healthy athlete: how to keep competition horses infection-free H&H Plus

How bridle pressure affects a horse’s performance H&H Plus

Back conformation and saddle fit: what’s new in the veterinary world? H&H Plus

How to help keep your horse happy and healthy while in transit H&H Plus