Head it Off at the Pass- Preventative Preparations for Show Season

As we prepare for show season, most riders think of extra lessons, fitting up their eventers with conditioning programs and trailering in to school at different arenas and venues and buying new accessories and gear. As a vet, my perspective is a little different, as I think of the ramped up work load as an extra stress/strain on joints and muscles, vaccination, deworming, nutrition and dental floating. Just as people are getting geared up for bikini season with extra training sessions and if we’re lucky, a new wardrobe, so are our horsey companions. However, they aren’t getting prepped to lay on a sandy beach with a cold beer, they’re getting ready to work harder in the summer heat!

As I found when training for a half marathon, in a new training program, your muscles are sometimes sore and problems you never knew you had come to light. Before you know it, you’re finding it difficult to train/compete due to an injury! Before my first ½ marathon, I developed very painful shin splints, and found out I needed orthotics and needed to retrain myself to run in a more ergonomic way, as well as perform exercises on an ongoing basis to strengthen my muscles to avoid further injury. If I had taken the principles I apply to my patients, I could have avoided the agony of sore shins and had a much more comfortable race. A mid-training dynamic exam with a physiotherapist/ sports medicine doc would have revealed these problems and helped me solve them sooner!

Typically, I encourage as many of my patients as I can to take advantage of a pre-season checkup, which includes a physical exam and a dynamic musculoskeletal exam. I consider myself one part of the horse’s health care team, and I hope to be one of the voices to let the rest of the team know what is going on. I could obviously tell my doctor that my shins were killing me. Horses have all different ways to let us know; whether through actual limping, mild tenderness on palpation, a change in attitude etc. It’s best if the horse has been in at least moderate work prior to the examination so that we can gain the most information. Listening to the heart, lungs, GI tract and looking in the eyes are just part of the physical exam. I have often identified new heart murmurs (potentially dangerous when jumping obstacles!), or cataracts or other ocular abnormalities that would otherwise be unknown, even on horses who have been normal in previous years. Additionally, it allows us a chance to take a dedicated look at the horse in a holistic sense. Is there weight gain/loss? Muscle loss, or uneven development? Is his coat all of a sudden dull and burnt out?

The palpation and dynamic aspects of the exam is an important annual aspect as well, allowing me to monitor ongoing problems and identify new ones prior to investing in expensive show fees. Conformation issues, shoeing changes, or new lumps and bumps and areas of referred pain give me clues to changes or areas of soreness in the body. Sometimes we’ll find some lower back pain prior to true hock pain, or a small splint that has been causing a left drift. The dynamic aspect of the exam is usually performed on the lunge line to start, and involves a thorough look at how the horse behaves in motion. A new way of moving a limb, out of character behavior, or new musculature issues can all be clues to a small underlying soreness. We may perform an under saddle portion, or surcingle exam. Flexions are a part of the exam allowing us to stress a particular joint and see if there is any change to movement. When I look at horses annually, I get to know them pretty well. Sometimes I forget a horse’s face marking, but I can often recall their legs and way of traveling for years! Of course good record keeping is also key!

A common misconception many clients have is that pre-season checkups always end with the recommendation to inject specific joints and a huge bill. Sometimes this is elected, but I tailor my approach to the level of competition of the horse, age, issues we know to be at hand, and what is best for the horse. Understanding your goals for the season helps me make better recommendations. For example, if you were hoping to jump FEI in 3 weeks’ time, leaping over 1.50m fences and continuing with an aggressive schedule for the season with your campaigner with some extra arthritis baggage, I’m going to recommend something different than a young clean horse in his second year of A level or Trillium level competing! Often I will make shoeing recommendations together with the farrier, provide exercises to strengthen an area, recommend a nutrition change, or recommend preventative care such as Adequan, acupuncture or chiropractic to maintain a specific problem. The rider is usually more aware of specific deficits their horse has, so they can work on them with their coach too. All in all, a pre-season examination usually yields good preventative results for most horse rider teams, it allows us to get a handle on how the horse is doing going into the season, and have some idea of what bumps there might be in the road ahead.

Melanie Barham DVM

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Veterinarian or Chiropractor- What hat will I wear today?

Chiropractic Services with Dr. McKee

I want to start today by thanking our clients- I have been intensely gratified by the interest in chiropractic care for your animals and the enthusiastic response that Dr Surasky and I have received now that we are certified practitioners.

This leads to an interesting challenge- who am I exactly? Chiropractic theory and practice has given me a new way to assess and treat patients, and it has also improved my skills as a lameness and performance veterinarian. The challenge now lies in deciding how to proceed with an integrated approach on a case-by-case basis.

Sometimes the decision is made for me when a person who already has a regular veterinarian contacts me purely for chiropractic care and nothing else. Although this is often related to an ongoing lameness or performance issue, my role is very clear. I perform my exam, followed by appropriate adjustments, but it is not ethical for me to “take over” the case or indeed the entire client based on that interaction. I am both humbled and grateful when another veterinarian refers a horse to me for chiropractic, and I would not jeopardize my professional reputation by becoming a “pirate”. “But”, you may ask yourself, “what if you see something that is critically important to the overall case?” This is where openness and communication is key. I should be able to speak to the regular veterinarian about my observations and how they may contribute to the overall diagnosis and management of the horse. This is in the best interest of the patient, yet it preserves the relationship between client, the vet they have known and used for years, and me in the role of chiropractor.

Other situations are more complex. We see a lot of lameness and poor performance problems in our caseload, and while some are fairly straightforward, others are the result of multiple subtle issues that finally culminate in an observable problem. Once we get past the easily identifiable head-nods and concrete diagnosis through blocking, we are left with these complicated and challenging cases. Chiropractic has given me additional keys for unlocking this puzzle, but I have to decide where to integrate it into my diagnostic and treatment strategy. Is a series of adjustments alone going to be enough to resolve the problem? Do we have to start with more aggressive interventions? Ultimately I have to devise a program as unique as the individual I am treating.

This is when I manage to squish both hats onto my head. As a veterinarian-chiropractor, I palpate all over the horse’s body and limbs, observe it move under various conditions and challenges, and decide what areas to focus on. As a veterinarian I perform the diagnostic tests and imaging, various therapies ranging from joint injections and PRP/IRAP to shockwave, mesotherapy, and more, and finally set up the ongoing medication and management protocols. As a chiropractor, I perform the adjustments and suggest stretches and exercise programs that will develop the proper musculature and functionality. Finally, I put both hats on again and try to identify how those multiple separate issues have contributed to today’s problem. Whether we start with chiropractic alone, or more aggressive treatments followed up by series of adjustments all depends on the nature of the problem, the circumstances of that particular individual, timing of competitions, and preferences of the owner/trainer. There is often more than one way to effectively address the issue, the key is to create a plan and stick to it, with regular reassessments to make sure we are staying on the right track.

While integrating all I have learned in my chiropractic training into my longstanding experience in equine veterinary medicine can be difficult, it is a challenge that I welcome wholeheartedly. It means that I have more resources to draw upon when trying to do my best for our equine companions.

Melissa McKee DVM

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Animal Chiropractors – Are they all the same?

Dr. Surasky

Well,  final examinations are now over for the 5 week long Animal Chiropractic course that myself and Dr. McKee have been attending.  I am sad that it is over, since the wealth of knowledge and passion the instructors possessed was unending, and I wanted to absorb as much as possible.    Not only was the specific class time intense (12 hour days with oral, written and practical examinations), but the work outside of class  was also intense (case reports, journal articles to read, practice and studying). It got me thinking that with the lack of specific regulations and the lack of “policing”, how can a potential client determine who is qualified to perform chiropractic care on their animals?  Unfortunately, animal chiropractic is  like the farrier industry – the amount of training can vary from none (self-taught), to a weekend course, to an intense course that often includes an apprenticeship or practical component.  Results will  also vary based on the individual performing the treatment.

Let’s look into the different ways you could evaluate a possible candidate to provide chiropractic care for your horse.  First off, find out if they are certified.  There are 2 main groups that provide certification in the area of animal chiropractic care – the College of Animal Chiropractors (COAC) (http://collegeofanimalchiropractors.org/en/), which is an international organization, and the American Veterinary Chiropractic Association (ACVA) (http://www.animalchiropractic.org/). To become certified by either of these two groups, the candidate must be either a human chiropractor (DC) or a veterinarian (DVM).  This ensures the individual has a comprehensive knowledge base to draw from.  As well, they will have complete a regulated course on animal chiropractic that includes both written and practical testing throughout the program. If the candidate has passed the course, they have to write yet another examination in order to be certified.  Finally, to maintain certification a candidate must also complete a specified amount of continuing education every year to ensure they are up to date on the most recent advances and techniques.

If the individual is not certified by the COAC or ACVA, inquire as to how they learned their craft – legitimate courses have extensive information available online, so take a peek to see what was involved.  Speaking from personal experience, a weekend is not enough time to properly learn animal chiropractic even if you are already a veterinarian or a human chiropractor – there is just too much information!

Because of  confidentiality, a certified animal chiropractor is not able to give out clients names for  references, but you can ask other horse owners who they use and if they notice an improvement in their horse.  Finally, try to be there for the adjustment so you can watch it yourself – chiropractic is not adjusting the entire horse- it is adjusting individual segments- so it should not look rough and they should not use any mallets or other external devices.

Although this is not a fail safe method, it can be a good way to ensure the person working on your horse is competent and will do the best job.

Kathryn Surasky, DVM

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The Silent Dialogue

I can’t believe it, but we have finished the practical and course material! Now we just have to get through exams and final case presentations before we are truly pushed out of the nest. I shouldn’t say “just the exams” though, considering we have three written and two practical exams it is certainly not to be taken lightly. I must compliment our dedicated team of instructors though, as long as I study the material carefully and keep working on horses and dogs at every opportunity, I know they have prepared us extremely well for the final and certifications. I sure wouldn’t want to let them down!

Doing well on exams and achieving high scores on the practical sessions is all well and good, but the critical test that we must pass every day is the one that challenges our ability to translate this knowledge, as well as integrate it with our skills as veterinarians, into results for our patients. These are the real world tests that really matter.

I have been working on many horses and dogs lately, and have grown to appreciate the spontaneous and honest feedback that they give me during an adjustment, if I listen carefully and sympathetically to them. Animals don’t suffer (or benefit!) from the placebo effect. No matter how badly you want them to feel better, they will not pretend to improve just to make you happy. In many ways, this holds us to a rigorous standard of practice, as nothing less then your best and most thoughtful efforts will create a positive result for your patient. Empathy, positive intent, and maintaining the lines of communication with an animal during the session are of paramount importance. This is also true for any veterinary examinations and procedures we perform during our daily clinical activities, so I continually have the opportunity to develop this skill!

Horses are so in tune with their bodies that they speak a rich language through their posture, facial expression, and the energy that you feel in their bodies when you put their hands upon them. This is the beginning of your conversation with them, and if all goes well, they will go from tense and uncertain to relaxed and in a state of trust as you move about them. Whenever I adjust a horse, I watch for signs that we are progressing in the right direction- sighing, chewing, soft eyes, yawning. The opposite reactions are also valuable information as you approach a tender area or assess the response to your adjustments. I love the dialogue we share, even though a word is never spoken. This kind of connection with an animal is one of the privileges and highlights of my profession. I look forward to developing this with my patients every day.

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The Fear of Power

Dr. Courtemanche

“The power float cut the inside of my horse’s mouth and there was blood everywhere!”.  “My horse wouldn’t eat for days after power floating!”.  “Power floats remove too much and kill the teeth!”.  “Power floats cause heat damage and kill the teeth!”.  Power floating myths are among the most resilient stories in horse industry folklore.  It is a constant battle to deal with misinformation and fear mongering that some people put out there.  A little bit of education goes a long way toward increasing people’s comfort level when it comes to power dentistry.  I would like to show people that in the hands of a trained professional motorized equipment does a great job, is efficient and safe.

MYTH: So picture the following real life scenario.  I’m working on a young horse and I start by pulling out the wolf teeth.  There is obviously blood associated with the procedure.  Add to that 1-4 cap removals (more blood) and things can get quite messy.  I move on and start power floating a mouth that is now dripping blood from multiple extraction sites.  Blood pools in the lower lip and spills randomly down my arm, the bloody tongue is flicking drops of blood every which way. After regularly reaching into the mouth with my gloved hand to check my work I grasp the float with my now bloody gloves and happily work away.  You should now have a mental image of me with my blood spattered face and clothing, bloody hands and bloody tools.  It’s a scene right out of an episode of Dexter.  And this is the moment that some unsuspecting horse owner walks in and gets their first impression of power dentistry!  Years of client education are slipping away from me as I scramble to explain the work that took place before they walked into the barn.

Truth: The reality is that power floating is generally a bloodless procedure.  The carbide or diamond grinding wheel works very well on enamel but is essentially harmless to the cheeks and gums.  I can even hold my thumb over the spinning wheel and to this day I still have fingerprints!  Guess I have to put off my life of crime a little while longer!  Trauma is also reduced due to the precise action of the power float.  I can place the tool exactly where I want it to work as opposed to the long stroking action required with hand floats.

Myth: I once had a barn tell me that they refused to have their horses power floated.  Their reason was that they had tried it once before and the whole barn stopped eating hay for days!  Then they told me they had started a new batch of hay the same day…and that the horses that didn’t even have their teeth done were not eating it either.

Truth: A floated horse should be ready and willing to eat as soon as they wake up from the sedation (sometimes sooner!).  Horses requiring major corrections or those that have TMJ pain may need a little Bute on the day of the procedure if they are sore from wearing the speculum.  If anything power floating is better for these guys since it is faster and they spend less time with their mouth open.  There probably have been cases where the grinding surface was excessively floated or the incisors were reduced too much causing the horses to be unable to eat properly.  These cases are rare and easily avoidable with minimal training on the equipment and procedure.

Myth: People are terrified that power floats will bolt out of control and grind off an entire tooth in the blink of an eye.  The tooth will die and a multitude of terrible consequences will ensue.

Truth: I know I said power floating is efficient but let’s not get carried away!  It does take some effort to remove the desired amount of tooth.  When there is a lot of tooth to remove (as in large hooks, steps etc.) it may have to be done in stages.  A few millimeters today, then a few more in 3-4 months until the tooth is returned to normal.  Taking off too much doesn’t happen easily, you have to work at it.  An understanding of the anatomy of the tooth and the simple rules of floating greatly reduce the risk of over floating and any ill effects that could result.

Myth: Another comment I hear all the time is that the high speed spinning grinding wheel generates a lot of heat that will damage the tooth.  Over time that damage will lead to tooth death and loss.

Truth: There is actually truth to this theory.  It can indeed happen.  This is another case of a problem that is avoided with a little knowledge and training.  There is a limit to the amount of time spent grinding an individual tooth.  It is important to respect that time limit when working on a single tooth especially if the tooth needs significant reduction.  If necessary, water can be used to cool the tooth.

The introduction of motorized equipment has greatly changed the face of equine dentistry.  The horses receive better care and spend less time in the speculum, and the veterinarian does not suffer from fatigue and the sloppy results that occur with hand floating.  I hope that by educating my clients on the advantages of power floating the day will come when fear of the power float is a distant memory.

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Chiropractic Accreditation: Almost There

So Dr.Kathryn Surasky and I are well over halfway through our training to become certified as animal chiropractors! The workload over the first several modules was surprisingly intense, we learned not only the theory and techniques of chiropractic but also spinal column and neuroanatomy- in even greater detail than in vet school. This has given me the unexpected benefit of improved skill when performing and interpreting my neck and back ultrasounds, as well as a better understanding of exactly what I am palpating during my physical exam of these areas.

Dr. McKee

Our instructors are the most patient and giving group of teachers I have ever had the pleasure to work with. Believe me, we give them plenty of opportunities to be critical or make fun of the totally boneheaded and klutzy errors we make during the practical sessions! Their kindness gives us the confidence to try, to fail, and to learn without (much) self-recrimination. Everyone taking the course wants to be a high achiever so I’m sure we are already hard enough on ourselves when we make mistakes, no need for an outside party to chip in.

At the beginning of the course, when several bulging binders were thumped down in front of us, Kathryn and I looked at each other with more than a little apprehension- were we up to the task? We had both been out of university for a while, and even though we take a lot of continuing education every year, it was obvious that we were in for a lot of plain old hard work. Thankfully, years of dogged study during vet school has set us up well for the routine of “just sit down and learn it”. If you don’t have well-established fundamentals, then you have nothing to build upon. Then you are literally just “thumping on the high side” without a true understanding of the animal’s medical condition or how you may be affecting them.

At first I felt like I was never going to get the hang of the specialized palpation required to assess the integrity of each joint. At night I would head home feeling a bit depressed, frustrated with my uncertainty and confusion, sure I was the only “unteachable” student they had ever encountered. Of course, I now know that most of us felt that way at the beginning! Bit by bit I began to integrate classroom learning with hands-on manipulation of the saintly and patient teaching animals, and develop the confidence to believe what my hands and eyes were telling me. Having practiced primarily as an equine lameness vet over the last 10 years was certainly a benefit when it came to watching animals move and palpating their bodies, and potential clinical applications of new skills I have learned are very exciting. Every session I pester the (also saintly and patient) instructors about ways that chiropractic can help me treat the myriad of conditions I see every day, such as airway dysfunction in racehorses, lameness, digestive problems, poor performance, sore backs, neurologic conditions, the list is endless. I see chiropractic therapy as a way to improve and enhance the results of my traditional treatments, keep horses functioning in tip-top shape during stressful race and show seasons, prolong the intervals between more invasive therapies such as joint injections, and overall improve the health and welfare of my patients. The fact that I can sometimes help an animal without having to reach for drugs and needles is incredibly rewarding (and probably a relief for the horses too).

None of this really matters if we can’t translate what we have learned into real-life decisions and manipulations that will truly help our patients. I’m very happy to say that so far, both Kathryn and I have been practicing our skills on any willing horse and dog that we encounter. Animals are great for providing honest feedback, since they don’t really respond to the placebo effect. If they don’t feel better they won’t stop limping or race faster just to please us. We have seen real results, some minor and others very dramatic. For example, the horse I selected for my case report is now voluntarily bearing weight on a limb that she had not used for over six months. We made no other changes to her routine, just adjusted her every 2-3 weeks for the last 2 months. How cool is that!!

We will complete the last module at the beginning of March, and if all goes well during the intensive final testing, we will be certified and ready to go. I can’t wait!

Melissa McKee DVM


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Back to School: Equine Chiropractic Accreditation

I have to admit – 6 years ago, when I wrote my final board examination at the start of 4th year vet school, I was so excited to be finished exams!  Don’t get me wrong, I loved school, I loved learning, but after 6 years of university I was so excited to be done with all the studying.  I figured all my big exams, all the paper, all the studying was over.  Sure I would continue to learn everyday, and take small courses but no more sitting for hours with a binder on my lap.  That was until recently…

I have become very passionate about sport horse care.  Horses are amazing animals, and I want to be able to do whatever is needed to keep them feeling and performing at their best.  Therefore I wanted to be able to offer chiropractic care.  After a little research, I found the Veterinary Chiropractic Learning Center in Brantford Ontario.  It had a stellar reputation and was an accredited course available to veterinarians and chiropractors only.  Both Melissa McKee and I eagerly signed up.  I didn’t even consider what was involved, because really, isn’t chiropractic just “putting a bone back in place?”

Wow was I WRONG!

The course is 5 weeks long, spread out over 6 months.  Each week is Wednesday through Sunday, and days are long – 12 hours or so.  And after being in practice for the past 5 ½ years, which means I’m constantly on the move working on horses, 12 hours inside a classroom makes for a very long day!  It consists of in depth anatomy, and physiology, not to mention neuroanatomy (anatomy of the nervous system) and neurophysiology (how the nervous system works).  Some of the information is familiar, but a lot of it was never covered in this detail in veterinary school.  There is also a lot of practical time – in the barn working on horses, and in the classroom working on dogs.

Oh, and yes there are exams; every week – practical, oral and written.    I am now spending evenings in an old, familiar position – sitting with a binder on my lap studying and in the barn practicing on horses.  We have covered the neck, thoracic and lumbar spine and the pelvis.  I am anxious to put all the pieces together.  My understanding of chiropractic is growing every day and it is definitely not “putting a bone back into place”; that I learned on the first day of class.  What we will learn by the end of the course is an exciting possibility.

Kathryn Surasky DVM

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Geriatric Care

At this time of year I find myself having many conversations with clients about what to do for older horses that have a difficult time maintaining their weight during the winter.  This is a pretty common problem among horses 18+ years old, and it brings to light the important topic of geriatric horse care.  Weight loss is usually the first clue that a horse has reached the golden age where they require a little extra TLC, and indicates that there are changes occurring in the horse’s system that need to be addressed. While there can be numerous causes for both sudden and gradual weight loss in aged horses, the key areas of concern are dentition, nutrition, musculoskeletal problems, internal problems, and environmental factors.  It is important to have your horse examined by your veterinarian at the first sign of trouble.  A thorough physical exam, dental exam and routine blood work can reveal valuable information needed to correctly manage the situation.

Dental Care:  “Well, Doc, the horse seems to be eating the same amount of food but is still losing weight”. This is a story that I hear all too commonly, and the first thing that comes to mind is dental issues. As horses age, so do their teeth. Older horses are often plagued with dental problems ranging from missing or loose teeth,  misalignments or malocclusions of the dental arcades, overgrown teeth (steps, hooks, ramps),  gingivitis, infected tooth roots – the list goes on.  It’s not hard to imagine why these changes would make chewing painful, difficult, and even ineffective. When feed is not chewed correctly before being swallowed, the GI tract cannot extract the nutrients it needs. Weight loss occurs as a result; not because the horse isn’t eating, but because they can’t digest what they are eating. Furthermore, dental problems can make it outright impossible for some horses to eat hay at all, as it puts them at an increased risk for choke.  It is therefore important to have your veterinarian monitor and manage dental issues with routine dental exams one to two times per year.   Regular dental exams and floating will help to preserve the function of the teeth, maintain comfort, and allow your veterinarian to make appropriate feed recommendations based on what he/she feels your horse can safely eat.

Nutrition: The main goal in feeding senior horses is to supply the essential components of the diet in a form that is easily chewed and digested.  This can be done in several ways, but some common options include hay cubes or pellets, beet pulp, and complete feeds.  Complete senior feeds are commercially available from several companies, and contain appropriate amounts of vitamins, minerals, fat, protein and fibre in an easily digestible extruded feed.  When soaked to form a mash, these feeds are excellent options for horses who can no longer chew hay.  Hay cubes are also a great way to supply roughage in a form that is easy to digest, as they are already processed into small particles (therefore requiring less chewing).  Non-molasses beet pulp is a safe source of fibre, but care should be taken in older horses due to the high calcium content. (Always remember to soak hay cubes and beet pulp to avoid potential choking hazards.)

Before making any dietary changes, blood work should be assessed to ensure that there are no underlying systemic issues that may be causing weight loss.   Based on the results of a physical exam and blood tests, your veterinarian can recommend a specific diet to ensure all your horse’s requirements are being met.

Musculoskeletal Problems: Appetite and weight gain can be negatively impacted by musculoskeletal pain.  Arthritis, old injuries, or any form of chronic pain must be identified and appropriately managed if this is contributing to the weight loss.  Your veterinarian can discuss and recommend various treatments for chronic lameness, ranging from oral and injectable joint supplements, to long term anti-inflammatories, and alternative treatments such as chiropractic and acupuncture therapy. Daily turnout with appropriate exercise is also important to help prevent stiffness and joint pain.

Internal Problems: Older horses can suffer from several internal problems including parasitism, Cushing’s disease, metabolic syndrome, liver and kidney dysfunction, repeated bouts of colic, and various types of tumours/cancer. Your veterinarian can help to diagnose these issues through bloodwork and specific testing.

Perhaps the most common problem on this list is Cushing’s disease, or pars pituitary intermedia dysfunction (PPID).  Some reports suggest that up to 30% of the horse population over the age of 20 have Cushing’s disease. This condition causes increased levels of cortisol in the blood stream which often leads to excessive water intake, excessive sweating, weight and/or muscle loss, laminitis, recurrent skin infections, and long curly hair coats that don’t shed well.  Cushing’s disease can be easily tested for and managed with daily medication, and is worthwhile investigating if any of the above signs are observed.

Environmental Factors: Extreme weather conditions, changes in herd dynamics/social status, loss of a companion, and inadequate shelter can also have a big impact on how well older horses maintain their health.  It is important to keep an eye out for these problems and recognize that they may have a significant impact on senior horses as opposed to younger horses in the heard.

While at one time they were considered a working animal, these days horses are considered a valued part of the family and are being cared for well into their late twenties and early thirties.  We can owe this to the many advances we have made in equine dentistry, nutrition, and specialized geriatric care.  By addressing these issues we can ensure our horses are living out their golden years happy and healthy.

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Dentistry: Don’t Forget the Little Guy!

Equine dentistry can be one of the most challenging and rewarding aspects of veterinary medicine.  These days many veterinarians have special training in dentistry and several have devoted their practice exclusively to the subject.  As an associate at McKee-Pownall Equine Services I perform a variety of services on a daily basis but dentistry has always been area of special interest to me.  You never know what you are going to find when you look into a horse’s mouth…and it’s a great upper body workout!

All horses, large and small, benefit from regular dental care.  Their adult teeth erupt continuously over their lifetime and are ground down through the action of chewing.  Due to the conformation of their jaws they form sharp enamel points on the cheek side of the upper cheek teeth and the tongue side of the lower cheek teeth.  Left as is, these sharp points can cut into the cheeks and tongue causing painful sores that bother the horse when it is chewing or wearing a bridle.  Sharp enamel points are a normal finding that must be maintained in all horses.  In addition to that, many horses have actual dental problems and can suffer much more serious consequences without dental care.  Every horse, no matter the size, should have a full dental exam once a year.  A proper exam includes sedation and a full mouth speculum.  The speculum allows the veterinarian to visualize the entire mouth, feel problem areas and use mirrors or other tools to complete a thorough exam.  The sedation ensures that the horse is cooperative, relaxes their jaw for speculum placement and helps alleviate fear and nervousness.

With my interest and experience in the Miniature Horse industry I am surprised at how few of them I see for dental care.  Miniature Horses present a number of challenges to the dental practitioner with their cramped working space and special set of problems.  Though often overlooked, Minis usually have a greater need for good oral care than their large counterparts.  Efforts by breeders to produce horses with smaller, more refined heads has led to disproportionately large teeth compared to skull size.  For this reason Minis are prone to tooth overcrowding which predisposes them to problems with occlusion and eruption.  Tooth root abscesses, eruption bumps, tooth impactions and sinusitis are all more common in Miniatures.  Early diagnosis of these problems can prevent serious and permanent damage.  Also, in a breed where parrot and monkey mouths are a problem it is important to check the whole mouth frequently in youngsters.  In some cases cheek teeth malocclusions can create a false “off bite”.

All horses deserve a healthy, comfortable mouth.  For most, this means a thorough dental exam and float once a year.  For horses with problems your vet may have to see them more often.   When it comes to equine dentistry it is much easier to prevent a problem than correct one.  Whether your Mini is a competition horse or a backyard pet, dental care needs to be part of their annual maintenance.  Diligence now can prevent a lot of discomfort, expense and heartache long term.

Michelle Courtemanche DVM

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Acupuncture for a Sick Horse

Typically, I would not choose acupuncture for a sick horse as my first line of defense.  We have excellent drugs, like antibiotics and anti-inflammatories that have been known to save lives. During a course lecture for “Evidence Based Acupuncture” I am attending, research papers talking about the use of electro-acupuncture in respiratory disease were discussed.  Various studies noted that stimulation of certain points caused increased clearance of mucus in the trachea (windpipe), reduction in inflammatory cells, and increase in circulating infection-fighting cells (neutrophils).  When I was called in recently to use acupuncture as an adjunctive therapy on an ill patient, I was pleased to be able to put this information to use!

My patient was on antibiotics for a lung infection (pneumonia), and one of the required medications tasted particularly bad.  The poor thing didn’t want to eat (as many horses on this medication don’t).  Of course he had to stay on this excellent drug to help him get better, so we were in a catch 22-position. While he did not have a fever, he was quite dull and almost looked sleepy upon pulling him from his stall.  We worked the points noted in the papers, as well as a couple for appetite stimulation.  Afterwards, our boy was pretty relaxed, partly due to feeling poorly, in addition to the sedative effects of acupuncture.  However, later that day, he began to feel better and started eating again.  His attitude improved and he is on his way to a recovery.  I obviously can’t and won’t take credit for healing the pneumonia; antibiotics were of course the right therapy to use! I think this is a perfect example of marrying Western and Eastern medicine to achieve a positive outcome for our patient.

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