Equine Lameness Problems
- I just found out my functionally sound OTTB had pins for a hairline condylar fracture during her racing days some eight years ago. Some mild arthritic changes showed up on a recent x-ray, which also explains why she can be uncomfortable working on a shifting surface like sand. What are some best ways to help her moving forward from here (i.e. boots, supplements, types of work surfaces, etc.)? (View Answer)
Condylar fractures are the number one fracture affecting TB racehorses, most commonly it will be the left front lateral condyle affected. Because this area involves the joint surface of the fetlock, these injuries can lead to the development of arthritis down the road. Fetlock injuries and arthritis can be challenging to manage because the fetlock is a complicated high motion joint, it is subjected to a tremendous amount of stress because of the forces exerted on the joint during movement.
It sounds like you already have radiographs of that limb so perhaps a lameness has already been worked up. If you have not had the lameness localized, I would recommend that as the first step. If not already completed, you can have your veterinarian localize the lameness through flexion tests, joint and regional nerve blocks and imaging studies such as ultrasound/MRI/CT (example - ultrasound examination of the many soft tissue structures in the fetlock region). It is possible that the arthritic changes in the fetlock are not the primary source of pain.
Assuming that the fetlock arthritis is the source of pain you have a few options for management. You can have your veterinarian inject her fetlock with Hyaluronic Acid with or without steroids as he/she prefers, some clinicians like Glycosaminoglycans intra-articularly also. You can inject the joint with IRAP or Pro-Stride (made from your horses own blood) which utilize the bodies own anti-inflammatory mediators to quiet down inflammation – these are a good option for long term management. There is some indication that Stem Cells or PRP (platelet rich plasma) may also be beneficial. Shoeing should be balanced with plenty of support, short toes and easy break over. There are some good options for therapeutic shoes available now. Denoix shoes by Grand Circuit are specific for decreasing strain on certain areas of the limb and might be something to investigate. Radiographs to monitor shoeing balance a few times a year are helpful.
You can utilize hot and cold therapy as needed. When it is chilly outside, and she gets stiff, you can apply heat over that joint while you get her tacked up for work. This will increase blood flow and loosen her up. Similarly, you can apply 10” of ice or cold hosing after work to help decrease inflammation in the joint. There are topical products you can use to hep control pain and inflammation. Examples are: Surpass, Arnica gel, Traumeel gel or Sore No More. Not all of these are USEF legal. Acupuncture can be helpful for long term management of arthritic pain and is another option to consider. There is some evidence to back the regular use of intramuscular injections of either polysulfated glycosaminoglycans, pentosan polysulfate and/or intravenous hyaluronic acid in the management of arthritis. Of course, you can always utilize NSADs (phenylbutazone, banamine or firocoxib) as needed to manage pain and inflammation.
For oral supplementation, look for joint supplements (chondroitin sulfate, glucosamine) that are backed by research. The manufacturers of these products will usually publish the independent research on their websites. I have had good results using Cosequin ASU, but there are many other options. I have had good success with adding in MSM, Boswellia, Fatty Acids (chia seed or flax seed) and antioxidants to the daily diet in addition to a joint supplement. Make sure to use reputable manufactures for supplements.
Fitness is important for joint stability. Try to work to minimize strain on that fetlock, lots of straight lines, minimize small circles to that side etc. Work her on even ground with footing that is not too deep or too hard. Avoid uneven footing, this is very important to decrease the chances of straining the fetlock. You can use a fetlock support boot during work and ice boots or hosing after work. If she has had a hard day consider adding standing leg wraps after she is worked. All the best to you and your mare! Terri Van Wambeke, DVM, Oregon City, Oregon
- How do I treat high ringbone and navicular in the left front of my 16-year-old gelding? I used osphos about six months ago and injections of steroids into the bursa and navicular joint. My horse is also receiving 57 mg. of Equioxx daily and is shod with natural balance shoes. The ringbone flares up from time to to time making him unrideable. I have tried to work him very light 2- 3 times a week. (View Answer)
It looks like you are off to a good start with management of your horse’s pain. Ringbone is a progressive arthritic disease of the pastern that can be difficult to manage. Keeping the shoeing balanced is very important and some radiographs to look at the balance of the foot would be helpful. Most of the options for management I have listed below will cross over to management of navicular disease. If the Osphos is helping manage the navicular disease, I would continue to use it. Natural Balance shoes are a good choice, but there are some other options if those are no longer working as well as they used to. Denoix shoes by Grand Circuit are worth looking into. Perhaps your farrier and veterinarian can look at the shoeing together and see if there might be something to change in the angles, medial/lateral balance or type of shoe.
You can try adding in some oral supplements. For oral supplementation, look for joint supplements (chondroitin sulfate, glucosamine) that are backed by research. The manufacturers of these products will usually publish the independent research on their websites. I have had good results using Cosequin ASU, but there are many other options. I have had good success with adding in MSM, Boswellia, Fatty Acids (chia seed or flax seed) and antioxidants to the daily diet in addition to a joint supplement. Make sure to use reputable manufactures for supplements.
There are systemic injectable joint medications such as pentosan polysulfate, glycosaminoglycans and hyaluronic acid (intravenous) that may be helpful in management of your horse’s pain. You can utilize hot and cold therapy as needed. During periods of cold weather or when your horse seems particularly stiff, you can apply heat to the joint prior to work. Similarly, you can apply 10” of ice or cold hosing after work to help decrease inflammation in the joint, if you feel like the joint becomes inflamed after work. You may find that your horse responds better to either heat or cold. Either one is a safe, simple and easy therapeutic to utilize. There are topical products you can use to help control pain and inflammation. Examples are: Surpass, Arnica gel, Traumeel gel or Sore No More. Acupuncture can be helpful for long term management of arthritic pain and is another option to consider. Extracorporeal shockwave therapy can be helpful for pain management in these horses if you have that modality available to you. Some of my clients have reported success using the magnetic bell boots on these horses while they are stalled. Additionally, it is important to use heavy bell boots while your horse is worked and during turn out. This prevents him from accidentally hitting himself with his shoe and further exacerbating the pastern arthritis.
You may have to use a stronger NSAID like banamine or phenylbutazone during periods of flare up and place him back on the Equioxx once things quiet down. Movement is good for joint health, so keeping up with the light work as he can tolerate is wonderful. If you have not already tried biologicals in the joint, IRAP or Pro-Stride would be options. These biologicals, that are made from the horses own blood and injected into the joint, use the body’s own anti-inflammatory mediators to quiet down joint inflammation.
Eventually, with high ringbone, the pastern joint may fuse, when this happens the motion in the joint decreases and most horses are much more comfortable. Should all else fail, you can have the joint fused through either a special joint injection or surgery. If you decide to go this route you should have a consultation with an equine surgeon prior to the procedure so that you can learn about possible complications and prognosis. Good luck with your horse and I hope you can continue to keep him comfortable and enjoy him! Terri Van Wambeke, DVM, Oregon City, Oregon
- My horse has been diagnosed with a very mild strain (mild fiber disruption) to his sesamoidean ligament on his left foreleg. What is the recovery time and outlook for this type of injury? He has no swelling or heat and is lame only at the trot, no lameness at the walk. He is currently on his normal turnout schedule which consists of three hours a day. (View Answer)
Please refer to the AAEP Ask The Vet Q&A referenced below for an in depth explanation of tendon and ligament injuries and rehabilitation strategy. If this is a recent injury, I am concerned that you have your horse on a turn out program.
Sport Horse Injuries: Preparing for Rehabilitation August 2017 Question #3 (TB with bowed tendon)
I am not sure how old this injury is or at what point in your horse’s rehabilitation you are. If this is a recent injury, the initial recommendations are generally to keep the horse on strict stall rest, provide oral NSAIDs and controlled exercise (hand walking usually). Careful monitoring and rehabilitation of any tendon or ligament injury is very important in determining the prognosis for future soundness. The distal sesamoidean ligaments are a very important part of the suspensory apparatus of the leg and provide fetlock support, so any injury to these ligaments should be closely monitored. The distal sesamoidean ligaments are actually the continuation of the medial and lateral branches of the suspensory ligament. They run down the back of the lower leg (pastern region) and include four pairs of ligaments (straight, oblique, cruciate and distal sesamoidean). Injury to these ligaments is usually the result of hyperextension.
The general recommendation for rehabilitation of a ligament or tendon injury is 4-6 months of stall rest with a controlled rehabilitation/exercise program, limited to no turn out. During this time the horse’s progress is monitored with serial ultrasound examinations. If the horse goes back to work too early it can result in recurrence/lameness.
Good luck with your horse! Terri Van Wambeke, DVM, Oregon City, Oregon
- My 9-year-old Tennessee Walking horse has exhibited lameness the last nine months from a stifle injury and it's the medial patellar ligament that results in patella fixation....My vet is considering doing a fenestration tomorrow. Have you had success with this or any other treatments? He has had a PRP (Platelet Rich Plasma) with no noticed benefit and is currently on Previcox supplements. (View Answer)
The horses stifle joint is similar our knee. They have a patella/knee cap that slides along the end of the Femur (thigh bone) in a groove, called the trochlear groove. There are three patellar ligaments present in the horse; medial, middle and lateral patellar ligaments. This configuration coupled with the anatomy of the end of the Femur allows the horse to lock its limb in extension. The medial and middle patellar ligaments “hook” over the end of the Femur, allowing the horse to keep its leg in extension with minimum effort. So, although this function is normal for the horse, it becomes a problem when it occurs during movement, causing the problems that you are experiencing with your horse. I will assume that you have ruled out and treated any additional underlying causes of lameness.
There are a few options for treatment and I will list each briefly
First and foremost, exercise is recommended to strengthen the thigh muscles of the horse. Lack of fitness (decreased muscle tone) can cause the medial patellar ligament to become “lax” making it easier for it to become locked. Utilize hill work, work over poles if your horse can tolerate it, Equibands and regular conditioning to help build thigh muscles. Make sure that your horse is fit (having built adequate thigh musculature) and then see if he/she is still having problems. Do this before you commit to more invasive therapy. Acupuncture can also help manage patellar fixation in some horses. Address any foot imbalances with corrective shoeing and investigate any underlying lameness. Have radiographs of the hind feet taken to determine the angle of the pedal bone within the hoof capsule. You can then alter the shoeing if necessary to decrease the breakover – blunt or rocker the toe and elevate heels if necessary. You want to make it easier for the horse to break over at the toe and decrease the amount of time the leg is extended on the ground. Decreasing time in extension helps avoid upward fixation of the patella. You will need your veterinarian and farrier to work together to address foot imbalance issues. If your horse is not a mare you can consider estrogen therapy. Systemic estrogen tightens up ligaments and can be helpful for this problem. Because this is hormone therapy, you will need to speak with your veterinarian about this option. The other option is fenestration and infusion of counterirritant into the medial and middle patellar ligaments. This creates scar tissue which causes contraction and shortening of the treated ligaments, effectively pulling the patella into a normal position in the trochlear groove. This makes it much more difficult for the patella to become locked during movement. Many clinicians find this an effective means of treatment. Surgery or medial patellar desmotomy should only be considered when all else fails. Resection of the medial patellar ligament destabilizes the patella and can lead to arthritis and inflammation of the joint capsule over time. I wish you all the best in getting your horse back to comfortable work! Terri Van Wambeke, DVM, Oregon City, Oregon
- I have an aged gelding that I think had a sprained fetlock as it was slightly swollen and a bit warm to touch. He could barely walk at all. Within a few weeks, he has gotten better but now the hoof is a little bit bigger than the rest and the sole of the hoof has sloughed off. What could this be? (View Answer)
It sounds like your horse may have developed a subsolar hoof abscess. Often with hoof abscesses, the entire limb will become swollen and warm, there will be heat radiating from the limb and the foot and there will be an increase in the digital pulses to that foot. Subsolar abscesses can make horses extremely lame. They can become so lame that they will not want to bear weight on that limb or use it very tentatively. Once the abscess ruptures the horse becomes more comfortable and that region of the sole will slough off or there will be a drainage hole present with a soft sore spot around it.
I think it would be a good idea to have your veterinarian come out and take a look at the leg and evaluate the hoof to rule out something more severe such as a puncture wound to the foot or a laminitic event. Your vet can also evaluate the fetlock joint at the same time. It is always best to diagnose and treat limb injuries early on. That will give your older gelding the best chance of living out along and comfortable life. Wishing you all the best! Terri Van Wambeke, DVM, Oregon City, Oregon
- I have two ten-month-old Quarter horse colts that their hooves are splintering at the bottom. Could this this be from the wet conditions or something else? Should I apply a hoof conditioner? (View Answer)
I think what you are describing are cracks in the hoof wall or chips along the bottom of the hoof. Small or superficial cracks will grow out over time and generally do not cause a problem. Your farrier can trim the feet on a regular basis (every 6-8 weeks) to help. If you are letting your horse’s feet get long without regular trimming, there will be more pressure on the long hoof wall causing cracks and chips to occur. Cracks left unattended and allowed to propagate can cause lameness, due to hoof wall instability, and in some cases infection. Cracks and chips in the hoof wall are more common in the winter, when there is increased moisture in the environment, making the hoof wall softer and weaker. You will want to rule out white line disease contributing the hoof issues you are having. Either your veterinarian or farrier should be able to help with this. White line disease would need to be treated if your farrier is unable to remove the diseased tissue during repeated trimming.
Because I do not have information about your horses housing and what type of weather you are dealing with, I am unable to recommend any particular remedy to your problem. If the feet are too wet, keeping the horses in a dry environment, like a shavings bedded stall, will help dry out and firm up the hoof wall. There are topical hoof products you can use to help horses feet maintain integrity in the winter. Examples are Keratex and Farriers Finish. In addition, make sure that you are providing adequate nutrition for quality hoof growth. In particular, amino acids, Copper, Zinc and Selenium are important for proper hoof growth. Most ration balancers and young horse complete feeds are designed to provide these nutrients. There are oral supplements available (such as Farriers Formula) if you feel your horses need targeted nutrition for hoof growth. You should speak to your farrier and your veterinarian to determine the best course of action for your horses. Good luck with your youngsters and I hope you can their feet looking better! Terri Van Wambeke, DVM, Oregon City, Oregon
- How do you distinguish between: lameness, imbalance and unlevel ? (View Answer)
Lameness – Definition from the AAEP website “Traditionally, lameness has been defined as any alteration of the horse's gait. In addition, lameness can be manifest in such ways as a change in attitude or performance. These abnormalities can be caused by pain in the neck, withers, shoulders, back, loin, hips, legs or feet. Identifying the source of the problem is essential to proper treatment. “ Lameness refers to any unevenness or irregularity, a deviation from normal, of the gait of the horse. You can have a mechanical lameness that causes a gait deficit without pain (we would call this a gait irregularity). Gait irregularities can be normal for a particular horse, such as how a horse with a club foot will have different front leg strides. You can have an area of pain in the horse that, because of taking weight off that limb or compensation, causes a gait deficit.
Imbalance – We generally use this term when referring to the foot. A foot imbalance would be a deviation from the normal anatomy of the boney column of the lower leg secondary to changes in hoof growth, trimming or shoeing. These deviations can be visible with the naked eye or seen via radiographs. Sometimes you will hear people use this term if the horse has one foot that is different than the other. Occasionally we will refer to imbalance or unbalance when discussing a horse with neurologic signs that is losing its balance. This term is also used to describe young horses that are early in training and have not yet learned how to balance themselves while doing figures (circles, serpentines etc.) or while carrying a rider. Imbalance can also refer to a horse that is stronger going one direction than another while being ridden.
Unlevel - I will use the term uneven in addition to unlevel here. This can refer to a lameness or a gait irregularity and is a descriptive term. Uneven or unlevel can mean a change in the regularity of the footfalls for a normal gait. For example, instead of an even 1—2—3--4 beat at the walk, you might have a shorter pause between two of the foot falls. For example 1-2--3--4. Uneven or unlevel can refer to the length or height of the stride. Where one leg might have a longer or more elevated arc than the opposite leg. These terms can also refer to the musculoskeletal system of the horse. From behind you might see, for example, unlevel/uneven hips, where one tuber coxae or tuber sacrale is higher than the other.
You can see how all of these terms can easily overlap in their usage. Imbalance and unlevel/unevenness can be the cause of, or the result of lameness. An imbalance can cause, or be the result of, unlevel/unevenness, and likewise. This is why you see these terms used simultaneously and interchangeable. Hope this helps answer your question. Terri Van Wambeke, DVM, Oregon City, Oregon
- My mare (now 21-years-old) injured her knee two years ago while being lunged. Radiographs showed a small fracture on the inside of the left knee where she apparently struck it with her other hoof. After six months of stall rest and various medications/treatment, the bone showed healing, but also worsening of some arthritis that existed before the injury. Due to the stiffness from arthritis, she gets daytime turnout in a small paddock with a senior horse companion to keep her quiet and then stalled at night. She has not been ridden or worked since the injury, but she remains lame in that leg when she is on grass or dirt, but -- inexplicably -- seems to be pain-free as soon as she steps onto the concrete of the center aisle. Neither vet nor farrier can explain why she can walk on concrete with no sign of lameness. We tried to offer her stability with shoes and clogs, to no avail. Is it possible that there is a secondary ligament issue that is keeping her lame after the bone has healed? (View Answer)
The carpus/knee (equivalent to our wrist) is a complicated structure with many bone and soft tissue components. Soft tissue structures include the intercarpal ligaments, collateral ligaments, joint capsule and palmar carpal ligament. There is also a retinaculum, band of connective tissue, that houses tendons that run down the leg. Management of carpal injuries can be difficult due to this complexity. As a general rule, the carpus does not respond very well to the medical management of arthritis.
It might be a good idea to have your vet try to localize the current lameness using diagnostic nerve blocks (if safe to do so - you would not want to block out an area where there is concern about a fracture). Your veterinarian may have already anatomically localized the current lameness, but if not, perhaps there is another injury that is causing the lameness you are seeing on grass/dirt. For these purposes, I will assume the lameness has been localized to the old injury site. You are correct, there may be a secondary soft tissue injury involved in your mare’s lameness. Many soft tissues can be evaluated using ultrasound examination of the joint. Unfortunately, some injuries can only be found through advanced diagnostic imaging. There are additional diagnostic modalities like MRI, CT, PET that might help with diagnosing your mare’s lameness. I am not sure your mare would be a candidate for these modalities, because of her age and the need for general anesthesia. You would need to speak with your veterinarian.
It is possible that your mare is more comfortable on concrete than dirt/grass, because it is a flat even surface, and therefore offers her leg more stability. Dirt, grass and even sand, allow the leg to have more medial:lateral and forward:backward movement. If she has a soft tissue or bone injury that is more unstable/painful when the leg is bearing weight unevenly, she will be more uncomfortable on uneven ground. My guess would be that the medial:lateral movement on uneven ground may be making her uncomfortable. When I use the term medial:lateral (side to side), I mean that one side of the foot experiences more pressure than the other while in contact with the ground. For example, when stepping on a hoofprint in the dirt or stepping on a thick tuft of grass. This unevenness compresses one side of the joint more and strains or “pulls” on the opposite side of the joint. The arthritic changes in her knee, depending on the location, could also be irritated by these forces. This problem would be difficult to address with farrier work, because the uneven ground is the primary issue. Keeping her feet well balanced with good supportive shoeing and easy break over, like you are doing, is great. Horses with simple arthritic changes (no joint instability or soft tissue injuries) tend to be more comfortable walking on soft surfaces like dirt, grass or arena footing, and are often less comfortable on hard concrete or packed road, but this of course depends on the location and severity of the arthritis within the joint. Because this is the opposite of your mare’s presentation, it sounds like you might need to do some additional investigating to determine the exact cause of your mare’s pain during turn out. All the best to you! Terri Van Wambeke, DVM, Oregon City, Oregon
- My 16-year-old Haflinger was diagnosed with Ringbone last October. Per my veterinarian's recommendation, my gelding is receiving Adequan every month after inital weekly doses and Smartflex Senior to help manage any discomfort plus special shoeing. I can't help thinking he hurts every time I ride him and that's no fun. He hasn't been tripping since I started all this, but am I doing all I can to make sure he is comfortable? (View Answer)
Someone else asked almost the same question this month. Please refer to Question #2
I went over a variety of options to help manage horses with high ringbone in my response to the earlier question referenced above. With your horse's breed it is important to make sure that he maintains his weight and doesn’t get too heavy. Extra weight is a strain on any arthritic joint, so keeping his body condition score down (BCS) to between a 4-6 is ideal.
Here is a link to BCS
Ringbone is a very frustrating condition to manage but with some commitment and hard work you might be able to get your horse more comfortable under saddle. The work is good for him if he feels well enough to tolerate it, and it helps keep him in good weight! All my best to you and your pony. Terri Van Wambeke, DVM, Oregon City, Oregon
- Would you recommend a hoof conditioner for a long weanling (10-months-old) to maintain healthy hooves? (View Answer)
Most young horses do not need a hoof conditioner to maintain healthy hoof wall. Of course, this will depend on the environment the horse lives in and the nutritional status of the horse. If you are having specific problems with your horse’s feet, I recommend you consult your farrier and your veterinarian to determine what steps you can take to improve hoof wall quality. Good luck with your young horse! Terri Van Wambeke, DVM, Oregon City, Oregon
- If a horse has one or more white hooves or a white and black striped hoof, is there proof that the strength of that hoof is compromised? (View Answer)
There is no difference in the structure of a pigmented versus a non-pigmented hoof. The layers of the hoof wall are the same structure and thickness regardless of the color of the hoof. Terri Van Wambeke, DVM, Oregon City, Oregon
- I am looking for information on bowed tendons. My paint mare injured her left front tendon more than two years ago. She has since been doing much better but still exhibits some lameness. (View Answer)
The most important first step in diagnosing your mare’s current lameness is to have your veterinarian perform a thorough lameness examination to localize the pain. It is possible that the current lameness is not caused by your mare’s old tendon injury.
I have attached a link to another AAEP Ask The Vet post that goes over tendon injury in detail.
Question #3, off the track thoroughbred with a bowed tendon
All the best to you and your mare! Terri Van Wambeke, DVM, Oregon City, Oregon
- I have 7-year-old OTTB with thin soles and pedal osteitis. I am fairly certain it is from too many farriers and a horse that has long sloping pasterns. I recently read an Australian veterinarian website that claimed three months of calcium supplements followed by apple cider vinegar would help. Any suggestions on what kind? (View Answer)
Pedal osteitis refers to loss of bone density causing an irregular border (the solar margin – perimeter of the bone under the sole of the foot) of the P3/pedal bone secondary to inflammation. The condition can be chronic and may be non-clinical (it doesn’t always cause lameness). The appearance of the 3rd pedal bone, as seen on radiographs, can be highly variable between horses. Changes consistent with pedal osteitis are more commonly seen in horses with very upright hoof conformation and those with long sloping pasterns and flat thin soled feet. P3 changes can be seen when a horse is consistently worked on hard ground, secondary to foot injuries, if the horse has chronically bruised soles or poor conformation (thin soles, long toes and low heals, very upright feet are some examples). Pedal osteitis is more common in the front limbs.
The goal of treatment is to decrease concussion, and therefore, inflammation of the pedal bone. This is accomplished by addressing the underlying cause of the problem and using corrective shoeing to balance the foot, decrease the breakover and decrease pressure on the sole (by using pads if needed). Shoeing is usually coupled with oral non-steroidal anti-inflammatory medications and rest. Often a topical product will be used on the bottom of the foot of thin soled horses to “toughen” the sole. Horses are then brought back to work on a more forgiving surface until lameness has diminished.
I am unable to find any scientific evidence to back the use of either Calcium supplements or apple cider vinegar to treat pedal osteitis. Apple cider vinegar is rich in polyphenols which have anti-inflammatory, antioxidant properties, and vasodilatory effects. These properties might help decrease inflammation in the body when used as an oral supplement. Although insufficient Calcium in the diet can cause demineralization of bones, if you are supplying a balanced diet to your horse, calcium supplementation should not be necessary. When evaluating dietary calcium, it is important to make sure that the calcium:phosphorus (2:1) ratio is correct and that dietary calcium is available. Most equine diets provide adequate calcium, but if this is a concern, I recommend consulting either your veterinarian or an equine nutritionist. You can have a dietary analysis completed to determine if your horse’s current feed is adequate in Ca. You can also have your veterinarian check the mineral levels in your horse’s blood. Good luck to you and your horse! Terri Van Wambeke, DVM, Oregon City, Oregon
- I have a Quarter horse that has developed thrush. What can I do to treat it and will it make him sore? (View Answer)
Thrush is a degenerative condition of the equine frog, usually worse in the deep crevices on either side and in the middle of the frog. It smells bad and when you clean out the hoof you will notice black exudate. Pieces of the frog may become loose and come apart. If the infection gets deeps enough, your horse may become painful when you are cleaning out the deep sulci of the frog. Thrush is usually caused by a combination of factors including a wet environment, infrequent or improper trimming and lack of exercise. Although generally mild, thrush can become severe enough to make the horse lame and is better caught and treated early. Treatment is aimed at removal of the infected tissue through adequate trimming and application of a topical product directly into the affected area 1-2x daily. Application of these products is not painful unless thrush has affected the sensitive tissues of the foot. There are many topical products available, and your farrier or veterinarian will be a great resource for a recommendation of what product works best in your area. Treat the foot until all evidence of infection has been eliminated. Work with your farrier to keep the frog and foot regularly trimmed. Keep the horse in a dry clean area and provide adequate exercise. Severe cases of thrush require more aggressive frog removal, foot soaking and bandaging with medication. These cases should be managed by a veterinarian. Terri Van Wambeke, DVM, Oregon City, Oregon