April 2018 - Amputations & Neurological Conditions
Join us this month as our expert, Dr. Barrie Grant, joins the forum to answer your questions concerning neurological conditions in the horse. Dr. Grant will also be available to answer any questions related to amputations.
Click here to read this month's questions and answers.
The Western Performance and Rodeo Horse
- I have had a small Welsh pony that is now 16-years-old. He has been competing throughout his promise years and now is being used as a very limited lesson pony. He's always been an easy keeper and has gone barefoot. He does have to be kept on a low sugar and starch diet because he is insulin resistant. For the first time ever, he is having issues after being trimmed three weeks ago. I originally thought it was a stone bruise and poulticed and wrapped his feet. My farrier examined him and said all four feet were extremely sore and it looked like abscesses trying to form in all four. This pony has never had an abscess before let alone in all four feet. He's been getting his feet soaked and wrapped each night for the last two weeks plus bute 2x daily. I have not seen any improvement and I'm terrified he may have foundered. Is it possible to have all four hooves abscess after a trim or is it possible that he has foundered after one trim? If so, what is the best treatment? After his six month fecal test, he is a month behind on being dewormed for stronglyes and roundworms as well as a month behind from his 5-way vaccine (EWTFR). Could there be any linked side effects causing pain in hooves? (View Answer)
These are all good questions and observations because they are common in this type of horse.
Insulin Resistance, its connection to Cushing's disease and the relation of both diseases to feet problems and laminitis, is one of the most studied processes in modern veterinary medicine.
If your pony was diagnosed with an endocrine disease by an equine veterinarian, I would seek immediate attention by that or a similarly qualified veterinarian and not rely on foot packing. Laminitis is a potentially fatal disease that needs to be addressed sooner rather than later. Laminitis is the most common cause of foot soreness in multiple feet, especially in a horse with endocrine disease.
Time is of the essence. Acute laminitis is the stage we treat in the first 72 hours. After three days, the laminitis becomes "chronic" and your treatment options decline to deep or sand bedding and NSAID drugs.
It is extremely unlikely that a horse spontaneously abscesses in two feet at the same time, much less four. The more likely sequelae is that the horse was trimmed too short when the horse was already on the brink of laminitis because of its endocrine status. When the trimming caused excessive inflammation in the foot, the cascade of laminitis started. If you have been dealing with this for as long as I am understanding, I would strongly recommend you get lateral radiographs of all four feet to assess the rotation that may have begun or at least to get a baseline idea of how much damage you are dealing with since radiographs will likely need to be retaken as the disease progresses.
More information can be found at the following link:
Benjamin Espy, DVM, DACT, San Antonio, Texas
- I recently purchased a 3-year-old OTTB right off the track. He had only raced nine times and currently has a small knee chip in his front right knee in the radial carpal joint. His previous owner made no mention of lameness and said her veterinarian gave him a good prognosis. My veterinarian said to place him on stall rest for at least four months, with no lunging or turnout. My hope is to be able to jump him in the future after he is finished maturing, but his bone chip concerns me. Should I look into surgery? (View Answer)
I would always encourage you to explore every avenue you have available. In today's modern sports medicine, we have not only radiographs and ultrasound but also MRI available.
As far as treatment goes, intra-articular injections are popular but probably not good options if you plan on having a surgeon remove the chip as it damages the arthroscopic view of the joint making the procedure more difficult for the surgeon.
Waiting four months will not make the chip go away but it may allow the chip to temporarily reattach. My guess is when the horse is put back into full work, that would be false security and the chip will again begin floating.
I would recommend you seek a second opinion. Preferably from a surgeon that would be qualified to remove the chip and simultaneously assess the degree of lameness and the history. Benjamin Espy, DVM, DACT, San Antonio, Texas
- Are there any non-drug therapies for diagnosed PPID? What did horse owners do 50 years ago to care for their horses with this condition? (View Answer)
Pituitary Pars Intermedia Dysfunction (PPID) is the correct term for the disease commonly known as Equine Cushing's Disease. To my knowledge, there are no "non-drug" therapies for this disease; although some herbal and acupuncture options may exist.
To answer your question of what we did 50 years ago to treat PPID, it did not exist. No one knew of pituitary tumors, endocrine abnormalities and associated side effects in horses. In other words, 50 years ago it was not addressed and the clinical signs were likely ignored or unnoticed and no one realized they were associated with a disease. Benjamin Espy, DVM, DACT, San Antonio, Texas
- We have an Arabian mare with SGD (Systemic Granulomatis Disease). She started last summer with a skin condition that looked like ringworm (discoloration in a circular pattern). Then she began showing signs of heaves with a nasal discharge. As the disease progressed, she started to lose weight dramatically. She had foaled in August and I thought it was due to the foal nursing and dragging her weight down. I tried feeding her extra, but she would never eat more than three to four pounds per feeding. I couldn't figure out how to remedy the situation. I then read in several veterinary journals about SGD and our veterinarian confirmed the diagnosis. I know the prognosis for this disease is poor. It has been a year since this started and we did not choose euthanasia although she is still much too thin. Long prelude. My question is: Are there cases of SGD where the granulomas have dissolved over time either in the lungs, gut or both? Please advise. (View Answer)
SGD is actually called "Idiopathic Systemic Granulomatous Disease". The reason the distinction is important is because "idiopathic" means we cannot determine a cause, an origin, or why it occurs.
Secondly, we do know it is an autoimmune disease. That said, in answer to your question, I'm sure there are cases (like any disease) where there is spontaneous remission or improvement but in general, it is chronic and inherently always present to some degree due to the patient's inherently flawed immune system. Benjamin Espy, DVM, DACT, San Antonio, Texas
- My Haflinger has a "hip click", more precisely, a stifle click. Lark is a big 7-year-old Haflinger I rescued that stands at 15.1 hands and weighs approximately 1200 pounds. One of my veterinarians recommends Cosequin, the other recommends weight loss and additional exercise. We limit Lark's intake as much as we can as he receives no grain and I ride him three to five times per week. He is out in the pasture quite often and never kept in a stall for more than 6 hours a day, if that. He runs around in the pasture with no signs of pain or lameness. Would Cosequin help reduce the stifle click? If so, which kind would best suit him? (View Answer)
That's a good question that I get a lot from my clients and one, ironically that you have answered yourself already.
Medically, clicking comes from tendons and ligaments rubbing over bony protuberances around a joint. It's not usually coming from inside a joint. That's why it is of little consequence other than annoyance.
Secondly, this fact is also why joint therapies like injections and supplements are usually unrewarding.
I always decline treatment on things like this as I feel like I am treating the owner and not the horse. If the horse had a concern, they wouldn't be running around being horses. I believe that we need to treat horses when they show clinical discomfort, not on the "clicking" sound alone. Benjamin Espy, DVM, DACT, San Antonio, Texas