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Client education articlesLyme Diseaseby Lorie A. Valentino, DVM, MS, DACVIM
Diagnosed 30 years ago in Old Lyme and Lyme Connecticut. Caused by Borrelia burgdorferi, a spirochete bacterium. B. burgdorferi is hosted by Ixodes species of ticks (also known as deer ticks) which transmit the infection to humans, horses, and other mammals. Ixodes ticks have a two year life cycle from egg to adult requiring a blood meal at each life stage:
The ticks become infected with B. burgdorferi after the first or second blood meal as larvae or nymphs. Ticks often acquire B. burgdorferi from white-footed mice. Ticks must be involved for transmission to mammals. Ticks must be attached for at least 24 hours to transmit disease. The nymph stage is most likely to transmit disease because they are small and less likely to be seen. Clinical signs in horses:
Diagnosis if the horse has clinical signs of Lyme disease:
Reasons for a low titer:
We don’t know how long it takes for a horse to develop clinical signs after being bitten by an infected tick. Could be days to weeks – every horse is different. Treatment:
Stranglesby Lorie A. Valentino, DVM, MS, DACVIM Strangles is a disease of horses that is caused by infection with Streptococcus equi bacteria. The disease was first described in the veterinary literature in 1251. It was given the name strangles because sometimes horses were suffocated by enlarged lymph nodes that obstructed the airway. Strangles is characterized by an abrupt onset of fever (103ºF or higher) followed by nasal discharge and swelling with subsequent abscess formation in the sub-mandibular and retropharyngeal lymph nodes. The severity of clinical signs depends on the immune status of the animal affected. Younger horses are more likely to develop severe disease while older horses often have a milder form. Horses with strangles are often depressed and listless. Inflammation of the throat can cause difficulty swallowing. Horses may become reluctant to eat and often stand with the neck extended.
Nasal discharge is initially watery but rapidly progresses to a thick, profuse mucus consistency. Accumulation of mucus in the upper airway can cause a rattling noise. Submandibular and retropharyngeal lymph nodes become swollen and painful about one week after infection. Serum may ooze from the overlying skin for several days as the lymph node abscesses mature before rupturing to drain creamy pus. Retropharyngeal lymph nodes may open and drain into the guttural pouch. Other lymph nodes of the neck can be involved and abscessate. Lymph node abscessation may result in obstruction of the upper respiratory tract. Infection with Streptococcus equi is diagnosed by culturing nasal swabs, nasal washes, or pus from abscesses.
Although strangles usually involves the upper airway, involvement of other locations occasionally occurs. The bacteria may spread through the bloodstream or lymphatics to form abscesses in the lymph nodes and other organs of the chest and abdomen or even the brain. This form of the disease is known as “bastard strangles”. The diagnosis and treatment of strangles infections that have spread are potentially more complicated than in cases of uncomplicated strangles. The specific means of diagnosis vary depending on the site of infection and whether there are concurrent signs of classic strangles.
In rare cases, horses can develop an immune-mediated disease called purpura hemorrhagica following infection with or vaccination from strangles. Purpura hemorrhagica is an immune-mediated vasculitis caused by deposition of immune complexes in the blood vessel walls. This causes edema and hemorrhage of the head, limbs, and/or trunk. The severity of clinical signs varies from a mild, transient reaction to a severe, fatal disease. Severe edema may result in oozing from the skin surfaces and sloughing of the skin may occur. Corticosteroids are the primary treatment for purpura.
Nasal discharge from horses with active disease or recovering from strangles is an important source of new strangles infections in susceptible horses. Nasal shedding of Streptococcus equi bacteria begins 2 to 3 days after the onset of fever and lasts for 2 to 3 weeks in most horses. Strangles may originate from outwardly healthy horses that are incubating the disease and go on to develop the disease. Some recovering horses may shed the bacteria for a long period of time, even years, if the infection persists in the gutteral pouch. Direct transfer can occur from horse-to-horse contact or indirect transfer can occur from sharing contaminated housing, water sources, tack, or from the clothing of people.
Approximately 75% of horses develop an enduring immunity (5 years or longer) to strangles after recovery from the disease. Injectable vaccination for strangles is marginally effective in protecting against disease (only about 50% a few weeks after the final booster) and adverse reactions such as soreness, abscesses at the injection site, and occasionally immune mediated reactions can occur. Intranasal vaccination with a modified live form of the bacteria stimulates a high level of immunity but also has safety issues. Because the vaccine contains modified live bacteria, abscesses, nasal discharge, and immune mediated problems can develop. The majority of strangles cases require no treatment other than proper rest and a dry, warm stall with soft, moist, and palatable food of good quality while letting the disease run it’s course. During an outbreak, immediate antibiotic therapy of new cases with fever and depression may prevent lymph node abscessation. However, antibiotic treatment will inhibit the development of immunity to strangles so horses will be highly susceptible to reinfection once treatment is discontinued. Once lymph nodes become enlarged in otherwise healthy horses, antibiotic therapy will only prolong the eventual enlargement and rupture of lymph abscesses. Therapy should be aimed at enhancing the maturation and draining of abscesses. Anti-inflammatory medications such as phenylbutazone and flunixin meglumine may be used to reduce fever, pain, and inflammation. If a horse has difficulty breathing because of partial upper airway obstruction, antibiotic therapy is indicated to decrease abscess size and prevent complete airway obstruction. Penicillin is the antibiotic of choice for treatment of strangles. Other antibiotics may be used depending on ease of administration or the site of infection. Rarely, affected horses may require intensive supportive therapy such as intravenous fluids, feeding by stomach tube, and tracheostomy. West Nile Virus Encephalitisby Lorie A. Valentino, DVM, MS, DACVIM
Deworming your horse
Deworming your horse is a very important aspect of preventing disease. A
parasite load can predispose your horse to colic and can suppress the
immune system making him or her more susceptible to disease. It is known
that parasites are becoming resistant to dewormers, therefore it is
recommended that you keep your horse on a rotational schedule and
evaluate the efficacy of your deworm with fecal tests. It is important
to remember that no dewormer is 100% effective and environmental control
of parasites is as important as deworming. This involves daily removal
of manure and environmental management.
At Vermont Large Animal Clinic, we have formulated a set of basic
recommendations for deworming horses in Vermont.
During the spring and summer it is important to deworm your horse
every 6-8 weeks.
It is advantageous to have the entire herd on the same rotating
schedule.
Mares that have just foaled
should be dewormed with ivermectin when the foal is one day of age,
because the dewormer is passed through the milk and will deworm the
foal.
Foals should be dewormed every month for the first year of their
life. Panacur should be given once monthly for the first 6 months
at a double dose by weight (i.e.- for a 200 lb foal give a 400
lb dose) and then either a panacur and/or ivermectin (dosed
by weight, i.e.- for a 200 lb foal give a 200 lb dose) monthly after
this point until one year of age.
The daily dewormer (Strongid C) is a nice product for
prevention of colic. It is also very worthwhile to prevent new
infestations in horses that ingest larvae while grazing. While using
the daily dewormer your horse must still be dewormed twice yearly,
ideally four times yearly with an ivermectin/praziquantel product.
Horses on Strongid C can apply to be on the “Preventicare Program”.
This program will give you $5,000.00 towards colic surgery. Please
ask us about this program if you are interested.
Panacur Powerpac:
Is a dewormer that is given once daily for 5 days. This is useful in
horses that have chronic issues such as: weight loss, loose manure,
and/ or mild bouts of colic. This is the only de-wormer that
effectively kills encysted strongyles (strongyles that are in the
wall of the intestine). Using this de-wormer once every two to three
years is beneficial.
In Vermont, tapeworms have been found in horses that have
gone to colic surgery. Therefore, it is important to use either a
double dose of strongid or ivermectin containing praziquantel (i.e.-
Equimax or Ivermectin Gold) at least twice yearly and ideally four
times yearly to help control tape worms in your horse.
Doing a fecal examination once yearly in healthy adult horses
is a way to determine the effectiveness of your deworming schedule.
Fecals can be done more regularly on young animal (less than 2 years
of age), geriatric horses (>18 years of age), and/or any horses with
signs that suggest parasitism. Fecal test can be done through our
clinic. All you need is two to three fecal balls in a Ziploc bag
that should be collected on the day of submission. Fecals will be
read as having a light, moderate, or heavy parasite load based on
the number of eggs seen per gram of fecal material.
Equine Gastric Ulcer Syndromeby Philip van Harreveld, DVM, MS
Gastric ulcers disease is a common condition in foals and horses. Prevalence estimates have been reported to range from 25-50% in foals and 60 to 90% of adult horses, depending on age performance, and evaluated populations. Although ulcers are similar in foals and horses, they might present with different clinical signs. A diagnosis of this disease relies on the recognition of clinical signs and endoscopic examination of the stomach.
It is important to point out that 50% of horses with ulcers show no outward signs of gastrointestinal disease, but ulceration can interfere with performance by affecting training, appetite, and temperament. Ulcers may heal naturally if horses are turned out to pasture for an extended period of time, but they usually don't heal in horses that continue training.
The picture on the left is a normal stomach and the picture on the right is a stomach affected with ulcers. (Endoscopic views)
How do ulcers form?
The equine stomach secretes acid continuously. Lesions in the upper portion of the equine stomach (the squamous mucosa lining) result primarily from excessive acidity, whereas lesions that affect the bottom of the stomach (the gastric glandular mucosa lining) result primarily from defective mucosal protection. Like human ulcers, stomach acid appears to be the main cause of equine ulcers. Excess acid can eat through the protective lining and damage the stomach. The high prevalence of ulcers seen in performance horses results from many factors including the way the horses are fed and managed. Intensity of training also may contribute to ulcer formation, but the exact reason why remains undetermined. Helicobacter pylori, bacteria that are a factor in the development of human ulcers, have not been isolated from horse stomachs and are currently not considered to be a cause of horse ulcers.
Diagnosis: is based on the presence of clinical signs and confirmation with endoscopic examination. Clinical signs in foals include intermittent colic, laying on it's back, diarrhea, poor appetite, teeth grinding, and excessive salivation. In adult horses clinical sings include poor appetite, failure to consume a meal, dullness, attitude changes, decreased performance, reluctance to train, poor body condition, rough hair coat, weight loss, excessive laying down, and low grade colic. A definite diagnosis can only be made with an endoscope.
Treatment: Inhibiting gastric acid secretion is the mainstay of gastric ulcer treatment in horses. A number of treatment modalities have been used for treatment and prevention of gastric ulcers in horses and foals. Currently, there is only one FDA approved treatment for gastric ulcers, Gastrogard. However, many treatments modalities have been described in the literature. Older Horse Care
Because of advances in nutrition, management and health care, horses are living longer, more useful lives. It’s not uncommon to find horses and ponies living well into their 20s and 30s. While genetics play a role in determining life span, you too, can have an impact. You may think that turning your old-timer out to pasture is the kindest form of retirement. But horses are individuals. Some enjoy being idle; others prefer to be a part of the action. Whatever you do, don’t ignore the horse. Proper nutrition, care and exercise will help the animal thrive. Follow these guidelines to develop a total management plan for your older horse: 1. Observe your horse on a regular basis. Watch for changes in body condition, behavior and attitude. Address problems, even seemingly minor ones, right away. 2. Feed a high quality diet. Avoid dusty and moldy feeds. 3. Feed your older horse away from younger, more aggressive ones so it won’t have to compete for feed. 4. Feed at more frequent intervals so as not to upset the digestive system. Two-three times daily is best. 5. Provide plenty of fresh, clean, tepid water. Excessively cold water reduces consumption which can lead to colic and other problems. 6. Adjust and balance rations to maintain proper body conditions. A good rule of thumb is to be able to feel the ribs but not see them. 7. Provide adequate, appropriate exercise to maintain muscle tone, flexibility and mobility. 8. Groom your horse frequently to promote circulation and skin health. 9. Be aware that older horses are prone to tumors. Look for any unusual lumps or growths from head to tail as well as beneath the tail (especially on gray horses). 10. Schedule routine checkups with your equine veterinarian. Call immediately if you suspect a problem. A quick response to ailments, injuries or a decline in fitness can keep your older horse from having a serious or prolonged setback. That means less worry for you and a better quality of life for your old friend.
Reprinted with permission from the AAEP. Preventing Colic
The number one killer of horses is colic. Colic is not a disease, but rather a combination of signs that alert us to abdominal pain in the horse. Colic can range from mild to severe, but it should never be ignored. Many of the conditions that cause colic can become life threatening in a relatively short period of time. Only by quickly and accurately recognizing colic – and seeking qualified veterinary help – can the chance for recovery be maximized. While horses seem predisposed to colic due to the anatomy and function of their digestive tracts, management can play a key role in prevention. Although not every case is avoidable, the following guidelines from the American Association of Equine Practitioners (AAEP) can maximize the horse’s health and reduce the risk of colic: 1. Establish a daily routine – include feeding and exercise schedules – and stick to it. 2. Feed a high quality diet comprised primarily of roughage. 3. Avoid feeding excessive grain and energy-dense supplements. (At least half the horse’s energy should be supplied through hay or forage. A better guide is that twice as much energy should be supplied from a roughage source than from concentrates.) 4. Divide daily concentrate rations into two or more smaller feedings rather than one large one to avoid overloading the horse’s digestive tract. Hay is best fed free-choice. 5. Set up a regular parasite control program with the help of your equine practitioner. 6. Provide exercise and/or turnout on a daily basis. Change the intensity and duration of an exercise regimen gradually. 7. Provide fresh, clean water at all times. (The only exception is when the horse is excessively hot, and then it should be given small sips of luke-warm water until it has recovered.) 8. Avoid putting feed on the ground, especially in sandy soils. 9. Check hay, bedding, pasture, and environment for potentially toxic substances, such as blister beetles, noxious weeds, and other ingestible foreign matter. 10. Reduce stress. Horses experiencing changes in environment or workloads are at high risk of intestinal dysfunction. Pay special attention to horses when transporting them or changing their surroundings, such as at shows.
Virtually any horse is susceptible to colic. Age, sex, and breed differences in susceptibility seem to be relatively minor. The type of colic seen appears to relate to geographic or regional differences, probably due to environmental factors such as sandy soil or climatic stress. Importantly, what this tells us is that, with conscientious care and management, we have the potential to reduce and control colic, the number one killer of horses.
Reprinted with permission from the AAEP. Overweight HorseAs a horse owner, you play an important role in controlling your equine companion’s weight. Sound nutrition management, a regular exercise program and veterinary care are key to keeping your horse fit and healthy. Maintaining the ideal weight is not always easy, however. When implementing a weight loss program for the overweight horse, it’s important to do it gradually and under the supervision of an equine veterinarian. Follow these guidelines from the American Association of Equine Practitioners (AAEP) to get you started: 1. Be patient. Weight reduction should be a slow, steady process so not to stress the horse or create metabolic upsets. 2. Make changes in both the type and amount of feed gradually. Reduce rations by no more than 10% over a 7- to 10-day period. 3. Track your horse’s progress by using a weight tape. When the horse’s weight plateaus, gradually cut back its ration again. 4. Step up the horse’s exercise regimen. Gradually build time and intensity as the horse’s fitness improves. 5. Provide plenty of clean, fresh water so the horse’s digestive and other systems function as efficiently as possible and rid the body of metabolic and other wastes. 6. Select feeds that provide plenty of high quality fiber but are low in total energy. Measure feeds by weight rather than by volume to determine appropriate rations. 7. Select feeds that are lower in fat since fat is an energy-dense nutrient source. 8. Switch or reduce the amount of alfalfa hay feed. Replace with a mature grass or oat hay to reduce caloric intake. 9. Feed separate from other horses so the overweight horse doesn’t have a chance to eat his portion and his neighbor’s too. In extreme cases of obesity, caloric intake may also need to be controlled by limiting pasture intake. 10. Balance the horse’s diet based on age and activity level. Make sure the horse’s vitamin, mineral and protein requirements continue to be met. Once your horse has reached its ideal body condition, maintaining the proper weight is a gentle balancing act. You will probably need to readjust your horse’s ration to stabilize its weight. Exercise will continue to be a key component in keeping the horse fit. Because obesity can affect a horse’s health, communicate regularly with your veterinarian. Schedule regular check-ups, especially during the weight reduction process.
Reprinted with permission from the AAEP.
Equine Emergencies
If you own horses long enough, sooner or later you are likely to confront a medical emergency. From lacerations to colic to foaling difficulties, there are many emergencies that a horse owner may encounter. You must know how to recognize serious problems and respond promptly, taking appropriate action while awaiting the arrival of your veterinarian. Preparation is vital when confronted with a medical emergency. No matter the situation you may face, mentally rehearse the steps you will take to avoid letting panic take control. Follow these guidelines from the American Association of Equine Practitioners (AAEP) to help you prepare for an equine emergency: 1. Keep your veterinarian’s number by each phone, including how the practitioner can be reached after hours. 2. Consult with your regular veterinarian regarding a back-up or referring veterinarian’s number in case you cannot reach your regular veterinarian quickly enough. 3. Know in advance the most direct route to an equine surgery center in case you need to transport the horse. 4. Post the names and phone numbers of nearby friends and neighbors who can assist you in an emergency while you wait for the veterinarian. 5. Prepare a first aid kit and store it in a clean, dry, readily accessible place. Make sure that family members and other barn users know where the kit is. Also keep a first aid kit in your horse trailer or towing vehicle, and a pared-down version to carry on the trail. First aid kits can be simple or elaborate. Here is a short list of essential items: · Cotton roll · Cling wrap · Gauze pads, in assorted sizes · Sharp scissors · Cup or container · Rectal thermometer with string and clip attached · Surgical scrub and antiseptic solution · Latex gloves · Saline solution · Stethoscope · Clippers Many accidents can be prevented by taking the time to evaluate your horse’s environment and removing potential hazards. Mentally rehearse your emergency action plan. In an emergency, time is critical. Don’t be concerned with overreacting or annoying your veterinarian. By acting quickly and promptly, you can minimize the consequences of an injury or illness.
Reprinted with permission from the AAEP. Don't Skip the Purchase Exam
Owning a horse can be a big investment in time, money and emotion. Unfortunately, horses seldom come with a money-back guarantee. That’s why it is so important to investigate the horse’s overall health and condition through a purchase exam conducted by an equine veterinarian. Whether you want a horse as a family pet, a pleasure mount, a breeding animal, or a high performance athlete, you stand the best chance of getting one that meets your needs by investing in a purchase exam. Purchase examinations may vary, depending on the intended use of the horse and the veterinarian who is doing the examination. Deciding exactly what should be included in the purchase examination requires good communication between you and your veterinarian. The following guidelines from the American Association of Equine Practitioners (AAEP) will help ensure a custom-tailored exam:
The veterinarian’s job is neither to pass nor fail an animal. Rather, it is to provide you with information regarding any existing medical problems and to discuss those problems with you so that you can make an informed purchase decision. Your veterinarian can advise you about the horse’s current physical condition, but he or she cannot predict the future. The decision to buy is yours alone to make. But your equine veterinarian can be a valuable partner in the process of providing you with objective, health-related information.
Reprinted with permission from the AAEP. Help you foal grow with proper nutrition
A healthy foal will grow rapidly, gaining in height, weight and strength almost before your eyes. From birth to age two, a young horse can achieve 90 percent or more of its full adult size, sometimes putting on as many as three pounds per day. Feeding young horses is a balancing act, as the nutritional start a foal gets can have a profound affect on its health and soundness for the rest of its life. At eight to ten weeks of age, mare’s milk alone may not adequately meet the foal’s nutritional needs, depending on the desired growth rate and owner wants for a foal. As the foal’s dietary requirements shift from milk to feed and forage, your role in providing the proper nutrition gains in importance. Following are guidelines from the American Association of Equine Practitioners (AAEP) to help you meet the young horse’s nutritional needs: 1. Provide high quality roughage (hay and pasture) free choice. 2. Supplement with a high quality, properly balanced grain concentrate at weaning, or earlier if more rapid rates of gain are desired. 3. Start by feeding one percent on a foal’s body weight per day (i.e., one pound of feed for each 100 pounds of body weight), or one pound of feed per month of age. 4. Weigh and adjust the feed ration based on growth and fitness. A weight tape can help you approximate a foal’s size. 5. Foals have small stomachs so divide the daily ration into two to three feedings. 6. Make sure feeds contain the proper balance of vitamins, minerals, energy and protein. 7. Use a creep feeder or feed the foal separate from the mare so it can eat its own ration. Try to avoid group creep feeding situations. 8. Remove uneaten portions between feedings. 9. Do not overfeed. Overweight foals are more prone to developmental orthopedic disease (DOD). 10. Provide unlimited fresh, clean water. 11. Provide opportunity for abundant exercise. The reward for providing excellent nutrition and conscientious care will be a healthy foal that grows into a sound and useful horse
Reprinted with permission from the AAEP. Help your mare have a safe delivery
If your mare has made it through 11 months of pregnancy, you’re almost home free. Labor and delivery, while momentous, are generally uneventful. In most cases, you will simply need to be a quiet observer – if, that is, you are lucky enough to witness the birth. Mares seem to prefer to foal at night in privacy, and apparently have some control over their delivery. Because most mares foal without difficulty, it is usually best to allow the mare to foal undisturbed and unassisted. What you can do, however, is prepare your mare for a safe and successful delivery. Follow these suggestions from the American Association of Equine Practitioners (AAEP) to help the new mother and baby get off to a great start:
· Write down your veterinarian’s phone number well in advance of the birth and keep it by all phones. · Keep a watch or clock on hand so you can time each stage of labor. When you’re worried or anxious, your perception of time becomes distorted. The watch will help you keep accurate track of the mare’s progress during labor. · Wrap the mare’s tail with a clean wrap when you observe the first stage of labor. Be sure that the wrap is not applied too tightly or left on too long, as it can cut off circulation and permanently damage the tail. · Wash the mare’s vulva and hindquarters with a mild soap and rinse thoroughly. · Clean and disinfect the stall area as thoroughly as possible and provide adequate bedding. · If a mare is taking longer than 30 minutes to deliver the foal, call your veterinarian immediately.
Reprinted with permission from the AAEP.
Learn to recognize your horse's dental problems
Horses with dental problems may show obvious signs, such as pain or irritation, or they may show no noticeable signs at all. This is because some horses simply adapt to their discomfort. For this reason, periodic dental examinations are essential to your horse’s health. It is important to catch dental problems early. If a horse starts behaving abnormally, dental problems should be considered as a potential cause. Waiting too long may increase the difficulty of remedying certain conditions or may even make remedy impossible. Look for the following indicators of dental problems from the American Association of Equine Practitioners (AAEP) to know when to seek veterinary attention for your horse: 1. Loss of feed from mouth while eating, difficulty with chewing, or excessive salivation. 2. Loss of body condition. 3. Large or undigested feed particles (long stems or whole grain) in manure. 4. Head tilting or tossing, bit chewing, tongue lolling, fighting the bit, or resisting bridling. 5. Poor performance, such as lugging on the bridle, failing to turn or stop, even bucking. 6. Foul odor from mouth or nostrils, or traces of blood from the mouth. 7. Nasal discharge or swelling of the face, jaw or mouth tissues. Oral exams should be an essential part of an annual physical examination by a veterinarian. Every dental exam provides the opportunity to perform routine preventative dental maintenance. Mature horses should get a thorough dental exam at least once a year, and horses 2 –5 years old should be examined twice yearly.
Reprinted with permission from the AAEP.
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Client Education
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