It is important to understand the normal events following the birth of your foal in order to recognize any abnormalities as quickly as possible.  Neonatal foals can become very sick, very quickly and it is important to identify possible problems early so that appropriate therapy can be initiated in a timely fashion.  Medical treatment of sick foals can be a costly and involved process, but may often be avoided or significantly decreased if problems are recognized and attended to as soon as they arise. 

The normal foal should, within the first 15 minutes after birth, make vigorous attempts to stand.   It should be successful in doing so within the first 30 to 60 minutes and once up, it should make a deliberate effort to find the mare’s udder.  Normal foals should latch onto the udder and suckle well within 1 to 4 hours after birth. A normal neonatal foal should nurse vigorously at least once an hour.   Nursing properly is the most important task of the foal within the first day of its life.  A foal’s sole source of immunity to disease within the first few weeks of life is the colostrum it receives from the mare.  Even in the cleanest of environments, foals are constantly exposed to bacteria and can develop infections very easily if adequate passive transfer of immunity (colostrum intake) is not achieved.  The antibodies that the foal receives in colostrum are large proteins and the foal’s intestinal tract can only absorb these proteins within the first 24 hours after birth.  Therefore, it is extremely important to make sure that the foal is strong and suckling well within this first day of life.  In addition, any supplemental colostrum or commercial product given orally after 24 hours of age will not be helpful. 

There are a number of factors that may affect whether the foal receives adequate passive transfer of immunity.  First, the mare has to have adequate colostrum for the foal to ingest.  Mares may leak colostrum before they foal, or may not produce any at all.  Some mares may produce an adequate volume of colostrum, but the concentration of antibodies in it may be inadequate.  Checking to see what is actually coming out of the mare is important.  Colostrum is a thick, sticky, golden material and should be readily milked from the udder.  If you are unable to milk any liquid out of your mare’s udder, or if the material is thin and watery, or appears more like milk than colostrum, you should contact your veterinarian.  The antibody concentration of colostrum can be measured either directly or indirectly by assessing the density of it.  Commercial “colostrometers” are available, and may be recommended for larger breeding farms in order to assess colostral antibody concentration.  The second factor in the foal receiving adequate passive transfer of immunity is its successful ability to find the udder and suck.  Numerous medical conditions can cause a foal to be too weak or unable to stand.  Additionally, do not assume that if the foal is able to stand that it can find the udder and suck.  If you do not see your foal latch onto the udder and suckle well within the first four hours after birth, you should call your veterinarian.

Dipping the umbilicus is an important process in order to prevent infection.  The umbilical cord should break on its own during birth and a small amount of bleeding is normal.  It is very unusual for a foal to lose an excessive amount of blood from the umbilicus and it should not be clamped, or tied off as this can increase the likelihood of infection.  It is recommended that the umbilicus be dipped with a dilute antiseptic solution as soon as possible after birth.  One part of 2% chlohexidine (NolvasanÒ) solution mixed with three parts of sterile water has been shown to be best at reducing bacterial contamination.   This solution can be easily acquired from your veterinarian before foaling.  Tincture of iodine is not recommended as this can be very caustic and can increase the likelihood of infection and other umbilical problems.  The umbilicus should be dipped 3-4 times per day for the first 2 days after birth.  Between dippings it should remain clean and dry and if it appears to be constantly wet, swollen or if it drips when your foal urinates, you should call your veterinarian.

 Foals should pass their first manure (meconium) within the first four hours of birth.  This manure is often firm and may become impacted in the foal’s rectum.  The act of suckling stimulates intestinal motility and passage of meconium, colostrum is a natural laxative and most foals pass their meconium without incident.  However, many people advocate prophylactic enemas at the time of birth.  These should be given before the foal stands and suckles in order to be most effective.  Commercial phosphate enemas (FleetÒ enemas) are best but can be extremely irritating to the lining of the rectum if overused.  It is best to administer one enema and if meconium is not produced within the first four hours, call your veterinarian.

All foals should be examined by a veterinarian at around 24 hours of age.  Your veterinarian will test the foal’s blood immunoglobulin (IgG, antibody) concentration in order to determine adequate passive transfer of immunity.  He or she will also thoroughly examine the foal to ensure that it is healthy and strong.   Nutritional care, routine vaccinations and deworming of both the foal and mare should be discussed at this time in order to determine the ideal health care plan for each individual animal.  The importance of early recognition of problems and initiation of appropriate therapy cannot be overemphasized.  If you are not sure what is or is not normal, it is best to consult your veterinarian. 

 

A fair number of older show horse’s issues are related to lameness problems such as arthritis and osteoarthritis. If the horse is serviceably sound then this means that the horse is sound enough for the intended use but not completely sound. Maintenance therapy such as joint therapy, anti-inflammatories, as well as other things may be needed to keep the horse at that level of performance.  These horses are good to help get a child started in the beginner level as long as there are no general health issues that would prevent the child from riding in their lessons on a regular basis such as advanced COPD that may act up in certain environments.  You do not want a horse that is always sick the day of the lesson, because that can become very frustrating for the child and you as a parent.  Also you don not want to have a health issue that is going to be detrimental to the longevity of the horse such as cancer, eating problems, neurological problems, etc... 

If the purpose of the horse is to use for a few years and then resale then choosing a horse that may have maintenance issues and radiographic changes might not be the best choice since you may have a hard time getting your resale value.  One downside of older horses is if the horse is only suitable for lessons and not competition and your child wants to start competing.  You may have to rent another horse from the barn or lease another horse for competition purposes.  The same holds true if you child is moving up in levels fast and the horse is not able to compete at these higher levels. 

The upside of purchasing an older horse is that usually they know their job so the trainer can concentrate on the child and not the horse.  Also a horse that packs the kids around consistently and the child can be in the ribbons helps build confidence in the rider.  “Bomb-proof” horses are priceless if they can take care of your child even when they are messing up or hanging on one side.  If the problems the older horse has are acceptable than that is usually the best horse for a beginner. 

Younger horses require training at a level the child may not be able to handle and those horses have not been proven in the show pen.  You may find this horse is not suitable athletically or mentally to handle the discipline your child has chosen.  We have seen several instances where the rider wants a horse that has not been started to learn together.  That can work but someone needs to be the student and someone needs to be the teacher and that does not always work the best for a beginner/intermediate rider who may need more advanced teaching in that discipline.

The bottom line is that there is no right or wrong answer depending on your situation.  Have a pre-purchase examination done on the horse and you and your veterinarian can determine if the problems may be ones that are acceptable for the intended use.  Just remember a well trained horse whether young or old is golden, but a “bomb-proof”, sound child’s horse is priceless!  Best of luck during your search for the right horse!

Scott Reiners, DVM, Diplomate ACVS

Anytime your horse is faced with an emergent medical condition it can be scary for both you and your horse.  The first thing to remember when you find your equine friend in distress or injured is to take a deep breath and evaluate your horse.  A simple, quick evaluation includes 3 steps and takes only 5 minutes.

1. Look

Watch your horse in the field and as he comes in.  What is his primary problem?  Is he down or lame? Depressed or anxious?  Is he colicky? What signs have you seen?

2. Touch

Run your hands over your animal, does he have any new cuts, bumps or sore areas?  If you find an injury, how deep is the wound?

3. Listen

Take the pulse, respiratory rate and temperature of your animal.  Does he seem to be having any difficulty breathing?

Now when you call your veterinarian you can provide some key information that will help him advise you on how to stabilize your horse until he arrives.  Keeping a simple first aid and emergency kit in your barn will assure that you have the tools necessary to follow your veterinarian’s instructions until your horse can be seen.

We recommend a medium to large size tackle box to act as your kit.  Tackle boxes are easily stored and are portable enough to take along in the trailer.  Bright colored boxes are preferred as they are easily seen in an emergency.  The box should be stocked as follows at all times.

• Veterinarian phone numbers

Keep the numbers for your regular veterinarian and a second veterinarian in case your regular veterinarian is unavailable.

• Owner Information

This is especially important in boarding facilities as veterinarians cannot treat most conditions without direct owner consent.

• Flashlight and batteries

Most emergencies are noticed in the evening in fading light, and a flashlight is always helpful to evaluate wounds more closely. 

• Halter/ Lead Rope

A spare is always useful.

• Watch

Good for keeping track of the duration of signs and when to expect the veterinarian.  Also, a watch with a second hand is helpful for taking heart rate and respiratory rate. 

• Pen and paper

To keep a record of when you noticed a problem, what you saw, your evaluation, any treatment you have given, etc.

• Thermometer

Digital thermometers are accurate, durable and beep when the temperature is reached.

• Stethoscope

Basic stethoscopes are available at most drugstores.  If you are unsure where to listen to your horse, ask your regular veterinarian to show you how to use a stethoscope on his next visit.

• Banamine paste and Phenylbutazone paste or tablets (bute)

These are oral anti-inflammatories that can alleviate pain.  They should only be given under the instruction of your veterinarian.  They also have a long shelf life when stored properly.   

• Electrolytes

Powdered electrolytes that can be added to water and paste electrolytes are equally acceptable and have a long shelf life if stored properly.

• Ice pack

Your local drug store should carry room temperature ice packs that become cold when shaken or broken.

• Towel

To clean and dry your horse if wet or wounded.

• Leg Bandage (non-adherent pad, roll gauze, quilt/ cotton, vet wrap)

The materials listed can be found at your local drugstore in the first aid aisle and/or at your local tack shop or feed store.

• Foot Poultice

This can be a premedicated pad, ichthammol, or magna paste.  Each can help to alleviate the pain and pressure associated with a hoof abscess.

• Duct Tape

• Scissors and/ or a multi-tool

While you are waiting for the veterinarian, try to keep your horse (and yourself) calm.  If he is not colicking, give your horse hay to keep his mind occupied.  Grooming may also help him relax.  If he is colicky he can lie down, but only if he can do so quietly and without rolling. 

Finally, you can help your veterinarian in an emergency by providing the proper environment to evaluate your horse.  If your horse can walk, bring the horse into a clean, dry, covered, well-lit area.  If the horse has an injury, he may require radiographs, and you can help by having a power source handy.  The exceptions to moving your horse are if he is down, if he is lame and refuses to walk, or if he has diarrhea.  Horses with diarrhea may be contagious to their herd and stable mates and should be isolated until the veterinarian arrives. 

Preparation eases the stress associated with an emergency.  Routine preventative care, good nutrition, and adequate water intake are key to preventing many emergencies.  Please contact your veterinarian to discuss emergency preparation and wellness plans for the upcoming winter months. 

Equine Herpes Virus-1

Equine rhinopneumonitis virus (EHV-1 or equine abortion virus) is a highly infectious disease that usually affects the respiratory system. Occasionally, the virus may also cause neurological disease. Transmission likely occurs by inhaling infected droplets or ingesting material contaminated by nasal discharges or aborted fetuses. Clinical symptoms may include a fever, difficulty urinating, depression, and stumbling or weakness in the hind limbs. Supportive therapy is often used to treat these cases. In severe cases, horses will be unable to stand; these cases have a very poor prognosis.

 

On March 29, State Veterinarian Richard Wilkes released the final Virginia premises from quarantine due to EHV-1. Ten premises that housed animals that may have been exposed to the virus while they were being treated at the Equine Medical Center in Leesburg were placed under investigational quarantines. Horses in two of the facilities under investigation tested positive for EHV-1 after developing fevers or neurological signs. The horses on the other quarantined premises were not allowed to move until they had been observed and tested to determine that they were not likely to be shedding the virus.  More info at the Virginia Department of Agriculture

 

Summer is upon us.  But with the sun, rain, sweat and insects of show season, multiple equine skin diseases also become apparent.  The following is a brief summary of summertime skin problems in horses; common clinical signs, causes and treatments.

Rainrot:  This common ailment occurs mostly on the back, neck and rump of horses, but can develop anywhere on the body.  The classic lesions are scabby areas that may be pulled away with tufts of hair, thus being given the name “paint-brush” lesions.  The lesions are caused by a superficial skin infection due to the bacteria Dermatophilus congolensis.  This bacteria thrives in wet conditions and usually (although not always) causes problems after wet weather.  Treatment involves softening and removal of the scabs (which may be very painful to the horse), shampooing with a disinfectant shampoo such as betadine.  Severe cases may require antibiotic therapy.

Sunburn:  Horses suffer from sunburn and require proper sun protection as they are usually exposed to more of the sun’s rays than we are!  Sunburn is most commonly seen on pink skinned areas such as the nose and eyes, but may occur anywhere and on any color skin.  Paint horses may develop reddened skin and lose the hair on white patches with pink skin.  Horses with pink muzzles may develop severe and painful scabbing.  Treatment involves ointments to soften and soothe the scabs as they heal.  Prevention includes sunscreen applied to areas of concern, fly masks designed to cover the nose, and fly sheets to prevent sun exposure of pink areas on paint horses.  Severe crusting and ulceration of pink areas may also be symptoms of more serious systemic diseases such as liver disease, drug reaction or ingestion of certain plants and should be examined by a veterinarian.

Scratches:  A similar condition to rainrot, scratches is the development of painful scabby areas on the legs.  It is associated with standing in wet areas or dew-covered grasses which allow moist skin for bacteria to grow upon.  Treatment is similar to rainrot, consisting of softening of scabs and their removal but often necessitates topical corticosteroid and antimicrobial therapy as well.

Atopy:  Atopy is the manifestation of environmental allergies as skin lesions.  Clinical signs include hives, which may progress to large coalescing swollen areas that are very itchy.  Horses may rub these areas on anything they can find to scratch with and may cause hair loss and ulcerated areas.  Horses with atopy may be allergic to pollens, dusts or molds in their environment and usually are allergic to multiple things in each of the above categories.  Diagnosis may include skin biopsies, certain blood testing and skin testing in order to attempt to isolate which allergens are affecting the horse.  Treatment consists of environmental management in order to avoid allergens, corticosteroid and antihistamine therapy.  Hyposensitization therapy (allergy shots), as are used in people have been used in horses with varying results.  It is best to consult your veterinarian if you suspect your horse may have atopy.

Sweet itch:  Sweet itch is caused by hypersensitivity to insect bites, the most common culprit being the biting midge, Culicoides.  Clinical signs are usually quite dramatic with severe itching of the mane, tail and belly.  Horses frequently spend most of their time finding ways in which to scratch these areas, and usually rub out most of their manes and tails.  These areas may also develop secondary bacterial infections due to damage to the skin caused by scratching.  Treatment consists of avoidance of insects using long-acting fly repellants, fly sheets and masks, keeping horses stalled during peak insect activity at dawn and dusk, and the use of fans to deter insects in stalls.  Severely affected horses often need courses of corticosteroid and antibiotic therapy. 

While many skin conditions are mild and easily remedied topically, some may be severe and require diagnostic testing and systemic therapy.  It is best to consult your veterinarian before instituting any therapy to ensure the correct diagnosis.

Acupuncture is an ancient Chinese method of treating disease through harmonizing the inner energy known as “chi.” This is accomplished through placing small needles through the skin into what is known as points along a meridian.  Each meridian and point is associated with external and internal structures of the body and help heal by reestablishing chi flow throughout the body.  Where there is pain there is chi blockage that needs to be relieved.  There are different forms of acupuncture and the most common is the dry needle stimulation.  However there are other forms used as well which include electro-acupuncture, aqua puncture, moxa sticks, and hemo-acupuncture.  When to use each type depends on skill and preference of the acupuncturist.  In general I use electro-acupuncture on my chronic arthritis, back pain, and colics.  I use moxa when I am dealing with cold induced arthritis to try to warm the points.  I use hemo-acupuncture for my immune regulated diseases and severe internal disorders such as Lyme’s disease and EPM.  I do not use aqua puncture with Vitamin B-12 that often since I use electro-acupuncture for my chronic diseases for which other acupuncturists may use aqua puncture. When to use acupuncture depends on you and your veterinarian.  Acupuncture is one of the complementary therapies that works well in conjunction with other treatments.  I think acupuncture works best for chronic back soreness, arthritis, uveitis, laminitis, EPM, diarrhea, and colic. When used in combination with other treatments I have seen reduced hospitalization time and shortened recovery.  It is important to remember that acupuncture can kill an animal.  If the animal is really old and debilitated acupuncture in the initial stages may be too powerful for the animal.  In an extremely sick animal it may push the animal towards death.  In pregnant animals you want to avoid very powerful points that may stimulate uterine contractions and lead to abortion.  For the most part acupuncture is harmless but these are a few occasions you want to be careful to avoid.  In our clinic we have found that if the horse has a medical colic that can be fixed medically then acupuncture will help fix the colic.  If the horse needs surgery acupuncture will only make the horse more painful and help us finalize our decision to go to surgery.  I most commonly perform acupuncture on arthritic horses with back soreness.  I find that it really helps the horse feel better while we are working on helping the joints.  There are so many things acupuncture can help, but remember it is usually done in conjunction with other therapies and should not replace a therapy just merely enhance the therapy. Best of luck and call if you have more questions!!

Arthritis is defined as the inflammation of a joint or joints. It can be an infliction of many if not all mammals. Inflammation of the joint usually is accompanied by pain, heat, swelling of the joint, excessive synovial fluid, and varying degrees of lameness. The more devastating manifestation of arthritis in horses is degenerative arthritis, degenerative joint disease, or osteoarthritis. Osteoarthritis is defined as arthritis characterized by articular cartilage erosion and/or surrounding bony changes. Arthritis can be caused by many things. Repeated trauma, stress to the joint through training, joint instability, nutritional, infection, etc. The joint is a resilient structure but over time inflammation and cartilage trauma can lower its resilience. Thus, leading to arthritis/osteoarthritis.

Joint anatomy

The joint is made up of bone, articular cartilage, and surrounding soft tissue (ie, ligament, retinaculums, tendons, muscles, and joint capsule).

 

The articular cartilage is principally composed of water, collagens and proteoglycans.

Articular cartilage is responsible for providing a frictionless gliding surface and distributing the load on the joint. The collagen ( mostly Type II) of the cartilage, to put it simplistically, is connected to the subchondral bone and provides a scaffold for proteoglycans to attach. The proteoglycans (aggrecan) are made up of proteins and glycoaminoglycans ( mostly chrondroitin sulfate and keratin sulfate). The aggrecan interacts with hyaluronan to form aggregates. Aggregates attach to the collagen. The aggrecans function is to hold water. With its negative charge it can hold as much as 50 times its weight in water. Water gives the articular cartilage the ability to dissipate load and gives compressive stiffness. Its like flopping onto a water bed, you land flat and then slowly sink in to the bed.  

 

Bones give structure and function to the soft tissue. The shape of the joint in many ways determines the way a joint can move.  At some joints, the bone ends change shape and become more pliable. This pliability gives the ends of the bones some resistance to loading shock and other every day forces on the joint. The ends of the bone that is mostly associated with the joint is subchondral bone. The articular cartilage attaches to this part of the bone. In very young animals, the subchondral bone will help feed the articular cartilage and chondrocytes( cell that help make the cartilage) by its vessels but in older animals the joint parts are feed through joint fluid.

 

The joint membrane is made of 2 layers, one gives strength and stability to the joint. The other is synovium. Synovium contains mostly 3 different cells A, B, and C.  Type A helps clean the joint and synovium up and also produce factors that mediate inflammation in the joint. Type B makes things like collagen and hyaluronan, which are needed to feed and maintain the joint. Type C do a little of both.

Physiology

Early in joint inflammation, the synovium is producing factors that increase inflammation as well as those that decrease inflammation and protect the joint. The chondrocytes are trying to produce more proteoglycans to replace the ones broken down in the cartilage but they may times get broken down faster then they can get produced. This results in cartilage erosion and brake down. Once the cartilage is damaged the subchronal bone starts to get affected. Over a period of time you start to see bone changes. Early in joint inflammation, pain comes from the excessive fluid pressure and inflammation in the synovium. The articular cartilage does not feel pain but the subchondral bone does through nerve endings. So once you have cartilage damage you can have chronic pain, so early detection and treatment is best for long term joint health of your horse.

Some of the early signs of arthritis are lameness off and on, increased fluid in the joints, lame or stiff at the beginning of riding but works it way out, abnormal movement, abnormal stance when resting, not performing like they use too, etc.

Joint Pain

Arthritis and osteoarthritis may be the most common cause of lameness in equine athletes but the level of pain does not correlate with the severity of the joint damage. Just because the horse is a “little off” does not mean that there is not a severe problem with the joint. The problem with using a degree of lameness as a meter for the joint damage is that articular cartilage is devoid of sensory innervation. The cartilage could be eroding slowly over time without pain input until the erosion reaches the subchondral bone. The initial pain of arthritis comes from the nerve endings in the joint capsule and surrounding soft tissue. There are inflammatory factors that increase pain response in the joint capsule but as the length time the joint is inflamed is increased, peri-articular fibrosis can develop. This decreases joint motion and can also cause degeneration of neurons thus, decreasing pain. So decrease range of motion can be a sign of arthritis. If you flex a normal joint the joint pressure increases, with a joint that has increased effusion (fluid) this pressure is increased in not only the joint but may increase the intramedullary pressure (in side the bone where the bone marrow is grown) thus causing pain not only in the joint but can cause pain in the long bones surrounding the joint.

Decrease range of motion as stated previously is a common finding with arthritis and probably caused by a combination of the horse guarding the joint from pain, synovial effusion and edema and peri-articular fibrosis. The pain and synovial effusion and edema is more of an early sign, where as the fibrosis takes time to develop and is considered to be a sign of chronic inflammation.

Joint effusion or increased fluid in the joint, appears as a distention or “bulging” of the joint pouches. It comes from a leakage of protein into the joint caused from a mismatch between a leaky capillary walls and/or over active synovium with a decreased filtration system (lymphatics). With all of the proteins in the joint more fluid is pulled in to the joint by something called colloidal osmotic pressure. Because of this, joint fluid can be obtained by arthrocentesis (joint tap) to detect inflammation.  Inflamed joints can have increased protein, decreased viscosity, color, lower mucin, lower hyaluronan, and higher cell counts but this is very variable from horse to horse.  The joint pressure is normally sub-atmospheric with only a thin film of synovial fluid in them, so if you stick a needle the joint and you here air being aspirated. This is not abnormal. With increased joint fluid pressure the chondrocytes and synovial cells can shut down production of nutrients, thus increasing the chance of further cartilage damage.

Nerve blocks and joint blocks can help localize the lameness to a joint or region from the lameness originates but does not tell severity. Sometimes even when we know the joint has a problem, we can not get it to “block out”. The reason is to lengthy to go into but sometimes we have to do nerve blocks in conjuction with joint blocks.

Some of the later signs of arthritis and/or osteoarthritis may be found with radiographs, nuclear scintigraphy, Magnetic resonance imaging (MRI), ultrasound, and arthroscopy.

Radiographs are great at revealing bony changes but do not detect some small lesions or lesions that just are affecting the cartilage or synovium. Radiographs are important in archiving many inciting inflammatory causes and changes in joint and bony architecture, which is important in cause and treatment. Some of the radiographic finding of osteoarthritis are narrowing of the joint space, subchondral bone mineralizing (sclerosis), joint spurring (osteophyte), subchondral bone lysis (bone being removed), small fractures or fragments, and in advanced stage, joint fusing (ankylosis).

Nuclear scintigraphy uses a radiopharmaceutical (Technetium-99m) that emits gamma rays just like x-rays but only it is injected into the horse and detected on the out side by a gamma camera which is computerized. The radiopharmaceutical can be attached to many different molecules to evaluate things like blood profusion, kidney function, inflammation, lung profusion, liver function, rapid bone repair activity, etc. 

The radiopharmaceutical and its molecule (oxidronate or methylene diphosphonate) will go through three phases after injection in the vein of the horse. The first phase is use as a vascular phase to detect blood flow to certain areas but only last about 1-2 minutes. The second phase is soft tissue phase which last about 3-15 minutes and is used to evaluate blood flow to soft tissue. This phase is often used to evaluate the horse for navicular problems, inflame joints,sacroiliac joint problems, etc. The last phase is the bone phase which is taken about 3 or more hours after injection. This phase is used to evaluate bone problems. Most radiation will be emitted from areas of rapid remodeling such as in degenerative joint disease, arthritis, periarticular bone sclerosis, etc. The advantage of using nuclear scintgraphy is that you can image multiple joints and the whole body if needed and is fairly accurate in finding areas of bony and soft tissue problems. The disadvantage is that it lacks specificity of cartilage health, lack of detail which results in other diagnostic to be performed, expense, and the horse has to be quarantined.  Scintigraphy is sometimes a useful tool for lameness.

 Magnetic resonance imaging (MRI) which detects alternating electrical currents produced from the hydrogen protons found mostly in fat and water. Its advantage is the joint is in a 3-D orientation, detecting water content changes in the cartilage, and with some machines we can find small cartilage lesions. The down fall of MRI is that it is expensive, and it can not detect arthritis before there are changes. 

Ultrasound has gained some popularity in visualizing joints. The advantage is that tendons, ligaments, synovial fluid, cartilage, and many other joint changes can be visualized. The disadvantage is limitation of depth and joint structure. Ultrasounds can not look thorough bone.

 Arthroscopy is the hallmark of arthritis and joint problem detection. It gives the advantage of seeing synovial inflammation, cartilage damage, early inflammatory changes in the joint, and at the same time flushing the joint fluid the contains large amounts of inflammatory factors. The disadvantage is cost and not every part of the joint can be visualized.

In the near future gene chips and biomarker testing will become more available and cost effective which will detect early mediators of arthritis. This will be a great advantage to help stop arthritis before it becomes a problem.

This is just a brief over view of some of the diagnostics that are routinely used for joint problems in the horse. Next month will be on treatments for arthritis in the horse.

At this moment, treatment for arthritis is geared toward treating inflammation, reducing pain, removing bad cartilage, and protecting the cartilage that is left, or reducing pain until the joint fuses and in some cases, fusing the joint surgically.  These goals can be obtained by controlled and planned use of NSAIDS ( non steroidal anti-inflammatory drugs), corticosteroids, hyaluronic acid, polysulfated glycoaminoglycans, other pain controllers, physical therapy, shoeing, herbals, acupuncture, shockwave, and  surgery. 

The key to arthritis control is to detect it early. Heed the early signs of arthritis. Set up an arthritis prevention plan for your horse with your veterinarian. Although arthritis not totally preventable there are many things that can be done to reduce the changes of your horse’s arthritis   

 

Prevention

The best treatment is always prevention which is difficult to provide in the equine athlete. Even horses in the wild get arthritis mostly in the form of osteochondrosis. In my opinion, prevention of joint problems begin in the selection of the sire and dam even though it is controversial whether or not there is a genetic predisposition to arthritis or osteochondrosis.

Health of the dam is very important to the maturing foal. Nutrition and the time of year the foal is born have been studied and show to be factors in cartilage development. The time of year effect is related to the nutrition of the grass in the pasture and maturity rate of different joints. The nutrition effect includes copper, digestible silica, calcium/phosphorus ratios, proteins amounts and types, etc. which have been found to affect cartilage and bone development.  Sick foals that have had septicemia or “joint ill” may develop arthritis at an early age.

Exercise both in the young weanlings and older horses have been incriminated as a cause for arthritis. Young horses with controlled forced exercise have been shown to develop better cartilage then those just in the fields. This is still under investigation. The flip side to this is that we see more joint problems in horses that are worked at a younger age then those started work when they are mature. This is anecdotal but neither side has been proven to my satisfaction.

Good conformation is important for joint health. Horses with “crooked legs”, “bucked knees”, “cow hocked”, etc. have abnormal stress exerted on ligaments, tendons, and different areas of the joint. This can lead to osteoarthritis over time in the working horse. Weight of the horse may also play a factor on joint stress.  Overweight horses over time place a lot more stress on their joints and may predispose themselves to develop arthritis early.

The old saying of “no foot, no horse” is somewhat true. Feet that are too long or out of balance may have no effect to the horse that is just grazing in the field but when that horse is worked problems may arise. Medial to lateral balance has been studied over and over and found that when the foot is out of balance it puts stress on ligaments and joints further up the leg. Long toes increase the stress of tendons. Also hooves that are “too up right” and club feet increase stress on the coffin joint, navicular articulations and other joints.

Icing down joints helps reduce inflammation and heat in a joint. It is thought that the cold slows the enzymes that produce inflammation and also has a rebound effect. The rebound effect is that when an area in the body gets really cold it decreases the blood flow to the area but when it warms up it excessively increases blood flow to the area. Icing after strenuous exercise has been shown to reduce joint inflammation.

Other preventatives such as joint supplements containing glucosamine HCL and chondroitin sulfate, manganese, vitamin C, and some containing MSM (methylsulfonylmethane) and other substances have been on the market for many years. Many of these products have varying amounts of these ingredients. Many of them have not complied with FDA ingredient-recognition processes nor does FDA seem to care for the most part. With that said, use only quality reportable products or you may not be get what you pay for. Many of these products make claims of reducing inflammation, protecting cartilage, etc. but it is illegal for any of these products to make claims for treatment of any thing because they are not drugs and have not been approved.  There have been many studies involving glucosamine HCL and chondroitin sulfate. There has been conflicting results, some say they do work and help reduce lameness and protect cartilage and some say they do not help. What they do know is that glucosamine HCL works better with chondroitin sulfate then each product alone. All and all, if you feed it and it works with no side effects then use it.

Treatment

NSAIDS are non-steroidal anti-inflammatory drugs which inhibit some component of the enzyme system that converts arachadonic acid into prostaglandins and thromboxanes better know as COX1 (cyclooxygenase) and COX2 inhibitors. Some NSAIDs also claim to be lipoxygenase inhibitors. In short, they are drugs that stop or reduce inflammation by slowing or shutting down the accepted inflammatory cascade called the arachadonic acid cycle thus reducing inflammatory mediators that cause pain, heat, and swelling of the joint and other parts of the body. The complete understanding of the mechanism of action for reducing pain is not yet complete. Reducing inflammatory mediators also reduces the mediators and enzymes that breakdown cartilage. Not all NSAIDS are alike and are there are too many to go over. Each one works differently and anecdotally are used for different aches and pains. They can be given as a prophylactic but are usually used to reduce arthritis and other pains but of the possibility of toxicity, most notably ulcers.  These drugs do work well and will be a part of arthritis treatment for many years.

 Adequan® is the only product that has been approved to be chrondroprotective to be given in the muscle or in the joint (Adequan® IA.). This product is a PSGAG (polysulfated glycoaminoglycan) which has been proven to decrease inflammatory mediators in the joint and protect cartilage during an inflammatory insult. This product is now being tested for it’s efficacy in protecting the horse against osteochondrosis. For a side note, there are no generic PSGAGs. Those products such as acetyl-D-glucosamine and Chondroprotec (FDA approved as a wound treatment device) are not the same as Adequan® and are proven to be less effective.

Oral sodium hyaluronate (HA) has recently common on the market for both treatment and preventative. It has been show in many studies to increase HA levels in the blood. The problem is that they have not been proven to increase HA levels in the joint. Even though research has not been completed on the products efficacy, many people use it for their horse and themselves and have good results.

Intravenous and intra-articular HA are used for treatment and prevention of arthritis. HA is a component of synovial fluid and articular cartilage in normal joints. It is synthesized by the cells of the synovial membrane and of articular cartilage. It provides lubrication, reduces inflammation (controversial), and is part of the structure that makes up cartilage. Given in the vein (Legend®) or in the joint (other brands), it has been shown to reduce lameness and synovitis. Even though given alone into a joint it works by itself, it works better when given with a corticosteroid.

Corticosteroids are drugs that shut down the arachadonic acid cycle completely. Thus it also shuts down some needed mediators the help protect and rebuild things in the body. Used in the proper way they are very useful in decreasing inflammation. Use excessively, they can cause many problems with repair of the body, ulcers, laminitis, etc. It is used in an arthritic joint many times in conjunction with HA but can be used alone.

High energy shockwave is being used more these days to treat arthritis. Shockwaves (too be simplistic) is energy. There are 3 mechanical devices available at this time to produce shockwaves some are good and some are not as good. When the energy passes through tissue and fluids it is released along the way at different tissue interfaces. For example, the shockwave will travel through a fluid with out losing much energy but at an air pocket it will completely release all energy. The shockwave has been shown experimentally and anecdotally to decrease inflammation, increase new blood vessels to the area, and have an analgesic effect (pain killer). More is needed to be learned about shockwave but it is an important tool against arthritis.

When cartilage erosion is evident or suspected, surgery is used. Most notably is arthroscopy for removing cartilage and bone chips in the joint. By removing the chips in the joint you remove some if not all of the source of the inflammation in the joint. At the same time, the joint is washed which will help decreased the inflammatory mediators and let the doctor see the cartilage surface which will help him make a prognosis and a treatment plan. Early intervention helps to lessen the destruction of the joint.

When a joint is so arthritic and other treatments are not working, surgery is the only option. The goal is to make the horse comfortable by fusing the joint and in some cases removing the nerves that go to the joint. There are many surgical procedures but are to in depth for this article. Some of procedures involve LASERS, metal plates, de-nerving, drilling, etc. Talk to your boarded surgeon for details and options.

This article is just a simplistic overview of some preventatives and treatments for arthritis. An in-depth study can be found in many different textbooks and scientific articles. There are thousands of studies that have been done on arthritis and at this time there is no “magic bullet” to treat or prevent arthritis. Recent research is focusing on early affordable detection of arthritis before it starts. Products such as gene chips, ELISA kits, and genetic typing are currently being researched. With earlier detection and a more precise understanding of what factors and mediators cause arthritis, there will probably be a drug that prevents it in the future.

This is a great question that I wish more people would ask.  The first thing I like to know from my mare owners is what they are looking for in a stallion (breed, temperament, discipline, marketability, etc.).  This question will help you narrow down your search before you dive any deeper.  I recommend before settling on one stallion you should go see the stallion, get a video, and/or see his offspring in action.  This will only help you determine the attributes this sire may posses and pass on to his offspring.  Make sure the stallion you choose compliments your mare’s qualities.

Once you have seen the stallion or his offspring and you have decided on a particular stallion next you need to investigate into the breeding fees and contracts.  Find out exactly what the “stud fee” or “breeding fee” includes.  Some places this fee includes the non-refundable booking fee. This is the fee that holds a spot in the stallion’s book for you to breed this year.  Other “stud fees” do not include the booking fee and is an extra fee you may not be counting on when budgeting for breeding.  Find this out first before signing a contract.  Look carefully at the contract for any hidden fees such as chute fees, handling fees, packaging fees, etc.  These small fees can add up quickly.  A stallion may only have a $500 stud fee but may also have a $250 booking fee, and a $100 chute fee per collection.  So your one collection may end up costing you $850 without any vet fees on your end. 

Does the stud fee include the first collection and shipment of semen?  If not this is another fee you need to factor into the total cost of breeding your mare.  Most stud fees do include the first collection and shipment but do not assume this is the case with all stallions.  Are you breeding with shipped semen?  If you are then there are another slew of questions that need to be asked if they are not already answered in the contract.  What days are the stallions collected for shipment?  This is important for the timing of when your veterinarian needs to be on the farm to check your mare and order semen.  How is the semen shipped?  Is it overnight via FedEx, UPS, DHL, or is it counter-to-counter through an airport?  If your closest airport is four hours away and he has to be shipped counter-to-counter for same day delivery you have to determine if you want to make that drive.  For overnight shipments I prefer that it is shipped directly to your veterinarian.  They normally have regular UPS or FedEx deliver days and can schedule their day better knowing they do not need to come to your farm until the semen arrives at their clinic.  How much notice do you need to give the stallion owner prior to ordering semen?  Most require 24 hours notice so they can make arrangements of how to plan the day and how many containers they need to ship.  They can start the paperwork the night before making packaging the day of shipment go a lot smoother. 

I do not mind for people to ask me if my stallions ship well and if they have good conception rates.  I always recommend you ask this question of your stallion owners, even though you may not always get a straight answer, it will give you a better idea of how easy or difficult the process of breeding your mare may become.  If the stallion has a marginal to poor conception rate with overnight semen you may want to request a counter-to-counter shipment or on the farm breeding.

Let us assume you are taking the mare to the farm to be bred for either live cover or AI on the farm.  I would visit the farm first before making the final decision.  Is it a place you feel comfortable leaving your mare?  Are their extra fees for the veterinary palpations while she is at the farm?  Are there extra handling fees?  What tests/vaccinations does the mare need to have before coming to the farm?  Will the mare have turnout and is that extra?  Be specific as to how you want your mare cared for so you can be sure to find out how much those extra things may cost. 

These are just a few things to get you started.  Carefully look at the contract before signing it and sending in your booking fee.  If you do not feel comfortable looking at the contract and formulating questions to ask the stallion owner then find someone who can help.  I would recommend a veterinarian that is either boarded in theriogenology (reproduction) or one with a strong special interest in reproduction.  We spend our whole spring dealing with mares and stallions and have probably dealt with every situation you may encounter.  We can help guide you to make a decision that is best not only for you but also your mare.  This is why we are her so use us!  Now that you have your stallion lined up watch for an article on preparing your mare for the breeding season this February.  Best wishes for a successful and fertile breeding season!

There are no clear cut signs of the equine gastric ulcer syndrome (EGUS).  Each horse varies in their demonstration of signs of a gastrointestinal problem due to their inherent differences in pain thresholds.  Horses with a high tolerance to pain may not show any obvious outward signs of EGUS.  Horses with either severe EGUS or mild EGUS with a low tolerance to pain may demonstrate more outward signs of colic.  Some common mild signs of general gastrointestinal problems include:  depression, off feed, decrease in performance level, dull hair coat, weight loss, grinding their teeth, playing in their water bucket, flipping their lip, acting interested in food but not eating, or signs of colic after eating.  Moderate to severe signs can also include pawing, stretching, looking at their sides, rolling, kicking at their abdomen, as well as others not listed.

A good general physical examination by your veterinarian is the best way to start in figuring out what is going on with your horse.  There are many diagnostics that can be performed to rule out gastrointestinal problems.  Currently the only way to confirm EGUS is with gastroendoscopy.  This is where a long flexible endoscope is passed into the stomach to visualize the stomach lining and look for areas of irritation/ulceration.  If you suspect your horse is unthrifty due to gastric ulceration contact your veterinarian and they can guide you to your best diagnostic course of action.

There are many different treatment options for EGUS.  These treatments focus on either coating/buffering the stomach from the acids that are being secreted or decreasing acid production through altering the acid pump mechanisms.  The treatment of choice depends on severity of the condition and cost.  For mild, intermittent cases or where cost is a concern  simple use of generic antacids may be helpful if given before a meal and at least 4-6 times a day, however the dose for a horse can be quite high (150 -200 ml/treatment).  Sucralfate is used frequently in preventing stress induced ulceration in neonates but is controversial in the adult horse.  Either ranitidine or cimetidine can be used as the middle of the road treatment.  They are more expensive than antacids but can be administered as few as three times a day orally.  The top treatment is still omeprazole (GastroGard, Merial, Ltd.).  It is more expensive but is administered as a paste once a day.   Complementary treatment options can include several herbal preparations and homeopathic agents such as Nux vomica, licorice, peppermint, etc.  Be careful with the use of herbals in competition horses.  Some of the herbals may be prohibited by your breed organization during competition.  Be sure to check on this before starting any complementary treatment. 

These are just a few of the pharmaceutical treatment options available out in the market.  Let us not forget that dietary changes are crucial not only for treatment but also for prevention of EGUS.  Horses are constant grazers and use this form of eating as a way to produce more bicarbonate in their saliva to help buffer the stomach.  Therefore feeding horses small amounts of roughage multiple times a day is ideal for horses susceptible to EGUS.  Also decreasing the carbohydrates in the grains and switching to higher fat feeds may be helpful.  Calcium as in alfalfa helps to protect the stomach and some veterinarians may recommend feeding your horse a grass/alfalfa mix as your source of roughage.  Again the information listed above just scratches the surface of EGUS.  For more information on any of the treatments listed above or others not mentioned contact your local veterinarian.  Your veterinarian can guide you as to what is the best course of action for the treatment of EGUS in your horse. 

Many fractures can be fixed today that could not be repaired 5 -6 years ago. I don’t know what kind of tibial fracture your horse had but if it was in an adult horse it was probably a fracture that was comminuted and compound (in many pieces and broken through the skin.) The tibia in an adult horse is a very strong bone and in order to fracture the bone it takes a lot of energy and thus leads to the explosion of the bone into many pieces.  Horses have to stand up immediately after a fracture repair and if the bone can not withstand the weight of the horse then the fracture repair fails.

Long bone fractures (cannon, radius, tibia, and femur) in adult horses, even in a simple fracture, are very difficult to repair because the implants are not strong enough to hold the stresses the horse puts on the legs. With new technology in implants and improved techniques more fractures are able to be repaired. Just a few years ago and even now, most fracture repair devices are developed for people and small animals and not for horses. It appears that Barbaro’s fracture configuration was one that has a chance of repair and potential successful outcome. They also were using a new type of implant and a pool recovery system. With all this and a wonderful surgery team they were able to repair the fracture and get him back on his feet.

Many fractures can be repaired. Foals fractures usually can be repaired because they are light and can usually bear weight on just 3 legs if needed. Adult horses that bear weight on 3 legs tend to “break down” in the opposite limb, i.e. laminitis, suspensory tears, hoof abscesses, etc. Adult horse fractures that involve the bones from the carpus and hock down and skull bones can usually be repaired depending on the fracture configuration.

Prognosis for fracture repair depends upon joint involvement, the horse’s attitude, type of fracture, further secondary complications, and what is the horse’s expected usability. The best thing to do when your horse fractures a bone is to call your veterinarian immediately and keep your horse ‘quiet’. Also you can consult your boarded surgeon of choice if you have more questions.

 

Scott Reiners, DVM, Diplomate American College of Veterinary Surgeons

Mountain View Equine Hospital 

It sounds like your horse may have a condition call upward fixation of the patella. In some horses the patella gets stuck and it can not get unlocked. The patella is part of the stifle and it locks over top of the medial trochlear ridge of the femur or the inside part of the stifle. This is part of a mechanism that enables the horse to lock up its hind legs and “sleep” standing up. Some times this mechanism does not function properly in the hindlimbs. Some of the causes are too straight of stifles, weak quadriceps, muscle spasms, joint inflammation.

Many treatments are available to treat this problem. The most conservative approach is some analgesics and controlled exercise that will build strength in the quadriceps muscles. This is reserved for horses that only mildly lock-up and are not too painful to work. Some exercise programs may consist of water trendmill work, hill climbing, and more. Sometimes the joints are too inflamed for analgesics alone, so the stifles may need to be injected with anti-inflammatory drugs.  Internal blistering to the medial patellar ligaments and/or quadriceps muscles is another treatment method. This method consists of injecting strong iodine mixed with an oil and then injected in the area of the medial patellar ligaments which causes the area to form scar tissue. The formation of scar tissue causes a thickening to the medial patellar ligament and making it thicker and possibly short so that it can not lock-up. The down side to this method is that it can cause abscesses to form and can be painful.

 Another method that I have been using is the standing medial patellar ligament splitting. This method of treatment can be used for both severe and mild cases of locking stifles. It consists of inserting a needle into the ligament several times in certain places to cause the ligament to get thicker and possibly shorter. The down side to the treatment is that sometimes it has to be done twice. It is very affective with very little complications when done properly. I prefer this method of treatment.

The last treatment option is to cut the medial patellar ligament. This alleviates the stifle locking problem completely by letting the patella not being able to lock up. The down side to this treatment is that it causes a big lump of scar tissue on the inside of the leg, some horse can not sleep standing up, and it can cause further  joint problems in about a 100% of the cases. This method should be reserved until after other methods of treatment have failed.

Many times radiographs need to be taken in order to determine which treatments are needed to repair the problem. Sometimes arthroscopy is indicated if there are signs of joint lesions.

The first step to alleviating the problem is to consult with your veterinarian. Early repair is usually a faster recovery. 

I would start by getting a full breeding suitability examination (BSE) done on your mare.  Each part of the examination will help guide you how to best manage your mare for the coming year.  We start by performing a general physical and conformational examination.  Mares need to be in good body condition (5-7 out of 9) coming into the breeding season in order to have the best chance of conception.  We also want to make sure there are no physical reasons the mare may not conceive or be able to carry a pregnancy to term.  Next we perform an external examination on the vulva.  This is the first line of defense against bacterial infection in the uterus.  We want to make sure she is not a “wind-sucker” where she pulls air into the vagina.  We also want to make sure the vulva is not tilted forming a shelf that will allow manure to collect and contaminate the vagina possibly leading to a uterine infection. 

After all external examinations are finished we begin examining the reproductive organs.  We start with palpation per rectum of the cervix, uterus, and ovaries and ultrasonographic evaluation.  That will not only tell us if there are problems such as fluid or cysts in the uterus but will give us an idea of where the mare is in her reproductive cycle.  This will also give us a starting point for future examinations.  Even if no problems are seen on the ultrasound, I recommend performing a vaginal exam, uterine cytology, and uterine culture.  The vaginal examination will help us determine if there has been past problems that have lead to adhesions and scarring.  We can also examine the mare to see if she backsplashes urine and pools it in front of the cervix.  All of these can lead to problems getting the mare pregnant and foaling.  The uterine culture and cytology are usually required by most stallion owners prior to breeding.  Uterine cytology is where we take a sample of the most superficial layer of cells using a swab or cap of the culturette.  Cytology is performed to look for evidence of infection and inflammation in the uterus and complements the culture.  There is a risk of contamination of the uterine culture swab during the procedure.  If performing a culture alone it may be difficult to determine contamination from real infection.  Uterine cytology confirms that the bacteria grown on the culture are actually causing a problem. 

One last thing I like to do routinely on a BSE is a uterine biopsy.  The uterine biopsy gives us a look into the health of the uterine tissue at the superficial and deeper layers.  One reason for a biopsy is to look for evidence of deep tissue infection that may require more aggressive treatment.  The other reason and main purpose of the uterine biopsy is to classify the amount of uterine scarring present.  Dr. Kenny has formulated a nice classification system to identify the likelihood of carrying a pregnancy to term based on the level of scarring.  Excessive scarring to the uterus prevents adequate nutrient and oxygen exchange between the fetus and the dam which may lead to pregnancy loss. Owners may not want to pursue breeding their mare knowing she has less than a 50% chance of carrying the pregnancy to term or may opt for embryo transfer instead. If your mare has passed her breeding suitability examination and you are now ready for the excitement of breeding your mare.  The time to get started preparing your mare is now so call your veterinarian today to set up an appointment for a BSE.  Best of luck on a fruitful breeding season. 

There are two forms of shockwaves that are routinely used for treatment of horses, dogs and humans, extracorporeal shock wave and radial shock wave. Extracorporeal shock waves are pressure waves generated outside the body that can be focused at a specific site within the body. There are a few different ways of producing these waves. One of the most used methods is the use of piezoelectric crystals that are arranged in a cup or funnel form. The crystals are energized with a pulse of energy. The crystals then expand and create a positive pressure wave which is several times that of atmospheric pressure and then a negative pressure wave. These waves are created in nanoseconds. The radial shock wave is created by a projectile mechanism to stimulate a pressure wave much like a hammer hitting the top of an anvil and the energy is transmitted to the bottom. The pressure waves produced in this fashion are transmitted through tissue radially and the energy is released at the surface and decreases strength as it travels through the tissue.

Pressure waves travel through fluid and soft tissue and release energy at areas of different impedance. For instance, at a ligament or bone the energy travels through the ligament and bounces off the bone which can cause expansion of the soft tissue. If a pressure wave travels through soft tissue and hits air like in the intestines, it causes the full release of energy into the air/soft tissue interface and can injure the intestine. Almost like a mini explosion.

What does the pressure waves do to the tissue? There are several ongoing studies to find that out but what we do know is that it decreases pain, increases new blood vessels in the area, stimulates healing of both bone and soft tissue, fractures kidney stones, and decreases agents that cause inflammation. It was once thought that it caused micro fractures in bones but this has been shown not to be true. It is used in humans for blasting apart kidney stones with some success but it is questionable if it will break apart calcifications in the soft tissue of the horse.

What do we use shock waves for in the horse? We use shock wave therapy for tendon and ligament injuries, arthritis, heel bruises, heel pain, navicular syndrome, calcification deposits, back pain, bursitis, synovitis and to stimulate acupuncture points just to name a few things. Mostly we use it to decrease pain, swelling and to stimulate healing. We also use it in dogs with hip arthritis, stifle arthritis, back problems, and to help stimulate non-union fractures.

There is a wide array of uses for shock wave and treatment protocols are still being worked out. Most treatments are done with 2000 shocks and 3-4 treatments. Treatment intervals are about 14 to 21 days apart. The healing of an injury is not immediately seen but the analgesic effects can be seen in a very short time after treatment.

This is just a brief look at shock wave therapy. If you have any questions or concerns, you can contact your veterinarian or us at Mountain View Equine Hospital.  

Unfortunately not every type of abortion will show signs of an impending problem.  But before we get into that let’s first talk about things that may cause a mare to abort and then we can review signs of a pending abortion, treatments and future prevention to help you prepare for future pregnancies. There are lots of things that can cause a mare to abort that may not involve a reproductive problem.  Any stressor to the mare such as hauling, new horses in the environment, poor nutrition, etc. may compromise the health of the fetus.  The mare will usually hang on to the fetus until the last possible minute, sacrificing her own body condition for the developing foal but that is not always the case.  If the mare becomes ill from another reason such as colic, laminitis, pneumonia, as well as others this can also cause significant stress to the fetus and abortion.  You may or may not see signs of impending abortion in these situations.  Herpes virus is usually the number one cause of infectious abortion in the mare.  The mare will not usually show signs until one visualizes a fresh fetus in the stall.  Upon investigating the abortion, there is usually a history of new horses, young horses, or sick horses in the recent past on this same farm.  The pregnant mare once exposed to the Herpes virus if not protected through vaccination may abort.  Bacterial and fungal uterine infections (placentitis) are usually the next most common cause of abortion.  Placentitis will almost always give you a sign that something is wrong prior to abortion.  These signs will be discussed below. How do you know there is a problem with your mare?  Of course if your mare is severely underweight one should worry about a potential loss of the pregnancy as the fetus undergoes rapid development in late pregnancy.  If the mare has been sick or if she undergone surgery recently one should also be more concerned with the health of the pregnancy.  Some other more specific signs of a problem are colic signs, off feed, fever, vulvar discharge, and early lactation (bagging up).  Any or all of these signs should send up a red flag to have your mare examined by a veterinarian to make sure the fetus is healthy.  During examination of your mare, your veterinarian may run tests to ensure the mare and fetus are healthy.   These tests may include bloodwork on the mare, transrectal ultrasound measuring placental thickness, transabdominal ultrasound to determine fetal heart rate, and estrone sulfate levels to assess fetal health.  It is always better to examine the mare as soon as you suspect a problem rather than wait until it is too late to save the pregnancy. If you do identify a problem what can you do to help maintain the pregnancy?  First thing you need to do is isolate the mare from other pregnant mares.  If this mare has a potentially infectious disease you want to minimize your other mares’ exposure.  Usually the other mares have already been exposed to the disease but I feel it is still better to be on the safe side.  If your mare is underweight, slowly start increasing her ration to a higher quality diet especially during the rapid fetal growth phase the last three months of the pregnancy.  If I am worried about a bacterial/fungal placentitis, I usually start the mare on an antibiotic/antifungal that is safe for the fetus and crosses the placental barrier.  Progesterone therapy may also help maintain a pregnancy.  If the placenta is compromised it may not be producing enough progesterone to keep the mare pregnant. These mares may benefit from supplemental administration of progesterone.  Any time a pregnant mare is stressed for any reason, I like to place them on progesterone just in case the uterine health becomes compromised.  There are other drugs you can also use to help increase blood flow to the uterus if the placenta is compromised and keep the uterus quiet.  It is best to get your veterinarian involved or contact a reproductive specialist prior to starting any treatment protocol. How do you prevent problems in future pregnancies?  Sometimes you can’t but here are a few things to keep in mind.  Always keep a close eye on your mare’s weight.  As soon as she begins losing weight you need to add in good quality hay and/or grain.  Good farm hygiene is a must!  It is best to keep pregnant mares away from your transient/moving population of horses and the young stock.  These are the ones that will expose the mares to viral infections that may lead to abortion.  Remember we (humans) are the biggest vectors for spreading disease.  I think it is best to feed your broodmares first prior to feeding everyone else in the herd to prevent exposure and keep your pregnant mares in a field by themselves.  If your mare has had problems in the past, prior to breeding again you may want to perform a complete breeding soundness examination to make sure the uterine health is sufficient to maintain a pregnancy.  During the pregnancy have the mare routinely checked with serial ultrasound and hormonal panels to ensure fetal well-being.  Abortion can be devastating emotionally and economically to an owner.  Trying to be prepared through prevention and knowing the signs are the first steps in the right direction!  My sympathies for your loss and I wish you the best of luck with your future breeding program! Wynne DiGrassie, DVM, MS, Diplomate ACT, CVA