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Health Tips

These client education articles are designed to give you good information on current topics in horse health.  They are meant to sort fact-from-fiction and to clarify and supplement owner’s research and knowledge.


Lyme's Disease in the Horse

Lyme Disease in the Horse: Keeping up with Evolution

Dear Friends,

Lyme Disease is considered the most important insect-borne bacterial infection in North America.  It is spread to mammals via the bite of specific hard-bodied ticks. The most common clinical signs observed in horses infected with Lyme disease are lameness involving multiple joints (75%) and behavioral changes (50%).  “Shifting lameness” is the most common presenting clinical sign, with a variety of other manifestations also reported.  Affected horses are in obvious discomfort and frequently unable to work. A diagnosis is difficult because of the many causes of equine lameness and the high incidence of sub-clinical infection in the equine population in endemic regions. A clinical diagnosis generally involves a physical examination, including functional and radiographic testing to rule out other causes of lameness, supportive serology testing, and response to treatment.

There is no vaccine approved for use in horses, but the vaccine marketed for dogs has been shown to be safe when used on horses. Veterinary researchers at Cornell University performed studies with an experimental vaccine that showed effectiveness in preventing disease in horses. Their study protocol is most closely imitated by the administration of three 1 ml doses of dog vaccine. The vaccine is administered alone (without other vaccines against other diseases at the same time), the second dose three weeks after the first, and the third dose three months after the first. We will administer the vaccine at the owner’s request, but it should be noted that this vaccine is not licensed for use in horses. The first year, three doses are required, followed by boosters every six months. Recent studies have shown that antibody titers from vaccination begin to decrease after six months, so boosters every six months are needed to maintain adequate levels of protection.

Susan Mende, DVM, ABVP

Read the full article here: Lyme Borreliosis (WCE)


Shockwave Therapy for Lameness

Shock Wave Therapy for Lameness – Keeping up with Evolution

By Dr. Susan Mende, DVM, Dipl ABVP

Don’t worry, this is not the shock therapy depicted in the 1970’s Jack Nicholson film“One Flew Over the Cuckoo’s Nest.” Although extra-corporeal shock wave therapy(EcSWT) won’t cure your horse’s emotionalor mental problems, it might be a treatment option for a number of your equineathlete’s orthopedic and soft tissue ailments. EcSWT is utilized for pain relief, stimulation of bone remodeling, andto improve blood flow at bone-tendon interfaces.
Extra-corporeal shock wave therapy (EcSWT) has been around since the 1970s. It’s earliest use was in human medicine to fracture bladder stones so they could pass without surgery. EcSWT has since become a therapeutic tool in human and veterinary medicine. Shockwaves are routinely used in Europe to treat common orthopedic conditions in humans including plantar calcaneal spurs (heel spurs), epicondylopathic humeri radialis (tennis elbow), epicondylitis humeri ulnaris (golfer’s elbow), calcifying tendinitis of the shoulder, and non-union fractures (Haupt 1997). Shockwave therapy is currently being evaluated by the Food and Drug Administration for similar use in the United States. The first use of EcSWT in the horse was reported in the late 1990s for treating proximal suspensory ligament desmitis and osteoarthritis of the hock. The development of this modality in human and veterinary medicine in the past 10 years has resulted in a fairly dynamic knowledge base. During the past decade there have been proclamations of wonder and disgusted claims of quackery regarding this form of treatment. Fortunately, the reality lies somewhere in between…

Read the full article here: Shock Wave Therapy for Lameness – Keeping up with Evolution



Colon Cleanse - Sand Colic

This is the recipe for a sand clearing equine colon cleanse. The first time that I did this myself I swore the horses would not eat it; if your horse doesn’t eat this, let me know but it will be a first…

Read the full article here: Colon Cleanse

Inject to Protect

Inject to Protect – WCEH Vaccination Programs

The goal of this program is to help us help you keep your horse’s immunization and health requirements in order. Because many of the contagious diseases of the horse are vector borne (carried by mosquitoes) or contracted by direct exposure, the timing of immunizations to offer maximum protection is paramount. We’re here to help you time it just right…

Read the full article here: Inject to Protect

Parasite Control

Modern dewormers rank near the top of advances in horse care made in the past 50 years.  Ivermectin became available in the early 1980s and had a dramatic effect on the prevalence of arterial larva and abdominal lesions due to parasite migration. However, horses that are not treated or are rarely treated with dewormers serve as reservoirs for large strongyle infections. Although the picture of a neglected equine comes to mind, many times it is instead a conscious decision of a loving owner who wants to avoid chemicals in their horses and building a resistant population of parasites on their farms.

By utilizing the fecal egg count, you can capitalize on the individual animals that have build a natural immunity to internal parasites and find the ‘shedders’ in your population.  According to recent research, 20% of horses carry 80% of parasites. If you can figure out which horses those are by doing fecal egg counts, you can target them.

Read the full article here: Parasites

Vaccination Needs

Vaccination Needs: Shot in dark?

Your equine partner brings you joy, and you repay that debt by providing the best care, including comprehensive vaccinations.  With contemporary vaccines rendering many diseases uncommon, it is easy to forget how awful those diseases can be.  Few things protect your horse as easily and effectively as immunizations.  Each year new discoveries are made not only to address specific pathogens, but also to formulate new methods for stimulating or enhancing immunity.  For the first time in recent history, we can say that the quality of our equine vaccines truly do depend on the maker (manufacturing company).  We endorse a Boehringer-Ingelheim vaccine, which offers aBreathe Easy Vaccination Guarantee to all of our owners if their horses are vaccinated appropriately by our veterinarians.  A brief rationale regarding the choices we have made on your behalf to help protect your horse is provided in the extended article.  Click on the PDF document below for more information.

Read the full article here: Vaccination Needs


Equine Metabolic Syndrome (Insulin Resistance)

Horses are relatively free of many of the health concerns that afflict people.  They don’t tend to develop high cholesterol, heart disease, or various other ailments common in our human population.  However, one by-product of the modern equine lifestyle for many of our horsey friends is their tendency to put on extra weight.  In horses as with people, obesity increases the risk of several serious health problems. There are obvious concerns about exercise intolerance, soft tissue strains and the effect on their joints of the heavy load.  Obesity also has other systemic effects, one of the most serious is insulin resistance (IR), a condition similar to adult onset (type-2) diabetes in people.  Left unchecked, through a cascade of metabolic effects, IR can evolve to Equine Metabolic Syndrome (EMS), a condition defined by the presence of obesity, insulin resistance and prior or current laminitis episodes.

Recently there has been substantial interest in the implication that insulin resistance, left unchecked for years and years, can lead to Pars Pituitary Intermedia Disease (PPID) or Equine Cushing’s Syndrome.  It is now believed that the development of insulin resistance in obese horses leads to the development of a pro-inflammatory state throughout the vasculature, which is the case in the human metabolic syndrome.  By doing so, IR may, in turn, promote the risk of laminitis, and obesity and IR represent risk factors for the development of PPID in horses and ponies.

Prevention is the preferred approach to this syndrome, if possible. Feeding a sensible, balanced diet and providing the horse with sufficient exercise to keep it from becoming obese. A more in-depth discussion on this topic is provided in the extended article.

Read the full article here: Equine Metabolic Syndrome.

Equine Polysaccharide Storage Myopathy (EPSSM)

The condition termed “Monday Morning Disease” (MMD) was recognized in Draft horses in the days when horses preformed the every day duties now performed by cars, trucks and tractors.  These days MMD is less common, probably because horses are generally not asked to perform the same amount of work as their predecessors (although still occasionally seen in Amish and pulling horses). The recognition that MMD reflects an underlying myopathy rather than being simply a management problem resulted in a whole new way of looking at horses with muscle disorders.

Although the pathologic findings characteristic of the disease now called Equine Polysaccharide Storage Myopathy (EPSSM) had been described sporadically in the veterinary literature, those early studies of muscle disorders and the evaluation of muscle biopsies didn’t seem to hold any unifying theories.  Then a landmark study by Valberg published in a human journal in 1992 recognized that polysaccharide storage myopathy (PSSM) was the underlying cause of recurrent exertional rhabdomyolysis (ER) in a particular group of Quarter Horse-related breeds.  Valentine then reported on an equine polysaccharide storage myopathy (EPSM) in Draft horses with a wider range of clinical signs, including severe ER, progressive weakness with muscle atrophy, abnormal pelvic limb gaits and shivers.  As there was no proof that these were different disorders, and given that this disorder had been found in Draft-QH crossbreeds with ER, the acronym EPSSM, for equine polysaccharide storage myopathy, was deemed an appropriate compromise. A more in-depth discussion on this topic is provided in the extended article.

Read the full article here: EPSSM

Exertional Rhabdomyolysis (Tie-up)

Muscle disease in horses, especially working horses, has been recognized for well over 100 years.  The condition termed “Monday Morning Disease” was recognized in horses in the days when horses performed every day duties now performed by cars, trucks and tractors.  Although it was recognized for years to involve a high grain ration and lack of exercise, decreasing grain and providing daily exercise were no guarantee that this disorder might not still occur.  The recognition that it reflected an underlying myopathy rather than a simple management problem has resulted in a whole new way of looking at horses with muscle disorders.

Exertional rhabdomyolysis (ER) literally means the dissolution of striated muscle with exercise.  It is now believed that many cases of ER are attributed to one of two underlying causes, both thought to have a genetic basis: 1) a defect in intracellular skeletal muscle calcium regulation in Thoroughbred and Standardbred racehorses, or 2) equine polysaccharide storage myopathy (EPSSM) in Quarter Horse, Warmbloods, Draft breeds, and their crosses. A more in-depth discussion on this topic is provided in the extended article, and a supplemental article about EPSSM.

Read the full article here: Exertional rhabdomyolysis

Equine Gastric Ulcer Syndrome

Despite modern emphasis and attention, gastric ulcerations in the horse are not necessarily a new disease; they have been observed at necropsy for decades.  These lesions were not considered significant, did not accompany signs of gastrointestinal distress, and were previously judged as incidental.  Due to the availability of longer endoscopes, a large number of publications appeared in the literature in the early 1990s, and those early studies indicated that up to 90% of horses in training had erosive and ulcerative lesions of the squamous mucosa of the stomach with varying degrees of severity.  From the collaboration of these early studies, the presence of gastric ulcerations has been further defined, refined to location and graded by degree of ulceration.  A modern breakdown of equine gastric ulcer syndrome recognizes three (3) categories of ulcers and grades them on a scale of 0-4.  Obviously, interpretation of early publications without the benefit of this evolved understanding is now challenging, as many early studies did not separate ulcer location or severity in the reporting of their findings.

The question arose concerning the similarity between equine gastric ulcer syndrome (EGUS) and gastric-esophageal reflux disease (GERD) in humans.  That is, are these horses suffering from what humans would complain of as “heartburn”?  The body of research that intended to answer that question made a huge contribution to a newer understanding of this syndrome in the horse.  A more in-depth discussion on this topic is provided in the extended article.

Read the full article here: Gastric ulcerations

Pituitary Pars Intermedia Disease (Cushings Disease)

In 1932, Pallaske reported a condition in geriatric horses that resulted in a long, curly hair coat and an enlarged pituitary gland.  This disease, known as Equine Cushing’s Disease, or re-named as Equine Pituitary Pars Intermedia Dysfunction (PPID) is now commonly recognized in equine practice, partly because of the increasing geriatric equine population.

The classic sign of PPID in horses is hirsutism, a long and curly hair coat that fails to shed.  The presence of late-onset hirsutism in an aged horse or pony is essentially diagnostic for PPID.  Other signs include elevated body temperature, depressed immune system, hampered protein and fat metabolism, dental abnormalities, polyuria, polydipsea (increased urinating and drinking) and hyperglycemia.  Another clinical sign is persistent lactation and infertility.        Chronic, insidious-onset laminitis is perhaps the major clinical complication of PPID. Most PPID horses are insulin resistant.  It is speculated that the excess cortisol and high circulating blood glucose increases the risk of laminitis through several mechanisms.  Individual management becomes essential.  This should include quality nutritional support and aggressive deworming protocols.  Providing frequent, high-quality hoof and dental care is critical, and affected horses should have their hair coat clipped according to the weather.  A more in-depth discussion on this topic is provided in the extended article.

Read the full article here: Cushings Disease


Equine Artificial Insemination

Artificial insemination is a more controlled way to breed horses than other methods and allows your mare to stay home along with broadening the scope of stallions available.  A mare’s estrus (‘heat’) cycle needs to be synchronized for the shipping of the semen.  This involves a veterinarian to monitor the mare’s cycle and manipulate if necessary.  Insemination with shipped-chilled or frozen semen in performed as a scheduled event.

Read the full article here: Artificial insemination


A leading cause of infertility and subfertility in mares is inflammation of the inner lining of the uterus.  Endometritis can be diagnosed by collecting an endometrial swab and smear samples for bacterial culture and cytology. Many mares show no signs of inflammation before breeding but fail to resolve the inevitable endometritis that follows the act of breeding. Evaluation of the uterus post-breeding is a crucial time to assess all mares.

Read the full article here: Endometritis

Foaling Mares

The birth of a foal is a swift, explosive happening. It is very different from the birth of a human or a calf, in which labor can be long and protracted.  There are generally considered to be three stages of labor in mares.  The first stage of labor can slip by quickly and quietly. Many of the signs of the first stag of labor are similar to those of mild colic, so be careful to distinguish true labor from colic.

The second stage of labor is distinguished by ‘breaking water’. When the placenta ruptures, the sound of rushing water may be accompanied by the appearance of a small amount of fluid.  The mare will lie down and have forceful contractions.  If all is going well, the force of nature will continue at its own pace, but the foal will come rushing from the mare quickly.  If you suspect something is awry, call a veterinarian immediately, time is of the essence.

The third stag of labor is the shedding of the placenta, which often subjects the mare to the most intense and prolonged pain. Once the mare has passed her placenta, save it for the vet to examine at her mare wellness exam.  If the placenta does not pass within 6 hours, call your vet.  Retained fetal membranes is an emergency.

Read the full article here: Foaling mare

So Your Mare Isn't Pregnant

If the end of the breeding season finds you disappointed and frustrated because your mare isn’t pregnant, don’t despair. Let the advantage of hindsight and the opportunity for advance planning for next season aid your future success.  A full reproductive examination is important in determining a mare’s potential for becoming pregnant in the first place, and should be re-visited to detect or treat problems that may have arisen during the season and could hinder future fertility.  Evaluations, such as cultures and biopsies, may need to be repeated.  When making decisions about a mare’s reproductive future, all aspects of the mare should be considered.

Read the full article here: So Your Mare Isn’t preg

So You Want to Breed Your Mare

Reproduction in the mare can be a tricky business.  It is important to evaluate your mare’s health status and fertility type early in the program.  Monitoring the estrus (‘heat’) cycle to know the right timing of breeding is paramount.  Some mares will show signs of heat and others may be silent or unable to be ‘teased’.  Hormone injections combined with veterinary evaluations are used to manipulate and monitor the mares cycle and find the right time to breed.

Technology today embraces breeding with artificial insemination via fresh chilled stallion semen that is shipped overnight or frozen (cryopreserved) in liquid nitrogen and stored at a breeding facility, along with more natural methods such as pasture breeding and live cover.  Depending on the method chosen, breeding can become quit costly.  The Breeder’s Balance Sheet is provided to help estimate these costs.

Read the full article here: So you want to breed your mare

The New Foal

The first step in evaluating a foal’s health is knowing what is normal and what is not.  Normal foals are vigorous and don’t require naps like human babies.  Elimination troubles are common in newborn foals.  Foals that demonstrate excessive sleepiness or fatigue may be ill.  Perhaps the first sign of trouble would be if the foals limbs or body seems askew – a crooked leg, over-sized head or misshapen jaw.  Premature foals are usually weak, small and underdeveloped.  In coordination can be a sign of a troubled foal.    A sick foal’s attention is turned inward and the foal will become progressively less able to respond to the outside world, with strength sapped and so is the willingness to eat, play and carry on other normal activities.  Quick recognition and treatment is key to helping a foal that makes a false start.

Read the full article here: New Foal