Author: Julie Nuttall

We’ve all been there! Feeling frustrated that your horse won’t pick up the correct canter lead, or does he/she disunite behind in canter? Will your horse perform lateral work happily one way and not the other way? Does it struggle to use it’s hindlimbs correctly to provide power to the gait? Or does it have an annoying hopping like gait on the bends?! These are all complaints that we are used to investigating every single day. Did you know that we have talented riders amongst our nursing team who will happily ride your horses on our arena whilst we investigate the ridden problem? 

As horse owners, we know that our horses are desperate to please us most of the time! Don’t get us wrong, there is the odd occasion when they push their luck of course with a little bit of cheekiness, but on the whole they want to do a great job for us as their riders. So when they are objecting to what we are asking them to do, we need to stop and ask these questions: 

• Is my horse at a suitable age to be able to do what I am asking? 
• Is my horse adequately trained and prepared for what I am asking them to do? 
• Are there any external factors or management changes that could be impacting my horse’s ridden behaviour? 
• Am I asking something that is out with the athletic capabilities of my horse? 
• Could my horse be in discomfort? 

Sometimes, by simply examining the musculoskeletal status of your horse, we can help you to make adjustments to your feeding or training regime to help strengthen the weaker areas of the horse. Further investigation is not always warranted or recommended!

As highly trained professionals, we are here to advise you regarding the best way to proceed with your horse, that may be a bute trial, a lameness investigation, x-rays of the spine or gastroscopy……Horses are unique, and the way they present is unique, you are unlikely to find a solution to the problem on Facebook 🙂 and are often much better bringing your horse to our clinic for an initial assessment with one of our experienced veterinary surgeons in this field.

We are more than happy to begin a discussion with you by phone if you have any concerns about your horse’s ridden performance, we are always here to help.

New year, a fresh start. What better time to check our horses vaccinations and ensure they are up to date. Vaccination seems to be the word of 2021 but sometimes the information surrounding them can be overwhelming. Vaccines are important not only for preventing diseases but also for slowing disease transmission and reducing the severity of clinical signs.

Horses that compete or attend organized events require 6 monthly flu boosters. Vaccination amnesties were put in place in 2020 due to COVID 19. However, the major governing bodies have either since returned to 6 monthly boosters or are yet to announce 2021 regulations. We recommend to keep up to date with annual vaccines and when competitions return boosters can be administered if needed. Remember to always check with the organizers about their specific rules.

In the UK, horses and donkeys can be vaccinated against various diseases but the most common conditions to vaccinate for include Equine Influenza and Tetanus.  With reports of sporadic cases of equine flu in the north west area and a case of tetanus recently treated by one of our vets, here is a brief reminder of these diseases and what to look out for. 

Equine Influenza is endemic in the UK, it is a highly infectious virus that affects the respiratory system. It spreads rapidly among equine populations and can be passed on via direct contact or a contaminated environment. Equine flu can be a very debilitating disease, requiring a long recovery period and in rare cases can even be fatal.  Signs to look out for include: Fever, harsh dry cough, nasal discharge, loss of appetite and depression.

Tetanus is a dangerous and often fatal disease that can affect any horse or pony.  Clostridium tetani bacteria found in the soil can contaminate even a minor wound. The bacteria produce a toxin that causes muscle spasms, paralysis and death. Every horse or pony should be vaccinated for tetanus. 

If you are vaccinating for the first time or the vaccines are out of date, here is a reminder of the vaccine schedule: These vaccines can be administered in combination or separately.

Equine Influenza

• 1^st vaccination – Foals can start from 6 months of age
• 2^nd vaccination – 4 weeks later  (21- 92 days after the 1^st)
• 3^rd vaccination – 5 months later (150 – 215 days after the 2^nd)
• Annual booster – within 365 days of the last vaccine. 

Tetanus

• 1^st vaccination – Foals can start from 6 months of age
• 2^nd  vaccination – 4 weeks after the 1st vaccination
• 1^st  booster – 12 months later
• Subsequent boosters administered every 2 years

Other diseases that horses can be vaccinated for include Equine Herpes Virus, Equine Viral Arteritis and Rota Virus. Our Equine Care Plan’s make it easy and affordable to keep up to date with vaccinations.  Please call or send us an email if you have any questions regarding vaccinating your horse.

Growing up in Manchester I spent all my free time at my local riding school, and I was extremely fortunate to have my own horse and supportive patients who gave up their weekends to take me showjumping.

This hobby soon developed into my passion, and after completing a BSc Equine Science (Hons) with Hartpury College, I started my career as an Equine Technician at the Animal Health Trust, Newmarket.

After 5 years down South, I recently moved back home and began my new role at Oakhill Veterinary Centre. Day to day I look after our lovely patients and assist our vets throughout a variety of procedures and surgeries. I especially enjoy all things imaging, with my principle role being in the acquisiton of MRI scans.

I am working towards qualifying as an Equine Veterinary Nurse so spend a lot of my free time studying but when I can, I enjoy keeping fit and spending time with family.

Bonita is a lovely, 21 year-old Welsh Cross mare whose owners ensure that her teeth are regularly examined and floated. Several years ago it was noted that her 209 and 109 (4^th cheek tooth back on the upper right and left side) suffered from a condition known as infundibular caries. There are two infundibula in the middle of each upper cheek tooth, and consist of an enamel cup which should be filled with a material called cementum. In Bonita’s case this cementum was absent and food and bacteria had caused decay within the infundibula. As the disease progresses the two infundibula can merge leaving a weak point in the middle of the tooth, leaving it at risk of fracture and sequential apical (tooth root) infection.

To preserve the structural integrity of the teeth affected and to preserve the tooth for as long as possible Bonita’s owners decided to restore the infundibula. This involved removing all decayed material and food and filling the cavity remaining with a flowable composite material.

Unfortunately, Bonita’s caries was quite advanced so whilst the filling preserved the tooth for as long as possible (some years) one of the teeth did eventually fracture.

Here is an oroscopic picture of the tooth. As you can see there is a white composite which is the filling material sandwiched between two fragments of tooth. As the fragments have separated, food has travelled up between the two allowing infection to spread to the root of the tooth.

Stuart performed the extraction under standing sedation and a local anaesthetic nerve block which anaesthetises the entire right upper jaw.  Initially the gum is elevated from around the tooth. The gap behind and in front of the affected tooth is then spread using appropriately named ‘spreaders’. Forceps are then placed securely on the tooth and gradual left to right movements are made to stretch the periodontal ligament, which secures the tooth within the socket. When loose enough the tooth is then ‘fulcrumed’ (pulled at a right angle) out from the socket. The socket can then be fully examined and cleaned whilst placing a honey soaked swab to help the socket to heal.

An x-ray taken following tooth extraction shows no remaining root and lots of bony reaction surrounding the socket due to the infection and inflammation that will now subsequently resolve.

Bonita was soon back to eating hay as if nothing had happened. She was discharged home the day after the procedure on antibiotics and pain relief and we are pleased to report that after 4 weeks the socket has completely healed!!!

Horses cope incredibly well with extractions and only usually need 1 week off from ridden work. Bonita’s owners are continuing to keep a close on her for any evidence of further oral discomfort such as quidding and dropping of her feed.

Our horse’s thicker and longer coats over the winter months becomes an ideal breeding ground for lice, especially when we then cover them in a warm rug. The life cycle of the louse is complete within 4 weeks and eggs hatch 10 days after being laid. Eggs or nits are small (1mm), yellow-white in colour and glued tightly to the base of hairs.

Lice are incredibly contagious and can affect horses of all ages but those kept in large groups indoors, the elderly, young and those with immunosuppressive conditions such as malnourishment and Cushing’s Disease are at an increased risk.

The feeding nature of the lice causes intense skin irritation with horses becoming extremely itchy. This can lead to patchy hair loss and a scurfy coat. In severe infestations the horse or pony can become anaemic.

Lice can be readily spotted by parting the horse’s fur especially along the topline.

Treatment involves topical application of a permethrin or cypermethrin product applied twice at two-week intervals. In contacts should be checked and treated in addition to washing rugs, numnahs, head-collars at a high temperature.

Clipping should also be considered.

Remember, lice are species specific and equine lice do not live on human hair/skin

Lameness is a pain-avoidance strategy adopted by horses, and is a common cause of poor athletic performance and compromised welfare.  Whatever the precise cause of pain (e.g. osteoarthritis,  tendon injury), that pain is caused by inflammation. 

Inflammation is the cascade of chemical and cellular events that occurs following any type of tissue damage. By causing pain it alerts the animal to rest the damaged area, thereby preventing further injury. Inflammation also acts as the initial stimulant of the healing or repair process, hence it is extremely important. However ongoing, uncontrolled inflammation causes chronic pain and can actually exacerbate the tissue damage. This is where veterinary intervention becomes necessary.

Conventional therapies aim to stop the inflammatory process, and these remain a vital, cost-effective component of orthopaedic disease treatment.  However, they do not influence the repair of tissue and can occasionally delay this important process. 

‘Regenerative therapies’ aim to optimise the repair of a structure by replacing damaged tissue with tissue of the same cell type and hope to minimise the formation of non-functional scar tissue, hence maintaining the original biomechanical properties of the structure. This increases the probability of return to previous athletic ability, and reduces the likelihood of ongoing lameness and/or reinjury. 

Research and clinical trials of regenerative therapies have been ongoing since 2003, but there are now several exciting options that have been scientifically proven to modify inflammation and reduce pain in clinical trials, all of which are available at Oakhill.

Stem cells are a type of cell which have the potential to develop into a variety of more specialist cell types dependant on the environmental signalling that they are subject to. An embryo begins as a ball of stem cells that go on to develop into every type of cell required to make a mature being! Stem cells continue to be present within the body after birth in reduced quantities.

It is not fully understood how stem cells behave when they are used as a medical treatment – whether they differentiate into the same cell type as the tissue they are introduced to, or if they modulate the inflammatory process. Either way, they have been found to decrease or eliminate lameness when used to treat joint disease, and have the potential to reduce the reinjury rate when used to treat tendon injuries!

Autologous stem cells are collected from the individual horse that requires treatment. Bone marrow is collected (most commonly from the sternum) under sedation and sent away for complex processing to provide a product containing millions of stem cells. 

These cells are injected into core (central) lesions within tendons and ligaments.

Allogenic stem cells are produced from the blood of donor horses (treated to prevent reaction when introduced into the horse requiring treatment). These are purified to get rid of other blood cells and then cultured to increase the number of cells into the millions. They are specifically stimulated to give the ability to differentiate into chondrocytes – the cell type present in cartilage.

Commercially this product is available as Arti-Cell. This has proven highly successful at reducing lameness in horses with degenerative joint disease.

Interleukin-1 Receptor Antagonist Protein, more commonly referred to as IRAP, is a protein synthesised by a variety of cells. It prevents the actions of Interleukin-1 – a substance which has an important role in the induction and maintenance of inflammation within diseased joints. Studies in humans and horses have proved that intra articular IRAP injections reduce synovial (joint lining) inflammation and lameness.

IRAP is produced by collection of blood (from the horse to be treated) in a special syringe.  This is then incubated overnight before filtration to produce concentrated and purified IRAP. This can be frozen to allow storage of the product until an appropriate time for medication of a joint. This product can be of benefit where steroid medication is not appropriate (e.g. competition horses where steroid medication is prohibited, horses at risk of lamintis) or where joint pain no longer responds to steroid medication. There is also some evidence that the effects of IRAP last for up to two years!  

Platelet Rich Plasma, or PRP is simply defined as plasma (the none cellular component of blood) which has been processed to have a high concentration of platelets. It is rich in growth factors – substances which stimulate cell multiplication and tissue repair, therefore it promotes a favourable environment for healing. Like IRAP, it is produced by the specialist collection and processing of blood (from the horse to be treated). This can be done immediately prior to injection of the PRP into the area of damage. 

PRP is most commonly used in the treatment of ligament injuries that are not healing as well as anticipated. It is also occasionally used in the treatment of joint disease that has not responded to steroid medication or IRAP.

Polyacrylamide hydrogel (marketed for use in horses as Aquamid) is unlike other regenerative therapies in that it is a synthetic compound. It is the same material used as a cosmetic filler in humans! When injected into joints, it becomes integrated into the synovial membrane (joint capsule) which decreases joint effusion (overproduction of poor quality joint fluid) and stiffness. 

Clinical trials have indicated a high success rate with this treatment, whether used as a primary treatment or in joints that have failed to respond to other treatments. 

Overall, this is an exciting time for the treatment of equine lameness. If you wish to discuss the potential benefits of regenerative therapy for your horse, we would be happy to do so.

Infundibular Caries is the name given to a condition affecting the upper molars of some horses. Horses have many adaptations in their teeth designed to help with the rough nature of their diet. One of these adaptations is the ‘infundibulum’.

This is simply an extra area of enamel, one of the hardest compounds found in the body, filled with a softer cementum. Having more of this hard enamel is therefore ideal for grinding down rough tree branches in the wild! Occasionally, the area within this extra enamel doesn’t develop as it should, for reasons that are not completely understood.

The horse is therefore left with a hole within the tooth which fills with food. Over time this food can cause the tooth to rot resulting in either infection of the tooth or catastrophic fracture. You will be pleased to hear that both of these outcomes are completely avoidable!!

Regular dental examinations using a mirror, or an oral camera, enables us to visualise the surface of the teeth and detect these small but significant defects. Once detected, they can be investigated by probing and/or x-ray to determine the depth of the hole and the requirement for filling.

These holes can easily be filled, much like if you or I went to the dentist! Under standing sedation at our clinic, these holes are thoroughly cleaned out of all the rotten food and filled using a material that binds to the tooth. Once the hole has been filled, food can no longer become trapped and the tooth is no longer at risk of becoming infected or fracturing.

If you have any concerns regarding your horses dental health, please phone our clinic and ask to speak to one of our friendly team who can point you in the right direction! 

Colic

• Colic is a collection of clinical signs shown by a horse that indicate abdominal discomfort.
• Changes in management, especially if not made gradually, can precipitate episodes of colic.
• At this time of year, horses undergo a significant management change, coming in from pasture to spend prolonged periods of time in their stable.
• Therefore, we frequently see an increased incidence of colic cases.
• Fortunately, the vast majority of cases can be managed medically and although arguably, spasmodic colic remains the most prevalent form of colic that we see, impaction colic occurs at an increased frequency.

Impactions

• Impactions generally occur following the accumulation of food material, which subsequently dehydrates (dries out), in a horse’s colon.
• The colon’s pelvic flexure is the most common site for this to occur. The pelvic flexure is a part of the large colon which turns 180 degrees on itself and naturally narrows. The reduced speed of food material passing through this area means it is more susceptible than other areas to blockage.
• Other risk factors for impaction development include reduced grazing and increased hay/haylage in the diet, reduced exercise due to increased time spend confined in the stable, reduced water intake during cold/frosty periods and straw ingestion (if bedded on straw) to name but a few.
• Clinical signs of impaction colic include passing reduced amounts of, drier than normal, faeces over the preceding 48-72 hours to eventually passing no droppings at all, reduced appetite and signs of colic which vary in severity but can be relatively mild.
• Veterinary examination may reveal a normal/mildly increased heart rate, dry gums and prolonged skin tent. Gut sounds are generally reduced. Impactions of the pelvic flexure are confirmed on rectal examination. They are usually ‘doughy’ in consistency and sit in the left, lower abdomen.
• Treatment, similar to other forms of colic, includes the administration of pain relief and smooth muscle relaxants. In addition, the blocked food material requires rehydration. The most effective way to achieve this is by regularly administering an electrolyte solution via stomach tube. The administered fluid stimulates colon contraction and the fluid passes through the gastrointestinal tract to rehydrate the impaction stimulating it’s passage through the remainder of the gastrointestinal tract prior to evacuation from the body. For the majority of patients, monitoring and treatment of the impaction is carried out most effectively at our equine clinic. Depending on severity, impactions can take varying periods of time to resolve from 24-48 hours to 5 days. Food is withheld until the impaction has cleared and is gradually reintroduced starting with walks to grass and ‘sloppy’ bucket feeds.

Tips for preventing impaction colic (and colic in general)!

• Make dietary changes slowly over a 2-week period of time.
• Avoid straw bedding if you are concerned your horse or pony eats it.
• Try to maintain exercise. A walk around the yard is better than standing still in a stable.
• Ensure a ready access to fresh water- break ice regularly when temperatures drop- a tennis ball/apple placed in water may help reduce freezing. 
• Ensure your horse is drinking. Water intake can be increased by adding water to your horse’s feeds. Providing a salt lick will also stimulate thirst.

Mud Fever

• Mud fever is an infection of the skin usually affecting the pastern.
• The bacteria implicated (Dermatophilus congolensis), gains entry to the skin most commonly, following prolonged periods of wetting/standing in mud.  
• The resulting dermatitis is characterised by hair loss and crusting. Hair comes away in tufts bound by a scab/crust (known as paint-brush lesions).
• Minor cases may present as just a few scabs; however, cellulitis (subcutaneous skin infection) can ensue.
• Treatment is based on removing your horse from the wet/muddy conditions. Mild cases can be managed topically using a combination of anti-bacterial and steroid based creams. The affected area may also be clipped and cleaned using a warm dilute chlorhexidine solution. Different vets vary in their recommendations as to frequency of cleaning so please follow your vet’s recommendations. In moderate to severe cases, sedation may be required to examine, clip and clean the area in the first instance. In cases with secondary cellulitis, antibiotics and anti-inflammatories are also required.

Rain scald

• Rain scald is similar to mud fever, in that it is caused by the same bacterium following prolonged skin wetting, but affects the horse’s topline.
• Treatment mirrors that of mud fever.