Category: EQUINE

Sweet itch is a common disease of horses in summer causing them to rub their mane, tail and body. It is caused by a hypersensitive reaction to the saliva of the female Culicoides midge. Affected patients can suffer from frenzied itching of the mane, tail, head, poll and abdominal areas. This results in loss of hair/fur, skin thickening and in severe cases, open wounds from self-trauma.

How can you manage it?

There are three main approaches to approaching/managing sweet itch: midge avoidance, soothing creams/shampoos and medications.

Avoidance is better than cure so the most effective method is midge avoidance. This includes:

• Stabling mid-afternoon to mid-morning, as midges are most active dawn to dusk.
• Using fans in the stables to help reduce midges.
• Choosing open (windy) fields, avoiding woodlands and areas of standing/stagnant water.
• Keep muck heaps away from grazing.
• Using full fly rugs, to provide a physical barrier.
• Fly/midge repellents, especially those with contain permethrin or cypermethrin which should last a couple of days- we can provide small bottles of these on request, which will dilute to 500ml of repellent.

In mild clinical cases, topical management through the use of soothing creams/shampoos on affected areas is generally the first port of call. While these products do not treat the problem, they improve the comfort of the affected patient. Oatmeal containing products are gentle and soothing for irritated skin. Benzyl benzoate can also help, but be very careful if the skin is broken as it can irritate these areas. There are also a number of prescription-only topical medications which can be prescribed by your vet.

Medical treatments

Antihistamines may/may not be of assistance in such patients. Use is off licence in horses and the response is very variable with some horses showing improvement in clinical signs whereas in others, no response is noted.

In severely affected patients, oral or injectable medications, the most efficacious being steroids, are required to control the allergy.

Finally, allergy testing is an expanding area, which can be coupled with desensitisation therapy. If you are interested in going down these routes, it is worth discussing it with one of our vets for more information as it is a complex topic. On a similar note, some people use a ringworm vaccine to try and reduce the signs of sweet itch. Some owners report a good response; however, there is limited evidence it is effective, especially as ring worm and sweet itch are two very different disease processes. Again, if you are interested in this, it is worth talking to our vets.

Ultimately the best but most difficult management method is controlling a horse’s exposure to midges; however, as per the above, there are other options available to help manage the disease when this isn’t enough.

Under a general anaesthetic, concsciousness is lost preventing pain and stress to the horse before, during and after major surgery. Horses that are to undergo surgery under general anaesthesia are admitted to the clinic the day before their procedure. They will be thoroughly assessed to detect any potential risks. This involves examining the heart, lungs and checking for signs of infection. Based on the assessment the anaesthetic plan will be modified to suit the horse. The horse will be weighed to ensure accurate drug dosages are given.

Horses are sedated to reduce stress while its neck is clipped and a catheter placed to allow safe access to the horses vein throughout the operation. If the horse has shoes then these will also be removed to minimise injury to itself, with the feet scrubbed to prevent contamination of the theatre and surgical site.

The horse will then be sedated further and carefully walked into our specially designed induction/ recovery box which has a padded floor and walls to help prevent injury.  A padded head collar is applied to prevent injury to the head and face on induction. 

Two vets induce anaestheisa via an injection and ensure the horse is guided down as safely as possible.  Once anaesthetised (unconscious) a breathing tube is placed via the horses mouth into the airway so that anaesthetic gases and oxygen can be inhaled throughout the surgery to keep the horse anaesthetised and safely immbolised. 

The horse is then transported into theatre by a mechanical hoist, where it is placed on a padded mattress to help support the horse’s weight and muscles during the surgery. Monitoring equipment is also applied to the horse to allow the anaesthetist to observe the horse’s depth of anaesthesia and monitor its breathing, eye reflexes, blood pressure, heart rate and rhythm. 

Once the surgery is complete, the horse is carefully transported back into the recovery box which is kept warm and quiet to allow for a safe and easy recovery. The horse will usually be on its own in the box at this point as movements can be unpredictable, making it dangerous for people to be in with it.  However, the anaesthetist closely monitors the horse during recovery via CCTV allowing them to intervene if required. The surgery is only considered complete when the horse is safely standing up.

Jess Watson BSc BVSc Cert AVP MRCVS
Veterinary Surgeon

Squamous ulceration and glandular ulceration are considered separate disease entities and whilst the risk factors for squamous ulceration are well publicised, further research is required for glandular ulcerative disease. By knowing the risk factors for ulcerative disease, we can endeavour to develop prevention strategies. In some horses, it is impossible to ascertain the trigger factor but ongoing care with diet, management and reduction in stress are of paramount importance regardless. 

1.      Diet 

As we will have previously discussed, access to fibre, little and often, is very important for the prevention of gastric ulceration. Horses should have access to grazing, ideally with companions, and whilst stabled, receive access to hay/haylage. Many people interpret this as a licence to over feed horses and this is certainly not the case. In those horses that are overweight, the recommended quantity of hay should be divided out over a 24-hour period, ideally as 4-6 feeds and not given as one feed only. Hay may be soaked and double netted to slow ingestion speed.  

If feeding bucket feeds, select low starch/sugar feeds. A number of suitable feeds are available and we are more than happy to discuss this with you on an individual basis.  

Corn oil has varying scientific evidence and as such goes ‘in and out’ of fashion but may reduce gastric acidity. But remember, corn oil is calorific so may not be suitable if your horse is carrying too much weight as it will result in further weight gain.  

2.      Water restriction & over supplementation with electrolytes 

Are also considered risk factors for the development of ulceration. Ad lib water should be provided at all times and if using electrolytes, these should be used judiciously and added to feed.  

3.      Intense Exercise 

Intense exercise is another risk factor for squamous ulceration. As exercise intensity increases, so does the incidence of squamous ulceration. Remember to feed a handful of hay/alfalfa 15 minutes before work to increase the fibrous matt in your horse’s stomach and in turn, reduce acid splash.  

4.      Stress 

Stress is inevitably a contributing factor to gastric ulceration. Horses are herd animals and as such should have companions and freedom to display natural behaviors including access to turn out alongside their companions.  

Stable enrichment should be considered for periods your horse is stabled- stable mirrors, treat balls etc. A number of commercial calmers are also available with varying degrees of success in individual patients. 

5.      Supplements 

Lack conclusive scientific evidence but a couple of new products have been released as of late. It is too early to comment on our experiences just yet but watch this space! 

Toby, a 7 year-old, Cob cross pony presented to Oakhill with a several week history of mild, right forelimb lameness. Despite a short period of box rest and pain-relief, the lameness did not resolve, and a veterinary opinion was sought.

Nikki Platt, our senior lameness veterinary surgeon examined the pony and noted that the pony’s front feet pointed in slightly, and that the outer walls of his hooves were slightly longer than the inner walls. When observed moving, Toby was sound in a straight line, 3/10 right forelimb lame on the left rein and 2/10 right forelimb lame on the right rein. The lameness was slightly more obvious on a firm surface. The pony did not resent standing with his limbs flexed up, and this procedure (known as a flexion test) did not cause any increase in lameness.

In order to be certain of the origin of the lameness, diagnostic analgesia was performed (where local anaesthetic is used to remove pain sensation from an area). A palmar digital nerve block was used to de-sensitise the right foot. This caused the resolution of the right forelimb lameness, and the appearance of a mild left forelimb lameness was present when the horse was lunged. It is common when performing diagnostic analgesia that, having eliminated the most significant pain from the lame limb, the horse then begins to show lameness in the opposite limb, as the horse is a symmetrical animal after all!

Having conclusively identified the source of pain, x-rays of the feet were taken. In this case, the bony structures of the foot were unremarkable other than to identify a slight compression of the coffin joint space on the medial (inside) aspect compared to the lateral (outside). The lack of explanation for the cause of the lameness on the radiographs meant a need to assess the soft tissues of the foot by performing MRI (magnetic resonance imaging).

The procedure was carried out under mild sedation with the pony standing. Following the evaluation of the 400+ images of Toby’s feet we obtained, the diagnosis was clear – moderately severe collateral ligament desmitis (inflammation) of the coffin joint in both front feet. 

The collateral ligaments are responsible for stabilising the movement of a joint. If (like with this pony’s ‘toe in’ conformation) there is a slight twist in the limb, a joint can be loaded unevenly across its surface during weight bearing. This means that one or both of the ligaments may be subject to more strain than it is designed to take whilst stabilising joint movement. This repetitive, excessive strain leads to microscopic damage of fibres within the ligament, causing inflammation, pain and scarring.

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On the MR images pictured, the red arrows and circles indicate the damaged medial collateral ligament (with the green circles highlighting the comparatively normal lateral ligament). The damaged ligaments have an ‘increased signal intensity’ i.e. they have a brighter, whiter appearance, due to the infiltration of inflammatory fluid into the structures. The damaged ligaments are also larger, partly due to this fluid infiltration, and partly due to scar tissue being laid down.

MRI was crucial in this case to reach a diagnosis. In reaching a diagnosis, we were able to advise on appropriate treatment. In the first instance, this horse was prescribed six weeks of box rest with a gradually increasing walk exercise programme. The farrier’s involvement was also crucial in this case – the pony was trimmed to maximise the symmetry of the foot (the farrier was able to work from the radiographs provided) and shod in heart bar shoes to help to stabilise the way it was landing. 

After six weeks, the pony was greatly improved, showing just 1/10 right forelimb lameness on the left rein only. Having given the soft tissues adequate time to rest, a low dose of steroid was injected directly into the coffin joint, to resolve the mild inflammation that remained at the margin of the ligaments. One month later, the pony was sound!

Toby is now successfully building back up to his previous level of exercise, and is anticipated to remain sound with ongoing maintenance of good foot balance.

To continue our series on Winter medical conditions, in this newsletter, we are going to cover swollen sheaths and worming your horse at this time of year.

Swollen Sheaths

It is quite common for geldings/stallions to present to us with swollen sheaths over the Winter months. More often than not, sheath swelling results from the affected patient being stood in for prolonged periods of time which sadly, is inevitable with deteriorating weather conditions. Swelling should improve, if not resolve, with exercise/increased movement.

Other causes of swelling include excessive accumulation of smegma, low blood protein, infection and fortunately less commonly, infection secondary to penile tumours (squamous cell carcinomas). Fat can also accumulate in the sheath but this has a more gradual onset.

Should excessive smegma occur, then cleaning the sheath and penis is indicated. Sheaths should not be over-cleaned as this can disrupt the normal flora (bugs) that should be present to maintain ‘normal’ sheath health. 

Low blood protein can result from small encysted redworm and colitis to name but two potential causes. Diagnosis can be suspected based on history and compatible clinical signs but blood test results are confirmatory.

With infectious causes of sheath swelling, the sheath is firm, hot and painful to palpate. Your veterinary surgeon will examine and clean the sheath and penis under sedation in addition to prescribing antibiotic and anti-inflammatory drug therapy. 

Penile tumours sadly occur but fortunately are not terribly common. The tumorous growths vary in appearance from small white plaques to large proliferative growths.

Treatment options depend on the stage of the disease at presentation. Surgical removal is indicated, if possible.

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Worming

A common question we are asked at this time of year is ‘what wormer, if any, should I use for my horse?’

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At this time of year, we should cover horses for small encysted red worm (cyathostomes). Suitable wormers include a single dose of moxidectin (which is the drug found in Equest and Equest Pramox) or a 5-day course of fenbendazole (Panacur Equine Guard).

Sadly, due to overuse of wormers in the past, a huge amount of resistance to fenbendazole exists. This highlights the importance of practising responsible worming and seeking your vet’s advice to devise a suitable control programme for your horse.

A blood test for small encysted redworm has recently been developed. This means that we now have diagnostic tests available for roundworm, tapeworm and small encysted redworm. Testing for small encysted redworm should be performed between September and April. The test is not suitable for horses who have had high faecal worm egg counts throughout the rest of the year; these horses should be covered with a suitable wormer, as per above, regardless.

Keep your eyes peeled over the next 4-6 weeks for the launch of our 2021-2022 Equine Worm Control Plan; more information to follow! As always, if you have any questions on worming, please contact our team. 

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