Equine Health

December 2014

How To Prevent Impaction Colic

At is every horse owner’s nightmare to come outside to discover your horse acting uncomfortable.

Will Tildren Help Your Horse?

Article appears in our Nov./Dec. 2013 Issue
Written by Dr. Courtney Bowers and Dr. Jonathan Hirsch of Woodside Equine Clinic

As veterinarians, we are frequently asked about products to treat chronic conditions, subtle lameness or lameness that has not responded to other therapies.  One of the most exciting products to come along in the last few years is Tildren.  It is a medication that has allowed us to offer a novel therapy for some of the most chronic causes of lameness that are often unresponsive to other therapies.

How does it work?
Tildren, or Tiludronate for all you pharmacology buffs, is a non-nitrogen containing bisphosphonate.  The bisphosphonates are a class of drug that work at the cellular level to slow down or prevent bone loss.  Bone is constantly changing and remodeling based on the forces applied to it. Osteoclasts are specialized bone cells which resorb bone, while osteoblasts are bone cells which serve to lay down new bone, a process known as mineralization. Tildren is thought to regulate bone remodeling by reducing the activity of osteoclasts while increasing osteoblastic activity.  Bone loss is reduced, resulting in the maintenance of or increase in bone density and strength.   Tildren was first used in human medicine for treating diseases that cause bone loss such as osteoporosis and Paget’s disease.  Other bisphosphonate drugs include Fosamax, Boniva, Actonel and Reclast.  In horses, Tildren has been studied for treatment of navicular disease, osteoarthritis and lesions of the thoracolumbar vertebral column.

Navicular Disease
Navicular disease, or caudal heel pain, is seen most often as a low-grade front end lameness of both front feet.  The discomfort can be caused by changes to the bones as well as the soft tissues within the hoof.  The cause of navicular disease is still not well understood, and each individual horse may suffer from differing pathologies.  Often, the navicular bone itself is affected when it undergoes excessive bone degeneration or proliferation.  These changes can weaken the bone, causing pain in the back of the foot.  A drug that affects the cells that mediate bone resorption and proliferation like Tildren can therefore be helpful.  Clinical trials have shown that Tildren is effective in treating navicular disease when given at a total dose of 1 milligram per kilogram of body weight broken up into 10 daily intravenous injections.  A recent research study showed that 100 percent of horses suffering from acute navicular disease (affected by the disease for six months or less) responded to Tildren treatment, whereas only 60 percent of horses that had chronic disease (affected by the disease for greater than six months) responded, and that of the horses with more acute navicular disease, 75 percent returned to normal work within six months.  Therefore it’s very important that Tildren be given earlier rather than later in the disease process.  Although there was clear success in horses treated with Tildren in this study, it’s important to keep in mind that not all horses diagnosed with navicular disease have disease of only the navicular bone.  Therefore, Tildren, which treats bony lesions, may not help every horse with navicular syndrome.


August 2014

Skin Allergies: How to help your itchy horse

Skin allergies make our horses miserable, and by mid-summer, some of them have rubbed themselves raw. Read more about how to combat this aggravating condition

May 2014

When and Why does my Horse need Chiropractic Treatment?

Chiropractic therapy is becoming a more common addition to equine health care.

How to Treat and Prevent Scratches in Horses

“Clean and dry, clean and dry” is what I tell horse owners after treating a patient with pastern dermatitis.

March 2014

Equine Odontoclastic Tooth Resorption and Hypercementosis

By Emily McNally, VMD, Rappahannock Equine Clinic

Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a disease that has just recently been properly identified and named in the horse population. First described in 2006, it is a painful condition affecting mainly the incisors and canine teeth of older horses.

A horse’s tooth has an outer layer of enamel covered by cementum. The cementum gives grip for periodontal ligaments in the socket to keep the tooth in its place. Unlike humans and many other animals, horses’ teeth continuously erupt throughout life. They are able to do this through two steps: breakdown of the periodontal ligament attachment to allow the tooth to move and reproduction and subsequent re-attachment of the periodontal ligament. Odontoclasts are live cells in the tooth that cause lysis, or eating away, of cementum and tissues surrounding the tooth. When the attachment breakdown is overactive, the result is resorption or lysis of the tooth. Sometimes, other cells respond by exaggerating the re-attachment of the periodontal ligament, creating extra cementum on the tooth surface. Subsequent inflammation and infection of the teeth lead to decreased structural support which can result in gingivitis, pulpitis, and loose and fractured teeth.

The cause of EOTRH is not completely understood at this time. It is clear that chronic inflammation is somehow involved. One theory is that as a horse ages, the angulation of its incisor teeth puts more strain on the periodontal ligament, leading to increased inflammation. A study presented at the 2013 AAEP convention by Dr. Ann Pearson looked into associated risk factors of EOTRH. Excessive dentistry, periodontal disease, and horses fed alfalfa without pasture or grazing were more likely to have EOTRH, but more research is warranted.


January 2014

Causes and Treatments for Rain Rot

Written by Emily McNally, VMD   Rappahannock Equine Clinic

With winter upon us, we can be sure to see a fair share of wet days over the next few months. Wet weather brings a myriad of different skin conditions that can be frustrating for horse owners to deal with. One of these conditions almost all owners have to deal with at some point is commonly known as “rain rot” and is one of the most common skin infections seen in horses.

The organism Dermatophilus congolensis is the causative agent of rain rot. These bacteria can be found dormant on the skin of many healthy horses and do not pose a problem until the skin is compromised in some way or infection is exacerbated by weather conditions. There is a certain natural immunity to the organism, but as many owners have seen, some horses are more susceptible to infection and can get rain rot year after year. Horses with heavy winter coats keep moisture in contact with their skin, producing an environment for the organism to grow. When the skin is damaged, such as with an insect bite or scrape, Dermatophilus congolensis can infect deeper down into the epidermis.


December 2013

Care and Treatment of Equine Wounds

Written by Dr. Mike Stanford, DVM, Rappahannock Equine Clinic

From our Nov/Dec 2013 issue

If you have had horses for any length of time, there is one thing you may have learned: Horses and wounds seem to go together.  Our tack trunks seem to be filled with a variety of creams, gels, and ointments in the colors of the rainbow.  What is the best way to treat wounds though?  From little scratches to serious lacerations, wounds all follow the same healing pattern.  In this article we will look at how wounds heal and what we can do to get the best result possible.

Phases of wound healing

The inflammatory phase: Within moments of a wound occurring, the little blood vessels in the affected area constrict to limit the amount of bleeding into the area.  This effect is short-lived though, and within 5 to 10 minutes the vessels open up to allow blood and plasma to leak into the wound as well as white blood cells that have begun to accumulate.  A clot generally forms at this time to minimize the bleeding, to create a protected environment for healing to occur in, and to provide a framework or scaffold for future repair.  When this clot dehydrates, it forms a scab that will protect the wound from the outside environment.

The debridement phase: In this phase, the white blood cells that have been accumulating in the area of the wound begin the process of cleaning up.  Some of the white blood cells kill bacteria, break down debris, and enhance the inflammatory response. Others surround and engulf foreign material and damaged tissue.  These white blood cells remain active as long as there is contamination or damage in the wound area, and though it is essential in the early stages of healing, excessive white cell activity and inflammation will slow overall healing of the wound.  For this reason, adequate cleansing of the wound is critical.

The repair phase: Epithelialization, or the growth of new epithelial or surface cells, begins to occur very rapidly after injury.  In a sutured wound, epithelial cells may cover the wound in as fast as 12–24 hours.  In an open, full-thickness wound, a bed of granulation tissue must form first to provide a surface for the new epithelial cells to grow across.  This granulation tissue is made up of cells that provide the new connective tissue to fill in the defect as well as new blood vessels and begins to appear 3–6 days after the injury occurs.  In addition to providing the new surface for the epithelial cells, granulation tissue is also very resistant to infection.  Wound contraction occurs during the repair phase. Through the action of specialized cells, the edges of the open wound are moved toward the center of the wound.  This effect is most pronounced in areas where the skin is quite loose.

The maturation phase: During this phase of healing, the wound increases in its tensile strength as collagen fibers are aligned along areas of stress. It is important to remember that a scar will never be as strong as the tissue that it replaced.  Most estimates claim that the scar is 15–20 percent weaker than the surrounding tissues.

Wound Care

So, what can we do to promote the good repair and healing of an injury in our horses?

Initial care of the injury: It goes without saying that many wounds are easily taken care of at home with no professional involvement.  Careful cleansing and the application of an appropriate topical product can be all that is needed.  Be cautious though, as sometimes the smallest wound can create the largest problems.  Puncture wounds and even small wounds over joints are veterinary emergencies and require immediate professional evaluation and care.  Antiseptic products containing povidone-iodine and chlorhexidine are very common and effective.  Be careful, as some horses may have skin sensitivity to the povidone-iodine products. Therefore, all cleansing solutions should be thoroughly rinsed off after use. Also, be sure to keep chlorhexidine-containing products away from the eyes.

“To suture or not to suture?” That is the question: I’m often told by clients that they would have called me to suture a wound but it had been more than 6 hours.  They knew I would not be able suture it and so they have just been cleaning it as best they can.  This so-called “Golden Period” is from early research on laboratory animals. It was felt at that time that it took more than 6 hours for a wound to develop significant enough numbers of bacteria to become clinically infected if the wound was sutured.  More recent studies have shown that there are many more factors involved, and the most important criteria for a decision of how to treat the wound comes from examination of the wound and the overall health of the patient.  From the discussion of the healing phase above, we see that the epithelium can cover a sutured wound in as fast as 12–24 hours, whereas an open wound could take days to weeks to months.  It never hurts to look and consider.  Many wounds can be closed or at least minimized to promote healing.


November 2013

Virginia Tech works to treat sarcoids in horses with a cutting-edge method

He’s 8 years old, brown black, has a sense of humor, is very patient, tall — about 16.3 hands — and has a gorgeous tail. His name is Paco and not what you’d envision as a patient in a clinical trial using a novel, cutting-edge treatment on a tough skin tumor.

Paco is a horse, half Thoroughbred / half Percheron, and at the point of his shoulder — withers — he stands 5 feet 7 inches […]

October 2013

Chili and Chocolate Equine Seminar Series Nov. 13, 2013

Chili and Chocolate Equine Seminar Series
Sponsored by Old Waterloo Equine Clinic and CFC Farm and Home Center

Wednesday, November 13, 2013 at 6:00 p.m.,  Fauquier County Fairgrounds, 6203 Old Auburn Road in Warrenton, VA

Alisha Oehling, DVM, Old Waterloo Equine Clinic, will discuss: “No Hoof No Horse”. At the base of everything is the hoof, so come learn how to keep it healthy and your horse sound.

Kathleen Crandall, PhD Equine Nutritionist, Kentucky Equine Research, will discuss: “Advanced Carbohydrate Control”



6:00: Manufacturer’s […]