Tag Archives: Palm Beach Equine Clinic

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Taking a Chance on Madison

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Madison at home in Florida. Photo courtesy of Sariah Hopkins.

Palm Beach Equine Clinic helps one mini donkey survive a roller coaster of health concerns

The popular veterinary adage, “if only they could just tell us how they feel,” never rang truer than in the case of an 11-year-old miniature donkey mare named Madison. Owned by Sariah Hopkins, “Madi” came to Palm Beach Equine Clinic by referral and was diagnosed with hyperlipemia, a fatty liver syndrome common in miniature donkeys. Madi’s case, however, was never exactly how it seemed.

Hopkins describes Madi as the “center of attention.” Rescued from an animal hoarding situation by Safe Harbor Sanctuary in Nashville, TN, where Hopkins serves on the Board of Directors, Madi was officially adopted by Hopkins and her husband Joel in 2015.

“She was one of 40 horses and donkeys being kept on four acres of land,” said Sariah, who relocated to Juno Beach, FL with Madi in tow in 2018. “She has always had a super sweet, calm personality, but likes to kick up her heels. We’ve done behavioral health therapy work with foster children and she makes everyone who meets her fall in love. She is so engaging.”

After trading Tennessee for Florida, Madi didn’t adjust to her change in environment with ease. According to Sariah, a systematic decline in her health started as the mare tried to adjust to a new barn, environment, farrier, and life. “She was depressed,” said Sariah. “She wasn’t her bright-eyed self. She’s a donkey and she will eat anything, so when she went off her grain and refused alfalfa, I called a local vet to pull fluids and run blood work.

“I reviewed the results with my vet in Tennessee who knows Madi and her history,” continued Sariah. “They were catastrophically bad, and she told me I needed to get Madi to a clinic immediately. I was referred to Palm Beach Equine Clinic by my friend Nataliya Boyko. Within minutes, I was on the phone with her vet, Dr. Bryan Dubynsky, and soon after we were on our way.”

Once Madison arrived at Palm Beach Equine Clinic, she was treated primarily by Dr. Abby Berzas and overseen by Dr. Dubynsky. They diagnosed her with hyperlipemia, and she remained at the clinic for two weeks.

Hyperlipemia syndrome is a common metabolic disease of ponies, miniature horses, and donkeys. In affected patients, an increase in serum triglyceride concentrations (hypertriglyceridemia) puts them at risk for liver failure, renal failure, and multiorgan dysfunction that can ultimately lead to death.

Genetically, donkeys are designed to live in harsh environments with poor-quality forage. As a result, they tend to put on weight and gain excess fat reserves when living on relatively lush pasture. Unfortunately, when they stop eating for any reason – usually stress induced – hyperlipemia may develop due to a negative energy balance where more energy is being used than is being taken in through eating. The essential organs of the body still require a food supply, so it uses the energy that has been stored as fat deposits. The result is that free fatty acids are circulated to the liver and converted to glucose for use by the body.

However, donkeys are not able to efficiently turn off this fat release. The blood soon fills up with excess fat in circulation, causing them to become very sick and uncomfortable. This circulating fat is measured in the blood as triglycerides.

Madison’s case presented as a severe spike in triglycerides, which can be reduced by introducing sugars into the system. The sugar causes the body to release insulin and drive the triglycerides down.

“She responded well the first day, but we didn’t see the improvement that we would have liked or that she needed,” said Dr. Berzas. “We started more aggressive treatments the following day with insulin therapy and antibiotics. The dextrose caused a physiological increase in insulin, but it wasn’t enough. As soon as she had insulin therapy her triglyceride levels started coming down. They decreased significantly and she started eating again.”

Madison remained on insulin therapy for a week and was evaluated hourly by Palm Beach Equine Clinic veterinarians to monitor the possibility of hypoglycemic shock. When Madison was able to eat regularly and maintain low triglyceride levels without any help, she was discharged.

“I had access to Madi daily, and we made the most of her time in the hospital with long hand walks, grazing, and relaxing in her stall,” said Sariah. “I got updates from the clinic every two to three hours when I wasn’t there, and without any more clinical signs, she appeared to be improving.

“But, when I got her home she still was not herself,” continued Sariah, who spent hours sitting in Madi’s stall with her. Madi’s home was now Sariah and Joel’s private farm and they did all they could to eliminate the stress that supposedly led to Madi’s condition. “She was good for 24 to 48 hours and then would slide backwards again. One afternoon, I was sitting in her stall and she had a coughing fit that I was able to video. I sent it to [Dr. Berzas] and she came out to the farm to check on Madi.”

Dr. Berzas performed a thoracic ultrasound and spotted comet tails in her lungs, leading to one thing: pneumonia.

“We were wracking our brains to figure out what the original stressor might have been that led to the hyperlipemia, but Madi did not display any signs of pneumonia at the clinic and did not cough once,” said Dr. Berzas. “Then, there it was! Donkeys are stoic, tough animals, and sometimes they don’t give us traditional clinical signs.”

While hyperlipemia was the result, pneumonia was the cause.

“Cortisol, also known as the ‘stress hormone’ has a vast array of effects within the body, and it is one of the first triggers for the body to recruit energy from its peripheral stores,” explained Palm Beach Equine Clinic Internal Medicine Specialist Dr. Peter Heidmann. “It minimizes discomfort and increases blood pressure and metabolic rate, basically saying, ‘Now is not the time to conserve energy for the future. I need energy now in order to survive.’ In Madison’s case, the infection prompted the body to need more than average energy – it needed extra fuel to fight the infection.”

The typical diagnostic procedure for pneumonia is a tracheal wash procedure, but after consulting with Dr. Heidmann, Dr. Berzas elected to try and mitigate any further stress on Madison by choosing a less invasive procedure. Instead, Dr. Berzas used a special stylette that allowed them to go through the nasal sinuses and cleanly aspirate back cellular fluid for analysis. This option is called a bronchoalveolar lavage (BAL), and is most typically used for diagnosing cell types in the lungs.

“After culturing her fluid aspirate, she went back on antibiotics and responded well,” said Dr. Berzas. “She also had nebulizer treatments that delivered antibiotics directly to the lungs, which is the best way to treat the infection.”

One month after the pneumonia diagnosis, Sariah was proud to report that Madi had made a full recovery. “When we brought her in that first day, we frankly were getting ready to say goodbye,” said Sariah. “We were devastated, and Dr. Dubynsky agreed to try and save Madi. Thank goodness he did!”

Once the pneumonia was cleared, Madi’s routine returned to normal and the hyperlipemia was no longer an issue. Today, Madi is happily overseeing the day-to-day at Sariah and Joel’s farm.

“Palm Beach Equine Clinic treats some of the top sport horses in the world, but I feel that Madi – a very special donkey – received the same treatment,” concluded Sariah. “Dr. Berzas was 100% available to me, and she championed Madi. I could not be more thankful to her and the entire team of veterinarians and staff who rallied around our Madi.”

“When we have a case that’s particularly challenging to diagnose,” Dr. Berzas remarked, “it just reminds us of how fortunate we are to be part of a team of specialists. At Palm Beach Equine Clinic, we are able to tap into the knowledge and experience of our fellow veterinarians from different specialties, and really deliver that value for the patient.”

Sariah chronicled Madi’s condition and recovery on her Facebook page, developing quite a fan base for the little donkey. Madi’s story is far from over, but now she’s telling it herself and can be followed on Facebook as @MadisonJoelleDonk.

Palm Beach Equine Clinic
www.EquineClinic.com

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Happy Birthday Belle: Recovering Geriatric Colic Case Turns 34

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Belle recovering at home in Vero Beach, FL. Photo courtesy of Jennifer Penn.

When Jennifer Penn learned that her horse Belle was in the beginning stages of a bout with colic in February, she knew she was not ready to say goodbye to her beloved horse. The 33-year-old American Quarter Horse named Wagners Mint Joker, but known to Penn and her family as Belle, was the horse of a lifetime.

Penn’s mother, Becky Seton, and late grandfather, Bob Lowery, both of Vero Beach, FL, purchased a then 12-year-old Belle for Penn in 1998. “We were both 12 years old and it was a match made in heaven,” recalled Penn. “I had outgrown my show pony, so it was time to look for an all-around horse that I could show and have fun with. I am an only child, so she is like a sister to me. As I grew up, I experienced life right alongside her.”

Belle quickly lived up to her reputation as an all-around horse, actively competing with Penn at AQHA breed shows, open and 4-H circuits throughout Florida, show jumping events, and excelling in western trail competitions. Belle even pulled a cart for a time.

When Penn was 18, she started her own lesson program with Belle as her equine partner. “Belle provided a solid foundation for many riders, both young and old,” she said. “She not only taught me how to become a horsewoman, but she has also impacted so many young people’s lives and taught them showmanship skills. She’s special to me and my mother Becky, but also to so many people who have gone on to become very successful horsemen and horsewomen.”

Belle was partially retired in 2018, and was the guest of honor at Penn’s wedding the same year. The mare gave her last lesson about six months ago. She was still being ridden once a week with the occasional trail or pony ride for yet another up-and-coming rider.

Belle was thriving until colic threatened to disrupt her retirement.

On Saturday morning, February 1, Belle had not been drinking from her water buckets, did not finish her breakfast, and had only passed manure twice throughout the night before. Penn took these abnormal behaviors very seriously. “She’s tough as nails, so she was not showing any signs of discomfort; she was just standing there quietly in her stall. By knowing her habits we were able to identify a problem and make early decisions.”

Belle was initially treated by her primary veterinarian, Dr. Kelly Alderman of Alderman Veterinary Services based in Fellsmere, FL. Based on Dr. Alderman’s recommendation, Belle was transported to Dr. Karie Vander Werf’s Treasure Coast Equine Emergency Services in Palm City, FL, where an ultrasound on Sunday showed an impaction in the large intestines and displacement of the small intestines.

“It was very obvious to us that if we were going to consider surgery, we would have to do it sooner rather than later,” said Penn. “The decision was made to preserve her strength and transport her to Palm Beach Equine Clinic for Dr. Weston Davis to operate on her.

“It was because of his confidence in the surgery despite her age, that I was at peace with the decision to proceed with surgery,” continued Penn.

One of three board-certified surgeons at Palm Beach Equine Clinic, Dr. Weston Davis performed the emergency colic surgery to remove a right dorsal impaction in the large colon and correct a severe displacement caused by altered motility within the intestines.

“Her primary veterinarian had done everything that she could medically do for the horse before referring the case to Palm Beach Equine Clinic,” said Dr. Davis. “In some colic cases, a prolonged course of medical treatments might result in the horse no longer being a surgical candidate. When things were not improving quickly enough, the horse was sent to us. Our main concern was to determine if Belle was as healthy a surgical candidate as she could possibly be.”

According to Dr. Davis, Belle’s physical examination and blood work revealed her to be a very healthy, albeit geriatric, colic case. “She is the oldest horse that I have performed colic surgery on. At the time of her arrival, Belle was well-hydrated with balanced electrolytes levels and stable organ systems. She was an overall good candidate for colic surgery, even at 33 years old,” he said.

While not every geriatric colic case is well-suited for surgical intervention, Dr. Davis considers two factors before moving forward with any surgery. “The surgery has to make sense for the horse, meaning that they are a healthy candidate with the ability to recover, and they have the will to live,” said Dr. Davis, who noticed how resilient Belle was from the moment he saw her. “The other point is that the surgery needs to be financially reasonable for the client. In Belle’s case, there was a will to live, and a strong emotional connection with this horse.”

After a successful colic surgery, Belle was moved to the Palm Beach Equine Clinic Hospital for recovery where she was cared for round-the-clock by Dr. Candelaria Chunco and hospital staff.

“Dr. Davis and Dr. Chunco were fantastic,” said Penn. “They were both so kind, and I received regular text updates. I knew that they were invested in her recovery. When she stood up after anesthesia, I remember Dr. Davis saying to me, ‘this horse is a badass,’ and she really is!”

Belle returned home to Vero Beach on February 19, and celebrated her 34th birthday on March 27. “Her recovery was slow, but she is doing well, regaining an appetite, working her way back to regular turnout, and starting to act like her old self again,” said Penn. “She is an incredibly special horse to not only me and my mother, but to my husband, family, friends, and the horse community here. It’s so wonderful to have her back home.”

Palm Beach Equine Clinic continues to stay up to date on COVID-19 developments and will update our clients, partners and fellow equestrians as the situation progresses. Contact Palm Beach Equine Clinic at 561-793-1599 for questions or to speak with a veterinarian.

Palm Beach Equine Clinic
www.EquineClinic.com
561-793-1599

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Equine Coronavirus vs. COVID-19: Two Distinctly Different Diseases

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The recent spread of the novel coronavirus has raised serious concerns as the status continues to evolve. As equine veterinarians, Palm Beach Equine Clinic would like to address the questions and concern raised by horse owners regarding the potential impact of this disease on the equine industry.

Coronaviruses include a large group of RNA viruses that cause respiratory and enteric symptoms, and have been reported in domestic and wild animals. Equine Enteric Coronavirus and COVID-19 are both coronaviruses; however, they are distinctly different viruses.

The Center for Disease Control and Prevention (CDC), infectious disease experts, and multiple international and national human and animal health organizations have stated that at this time there is NO EVIDENCE to indicate that horses could contract COVID-19 or that horses would be able to spread the disease to other animals or humans. Equine enteric coronavirus and COVID-19 are NOT the same strain, and there is no indication that either are transmissible between species.

Therefore, it is important to concentrate on the health of our equestrians by being precautious and following recommendations from public health officials. Palm Beach Equine Clinic will continue to make every effort to stay informed on the developments with COVID-19, and will continue to provide expert veterinary care to all horses regardless of the status of this disease.

A Profile of Equine Enteric Coronavirus

Equine coronavirus is an enteric, or gastrointestinal, disease in the horse. There is NO EVIDENCE that equine enteric coronavirus poses a threat to humans or other species of animals.

  • Transmission: Equine coronavirus is transmitted between horses when manure from an infected horse is ingested by another horse (fecal-oral transmission), or if a horse makes oral contact with items or surfaces that have been contaminated with infected manure.
  • Common Clinical Signs: Typically mild signs that may include anorexia, lethargy, fever, colic, or diarrhea.
  • Diagnosis: Veterinarians diagnose equine enteric coronavirus by testing fecal samples, and the frequency of this disease is low.
  • Treatment and Prevention: If diagnosed, treatment is supportive care, such as fluid therapy and anti-inflammatories, and establishing good biosecurity precautions of quarantining the infected horse. Keeping facilities as clean as possible by properly disposing of manure will help decrease chances of horses contracting the virus.

Information for this notice was compiled using the following sources:

Cornell Animal Health Diagnostic Center

American Association of Equine Practitioners, Equine Disease Communication Center

CONTACT PALM BEACH EQUINE CLINIC

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Palm Beach Equine Clinic Is Changing the Prognosis for Condylar Fracture Injuries

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Photo by Jump Media.

Wellington, FL – Palm Beach Equine Clinic is changing the prognosis for condylar fracture injuries in race and sport horses. Advances in diagnostic imaging, surgical skillset, and the facilities necessary to quickly diagnose, treat, repair, and rehabilitate horses with condylar fractures have improved dramatically in recent years.

Most commonly seen in Thoroughbred racehorses and polo ponies, a condylar fracture was once considered a career-ending injury. Today, however, many horses fully recover and return to competing in their respective disciplines.

What is a condylar fracture?

A condylar fracture is a repetitive concussive injury that results in a fracture to the cannon bone above the fetlock due to large loads transmitted over the cannon bone during high-speed exercise. On a radiograph, a condylar fracture appears as a crack that goes laterally up the cannon from the fetlock joint and out the side of the bone, essentially breaking off a corner of the cannon bone, sometimes up to six inches long.

“A condylar fracture is a disease of speed,” said Dr. Robert Brusie, a surgeon at Palm Beach Equine Clinic who estimates that he repairs between 30 and 50 condylar fractures per year. “A fracture to the left lateral forelimb is most common in racehorses as they turn around the track on a weakened bone and increased loading.”

Condylar fractures are further categorized into incomplete and non-displaced (the bone fragment hasn’t broken away from the cannon bone and is still in its original position), or complete and displaced (the fragment has moved away from the cannon bone itself and can often be visible under the skin).

Additionally, condylar fractures can occur laterally or medially. According to fellow Palm Beach Equine Clinic surgeon Dr. Weston Davis, most condylar fractures tend to be lateral on the outside condyle (a rounded projection on a bone, usually for articulation with another bone similar to a knuckle or joint).

“Most lateral condylar fractures are successfully repaired,” said Dr. Davis. “Medial condylar fractures tend to be more complicated configurations because they often spiral up the leg. Those require more advanced imaging and more advanced techniques to fix.”

What is the treatment?

The first step in effectively treating a condylar fracture through surgery is to accurately and quickly identify the problem. Board-certified radiologist Dr. Sarah Puchalski utilizes the advanced imaging services at Palm Beach Equine Clinic to accomplish exactly this.

“Stress remodeling can be detected early and easily on nuclear scintigraphy before the horse goes lame or develops a fracture,” said Dr. Puchalski. “Early diagnosis of stress remodeling allows the horse to be removed from active race training and then return to full function earlier. Early diagnosis of an actual fracture allows for repair while the fracture is small and hopefully non-displaced.”

Once the injury is identified as a condylar fracture, Palm Beach Equine Clinic surgeons step in to repair the fracture and start the horse on the road to recovery. Depending on surgeon preference, condylar fracture repairs can be performed with the horse under general anesthesia, or while standing under local anesthesia. During either process, surgical leg screws are used to reconnect the fractured condyle with the cannon bone.

“For a small non-displaced fracture, we would just put in one to two screws across the fracture,” explains Dr. Davis. “The technical term is to do it in ‘lag fashion,’ such that we tighten the screws down heavily and really compress the fracture line. A lot of times the fracture line is no longer visible in x-rays after it is surgically compressed. When you get that degree of compression, the fractures heal very quickly and nicely.”

More complicated fractures, or fractures that are fully displaced, may require additional screws to align the parts of the bone. For the most severe cases of condylar fractures, a locking compression plate with screws is used to stabilize and repair the bone.

Palm Beach Equine Clinic surgeon Dr. Jorge Gomez approaches a non-displaced condylar fracture while the horse is standing, which does not require general anesthesia.

“I will just sedate the horse and block above the site of the fracture,” said Dr. Gomez. “Amazingly, horses tolerate it really well. Our goal is always to have the best result for the horse, trainers, and us as veterinarians.”

According to Dr. Gomez, the recovery time required after a standing condylar fracture repair is only 90 days. This is made even easier thanks to a state-of-the-art standing surgical suite at Palm Beach Equine Clinic. The four-and-a-half-foot recessed area allows doctors to perform surgeries anywhere ventral of the carpus on front legs and hocks on hind legs from a standing position. Horses can forgo general anesthesia for a mild sedative and local nerve blocks, greatly improving surgical recovery.

“A condylar fracture was once considered the death of racehorses, and as time and science progressed, it was considered career-ending,” concluded Dr. Brusie. “Currently, veterinary medical sciences are so advanced that we have had great success with condylar fracture patients returning to full work. Luckily, with today’s advanced rehabilitation services, time, and help from mother nature, many horses can come back from an injury like this.”

Competing in Wellington this season? Stop by the Palm Beach Equine Clinic annex office conveniently located next to the stabling office on the WEF showgrounds, visit www.EquineClinic.com, or call 561-793-1599.

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Unparalleled Support: The Role of Veterinary Technicians at Palm Beach Equine Clinic

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Yessica Arrua assisting with an electroacupuncture treatment. Photo by Jump Media.

Wellington, FL – Palm Beach Equine Clinic (PBEC), based in Wellington, FL, is home to world-renowned surgeons, board-certified specialists, and state-of-the-art diagnostic technology. In addition, PBEC is home to 30 veterinary technicians who provide support to the veterinarians they work alongside.

PBEC takes pride in the diligence of the technicians who work in collaboration with the veterinarians to maintain the daily functionality of the clinic. The typical responsibilities of an equine veterinary technician include:

  • Manage veterinarians’ schedules
  • Stock veterinarians’ mobile unit with supplies, equipment, and medications
  • Accompany veterinarians on barn calls and emergency response
  • Consult on cases with veterinarian
  • Care for and monitor horses admitted to the on-site clinic hospital
  • Plan patient care and follow-up
  • Oversee billing and invoices

According to Dr. Marilyn Connor, veterinary technicians are the right hands of the doctors they work with. PBEC employs 30 technicians and the hands-on experience they have access to gives them invaluable opportunities to learn.

“One thing that is special about PBEC is that we have a full staff of technicians day and night,” said Dr. Connor, who first joined PBEC as an intern and now works as a full-time veterinarian. “They are the ones feeding and caring for horses, administering medications that do not require a doctor, and assisting veterinarians on cases. During the peak of season, there are roughly 40 doctors with very diverse caseloads for technicians to learn and gain experience from.”

Yessica Arrua is one PBEC technician who has become an accomplice for veterinarian Dr. Natalia Novoa and the clinic in general. Arrua, 22, was born in Buenos Aires, Argentina but now calls Florida home and is a pivotal part of the PBEC team.

Five questions for PBEC veterinary technician, Yessica Arrua:

  1. How did you first get involved with horses?

I have been around horses since I was three years old. Both my parents have been working with horses since before I can remember. My dad works with polo ponies and my mom with dressage horses. They both traveled to Florida to pursue work with horses here and that is how I came to be a resident of Wellington and a team member with Palm Beach Equine Clinic.

  1. What are your day-to-day responsibilities at PBEC?

I work with Dr. Natalia Novoa, who focuses on both traditional veterinary medicine and alternative therapies like chiropractic adjustments and acupuncture. My day-to-day responsibilities include making sure our truck is stocked with the equipment and medications that we may need. I also look after all the invoices in our system on a monthly basis. Overall, my role is to ensure Natalia has everything she needs and is prepared for our farm call visits.

  1. What do you enjoy most about working with equine veterinarians and the horses they treat?

Other than being around horses every day, which is the best part of my job, I really enjoy being able to experience all the different types of cases that come through Palm Beach Equine Clinic. Especially during the winter season, we see so many interesting cases from emergencies to routine exams.

  1. Do you have a favorite case?

My favorite cases to work on are the ones where horses have anhidrosis, which we see often in the Florida heat.

(What is Anhidrosis? According to the American Association of Equine Practitioners (AAEP), anhidrosis is a compromised ability to sweat in the face of exercise or high ambient temperatures. This is a potentially dangerous condition for horses, especially working horses, because they thermoregulate (maintain a consistent body temperature) primarily through sweating.)

There is no universal or proven treatment for anhidrosis, but people often try salts, electrolytes, thyroid supplements, and even beer. But Dr. Novoa has been able to help these horses with acupuncture. We had one case where the horse didn’t respond to any traditional treatments, but started sweating right away during our first acupuncture treatment.

  1. What can we find you doing when you aren’t working at PBEC?

You will find me at the beach, reading, and spending time with my family!

To find out more, please visit www.equineclinic.com or call 561-793-1599.

Contact: Lindsay Brock
lindsay@jumpmediallc.com

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PBEC Case Study: Ethmoid Hematoma

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Dr. Michael Myrhe and Dr. Weston Davis performing the Ethmoid Hematoma procedure. Photo courtesy of PBEC.

A horse was recently admitted to Palm Beach Equine Clinic (PBEC), based in Wellington, FL, with symptoms that included bleeding from the nostril. The patient’s referring veterinarian had diagnosed the horse with an ethmoid hematoma, which in layman’s terms is essentially a mass that fills with blood in the nose or sinus cavity.

The patient was placed under the care of PBEC’s board-certified surgeon Dr. Weston Davis and Dr. Michael Myhre. They performed an airway endoscopy to locate and evaluate the hematoma that the referring veterinarian had identified. After confirming the diagnosis, Dr. Davis and Dr. Myhre were eager to ensure that it was the one and only hematoma they were battling.

PBEC is one of an elite group of equine veterinary clinics to have a computed tomography (CT) machine in their arsenal of diagnostic imaging equipment. A CT gives veterinarians a unique look at the head, neck, and spine of a horse that they would never be able to accomplish with other imaging modalities. After a CT of the patient’s sinuses, more masses were indeed identified.

“This was a fairly typical presentation of an ethmoid hematoma, but there were certainly more masses than normal,” said Dr. Myhre. “It’s for this reason that the CT was very useful. If we were not able to obtain the scans that we did, we may have missed the masses that were located deeper in the sinus.”

Click here to watch the CT scan that spotted the additional masses in progress.

The cause of an ethmoid hematoma is unknown, but the mass resembles a tumor in appearance and development without being neoplastic. Horses with extensive masses may have reduced airflow and an expanding hematoma can cause pressure necrosis of the surrounding bones, but rarely causes facial distortion. Treatments of the condition can range from conservative management to surgery. The conservative treatment route includes the injection of formalin – a mixture of formaldehyde gas and water – into the mass using a guarded endoscopic needle. Once injected, the mass typically regresses rapidly, but recurrence is common. For some cases, surgical excision is achieved via a frontonasal bone flap procedure.

Due to the location and advances nature of the masses in this case, injection was not an option and the CT imaging was used to plan a surgical approach. “After sedation and a local block, we went into the sinus through a flap approach where we took a section of bone, cut it into a flap, and moved it back so we could go into the sinuses through a nice window,” said Dr. Myhre. “We removed a mass four centimeters in diameter as well as several smaller masses two to three centimeters in diameter, then flushed the area and closed.”

According to Dr. Myhre the advantages of a standing procedure included fewer risks from bleeding and fewer risks of recovering from anesthesia.

Post-surgery, the bone flap will require several weeks to heal, but the skin itself healed within one to two weeks, which is when the horse was cleared to return to normal activity.

Jennifer Wood, Jump Media
jennifer@jumpmediallc.com

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PBEC Veterinarians on Call and Available as Hurricane Irma Approaches Florida

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Hurricane Irma is making its way toward Florida, and Palm Beach Equine Clinic is ready and available to help horse owners prepare for and weather the storm. Owners are urged to put their hurricane emergency plans into action and take precautions to ensure their horses’ safety before conditions worsen.

Hurricane Safety Tips Include:

  • Clean up around the barn for debris that may take flight.
  • Put a halter on your horse with a tag stating the horse’s name/contact number in case he or she gets loose for the duration of the storm.
  • Ensure that horses have access to fresh water.
  • Place feed/hay in an easy place to get to and off of the ground.
  • As an owner, perform a physical examination of your horse the day before to make sure all is healthy and have a comparison for after the storm examination.

Palm Beach Equine Clinic is available for all emergencies 24/7. In case of an emergency, please call the main line at (561) 793-1599. Doctors will be on call to drive to farms to assist or treat horses.

Lend a Helping Hand

In the wake of Hurricane Harvey, there are several ways members of the equestrian community can help. Click below to donate to American Association of Equine Practitioners (AAEP) and U.S. Equestrian Disaster Relief Funds.

The American Association of Equine Practitioners (AAEP) Foundation’s Equine Disaster Relief Fund

USEF Equine Disaster Relief Fund

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Early Response to Equine Joint Disease Improves Career Longevity

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Photo courtesy of Palm Beach Equine Clinic.

Wellington, FL – At Palm Beach Equine Clinic (PBEC) in Wellington, FL, the team of three Board-Certified surgeons are all experts in minimally invasive surgical techniques, aiming to reduce joint disease, resolve lameness, and improve the longevity of sport horse careers.

Arthroscopy (or arthroscopic surgery) is a minimally invasive surgical technique that can be performed on an injured joint or synovial structure to accurately explore and treat pathology. The surgery generally involves two very small (8mm) keyhole incisions. The first incision is where the surgeon will insert the arthroscope, which is an instrument with a small surgical grade camera installed that allows a complete, clear view of the interior joint surface. The second small incision is created to insert the surgical instrument to perform the procedure.

Arthroscopy is used to treat a broad range of injuries in the joint. Chip fracture removal is a procedure that is particularly commonly in both young Warmbloods with developmental disease and racehorses working at high speeds. A small chip fracture is something that can cause persistent irritation in the joint, as well as arthritis, if left untreated and is best removed immediately so that no further damage is created. The surgeon can easily go into the joint, remove the chip, and clean up the cartilage underneath. Most horses heal quickly and return to their normal athletic activity.

Board-Certified Surgeon Dr. Weston Davis performs many arthroscopic surgeries at PBEC alongside fellow surgeons Dr. Robert Brusie and Dr. Jorge Gomez.

“In many horses, we consider arthroscopy as a prophylactic measure, intervening after injury, but before the development of a generalized degenerative arthritic cycle ensues,” Dr. Davis stated. “Arthroscopy is definitely something that you want to do early in the game if you feel like the horse has joint disease, or a chip, or cartilage disease, or an undefined injury that is not responding appropriately to medical therapy. Arthroscopy can be curative for some of these horses. But if you do not intervene early on in the course of the disease and there is already advanced arthritis, then you have missed your window.

“Arthroscopy is a preferred treatment measure because it is so minimally invasive that most of those horses get right back to sport,” Dr. Davis continued. “In a normal scenario, we thoroughly explore the joint with the arthroscopic camera, we remove a chip or repair a lesion, and the horse is never lame after surgery. Because of the small incisions, there is minimal aftercare and horses are often back to work quickly.”

Other common indications for arthroscopic surgery are meniscal disease in the stifle, subchondral cystic lesions, primary cartilage lesions, and debridement of damaged tendinous/ligamentous tissue (such as deep digital flexor tendon tears in the navicular bursa). The surgeons at PBEC can perform arthroscopy on virtually any joint in the horse. Anything from the Temporomandibular Joint (TMJ) of the head to the navicular bursa within the hoof capsule can be explored and treated with this minimally invasive approach.

Almost all arthroscopies are performed under general anesthesia with the horse on its back. New renovations at Palm Beach Equine Clinic include a set of stocks of adjustable height adjacent to a surgeon’s pit, allowing the surgeons to have eye-level access to the joint they are working on, enabling many new procedures on the legs of standing horses.

Minimally invasive surgery allows for a simple and quick recovery for the horse. The traditional horse would be on stall rest with a bandage on until the sutures come out at two weeks, and then start doing some light hand walking and physical therapy. Barring severe damage in the joint or associated tendon/ligament disruption, most cases will undergo a six-week rest and rehabilitation protocol, then return to normal work.

As always, the advanced diagnostic imaging at PBEC permits the surgeons to get a complete evaluation of an injury involving a joint to ensure the best possible outcome. Depending on the injury type, digital radiographs, ultrasound, MRI, and Nuclear Scintigraphy, or a combination thereof, may be used for pre-operative diagnosis and planning. Ultrasound and digital radiography are available for intra-operative use. Intra-operative CT scanning will also be available in the future with the new additions at Palm Beach Equine.

“When you are inside the joint with an arthroscopic camera, you have the most complete picture of the surface and health of that joint,” Dr. Davis noted.

Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. To find out more, please visit www.equineclinic.com or call 561-793-1599.

Contact: Lauren Fisher
Jump Media
lauren@jumpmediallc.com

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ESP and PBEC Remind Wellington Equestrian Community of Proper Biosecurity Procedures

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Wellington, FL – March 31, 2017 – Equestrian Sport Productions (ESP) and Palm Beach Equine Clinic, the official veterinarians of the Winter Equestrian Festival (WEF) at Palm Beach International Equestrian Center (PBIEC) in Wellington, FL, remind the Wellington equestrian community to follow strict biosecurity procedures as horses are prepared for long-distance travel in the coming weeks.

As a result of the positive equine influenza test reported at WEF on March 14, veterinarians have implemented biosecurity procedures, and those in contact with horses in Wellington are encouraged to do the same. Because of the presence of equine influenza in Wellington, we remind all competitors of the importance of regular temperature checks, proper hygiene, and biosecurity, with suggested protocols listed below.

While there have been confirmed cases of equine influenza in Wellington, there are still NO confirmed cases of equine herpes or other infectious diseases.

If you have any further questions or concerns, please contact your veterinarian or the horse show office at 561-793-5867. Questions may also be directed to Palm Beach Equine Clinic at 561-793-1599.

Further information will be updated as it becomes available.

BIOSECURITY PROCEDURES

An integral part of a showing environment includes healthy horses.  Exhibitors, especially those traveling long distances, can contribute to that healthy environment by following some basic recommendations listed below.

  1. A current negative Coggins test. Please renew before it expires, and not just before it is necessary to leave the state. It is strongly recommended that all horses be vaccinated for Equine EHV-1 (either modified live or killed vaccine) no sooner than 7 days prior and no later than 90 days prior to entering the show grounds. Most EHV-1 vaccines are only considered effective for 90 days. Check with your veterinarian about which vaccine you use.
  2. A health certificate within 48 hours is required for all horses shipping onto the property. All horses should be able to produce proof of vaccine, preferably labeled on these health certificates. Those who need health certificates when they arrive can contact Palm Beach Equine Clinic at 561-793-1599 or contact PBEC vets on the show grounds.
  3. You should be able to document your horse’s normal temperature before arrival. Please do not ship horses with elevated temperatures. It is recommended that you establish a log of temperatures taken at least twice daily. If there is an elevated temperature for more than a 24-hour period, please consult your local Veterinarian immediately.
  4. Every effort should be made to minimize stress and commingling of horses shipped long distances. Extra hours on a horse van, or moving from stable to stable, is the fastest way to compromise your horses’ and your neighbors’ horses’ health.
  5. Any horse on the show grounds with a fever of unknown origin or of suspicious origin should be reported to Equestrian Sport Productions Management. It is always better to err on the side of safety. Isolation stalls will either be available on the grounds or at a local veterinary practice if the need arises.
  6. Please take the time to review equine good hygiene practices and express its importance to your grooms in everyday care.

Please visit www.PBIEC.com or call 561-793-5867 for more information.

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Twenty-Five Dollars Could Save a Horse’s Life

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Photo by Jump Media.

Wellington, FL – Several regions across the U.S. have reached the peak of the winter show season, and with the increase in equine travel, as well as large populations of horses in close contact with one another, proper vaccination protocols are as important as ever.

Dr. Kathleen Timmins of Palm Beach Equine Clinic in Wellington, FL is often asked why proper equine vaccination protocols are imperative for all horses, and her answer voices directly to the welfare of the horse.

“You could save your horse’s life!” she said. “It is really important from an infectious disease standpoint, but also for mosquito-borne diseases or rabies; these are diseases that are life-threatening for lack of a $25 vaccine.”

Vaccinations: When, What, and How

According to Dr. Timmins, recommended vaccination protocols vary by vaccine and by the location of the horse, but the core group of vaccines is relatively standardized. As a rule, horses should receive vaccines to prevent against mosquito-borne diseases like Eastern Equine Encephalitis (EEE), Western Equine Encephalitis (WEE), and West Nile Virus twice a year. Equine Encephalitis is characterized by the swelling of the brain in an infected horse, while West Nile Virus infects the central nervous system and may cause signs of Encephalitis, including those ranging from fever to weakness and paralysis of the hind limbs.

“Vaccinations against mosquito-borne diseases become very important in south Florida because we have mosquitoes year-round,” said Dr. Timmins. “As you go further north, owners may sometimes choose to only vaccinate against those once a year.”

Included in the twice-a-year vaccination program is a Flu/Rhino dose. The Flu vaccination prevents the illness in horses much the same way it does in humans, while the Rhino vaccine is key in helping to prevent the Equine Herpesvirus (Rhinopneumonitis). Equine herpesvirus type 1 (EHV-1) and Equine herpesvirus type 4 (EHV-4) most commonly result in respiratory disease in horses and can progress to neurological disease.

East and West Equine Encephalitis, West Nile, and Flu/Rhino can all be administered as a combination vaccine requiring only one injection.

In addition to vaccinations given twice a year, annual vaccinations include those to prevent Potomac horse fever, a potentially-fatal illness that affects the digestive system and is caused by the intracellular bacterium Neorickettsia risticii; Strangles, a bacterial infection of the upper respiratory tract; and Tetanus, an acute, often fatal disease caused by the bacteria Clostridium tetani found in soil.

Much like the vaccinations administered to humans, the companies that produce the vaccines are in constant transition, adapting each vaccine to the most common strains to ensure the most accurate prevention of disease.

The Role of the Horse Show

To combat the rise of infectious disease outbreaks, many horse show organizers have taken a proactive step to reduce the spread of disease by developing vaccination requirements for the show grounds. This is a step towards preventing disease as an organized community, according to Dr. Timmins.

“No one wants sick horses,” she said. “All horse show organizers can do is put the requirements out there and hope that people comply and that they understand why vaccinations are so important.

“When a horse pops with a fever at a show everyone is alarmed,” continued Dr. Timmins. “If proper vaccination protocols are followed, it is easier for us to figure out why that horse has a fever and treat them quickly and appropriately.”

Negative Reactions

There are occasional cases of horses reacting negatively to certain vaccinations, making a regular schedule difficult. After receiving a vaccine intramuscularly, some horses experience local muscular swelling and soreness or signs including fever, anorexia, and lethargy. Severe reactions such as anaphylaxis can also occur in rare, extreme cases.

According to Dr. Timmins, there are procedures in place to help keep horses that suffer reactions on a systematic vaccination plan without threatening their health or competition schedules.

“What I will do first is break up the vaccinations so we can figure out which one is bothering the horse,” said Dr. Timmins. “Then sometimes all it takes is a change in the vaccine company because the particular horse is reacting to their preservative or their carrier. Veterinarians can also pretreat with a nonsteroidal anti-inflammatory drug to avoid really bad reactions. Finally, there is always an option to administer intranasal vaccines rather than using an injectable.

“Very few horses have severe reactions to vaccines and for the most part, the horses traveling to shows are part of young and healthy populations,” continued Dr. Timmins.

As the winter horse show season continues throughout the U.S., horse health must be a priority and vaccinations are a simple way for the equine community to do their part.

“Vaccinations are an easy and relatively inexpensive way to prevent infectious disease outbreaks, and keep our horses healthy and safe,” she said. “There’s just no reason not to vaccinate.”

More about Dr. Timmins

Dr. Kathleen A. Timmins is a 1993 graduate of the Ohio State University School of Veterinary Medicine. She completed her internship in equine medicine and surgery at the Illinois Equine Hospital near Chicago. Prior to coming to Florida, Dr. Timmins practiced in Aiken, South Carolina, where she met her husband, John, who plays polo professionally. Growing up in Central Ohio, Dr. Timmins began her relationship with horses as a child on the hunter/jumper circuit. She continues to ride and show as much as possible. She and her husband are enjoying parenthood with their daughter Schuyler.

About Palm Beach Equine Clinic

The veterinarians and staff of PBEC are respected throughout the industry for their advanced level of care and steadfast commitment to horses and owners. With 28 skilled veterinarians on staff, including three board-certified surgeons, internal medicine specialists, and one of very few board-certified equine radiologists in the country, PBEC leads the way in new, innovative diagnostic imaging and treatments. Palm Beach Equine Clinic provides experience, knowledge, availability, and the very best care for its clients. To find out more, please visit www.equineclinic.com or call 561-793-1599.

Contact: Lauren Fisher
Jump Media
lauren@jumpmediallc.com