Tying Up What you Must Know

Tying-up has many names and can be called exertional rhabdomyolysis (rhabdomyolysis means destruction of skeletal muscle cells), azoturia, set fast, Monday morning disease, or paralytic myoglobinuria. This last name is due to some horses passing dark red urine some horses produced due to a red protein called myoglobin that is released from damaged muscle cells and excreted in the horses urine.

Tying Up can Cripple your Horses Performance

Horses which are often described as tying up commonly used to describe horses that are stiff, sweaty, and reluctant to move due to pain originating from the large muscle groups in the back, pelvis, and hind limbs. In some severe cases, the muscle in the forelimbs and the shoulders can also be affected. Mild cases of tying-up can be challenging to diagnose because the horse might only seem stiff, “off,” or slightly lame. Horses who suffer moderate to severe tying-up episode show not only the classic signs described above, but can also exhibit an elevated heart and respiratory rates and appear anxious or colicky. These symptoms are a sign of the horse being in pain. In infrequent cases, severely affected horses can have massive muscle damage which can lead to kidney failure and even death.
So What are the Causes of Tying-Up?

TB Fillies Prone to Stress are Prone to Tying Up

Horses can tie up either unexpectedly/sporadically or chronically, ongoing, and be a frustrating problem. Possible reasons for a horse sporadically tying-up includes exercising beyond the current level of conditioning; sudden changes in training regimens; exercising in hot, humid conditions; a recent history of a viral respiratory tract infection; gender (high-strung/nervous fillies and mares appear to tie up more frequently than males); and finally dietary issues.

A typical case study of a horse prone to tying up would be a nervous filly fed a high-grain diet which is not balanced and is lacking selenium/vitamin E, electrolytes, and/or minerals. This filly might tie up more frequently than horses with balanced diets. Tying-up in some Thoroughbred racehorses is thought to be caused by abnormal regulation of muscle contraction.

Specifically, horses affected with tying up appear to have a defect in how the calcium is pumped back and forth into storage sites within muscle cells, which can lead to muscle cramping and damage.

Calcium is a crucial part of the process which maked muscles contract. In these horses, stress, excitement, lameness, high-grain diets, and certain levels of exercise are thought to be potential factors that trigger this abnormal calcium regulation.

Quarter Horses and draft related breeds can experience recurrent or chronic tying-up can be due to the horses muscles storing too much glycogen (sugars) in the muscles.

Diagnosis

You will need to get your vet to make a diagnosis of tying up. It will usually be made based on a physical examination and blood work, including measurement of muscle-specific enzymes in the blood serum sample. Creatine kinase (CK) levels can reach extremely high levels beginning within hours of the horse tying-up, whereas other enzymes- such as lactate dehydrogenase (LDH) and aspartate amino transferase (AST)-are longer-term indicators of tying-up. These enzyme levels peak approximately 12 and 24 hours, respectively, after the damage has occurred. CK levels return to normal within three to seven days; other enzyme levels can take up to 14 days to return to normal. Monitoring enzyme levels can help establish a diagnosis and be used to guide the owner, trainer, and veterinarian in determining when it is appropriate to return the horse to exercise. Establishing that a horse has in fact tied up is relatively easy, finding out the underlying cause of the tying-up episode can be much more of a challenge and generally requires trialling dietary and exercised changes. You may require additional diagnostic tests, such as muscle biopsy.

Like any disease, it is essential to be sure of the diagnosis. With anything reoccurring it is easy to put every issue down to that problem and exclude looking for other reasons. Tying up can be confused with more serious musculoskeletal conditions such as a fracture, laminitis, or conditions such as neurological diseases. Signs associated with the accidental ingestion of poisonous plants or other toxins can also be mistaken for tying-up.

Treatment

A Symptom of Tying Up is Strong Dark Urine

If you suspect your horse is tying-up, immediately stop exercising the horse and place him/her in a yard of stable and call your vet. While waiting for the vet, do not move the horse, try and keep them calm and still. Place a blanket on your horse if the weather is cool and offer small, frequent amounts of water. You can also offer a salt block or a bucket of water with electrolytes added to it. Offer hay only until directed otherwise by your vet.

Since there are multiple causes of tyingup, there is no one single treatment plan. Your vet will treat the horse depending on the severity and underlying cause (if known), they could possibly give a sedative such as Acepromazine and an anti-inflammatory such as phenylbutazone to help control pain and to relieve anxiety.
Some vet might also choose to administer intravenous fluids.

Recovery
Most horses recover within a few days, however severe cases can take onwards from 10 days or more. Once the horse is pain free and begins to move again, you can turn them out in a small paddock. When the enzyme levels are at or near normal limits, activity can be slowly reintroduced in a very controlled and careful fashion.

Some horses with chronic tying-up are kept active even when their muscle enzyme levels are above normal as total rest seems to exacerbate signs of muscle stiffness, however you will need to work closely with your vet on this.

Prevention
Your vet will recommend specific preventive strategies based on the cause of your horse’s tying-up, but there are some general ways to help prevent episodes. For example, maintain a regular exercise regime and increase training gradually, not abruptly. In young, high-strung fillies, establish a daily routine, minimize stress, and modify her diet to include a balanced vitamin and mineral supplement, feed high-quality hay with minimal grain and sweet feed, and increase the amount of fat fed (in the form of vegetable oil, for example Ranvet’s Racing Oil). These dietary changes can be appropriate for other horses suffering from chronic or recurrent tying-up. Acepromazine can be used daily at low doses in stressed or nervous horses that tie up frequently, and dantrolene can be fed to fasted horses one hour prior to exercise to potentially prevent an episode. Daily oral administration of phenytoin has been advocated, but can cause drowsiness depending on the dose. Each of these options requires a prescription from your vet – so work closely with them to work things through.

Remember to plan means nothing, but planning means everything – so you will need to work with your vet to create a plan to manage your horses exercise and nutrition for the good of all! Best of luck!

Thirteen Ways to Assist Your Horse to Have Natural Digestion

1. Keep your feeding regime simple. Provide a good balanced diet, taking care to read feed preparation instructions and serve to your horse in the correct quantities.

2. Select carefully any hay, oats, barley, protein additives, or other supplements for quality. A healthy horse will reflect the quality of the feed it is given.

3. You must check the colour and smell. Any mould, dust and dampness will severely affect the nutrients your horse receives from the feed.

4. Dust will cause your horse to have respiratory issues and may develop a cough. If exposure is prolonged, scarring in the lung tissue could occur.

5. Protein levels need to be as high as 18% for the growing horse and becomes less as the horse ages to about 10-12%.

6. The higher the physical activity is, the more protein your horse needs, as protein is the building blocks for your horses muscles. Too much and your horse will become fat.

7. You must provide fibre regularly. It’s so important for your horse’s mind and digestive system to have ready access to good quality hay.

8. You must make any changes to your horse’s diet slowly to avoid disturbance to your horse’s gut, temperament and condition.

9. Beware of lush grass and too much starch.

10. Keep an eye on your horse’s manure. It is a great indicator to how your horse’s gut is functioning.

11. Provide a good sloppy mash weekly using bran or boiled linseed.

12. You need to check your horse’s teeth every 6 to 12 months. Digestion starts at the first bite, if that causes pain or it cannot cut and grind efficiently none of the rest will flow as well.

13. Keep an eye on your horse’s physical condition, weighing and measuring may also be helpful.

The Truth about Leg Bandaging

Bandaging your horse. Think it’s easy? Well there’s a lot more to it than meets the eye.

A myriad of options open up when you begin to look into the topic, such as various ways of bandaging, which of the thousands of material to use, and dressing – which is tricky depending on the product you want to use.

Bandaging is an art and a science
So here is a helpful guide to make the whole process a little easier to get through.

The Why
Generally speaking, bandages are used to support tendons and ligaments, prevent or lessen swelling, protect from injury, act as a barrier against contamination and to help the healing process.
There are three aspects to bandaging – the bandage itself, the dressing and sometimes a poultice or wound dressing.

The Bandage
The bandage is simply a piece of material, often elasticised, designed to support a dressing or splint. Modern designs have seen horse owners doing away with trying to tape or pin the bandage to the horse in favour of an adhesive style that sticks neatly to itself.
How to get unstuck in applying bandages:

Horse with legs bandaged

They can end up being:
• Too loose
• Too tight
• Unevenly wrapped

This can lead to:
• The bandage moving out of place
• Putting pressure on the tissue and cutting off circulation
• Or if uneven, putting too much pressure in one place and not enough in another.

The Dressing
Dressings (or paddings) are made from two types of material. Be careful not to be confused with wound care topicals – also called dressings.

The purpose of the dressing is to give a protective layer of padding to avoid irritation caused by the outer elastic bandage.
The most popular dressing is flannel or cotton leg quilts, which provides lovely soft support on the horse and are reusable. Also used are sheet cotton or rolled cotton. Other types are also sold, so look around at what is best for you.

The other type of dressing is material for covering a wound or stopping bleeding. What you need here is something sterile, breathable and encourages a moist healing environment. It reduces infection and helps the injury heal more quickly and reduces scarring.

Materials for dressings are readily available to buy, and good news if you a mum of a newborn as nappies provide great absorbency as a wound dressing!

The Prep Work
A variety of medications are available to help speed healing, so the best advice is to talk with your vet about what is right for your horse before applying anything.

The Poultice
The poultice is used to relieve inflammation – usually targeting treatment on tendons. Sometimes it is used to prevent heat and filling after hard work, such as a race or cross country ride. It can also be used to treat wounds and abscesses by drawing out a pus build-up or abscess.

(Note: A hot poultice increases circulation, a cold one decreases inflammation)

Many horse owners use a “sweating” poultice to reduce a build-up of fluid. These often include ingredients such as DMSO (dimethyl sulfoxide), nitrofurazone, petroleum jelly (Vaseline), glycerine, Epsom salts and/or mineral oil.

If you choose to make your own poultice remember to dilute DMSO as it can cause skin damage.

When using a poultice under a bandage, place a layer of underwrap, such as soaked brown paper bags and/or a layer of plastic wrap over the poultice. Then use an overlayer of soft padded dressing, followed by the bandage.

The rule of thumb is to consult with your vet if your horse has a wound that needs dressing.
Bandage Type

Ensure your safety first.

The most common type of equine bandage is the stable, or standing bandage. It’s used on the lower legs of the horse – which is also the most common area of a horse to need bandaging.

When to Bandage
You first need to work out if the bandage is to keep down swelling or to keep a wound treatment in place. You also need to determine if it is an open wound, if it is hot and soft and if there is swelling.
Always check with your vet if you have any doubt as there may be other treatments that are also needed to heal the wound. Sometimes the dressing type will change with the healing process.

The inflammatory stage comprises the first 6 hours after injury, the debridement phase is 6 to 12 hours post-injury, the repair phase–when cells begin to form and later tissue forms – occurs about three days post-injury, and finally the maturation phase begins.

Each stage offers up different challenges.

Initial Stage: You need a dressing that that absorbs drainage and will even stick to the wound to help get rid of toxins and dead tissue.

This also helps the debridement stage.

Repair Stage: Non-adherent dressings are better as they absord drainage but don’t interfere with the development of new tissue.
And because tendon and ligament injuries have different stages of healing, it’s important to continually evaluate the healing process and adjust the treatment used. Talking with your vet is critical during this process.

Perfection is in the Details
A well-applied bandage should look neat, even, and finished. Don’t be afraid to practice and make sure you learn how to bandage from someone who knows what they’re doing.

Some Final Tips

Some bandages can be very difficult to apply.

• Remove dirt, debris, soap residue, or moisture to prevent skin irritation and dermatitis.

• Start with clean, dry legs and bandages.

• Use a thickness of an inch or more of soft, clean padding to protect the leg beneath the bandage.

• Apply padding so it lies flat and wrinkle-free against the skin.

• Start the wrap at the inside of the cannon bone above the fetlock joint. Do not begin or end over a joint as movement will tend to loosen the bandage and cause it to become unwrapped.

• Wrap the leg from front to back, outside to inside (counterclockwise in left legs, clockwise in right legs).

• Wrap in a spiral pattern, working down the leg and up again, overlapping the preceding layer by 50%.

• Use smooth, uniform pressure on the support bandage to compress the padding. Make sure no lumps or ridges form beneath the bandage.

• Check bandages daily to make sure they are securely in place and not cutting off circulation.

• Rewrap the leg every one to two days to minimize the chance of circulation problems caused by slippage or skin irritation due to dirt or debris entering the bandages.

The Secret Seven – Formula for Keeping your Horse Sound

1. PREPARE A PLAN: Planning for your riding season is one of the most important steps you can take, whatever your discipline. It is your road map to success.

Keeping a good balance between the frequency and intensity of your competition schedule is essential. Both you and your horse need to be challenged and grow during the season but not be over-stretched. For many of us, husbands, partners, friendships and most importantly children all add their own dimensions to the mix. What considerations do we need to make for them? Other commitments also play a huge role too so sit down at the beginning of the season and map out a competition plan. Listen to your gut – are you thinking this is too much or too little? Regularly modify your competition schedule to suit; nothing is set in stone.

In the lead-up to an event, fine tuning a plan is essential. Know and practice exactly what you have to do. If you are required to jump 90cm, make sure you are confidently jumping 1m – 1.10m at home. Know the movements in your dressage test so there are no surprises for you or your horse; learn your test even if you plan to use a caller. Focus on turning your weaknesses into strengths. Is your racehorse slow or inconsistent out of the gates? Work out why and practice.

Prepare your equipment as far in advance of an event/meet as possible. Ensure your truck/float/vehicle is road worthy, with current road user miles, WOF/COF and registration. Check the tyres and the lights. If you haven’t used your vehicle for a while take it for a test drive to warm it up and determine if everything is running smoothly. Most importantly leave for the event in plenty of time. Allow time for rest stops and unexpected delays so that you can give your horse the best ride possible both in the float and at the event!

2. Fitness Program: The fitness of both you and your horse can mean the difference between a great day out and a life-shattering injury. Make sure you and your horse peak right on the event. Sit down and take an honest look at yourself and your fitness level. What you do need to do to help your horse keep you safe? It may be losing those few winter kgs which have crept on, increasing your cardiovascular fitness so you are not gasping for breath. Strength training and flexibility are huge contributing factors to help you and your horse successfully work towards your goals. If your competitions are close together, do more technical schooling in between; if they are spaced further apart, focus on fitness. Timing rest breaks to allow you and your horses’ bodies to heal can also mean the difference between a successful season and a disastrous one.

The age of both you and your horse also needs to be considered in fitness training. Young horses tend to hold their fitness but require more technical schooling. Older schoolmaster types need more fitness work than technical work. Get the support of an experienced trainer to assist with lessons and advise.

3. Spice it up! What does your horse love to do? Is it dressage and your horse is spooky while hacking? Then school dressage while you are out wandering along the road.

The concentration required by the horse for dressage movements will take his mind off the monsters hiding in the bushes!

Own a jumping fiend? Put a few cavaletti up in the arena to mix up his boredom with flatwork schooling. Hunting is also fabulous for stress relief for the right horse/rider combination.

Racing? Hacking out and beach riding are popular. Some dressage riders are being hired by racehorse trainers to teach the horse balance and correctness and the most efficient use of the horse’s muscles. Working in the correct frame a horse is able to engage its powerful hind quarters – the birth place of the speed demon! Endurance horses require schooling and flat work for a similar reason. Everyone should try endurance riding. It is brilliant for the horse and the rider and it is a good reminder of what a beautiful country we live in!

4. Be aware of your weakest link! Know the injury history of both you and your horse. If you identify that your horse has a history of tendon damage, monitor it and be conservative on every outing. Hosing down his legs, applying Arnica cream or tendon cooling poultices and bandaging should be incorporated in your routine.

Back injury? Ensure your saddle fits correctly and gets regular check ups with experienced qualified practitioners. Age must be considered in the long-term wellbeing of your horse. If your horse is 4-5 years old and you are jumping at 1-1.20m, consider the long term soundness implications for them. Is it worth it for now if the horse is unsound at the age of 9-10 years old? For some it is – is it for you? Treat your older horse with kid gloves and they will repay you with soundness and happiness well into their twilight years with a bit of luck thrown in there!

5. Be Safe: You know the rules but do you follow them? Horse rider injury statistics when compared to other sports is enough to make even the most battle hardened ACC assessor burst into tears and dive straight into the nearest pub! As horse riders we do not have the most injuries but hey when we do it we do it BIG! So please give your gear regular checks for safety. If you fall off, replace your hat. Wear body protectors and ride to you and your horse’s ability.

Riding alone? Tell someone where you are going and what time you will be back and stick to it. Take your cell phone. Make sure you are up to speed with your first-aid. Some day you could make the difference between life and death.

6. Somebody needs to care for the bodies! Stretches are a simple way to keep both you and your horse sound. You exercise by contracting muscles.

If they are not stretched or lengthened then muscles can shorten by up to 40%. This is extremely important and can be looked at in two ways:

– Shortened muscles cannot adapt to increased pressure so are susceptible to rupture and tear. Muscles are attached to bone by tendons. If the muscle is shortened this places more tension on the tendons and suddenly you have bowed tendons. Bummer there goes your horse!

– If you and your horse do simple stretches and have regular massages (say every 3 to 6 months depending on your competition intensity) you can increase your horses muscle contractibility by 40%. That means your horses muscle can function 40% better! It’s a no brainer!

7. Recognising when things just aren’t happening: Does it feel like every step forward is five steps back? Sometimes success is recognising when you are about to fail! Stop to weigh up your options once your preparation is done. Has it gone well or badly? Is pushing ahead worth the risk if every part of your instinct is telling you “No not this time mate!” Remember what this is all about – having fun. So go ahead and ENJOY!

The Causes and Cures of Splints

Equine Splints are unsightly and can cause long term issues to your horses soundness. To manage them well, it is important to learn how to keep splints from becoming permanent blemishes or problems that interfere with your horse’s athletic career.

So What are Splints?

Splints are an inflammatory condition of the splint bones. They occur primarily in growing horses involved in heavy training. The Splint bones are located on each side of the cannon bone. Between the splint bones and the cannon bone is the interosseous ligament, which is made of a dense connective tissue that turns into bone as the horse grows into an adult. This ligament fuses with the cannon bone and splint bones. The bony fusion is usually complete in most horses by 3-4 years of age.

Splints happen due to:

1. Tearing of the interosseous ligament

2. External trauma to the bone

3. Secondary to healing of a fracture.

Splints commonly occur in 2- to 3-year-old horses, occasionally in horses 4 years of age and older, and are usually associated with training and subsequent injury. Splints usually occur on the inside of the front leg, about 3 inches below the knee, although they can occur on the outside splint of the front or rear legs.

There are four types of splints:

1. True splint This is a fibrous and bony enlargement on the splint bone which began as swelling because the interosseous ligament suffered a tear or other damage. The inflammation can e easily seen.

2. Blind splint The inflammation caused by an injury to the interosseous ligament causes a fibrous and bony enlargement between the splint bones and the suspensory ligament (i.e., little to no external swelling). Depending on the severity, this could have a profound long term affect on soundness due to the interference it causes to the suspensory ligament.

3. Periostitis This inflammation and bony reaction is secondary to trauma to the periosteum which is the soft tissue covering bone.

4. Knee splint This type of splint involves swelling located at the top part of the splint bone right near the knee. It involves the lower joint in the knee, resulting in osteoarthritis. If your horse has this then it is likely that it will be unsound for life.

Risk Factors
Ø Young horses in heavy training.

Ø Working/keeping your horse on hard surfaces

Ø Conformational abnormalities such as an offset knee, base narrow, toe-out conformation

Ø Improper hoof balance

Ø Mineral imbalances

Ø Over-feeding

Ø Brushing of your horses front legs against one another

Signs your Horse is Developing Splints

Heat, pain, and swelling along a splint bone in a 2- to 4-year old horse suggests a splint. The swelling may be painful to palpation initially, but as the inflammation subsides, the swelling becomes firm and no longer painful. If your horse has lameness it is usually mild and most evident at the trot. Exercise on hard ground will make the lameness worse. When a mild case occurs, no lameness may be evident at the walk. Lameness might come and go or be continuous.

Swelling that is painful to touch is usually sufficient enough evidence for indicating splints. However to gain an firm diagnosis an xray is needed to rule out a splint bone fracture, and to record size of bone grow in relation to simply swelling of the area. This establishes a baseline for monitoring and predicts the degree of permanent cosmetic bony swelling. It also helps determine the potential for the bone growth to interfere with the suspensory ligament, which could cause ongoing lameness.

Ultrasound may also be useful to determine if the splint is actually causing damage to the suspensory ligament. In some cases bone scans and other investigations may be needed to evaluate splints that are located between the splint bone and the suspensory ligament.

Treating Splints

There are various means of treating splints. Rest until the area is no longer painful is mandatory. This usually means 6 weeks however it could extend out to two to three months.

Other things you can try:

Ø Cold therapy with icing cold hosing, to decrease the swelling and inflammation

Ø Pressure bandaging to reduce swelling

Ø Oral non-steroidal anti-inflammatory drugs to reduce inflammation

Ø Topical anti-inflammatory drugs

Ø Injections of corticosteroids around the splint may decrease inflammation and reduce the size of the splint.

Ø For cases caused by interference due to improper trimming or shoeing, have the horse shod and trimmed to prevent further interference or stress on the area (by a better farrier!)

Ø Some chronic or severe cases might require surgery to remove the bony swelling or to remove a portion of the splint bone. Surgical treatment may be considered later once the inflammation and bone formation has stopped). The disadvantages of surgery are the risks and expense of performing surgery and that a bony reaction might recur after surgery.

Ø Lasers, ultrasound, and pulsed electromagnetic therapy may reduce inflammation and also speed healing.

Prognosis
After all inflammation has subsided, the horse can gradually return to work.

The prognosis is good to excellent except for those cases in which the bony growth is large and interferes with the knee joint or the suspensory ligament. In most cased your horse’s soundness will not be affected, although most horses will have a bony lump remaining once the inflammatory response has resolved. While it may not be visible in all cases, you will be able to feel it. Most high level performance horses have visible knots on the inside splint bone.

Prevention
Ways to prevent splints are:

Slowing down the intensity and frequency of your young horse’s work

Provide proper nutrition, and avoid obesity

Maintain proper foot care

Prevent limb interference by using protective splint boots during training

When choosing protective splint boots, look for a padded boot that provides more reinforced or rigid protection, especially along the inside length of the cannon bone. Boots can be synthetic or leather, but should have extra padding and material to absorb or dissipate the impact of hoof interference. Simple unreinforced neoprene leg wraps, Vetrap, or cloth stable bandages don’t provide sufficient protection against splints.

Remember

Don’t assume that a ‘splint’ is a simple problem. Act quickly and treat aggressively by reducing the inflammation and the resulting bony reaction, you can minimize the risk on your horse developing a long-term problem which could impact on his soundness and beauty.

Proud Flesh

If your horse has ever suffered a wound, you may have heard your vet bandy about the term “proud flesh”. Below is all you need to know about the problem.

What is proud flesh?

Granulation tissue, or proud flesh as it is more commonly known, is part of the wound healing process in horses. It is made up of small blood vessels and fibroblasts, but has no nerve supply. The tissue forms usually in wounds left open to heal rather than ones stitched up.

It is beneficial for three reasons:

1. It helps the open wound resist infection

2. As it fills the healing wound it provides a surface for the skin cells on the edge of the wound to “crawl” over and help cover it.

3. It helps to aid the wound in becoming smaller.

The tissue is a vital part of wound healing in your horse – but you can have too much of a good thing if too much of the tissue is developed.

Horses have the ability to produce granulation tissue more rapidly than other animals. When the tissue grows out and protrudes from the wound, it then becomes known as proud flesh.

Proud flesh is not beneficial to helping wounds heal as it prevents skin cells covering the wound.

It can sometimes take on a life of its own and can overwhelm the original wound.

It is believed the excess tissue forms as a result of excessive movement of the healing tissue, a small amount of soft tissue covering the area around the wound, infection of the injury, and a reduced blood supply.

This normally happens with injuries on the horse’s lower leg (as it is often moving and has less skin to cover the wound) and can be very difficult to manage.

It is therefore important that when a horse is wounded on its lower leg, steps are immediately taken to prevent proud flesh developing.

Prevention

Good wound management is the key to preventing proud flesh. Any major wound should be seen and treated by a vet as soon as possible.

Bandaging is crucial in the prevention of proud flesh as well as preventing bacteria from contaminating the wound. The injury should be covered with a non-stick pad and gauze bandage.

Depending on where the wound is, that can be followed by a thick cotton bandage and elastic bandage on top – to prevent contamination of the wound from bedding and dirt.

The pressure of the bandage also helps to prevent proud flesh.
Treatment will depend on the extent of the overgrowth.
Mild overgrowth – just protruding above the wound’s surface – might need just steroid ointment applied directly to the tissue, then bandaging to prevent proud flesh developing as well as encouraging skin to grow over the wound.

Moderate or severe overgrowth will require surgery to remove the excess tissue. This must happen to allow the skin at the edge of the injury to grow over the wound.

If the overgrowth is moderate, a scalpel can be used for the procedure while the horse is standing – as the tissue has no nerve supply.

However, severe proud flesh must be removed under anaesthetic or in several stages as there can be a significant amount of blood loss.

A splint of cast might then be used to stop the proud flesh from re-growing. In some cases a skin graft is used to cover large wounds, accelerate healing, and reduce scarring.

Laminitis – What the Scientists Say…

Finding the answer to laminitis is still proving elusive to scientists around the world.

The venogram is really the key to understanding laminitis, because with the venogram, you can really see how the horse’s weight and gravity force is doing in that moment to the blood vessels which bring nutrients to the horses foot.

So what actually is a venogram? A venogram is an X-ray of the foot after contrast (which shows up the blood vessels) has been injected into the foot’s blood supply, so you can see if there is any blood flow.

If an area has no blood flow, it will not receive the nutrients it needs to heal unless the biomechanics of the foot are changed to encourage blood flow to the area. If part or all of the foot continues to have no blood flow, the tissues will die, and the horse will often be put down.

Without the venogram, you are driving in the dark. It is impossible for any of us to clinically evaluate the horse without it. Venograms are to laminitis what radiographs are to bone fractures.
Some vets use an angled block that he stands the horse’s foot on.

The block can then change the angle of the foot in a controlled way, then he takes venograms at each angle to see the changes in the blood flow. (see picture)

Knowing how hoof and bone angles affect blood flow can help veterinarians and farriers understand how to modify trimming and shoeing practices to direct blood flow toward areas that are compromised and need healing.

Learning to Read Radiographs

Reading radiographs takes a trained eye, and it’s an important part of evaluating the horse’s foot, especially when lameness exists.

However it is just one part of the entire examination of the horse including a physical examination, gait analysis, and other diagnostic procedures that require a trained equine veterinarian.

Radiographs measure the following characteristics of each foot on a radiograph:
• Sole depth (SD) is the distance between the bottom of the tip of the coffin bone and the sole surface (pink lines).

• Palmar angle (PA) The green lines show the angle the bottom of the third phalanx makes with the ground surface of the hoof.

• Digital breakover (DB) is the distance along the ground from the tip of the third phalanx bone to the forwardmost point of contact between the shoe and the ground (purple).

• Horn-lamellar zone (HL) is the space between the face of the coffin bone and the outside of the hoof wall (orange).

• Coronary band-extensor process distance (CE) is the distance between the top of the extensor process of the coffin bone and the top of the wall at the coronary band (blue).

There are no shortcuts to examining the foot. You have to methodically learn everything you can about that foot and that horse in order to understand what’s going on, what you should do to help it heal, and why your solution will work.

How to Treat your Horses Life Threatening Wound

When you start to research how to care for different wounds, your head can start to spin with the amount of options available to you.
But as most injuries involve a certain amount of blood loss, so let’s start with some useful facts about blood and what loosing it can mean to your horse.

Blood Loss (Haemorrhage)

Oxygen is transferred from the lungs throughout the body to organs and tissue by riding the ‘super-blood highway’. This forms an incredible network of vessels (or tubes) of varying sizes. The blood vessels carrying blood away from the heart have firm walls. Large ones are called arteries and smaller ones are called arterioles. Blood vessels heading back to the heart are called veins. The pressure of the blood in vein are lower than arteries due to the distance travelled from the heart and the blood itself is darker due the lower amount of oxygen present.

A horse on average carries 80ml per kilogram of body weight – it’s a little more for hot blooded horses such as Thoroughbreds and a little less for cold bloods such as Percherons and Clydesdales. So the average horse carries about 54.5 litres of blood.

It takes about 10% of blood loss before a horse will show signs of shock and even though most bleeding from wounds appears to be a much larger volume of blood than it actually is. Any bleeding wound needs to be controlled as soon as possible.

Signs to look for that your horse is going into blood loss shock include weakness, whole body sweating, colic, a speeding up heart rate and pale or white mucous membranes such as your horses gums.

When bandaging the heavily bleeding wound, it should be applied in a firm and smooth manner, which will apply significant pressure directly over the wound (if possible). It is important to have your vet assess the wound as soon as possible.

Wounds/Cuts

It is vital for severe wounds that the sooner a wound is taken care of, the better the prognosis – both functionally and cosmetically.
One of the most important first steps in wound care is to ensure your horse has up to date tetanus protection and remembering to give your horse booster shots if necessary. Make sure you keep all vaccination records and vet phone numbers handy.

It’s a good idea to stay as calm as you can while applying pressure bandages to a fresh cut – remember, it will look like a lot more blood than it actually is. Your horse can probably stand to loose about 5 litres before there is a problem. By directing pressure onto the injury, the bandage will help the blood to clot.

However, if a major artery is cut, it can be tricky to apply enough pressure to slow the bleeding – but you should try your best to do it anyway. A trick to help is to wrap the wound in three sheets of sheet cotton, a shipping (travel) bandage, quilt and a large bath towel. These can be held on with several rolls of elastic bandage, which will also maintain pressure. Aside from your horse being mortified at looking slightly ridiculous, it should work to stem the gushing blood.

The elastic bandage needs to be applied in a smooth, even and firm manner. There must be a good amount of pressure to stem the bleeding. But be careful not to keep the tight bandage on for too long – only 20 to 30 minutes max. Enough time for you to contact your vet and receive some further advice. If the bleeding hasn’t stopped, take off some of the layers and replace them with new material. If the bleeding has slowed replace the bandaging with a clean and more normally applied support bandage.

Your horse will need to be strictly supported or immobilised if the cut is to a tendon or ligament. You will need to attach a splint as well as the bandage until a vet is able to see the damage. This can help prevent even more damage to the area if your horse puts weight on it. As tricky as it might be, the best thing to do is to try to stop your horse from moving as best as you can.

Older wounds present their own problems. Even though the wound might have slowed or stopped bleeding, by the time you get to it, it may have become contaminated with dirt, debris and germs. The ideal amount of time to tend to a cut is within 6 hours of it happening.

If the cut is properly cleaned with warm water and an iodine-based surgical scrub within that time, the chances of complications from infection are reduced. Also a sterile dressing and support bandage is a great help.

If the wound is old and has swollen, cold water sprayed on it can help reduce the inflammation and aid in cleaning it until a vet is able to properly treat it. Your horse will most certainly need antibiotics if it is a significant wound.

Wounds to the Abdomen

Any laceration to the abdomen area should be treated as though it has penetrated through the abdomen until you know otherwise. If it has been penetrated, there is a big risk of developing infection to the abdominal cavity. This needs to be treated extremely urgently.

The worst case scenario is if a piece of intestine has been punctured or cut. Horses with this type of wound usually will develop significantly elevated respiratory and heart rates and show signs of shock soon after the leakage of intestinal contents into the abdominal cavity.

In this nightmare case, and a piece of intestine is protruding, your horse must be kept still and the bowel supported. Call your vet immediately. The bowel can be supported by wrapping a clean bed sheet around the belly and tied over your horse’s back. If possible, don’t touch the bowel and do everything you can to stop it from touching the ground.

Cuts to Eyelids

Prevention is better than a cure, so check out your horse’s environment and clear away anything that could catch a delicate eyelid. If, however, that despite your best efforts your horse still manages to catch it’s eyelid and tears it, don’t panic. Luckily your horse’s face has a great blood supply, so even the worst looking cuts have a good chance of healing quickly.

No matter how small the cut, a vet should always take a look at it anyway, as the little eyelid has the most important function of protecting the eye. Even small defects could cause big trouble for the horse in the future. Also, there could be some small damage to the eye itself that a vet will be able to detect.

Which brings us to: Eye Lacerations or Punctures

Repairing these injuries varies and depends on the degree of damage to the eye as well as any infections. A vet should always see a damaged eye immediately as the longer you wait the greater the chance of an infection settling in and complicating the healing process.

Foot Puncture/Abscess

If whatever that has punctured your horse’s foot is still sticking out of the wound, do not pull it out. Your vet will need to look at it first. If the object is protruding a lot, you can tape some small wooden blocks to the foot or cut the object off close to the foot with wire or bolt cutters, so it doesn’t go in any deeper. But again – DON’T pull it out.

The reason for leaving the object in is that, depending on where the injury is, your vet may want to take a radiograph (xray) to determine what deeper structures are involved. The specific location of the puncture can greatly affect the initial treatment plan and the prognosis. Leaving the object in will also stem any flow of blood and prevent further contamination of the wound.

So where to next? Looking at how wounds heal is an essential part of being able to manage your horses wound so optimum healing results. Read the article ‘How Wounds Heal’ for further information.

Conquering Laminitis

What is laminitis?

Laminitis is a condition, commonly called founder, is an extremely painful inflammation of the foot. It mostly occurs in the front feet however it can affect the hind feet as well. Founder is the name given to the resultant tissue damage and complications following one or a series of acute attacks of laminitis.

Permanent damage to the laminae can result and the attachment of the coffin bone to the hoof wall breaks down. The whole weight of the horse bears down on the coffin bone, and without the attachment to the hoof wall, the bone rotates down and can actually be pushed right through the sole to the ground.

What are the symptoms of laminitis?

If just the two front feet are affected, the horse will stand in the “founder stance” with his hind legs well up under the body carrying as much weight as possible, and the front legs placed forward with the weight on the heel. The horse will not want to walk and will turn by leaning back and pivoting around on the rear legs.

If all four feet are affected, the horse will lie down for extended periods and may refuse to get up. If forced to stand, he will pull his hind feet and front feet in toward each other under the centre of his body.

Other symptoms include heavy breathing and glazed eyes due to pain. The feet will feel hot and the digital artery, located over the fetlock joint, will have a pounding pulse.

Each attack of acute laminitis can leave a ring formation on the hoof. A horse suffering from chronic founder will have multiple rings on his hooves. He might also have seedy toe, a separation of the hoof wall from the sensitive laminae in the toe area. If left untrimmed, the hoof wall also overgrows to form a “slipper foot”. Where the hoof sticks out looking like he is wearing slippers.

What causes laminitis?

Many different situations can cause laminitis. Grazing on lush pasture (particularly overweight horses), overloading on grain, eating lawn grass clippings, or drinking large amounts of water when overheated can all cause a horse to get laminitis.
Other causes include a mare retaining the afterbirth, hard or fast work on a hard surface or standing too long on a hard surface, and stressful situations such as colic.

What should I do if my horse has an attack of laminitis?

The first thing to do is identify and remove the cause of the problem and call a veterinarian. Treatment is given to relieve pain and reduce swelling and the horse is put on a carefully monitored feeding program. X-rays of the feet may be required to monitor progress.

Long term management of a horse with founder requires careful attention to feeding to prevent a recurrence. The horse will probably have to be kept off pasture and fed hay. To keep the foot in as normal a shape as possible, corrective trimming at regular intervals by a farrier will be necessary. Corrective shoeing might also be indicated.

Chronic cases can be kept reasonably sound by proper trimming and shoeing and a sensible feeding program. However, if the horse cannot be kept pain-free, euthanasia may be the kindest option.

How can I prevent my horse from getting laminitis?

Laminitis is a disease that can be avoided by following proper horse management. Being aware of how to recognise early signs are all helpful ways to keep your horse safe and sound.

Avoid feeding excesses and keep your horse at a reasonable weight. Watch for and avoid rapidly growing pasture. Removing your horse of the pasture and yarding him may be necessary to manage the horse during the lush periods. Feed hay in the morning and turn horses out after the lushness and dew is off the grass. Keep grain in closed bins and the door to the feed room closed.

Give horses unlimited access to fresh, clean water, except immediately after exercise, when the amount should be regulated.
Make changes to routines slowly and progressively.

Pay attention to breed and body types; some are more likely to founder than others. Be particularly careful with horses with thick, cresty necks and with ponies. If you have a horse or pony that has previously foundered, be extra careful to avoid it happening again.

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