Does Your Senior Horse Have EOTRH?

Today, our horses are living longer and healthier lives. With a longer life span we encounter additional challenges to keep our geriatric horses comfortable. One common condition in the older horse population is EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis).

Photo Courtesy PugnoM on Flickr

What is EOTRH?

EOTRH primarily affects the incisors, although canine teeth and cheek teeth can also be affected. The process is painful, with some teeth resorbing their roots and/or lying down extra cementum, which causes the roots to appear bulbous.

EOTRH is suspected based on dental examination and definitively diagnosed with radiographs. Some early signs of disease include recession and swelling of the gums. In more advanced cases, the incisors also become loose, with draining lesions around the gums. EOTRH is insidious and painful. Horse owners may notice that affected horses are sensitive to placing the bit in the mouth or become unwilling to grasp hard treats such as carrots. As prey animals, horses may only exhibit subtle signs of discomfort. The cause of EOTRH is unknown and the disease process may be underway before clinical signs are noted during an oral exam.

How is EOTRH treated?

Unfortunately, we lack treatments to prevent or stop EOTRH. Although it may seem drastic, extraction of affected teeth is the best way to manage this condition and keep horses comfortable. Because of the advancements in equine dentistry, extraction is often possible to perform in the field. Radiographs provide valuable information about the severity of disease and help your veterinarian plan for the extractions.

For extractions, the horse is be sedated and receives anti-inflammatories. Nerve blocks and local anesthesia are vital to minimize discomfort. Depending on the individual horse, extractions may be staged, with more severely affected teeth extracted first. Typically, EOTRH eventually affects all incisors, so horses having more severely diseased teeth extracted first may require additional extraction sessions.

After extraction, radiographs are used to confirm that no tooth fragments remain. Depending on how many teeth were removed, some veterinarians will close the gums with suture, although these often fall out within a few days. Post-op care includes a soft diet, anti-inflammatories, and antibiotics. Flushing the mouth with dilute chlorhexidine solution can also aid in healing.

What is the prognosis for EOTRH?

Horse owners observe that their horses are noticeably happier within just a few days of extraction- proof that EOTRH teeth are painful! Providing that the horse has adequate remaining cheek teeth, permanent dietary changes after extraction are not necessary. Without incisors, some horses may allow the tongue to stick out slightly, but are still able to graze and consume hay.

Photo Courtesy Public Domain Photos via Flickr

Benefits of Gastroscopy

Most horse owners are familiar with equine gastric ulcers, or EGUS (equine gastric ulcer syndrome).  Gastric ulcers are extremely common in horses and likely underdiagnosed. Because horses evolved as grazing animals, their stomachs are designed for continual digestion and eating, continually secreting stomach acid. Management of the modern horse often prevents continual grazing, so periods of time without access to forage allow stomach acid to contact the stomach lining, causing ulcerated areas. Common risk factors include periods of time with an empty stomach (such as stalled horses without grazing access), stress (training, showing, travel), and administration of non-steroidal anti-inflammatories (phenylbutazone and banamine).

The gold standard for diagnosis is gastroscopy, where your veterinarian will examine the stomach and document findings with photos. Gastroscopy allows us to assign a score of severity to the horse’s ulcers as well as demonstrate healing following treatment. Recent technological advances have made this diagnostic modality available in the field, so gastroscopy can now be performed on the farm instead of trailering in to the clinic.

After you and your veterinarian have decided that gastroscopy is indicated for your horse, the most important part of the gastroscopic exam is patient preparation. Preparation requires fasting your horse for about 20 hours before the exam to ensure your horse’s stomach is empty. If there is food remaining in the stomach, your veterinarian will not be able to perform a complete examination. Frequently we recommend applying a muzzle to your horse during fasting since some horses will ingest shavings or straw. Water must be removed 3 hours prior to gastroscopy.

At the appointment, your veterinarian will sedate your horse to allow passage of the scope. The scope is passed up one nostril and to the back of the throat, when your horse will swallow it. During this process, the back of the throat can also be examined. After swallowing, the scope is passed down the esophagus (also examined) and then into the stomach. The upper portion of the stomach is called the squamous/non-glandular portion, based on the cell type composing the lining. The lower portion of the stomach is the glandular portion, where stomach acid is secreted. These 2 areas are divided by a  demarcation called the margo plicatus. Ulcers are most commonly found on the squamous portion of the stomach along the margo plicatus. The entire stomach is examined, including all the way to the exit of the stomach (pylorus) and ideally including the beginning portion of the small intestine (duodenum). A score is assigned to your horse based on location of ulcers and the severity of ulceration, ranging from 1-4. Your veterinarian will then work with you to determine the most appropriate treatment for your horse based on this exam. Ideally, the horse is re-scoped following treatment to ensure adequate healing and response to treatment.

MVS is excited to offer gastroscopy to enable appropriate diagnosis and treatment of EGUS, keeping your horse feeling and performing at his best. Contact us today if you’re interested in gastroscopy or would like to learn more.

Colic: Separating Myth from Truth

Every horse owner fears colic, and with good reason: it’s the leading cause of death in horses, aside from old age. Fortunately, a vast majority of colic cases resolve relatively quickly and without surgical intervention. Early recognition of potential issues and knowing what is normal for your horse is crucial. Take the opportunity to assess your horse’s vital signs when he’s healthy so that you can provide your veterinarian with vital information during an emergency. Practice taking his temperature, pulse, and respiratory rate. Listed below are some commonly encountered colic myths.

Myth 1: Casual rolling will cause your horse’s intestine to twist.

If this statement were true, any healthy horse enjoying a good roll in the pasture would be at immediate risk of colicking. Severe pain, such as that associated with a twisted portion of the intestinal tract, will cause a horse to roll repeatedly and violently. If there is a large gas accumulation within a portion of the GI tract, rolling could potentially allow a GI structure to move in/out of its correct position. If your horse is violently colicking, remember to keep yourself safe first. If you can safely prevent your horse from rolling while waiting for veterinary care, please do so.

Myth 2: Always walk a colicking horse.

A mild colic may respond well to a short walking session of 10-15 minutes. But if your horse’s discomfort does not improve or worsens, walking your horse for hours until the point of exhaustion is unlikely to be of benefit to either of you. A horse that is willing to rest or lie down quietly in the same position is fine to remain that way while waiting for your veterinarian to arrive. If your horse is mildly or intermittently uncomfortable and is both willing and safe to walk, a short hand-walk while waiting for your veterinarian is appropriate.

Myth 3: Mineral oil is the best treatment for colic.

Historically mineral oil was the treatment of choice to administer to colics by nasogastric tube, the thought being that the oil would provide a laxative effect for breaking up impacted fecal material. However, a simple experiment can disprove this theory: Place a fecal ball in a cup of mineral oil and place another fecal ball in a cup of warm water and electrolytes. The fecal ball in the warm water/electrolyte solution will soften and break down much more quickly than the fecal ball in oil. Mineral oil is useful as a marker to indicate that manure has passed through the entirety of the gastrointestinal tract and has a useful role in certain types of colic, but its administration is not essential for resolution of most colic cases.

Myth 4: A horse does not have a serious colic if he is passing manure.

Because the gastrointestinal tract of the horse is so long, it is possible to have an obstruction or other issue farther forward in the gastrointestinal tract, with formed manure behind it. In this case, a horse may continue to pass additional manure while still exhibiting signs of colic.

Myth 5: Drastic weather changes cause colic.

Evidence that weather changes directly cause colic is lacking, but drastic weather changes often alter the management of a horse, which does affect colic risk. For example, keeping horses stalled instead of turning out because of inclement weather is a change in stabling, which is associated with increased colic risk. A sudden drop in temperature may cause a horse’s water source to freeze, which decreases his water intake and increases risk of colic.

Myth 6: Repeatedly posturing to urinate is a sign of a urinary tract problem, not colic.

While urinary issues do occur in horses, colic is much more common. A horse that is seen repeatedly posturing to urinate may be trying to relieve abdominal pain associated with colic.

While it is not possible to prevent every colic, good management strategies can minimize your horse’s risk of colic. Always provide access to clean, non-frozen water. Avoid sudden changes in feed- gradually mix in new concentrates or hay. Maintain a current relationship with your veterinarian to ensure your vet knows your horse and can provide care when the inevitable emergency arises.

Meet the MVS Staff: Spotlight on Dr. Kate Baer

Dr. Kate Baer is a 2012 graduate from the University of Minnesota College of Veterinary Medicine.  She completed a one-year internship with an equine referral and ambulatory practice in New Jersey, and then spent several years in Pennsylvania with a racetrack and ambulatory equine practice. In 2017, she attained certification in veterinary acupuncture through the Medical Acupuncture for Veterinarians. Dr. Baer joined MVS in 2019 and loves being a part of such a great team.

Dr. Baer appreciates the challenge and variety of equine ambulatory medicine. Her professional interests include geriatric horse care, dentistry, wound management, acupuncture, emergency medicine, and podiatry. Dr. Baer enjoys building relationships with clients and their horses, while working together to decide the best approach for each individual horse. She has also organized several educational seminars in the community for 4H, Westernaires, and Pony Club kids – previously in-person and now in an online format.

Outside of work, you will find Dr. Baer riding her off-the-track Thoroughbred, Liam, acquired during her days of racetrack practice in Pennsylvania. She hopes to return to the show ring this spring. She also takes full advantage of Colorado’s outdoor activities, including hiking, snowshoeing, rock climbing, mountain biking, and skiing. In rare moments of downtime, she also enjoys reading, foreign languages, cooking, and baking.

Pictured with Dr. Baer is Nora, vet truck dog in training.

Dental Xrays for Horses? Of course!

Dental radiographs (Xrays) are a routine procedure for us humans at the dentist’s office, but they are also invaluable for equine dentistry. As equine dentistry has significantly advanced in recent years, improvements in portable radiography equipment have dramatically increased the quality and diagnostic capability of our imaging. 

Findings on an oral exam that would indicate the need for dental radiographs include fractured teeth, loose teeth, diseased incisors, or evidence of sinus infection, such as nasal discharge. The portion of the tooth that can be visualized in the mouth is called the clinical crown, but there is significant length of tooth, as well as the roots, hidden beneath the gum line. Radiographs are the best way to evaluate the entire tooth while working in the field. They can identify disease that may not be readily apparent on an oral examination – such as infected or fractured tooth roots. Radiographs can help us decide if a tooth needs to be extracted and plan the best approach for extraction. Serial radiographs are helpful to monitor suspicious teeth over time. 

Preparing your horse for dental radiographs is much like preparing your horse for routine dentistry. Appropriate sedation ensures your horse is adequately relaxed and still so that we can capture good images. Depending on the area of interest (sinus, incisor teeth, or cheek teeth), your horse may have his mouth open for images taken at varying angles. We also have an intra-oral plate, similar to what you encounter with your own dentist. Intra-oral plates are great for imaging the incisors, as well as focusing on just few cheek teeth at a time while avoiding overlapping teeth of opposite sides. Our xray equipment allows us to take high-quality images in the field with the images immediately available for review. See below for some interesting Xrays.

Intraoral radiograph. The dark area is an abscess in the mandible (lower jaw) which developed secondary to an infected canine tooth.
Intraoral radiograph of 2 fractured incisors following trauma. Both teeth were extracted.
Red arrow is pointing to a “fluid line.” A sinus infection has filled the sinus with fluid. The nose is toward the bottom of the image, the horse is facing to the left, and you are looking at the horse’s head in profile.
The horse’s nose is pointed toward the right side of the image, showing the upper cheek teeth. The roots and tissue surrounding tooth 9 are abnormal. This horse had a history of one-sided malodorous nasal discharge. The diseased tooth was extracted.


Is your horse current on his rabies vaccination?

Rabies is caused by a virus that infects mammals and is spread through the saliva/bites by infected animals. The virus exists in several wild animal reservoirs, most commonly bats, skunks, raccoons, and foxes. After the virus is transmitted via bite, it replicates in the muscle at the site of the bite, and then travels to the central nervous system (brain and spinal cord). The virus continues to replicate in the central nervous system and then spreads through the rest of the body, including the salivary glands, which then allows transmission to other susceptible animals.

Is rabies a problem in Colorado?

In 2019, there were 173 lab-confirmed cases of animal rabies in Colorado, including canine, feline, and camelid cases. So far in 2020, Colorado has seen 71 lab-confirmed cases of rabies, including in a dog, goat, sheep, and bull. It is important to remember that because rabies is endemic in bat, skunk, and raccoon populations, these numbers don’t accurately represent the true prevalence of this disease.

What does rabies look like in horses?

While mention of rabies conjures images of a frenzied animal frothing at the mouth, clinical signs in the horse can be extremely variable, so many people may be potentially exposed before a diagnosis is made. Non-specific signs of rabies in horses can range from colic and lameness to fever and depression. There is no available testing to diagnose rabies in the live horse. When examining an un-vaccinated horse exhibiting bizarre behavior or neurologic signs, your veterinarian must consider rabies as a potential diagnosis. Signs in an infected horse progress rapidly, usually leading to death within 5-7 days. Rabies is always fatal in an unvaccinated horse.

The rabies vaccine is a core vaccine for horses, according to the American Association of Equine Practitioners (AAEP). A core vaccine is one that is essential for every horse, regardless of the horse’s lifestyle. Rabies is a FATAL disease but it is preventable through annual vaccination by your veterinarian. Because human infection is also fatal, rabies vaccination in domestic animals is a matter of public health. Any person who may have potential exposure to rabies should immediately contact their health provider.

Protect your horse- and yourself! Be sure to keep your horse’s rabies vaccination current, and don’t forget to vaccinate your barn cats and dogs!

Should You Microchip Your Horse?

Microchips: an easy, indisputable way to definitively identify a horse. In situations such as evacuations due to natural disasters or horse theft, it’s easy to see how microchip identification is invaluable. Other forms of identification are more subjective than a unique microchip number- markings change with time, tattoos become more difficult to read, and brands can be altered.

A microchip can also serve as proof of ownership, deter fraud in the sale of a horse, and identify at-risk horses at auction. But did you know the microchipping is also replacing older identification methods in breed registries? Did you know that many competitive organizations now require microchips?

Since 2013, the FEI has required microchips for competing horses. As of 2017, the Jockey Club requires microchipping for registration of Thoroughbred foals. The USEF and USHJA have required microchips since 2019. The AQHA is encouraging microchipping through the AQHA Microchip Pilot Project. The European Union has required microchips for foals since 2009. RPSI, Norwegian Fjord, and Oldenburg breed registries require microchipping.

The process of getting your horse microchipped is simple. First your veterinarian will scan your horse for an existing chip. Providing a chip is not found, your veterinarian will clean and prep the location for microchip placement. The standard location for placement is on the left side of the neck, halfway between the poll and the withers, within the nuchal ligament of the neck. The microchip is then scanned before placement to make sure the chip is read correctly. Each chip has a 15-digit unique number. The chip is inserted into the site and scanned again after placement to ensure it is read properly. Most horses tolerate this quick procedure very well, although the site can numbed with an anesthetic prior to chip placement if desired. Please contact us if you are interested in getting your horse microchipped. This procedure can be easily added to your horse’s next preventative care visit.

See the following links for more information on microchipping and show requirements:

https://files.usef.org/assets/WU5vkmldZDg/microchipping-faqs.pdf

https://equinemicrochiplookup.org/

https://www.aqha.com/-/aqha-microchip-pilot-project

https://www.ushja.org/competition/rules-and-proposals/microchipping-101

How does the smoky air affect my horse?

While the current wildfires are at some distance from us, we have not been spared from widespread smoke and poor air quality over the last few weeks. Just as poor air quality can be an irritant for us, it can also affect your horse. Unhealthy air contains irritants that can affect our eyes and nasal passages and may have a greater impact on those – both human and equine – with pre-existing respiratory conditions.

Smoke is composed of carbon monoxide, carbon dioxide, soot, nitrogen oxide, particulates, and trace minerals, as well as the primary source being burned (wood, vegetation, plastic, etc). The smoke from wildfires is high in particulate matter, which is problematic because of its extremely small size. Particulate matter easily travels to the smallest airways of the lungs, causing irritation and damage. For humans and horses, it can cause coughing, nasal discharge, and increased respiratory effort. It can also interfere with the normal defense mechanisms of the respiratory tract, decreasing immune function and the ability of the lungs to clear routinely encountered foreign materials. Horses with pre-existing respiratory conditions, such as heaves and allergies, are more sensitive to poor air quality.

How do I know if it’s safe for my horse to work?

The Air Quality Index (AQI) is the Environmental Protection Agency’s daily grade of air quality. The AQI accounts for five major pollutants: ground-level ozone, particle pollution (particulate matter), carbon monoxide, sulfur dioxide, and nitrogen dioxide. Air rated as “good” has an AQI <50. Today, August 17, 2020, Golden has an AQI of 57 (moderate), stating that air quality is acceptable, although there may be a risk for those who are more sensitive to air pollution.

Although there are currently no recommendations specifically for horses based on AQI, there are guidelines available for human athletes. The guidelines suggest removing sensitive human athletes from outdoor competition when AQI is >100 and removing all athletes from outdoor competition when AQI > 200.

What can you do to help your horse?

Be conscious of the air quality index and conditions. Go to https://www.airnow.gov/aqi/ to find the AQI in your area.

Limit exercise when smoke is visible.

Ensure adequate clean water is always available to your horse.

Limit exposure to additional dust- consider soaking hay prior to feeding.

Seek veterinary attention if your horse is showing any signs of respiratory difficulty or distress.

Coggins, Health Certificates, and Brand Inspections

While summer trail riding trips and horse shows may seem like wishful thinking right now, it’s always a good idea to understand what paperwork and lab testing are commonly required when traveling with your horse. What are Coggins Tests, Health Certificates, and Brand Inspections, and when do you need them?

Coggins Test

A coggins is a simple blood test that certifies that your horse does not have Equine Infectious Anemia (EIA). This test is generally required annually by many boarding facilities and horse shows. A current coggins is also required for travel across state lines.

This test requires a small blood sample from your horse and as well as digital photos displaying all of his markings. The blood samples are processed at a nearby lab and results are emailed when completed.

Health Certificate

A health certificate may also be called a CVI (certificate of veterinary inspection). A health certificate is mandatory for crossing state lines, and may also be required for some horse shows and events. Generally, a health certificate is valid for 30 days, although during infectious disease outbreaks (such as vesicular stomatitis), individual states may change their requirements for incoming horses. The health certificate requires a brief examination of your horse by your veterinarian, whose signature certifies that your horse is free of disease and healthy for travel. For interstate travel, the horse’s coggins information is also included on the health certificate. It is best to always check with your destination event or state in advance, as health certificate requirements can change.

Brand Inspection

Although not all states issue brand inspections, a brand inspection is required by the state of Colorado for horses traveling greater than 75 miles within Colorado or across the state border, and prior to transfer of ownership. The brand inspections are issued by a brand inspector with the Colorado Department of Agriculture. About 2-3 days notice is required to schedule a brand inspection for your horse. For more information about brand inspections, please see the Colorado Department of Agriculture’s website: https://www.colorado.gov/pacific/agbrands/when-get-inspection

Take home message: Plan ahead when organizing for travel with your horse and review any requirements specific to your destination or event. Please help your vet help you by allowing enough time to complete the necessary paperwork and testing so that your trip goes smoothly!