Horse Trailering 101

With summer finally here, I hope more and more clients will be loading up their horses and hitting the road on their next great adventure!  As you’re packing up your trailer here are a few aspects of trailering that might be worth considering to ensure safe and successful transit.

Trailer Maintenance

While your trailer doesn’t need its oil replaced and its wiper blades changed, it does require annual maintenance to insure safe and effective usage.  Every year, ball bearings should be inspected, cleaned and repacked with fresh lubricant.  The brake assemblies should be checked to ensure optimal braking and all exterior lights should be inspected and replaced if necessary to provide ample visibility.  Make sure your trailer breakaway battery is live and holding charge.  Kick those tires a few times.  Are they underinflated? Flat? Cracked or succumbing to dry rot?  Lift the floor mats and inspect the flooring underneath.  Any rotten wood or rusted metal should be replaced to ensure your horse doesn’t fall through the trailer floor.  Check the ceiling for any hornets or wasps who have decided to take up residence in your trailer over the last few months.  All old bedding should be stripped and new applied to prevent excessive dust from circulating while in transit.  Replace old hay with new and if you have a water tank, drain and clean it before adding fresh water for the season. 

Trailer First Aid

When traveling with my horse, I always make sure I have a well-stocked equine first aid kit.  (Do I have a human first aid kit too you ask?  I feel much of my horse’s first aid kit can be utilized for human trauma and there’s always a few Advil floating around the bottom of my purse.  That’ll suffice, right?!).  In an ideal world, your day to day equine first aid kit would be portable and you could just pack it along with your horse.  But, if you are leaving a few equine friends behind, follow this link to learn more about what should be in your equine first aid kit and how to determine if veterinary intervention is required in case of emergency.  https://aaep.org/issue/guidelines-equine-emergencies 

Now that we have equine first aid covered, what about your trailer?  What happens if you get a flat tire?  Do you have the tools to change it?  The two most important pieces of equipment for changing your trailer tire are a Trailer Aid wheel jack (or something comparable but trust me, this product is a lifesaver!) and a 4-way tire iron lug wrench.  There are plenty of good tutorials out there to demonstrate the tie changing process so I won’t go into that here.  Just be sure you pull off the highway as much as possible to change the tire, leave the trailer hooked to the truck and leave the horses on the trailer.  There are a multitude of other complications that can arise while on the road but this is where having reliable roadside assistance will come in handy!

Hauling Safely

Many horseman make the decision to wrap their horses legs while hauling.  There are various makes and models of equine shipping boots that are easy to apply and offer superior protection in the case of an accident.  Regardless of the length of the trip, as a horseman and veterinarian, I would always recommend wrapping your horse’s legs.  You never know when the car behind you won’t be paying attention and may end up rear ending your rig. 

In most situations, the horse’s head should be tied a length that precludes him from moving excessively in the trailer while also enabling him to eat, drink and clear his nose.  If a horse’s head is tied too short and they’re being shipped for long distances, they are deprived of the ability to clear debris from their upper airways through sneezing and coughing.  When this situation arises, equine shipping fever is a common complication of the respiratory tract.  I also recommend horses are tied in a trailer with a breakaway halter in case of trailer accident. 

As for distance, it is ideal to keep daily travel time under eight hours.  If you must exceed this time frame, be sure to offer water to your horse multiple times while on the trip.  It is common for horses to go off water while shipping so I recommend clients feed their horses a soaked diet for two to three days prior to a long trip, during the trip and two to three days after the trip to insure adequate hydration.  Soaked beet pulp, hay products and grain are great sources of feed that can be used to create a mash. Electrolytes in powder or paste form also work to stimulate thirst and facilitate the consumption of water.  Failure to consume adequate water during shipping may result in impaction colic. 

Taking your horse off property should be a fun and exciting adventure.  Preparing for common difficulties while on the road will help to establish confidence in the trailering experience and will set you and your horse up for success in the case of emergency. 

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!

Core Vaccines

***This blog was originally written in January of 2020, and as of today, March 24th, 2020, times have changed significantly.  With Covid-19 causing the issues that it is, we feel it necessary to add the following statement.

Governor Polis on 3/20/2020, in Colorado Executive order 2020 009, made veterinarians part of the list of essential workforce to continue with “necessary procedures.”  For the safety and welfare of horses, the Mobile Veterinary Services vaccination schedule will continue as planned.  If delayed 3 or more months, depending on conditions, our horses will become susceptible to deadly diseases.  

As always, at MVS, we strive for clear client communication.  We will keep everyone informed to the best of our abilities as to the orders placed on us as veterinarians.  Please feel free to call with individual questions that you may have. ***

There is a long list of vaccines available to give our horses.  Owners and even veterinarians can get bogged down in the details, and that’s just based on the vaccines available. 

Then we start to talk about schedules for each group of horses.  Groups like Adult horses vaccinated in the past, Adult horses with no known or no history of vaccines, Foals (of vaccinated mares), Foals (of unvaccinated mares), oh yeah, and the broodmares!  Whew, I think that covers the horse population!!!

Really quickly a discussion of “just vaccines,” gets complicated.  Mobile Veterinary Services will always fall back on, “talk with your veterinarian to make a plan for YOUR herd and their individual needs.”  Here, we would like to discuss “core vaccines.”

What is a core vaccine? 

As defined by the AAEP (American Association of Equine Practitioners) a core vaccine “protects against diseases that are endemic to a region, are virulent/highly contagious, pose a risk of severe disease, those having potential public health significance, and/ or are required by law.  Core vaccines have clearly demonstrable efficacy and safety, with a high enough level of patient benefit and low enough level of risk to justify their use in ALL equids.”  It’s a mouthful, but what does it mean?  In the end, it means that they are safe, low risk, and designed and developed to protect horses and humans alike. 

These are the Core Vaccines recognized by the AAEP:

Tetanus:  Should be given annually.  If there is a question as to the status of a horse, they should receive a 2-dose series (4- 6 weeks apart).  Colts should receive a 3 shot series beginning around 6 months of age, second dose 1 month later, and another dose at 1 year old. 

EEE/WEE (Eastern Equine Encephalitis/ Western Equine Encephalitis):  Just like the Tetanus, it should be given annually, and they should go through an initial 3 dose series.  Conveniently, tetanus is often in a combination vaccine with these two. 

West Nile Virus:  As with the two above, West Nile should be given annually.  This is often in combination with WEE/EEE and Tetanus and can be given to colts and fillies in one shot on the same 3 dose schedule. 

Rabies:  Rabies is 100% fatal, in ALL species.  All youngsters should receive 2 vaccines starting around 6 months old (second one about 1 month later).  Then, every horse, every year should receive a booster. 

Every horse should receive at least these vaccines, every year.

It is important that these vaccines are handled correctly and managed at the appropriate temperature and environment to ensure that the vaccine is an effective and SAFE one.  This is the biggest reason that we recommend that you receive your vaccines from a licensed veterinarian.   If you ever have questions about your herd’s (no matter how big or small) vaccination protocol, please feel free to reach out to MVS!

Coronavirus and Veterinary Medicine

As we all hunker down for a few weeks of self-quarantine and social distancing, we want to alleviate any concerns our clients may have as it pertains to the potential transmission of coronavirus between horses and people.  While equine and bovine coronavirus has been present in the agricultural industry for quite some time, the disease is of gastrointestinal origin (diarrhea) and is not related the human respiratory virus (pneumonia) currently circulating our continent. 

As more research is conducted on this current respiratory coronavirus impacting human patients, it has become clear that the viral particles remain active outside of a human host for up to nine days.  This means that if one of your family members has COVID and sneezes directly onto your horse’s neck and you proceed to immediately rub your nose in that site on the horse’s neck, the horse could act as a fomite, thus delivering viral particles to you.  Otherwise, your horse is not a carrier of COVID and you cannot transmit the virus back and forth between each other. 

Here at MVS, we are still working at full capacity while taking measures to practice social distancing amongst ourselves and our clients.  If you are sick or feeling under the weather, please know that our doctors travel with a technician and can complete the appointment in your absence.  If you wish to be present, feel free to reschedule your appointment.

If you have any additional questions or concerns, please don’t hesitate to reach out to one of the MVS docs.  We’re here to help!

How to Select a Concentrate for Your Horse

With the variety of different feed and supplement choices available, it can be overwhelming to make decisions regarding your horse’s diet. It is important to remember that horses are grazing animals, designed to spend much of their day eating forage. Forage (grass and/or hay) should comprise most of your horse’s diet, at a rate of about 2% of his body weight per day. Of course, the nutrient profile of different forage sources can vary as well, so a hay analysis can provide more detailed information about nutrient content. 

When selecting a feed, be sure to look for the feed tag or guaranteed analysis. This tag describes the composition of the feed, including protein, fat, fiber, and mineral content. You will also find guidelines for recommended amounts to feed your horse, depending on his weight, workload, and stage of life.

What kind of concentrate does my horse need?

If your horse is not in heavy work and maintains an appropriate body condition score easily, he does not need high levels of concentrate added to a forage diet. A product called a ration balancer is perfect for these horses. Ration balancers are designed for the easy keeper to be relatively low in calories but contain the vitamins and minerals that may be lacking in a forage-only diet. For these horses, daily forage intake at 2% of body weight per day, a ration balancer fed by weight as directed, and access to a mineral block may be all that is needed.

For horses in heavy training, those with a higher metabolism, or those with compromised teeth, more calorie-dense concentrates may be beneficial. For example, a Thoroughbred racehorse will need extra calories from a concentrate to take in enough calories each day for race training, while an aged horse unable to chew adequately will need a forage substitute.

Examples of horses with varying dietary needs



Red, a 16-year-old quarter horse gelding. 

Job: light trail riding 1-2 days per week, easy keeper. Because Red has a less demanding job and maintains his weight well on hay alone, he doesn’t need extra calories from high-energy feeds. A ration balancer is a perfect option to ensure Red has the appropriate vitamin and mineral balance in his diet, without supplying extra calories. 





GiGi, an 11-year-old TB mare

Job: upper-level eventer.  GiGi is a high-level athlete, and as a Thoroughbred, she has a higher metabolism. She is in intense training 4-6 days per week, eats free choice hay, and needs the extra calories from a performance feed to maintain her condition. Many performance feeds offer high-fat content in addition to protein and fiber, as a more calorie-dense option.





Jack, a 25-year-old appendix gelding

Job: retired, hard keeper with many missing teeth. Lack of teeth means that Jack has a hard time chewing hay efficiently, which also puts him at an increased risk of choking. The best feed for Jack is a complete senior feed. The “complete” description means that this feed is formulated to meet all of his nutritional and caloric needs in the absence of hay. Of course, this means that a much higher amount of feed must be fed daily. Regular (non-complete) feeds are generally not safe or nutritionally balanced to feed in such high amounts. If you’re feeding a horse like Jack, remember to check the label of the senior feed to be sure it says ‘complete’.



 Remember, ALWAYS weigh your feed- the label instructions on the bag will have recommendations based on weight (The weight is NOT 1 coffee can…) It is much easier to adjust your horse’s diet when we know exactly how much he is consuming. The easiest way to do this is to put your feed scoop on a food scale, tare it, add feed to desired weight, then draw a line on your scoop so you can feed consistently at every time. Another important note is that feeds are not all the same weight, so if you switch feeds, 2lbs of feed A is probably not the same amount in your scoop as 2 lbs of feed B. As always, if you have questions or would like help selecting a concentrate, consult with your veterinarian.

Paging Dr. Google!

The internet is a phenomenal resource readily available at our fingertips.  There is a wealth of published information for horse owners to access, but how can one tell if the data they’re reading about is legitimate?  How do you know if that source can be trusted and what key words should cause red flags to fly?  Below are some helpful tips to help decipher the plethora of equine related articles available to you on the world wide web.

AUTHOR: Who is the article written by?  If you’re looking for information on vesicular stomatitis in the Colorado equine population, be sure your data is provided by veterinarians at the forefront of the outbreak or governing bodies like the State Veterinary Board or the Department of Agriculture.  If there is no direct reference to the credentials of the author at the beginning of the article, there should be references listed at the end of it.  Feel free to refer to these references to assess their origin as well!

Photo Courtesy Public Domain Photos via Flickr

PUBLISHER: Has this data been published in association with a research institute like a university or college of veterinary medicine? Often such establishments are at the forefront of medical research and product development.  If you’re reading an article about the protein content of alfalfa hay published by the agricultural or livestock nutrition department of your local vet school, I’d say that data is worth utilizing.  If you’re reading about the magnesium content of crimped corn from your local neighbor’s horse blog, I’d dig a little deeper into the cited references of that information prior to quoting from such a source.  Or, better, yet, confirm those claims utilizing an advanced search engine!

ADVANCED SEARCH ENGINE: As a veterinarian, some of my favorite search engines include Google Scholar and PubMed.  Use of these search engines results in peer-reviewed literature, usually containing legitimate data.  Most of the search results will link directly to an abstract of the article where you can read the purpose of the study and the key findings.  Further perusal of the content usually requires purchase of the article for an exorbitant amount of money or requires you to access it through the online library of an educational establishment.  Now is the time to capitalize on the perks of your children in college!  By signing into the online library of an educational institution, there is a wide array of resources available to those who know how to find it.

QUANTITATIVE ASSESSMENT: So, you’ve found several articles that are pertinent to your quest for knowledge.  First, look at the date the article was published.  Anything older than five years of age warrants an additional search for newer material.  If you come up dry, that’s okay, at least you tried.  Generally speaking, the fresher the data, the better the outcome, kinda like milk.  Next, how large is the study group?  If a study conducted to determine the negative side effects of a prescription medication was only performed on 15 patients, I’d look for a larger study group upon which conclusions can be drawn.  Conclusions drawn from larger study groups are more statistically sound. 

QUALATATIVE ASSESSMENT: So, you’ve found a recent article, published in association with a research institute with a large test population.  Well done! Next let’s assess the study design.  When reading through the materials and methods portion of the article, does it sound like only one variable was tested, or were multiple variables in play?  Anything more than one variable confounds the conclusions of the study.  And how about the conclusions?  Could any conclusions be discerned from the study and if so, with how much certainty?  The higher the statistical support of the conclusions, the sounder the data originating from that particular study. 

RED FLAGS: When perusing articles for information, stay away from absolute verbiage like “Horses with Cushing’s Disease always have long, shaggy coats” or “Laminitic horses invariably stand with a camped-out stance”.  Most educators try to give a wide array of possible options for a given situation because no two animals ever act exactly the same.  (Now there’s an absolute you can count on!) Also, be wary of products touting “The Ultimate Supplement” guaranteed to address dull coats, shelly hooves, chronic gas colic, gastric ulcers and arthritis… all in one product!  No such magic exists. 

If you’re not interested in consulting research studies while pursuing equine related data, turn to trusted publications like The Horse, which often cites and digests scientific articles into reader friendly versions.  Or, just ask your veterinarian!  We’re always happy to help seek out and provide legitimate information for you and your horse. 

Deciphering GI supplements

Prior to picking out a GI supplement for your horse, I would highly recommend you refer to an earlier blog I wrote discussing how to go about picking a general nutritional supplement. The post contains some decent tips and tricks to better prepare you to find the best GI supplement for your horse.

Once you have a general idea of how to pick a bioavailable supplement, let’s dive into why you would want to supply a GI support supplement.

Does your horse need a GI supplement?

Some of the most common reasons I recommend a GI supplement include:
• Chronic, mild episodes of gas colic
• Chronic gastric ulcers
• Chronic diarrhea
• Sand accumulation in the hind gut
• Recovering from acute colic surgery
• Intoxication (plants, feed, GI disease, etc.)
• Long term use of Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

What ingredients should the supplement include?

If we’re looking to repopulate the equine GI tract with healthy bacteria, stick with a product containing Sacchromyces boullardi organisms. These bugs seem to be able to survive the incredibly acidic environment of the equine stomach so that they can make it to the hind gut to elicit a beneficial response. In addition, certain strains of microorganisms, like Lactobacillus, can also competitively disable pathologic bacteria within the GI tract to keep them from initiating a disease process.

As for the foregut, horses suffering from chronic gastric ulcers can usually benefit from long term supplementation of a product geared towards neutralizing the acid naturally produced in the stomach. This can include any kind of a chemical base but the key to delivering an efficacious response with these products is the consistency in which the supplement is delivered. Horses empty their stomachs every 10-15 minutes so direct buffering of the stomach contents must be an ongoing process. For best effect, these supplements are provided several times a day. There are also several plant-based products, like aloe vera, that some owners have anecdotally found to be effective.

What do the studies say?

In over the counter research studies pertaining to veterinary probiotics, label claims regarding the species and number of viable organisms in the product, appear to be quite inaccurate. As such, it is often more effective to focus on providing valuable prebiotics for the microorganisms currently residing in your horse’s GI tract. Many of the prebiotics on the market contain various type of high-value fiber products for the microbes to ferment. Since the forage and fiber in these products isn’t damaged by the acidic nature of the stomach contents, this is often a better approach to caring for the hind gut microbes.

Overall, there is a vast array of supplements on the market and most of them are not worth the investment. If you have concerns about the health of your horse’s GI tract, please reach out to your veterinarian and we will be more than happy to recommend products we have found to be most beneficial in each situation.

Caring for Your Senior Horse

At what age is a horse considered geriatric or senior? Does owning a senior horse mean that he must eat a feed labeled as a “senior” feed? As always, the answer is, it depends. Our horses are living longer lives than ever, thanks to an evolving understanding of the needs of geriatric horses and our ability to provide high quality care. There is no set age cutoff as to when a horse is considered geriatric, but most experts agree this can be around age 20. However, age is just a number, and many horses are still active and competing into their twenties, while others are happily retired. The main issues we see in our older horse population include dental disease, altered dietary needs, metabolic disease/PPID (Cushings), and arthritis.

 

Photo Courtesy PugnoM on Flickr

Dental Changes

The ideal time to begin focusing on your horse’s regular preventative veterinary care is when he is young. Horses receiving regular preventative care, especially veterinary dentistry, preserve their teeth longer and can age more gracefully. Waiting until signs of dental disease or difficulty chewing are observed often indicates advanced disease and more limited treatment options. Most horses benefit from yearly dentistry, which includes a thorough sedated oral exam with a dental speculum, light source, and mirror. A thorough oral exam is vital to accurately assess, document, and treat any issues.

Horses suffering from abnormal dental wear, cracked or missing teeth, or severe periodontal disease may require more frequent care. Even though horse teeth are described as “long rooted,” they do eventually wear out, so proper care ensures the longest possible life of the tooth. Common dental issues in older horses include fracture of cheek teeth, complete expiration or wearing out of cheek teeth, loose/painful teeth, and periodontal disease. The incisors can also be affected by similar conditions.

Staying on top of your senior horse’s dental care helps ensure that he gets what is needed from his diet. Sometimes severe dental disease and impaired chewing ability necessitates eliminating hay from the diet entirely. Complete feeds are formulated specifically for horses that can no longer chew hay effectively. These diets have greatly improved the quality and length of life for senior horses with compromised teeth.

Nutritional Changes

Nutrition recommendations for the geriatric horse are formulated around maintaining an ideal body condition. In the geriatric horse, this can be complicated by difficulty chewing, poor teeth, metabolic disease, and decreased ability to digest fiber and protein. For older horses in good weight and with adequate dentition, little dietary change may be required. For older horses who have difficulty maintaining weight and/or compromised teeth, complete feeds as mentioned above can help. These feeds are high in easily digestible fat, fiber, and protein, and are designed as easy-to-chew. They are formulated to replace hay entirely for those horses that can no longer adequately chew hay.
Adding water to soften the feed can reduce the risk of choke and ensure additional water intake. Feeding recommendations are often listed as pounds of feed per day depending on whether the horse is also eating hay, so it is important to weigh out your horse’s portion so that any necessary adjustments can be made more accurately.

Metabolic Changes

A curly haircoat and muscle loss over the back aren’t just signs of aging- They can indicate a common underlying condition: equine pars pituitary intermedia dysfunction, more commonly known as PPID or Cushings disease. This is a treatable (but not cureable) condition that is very common in geriatric horses, resulting in hormonal imbalances and symptoms such as delayed shedding, curly hair coat, muscle loss over topline, increased drinking and urinating, personality changes, and increased susceptibility to infections and laminitis. Diagnosis is made by a blood test as well as by history and clinical signs. Management involves daily administration of pergolide (Prascend) tablets, which help restore normal hormone levels and alleviate the clinical signs of the disease.

Equine Metabolic Syndrome (EMS) is a separate metabolic condition, but it sometimes occurs in conjunction with PPID. EMS horses typically show signs of being an “easy keeper”- cresty neck, regional fat deposits behind the shoulders and at the tail head. Horses with EMS are more susceptible to laminitis and usually have a higher baseline insulin level than normal. EMS horses are managed with strict attention to diet (minimizing sugar and starch) and exercise to help them maintain a lean body weight.

Joint and Muscle Changes

Just like us, aging horses suffer from daily aches and pains. An examination with your vet can help identify major and minor issues and

Photo Courtesy nikki_tate on Flickr

determine what treatment plan works best for you and your horse. Many options are available to keep our old horses comfortable.
Nutraceuticals (supplements) are very popular, although many of these products lack proof of efficacy and ingredients. More researched options include medications such as adequan (administered intramuscularly) and Legend (administered intravenously). These medications help provide the components necessary to keep joints healthy.

Joint injections target individual joints to reduce pain and inflammation and improve mobility. Non-steroidal anti-inflammatories such as Equioxx are also helpful, along with acupuncture and chiropractic care. Stable management is equally important- maximum turn out time allows horses to move at will, and monitoring herd dynamics ensures that older horses are not prevented from accessing food and water. In addition to these considerations, regular veterinary and farrier care will help your senior horse enjoy his golden years with you.

As always, if you have any questions about caring for your senior horse, please contact your veterinarian who can offer a personalized plan to help keep your geriatric horse happy, healthy, and comfortable well into their senior years.

Joint Injections: The what, when and why of intraarticular medications

Photo Courtesy nikki_tate on Flickr

Arthritis is one of the most common joint diseases found in the equine industry.  It is the leading factor of decreased performance and chronic lameness in our equine partners and is the source of much frustration and consternation.  The insidious nature of the process means that we as horseman don’t always catch it in the early stages, and instead, are left dealing with the disease in more moderate to advanced situations.  In a previous blog we’ve focused on how to prolong the onset of arthritis by using systemic nutraceutical or injectable products like Cosequin and Adequan (you can find that post here).  This article will focus on the options available to us when these initial attempts against arthritis are no longer efficacious.

What happens during a joint injection?

Once our systemic therapies like Adequan and Legend have no longer proven to be effective in reducing joint pain associated with arthritis, we turn to localized treatment directly within the damaged joint.  Prior to injecting any joints, your veterinarian will perform a thorough lameness exam to isolate the joint(s) from which the lameness is originating.  From there, we as veterinarians prefer to obtain radiographs of the joint in question.  This provides us both a baseline for future assessments as well as a better opportunity to understand any changes to the diseased joint that may alter our approach to needle placement.  The information obtained from the radiograph enables us to give our clients a more accurate prognosis for both post-injection soundness and duration of efficacy of the injection.

Preventing joint infection

Once you and your veterinarian have agreed to inject a joint(s), your veterinarian will then display an odd set of behaviors in which they tirelessly seek out the ideal location to perform an injection.  The biggest risk associated with a joint injection is infection, so we tend to be pretty picky about when and how we inject.  We avoid all windy situations, including drafts, as it seems just as you place the needle into the joint, a large gust of wind comes along and stirs up dust and debris which could potentially contaminate the joint.  We also avoid injecting horses with wet mud/manure directly over and surrounding the site of injection.  Clean, dry legs are necessary. We avoid areas of high traffic, as all it takes is an unknowing rider or the sneeze of a horse to contaminate our sterile site.

The ideal environment for a joint injection is one that has clean, dry footing (rubber mats or concrete work best), that is enclosed to restrict

Image Courtesy USMC via Flickr

or prevent airflow.  Fewer birds in the overhead peanut gallery is also preferred!  If these requirements cannot be found, don’t be surprised if your vet chooses to reschedule for a calmer/dryer day or you’re asked to relocate to a more ideal location.  At the end of the day, a joint infection can be life altering so we strive to avoid those at all costs!

The injection process itself is also sterile.  We will relocate all sources of potential contamination (tails, lead ropes, etc.) and will usually clip the injection site.  All joint injections are preceded with a 12-minute sterile scrub, and all products used in the injection process are also sterile, including your vet’s gloves!  Most practitioners will also use a small amount of antibiotic within the injection itself to further reduce the risk of infection.

What exactly is injected into the joint? 

As mentioned before, there is a small amount of antibiotic that is included in every injection, but beyond that, there is significant variability.  Larger volume joints (think coffin joints, knees, stifles, fetlocks) usually receive a high molecular weight hyaluronic acid (HA) and possibly steroids.  The steroids work to decrease the pre-existing inflammation within the joint and the HA helps bring healthy components into the area to improve the overall joint environment.  (There is also a mild anti-inflammatory response associated with HA).  Lower volume joints (pastern joints and the lower hocks) usually just receive steroids and antibiotic, forgoing the HA due to the small volume of joint space available to accommodate the injection.  There are several types of steroids available to use and which steroid we use is dependent on a multitude of factors.  These include high vs low motion joints, age of horse, severity of the intraarticular disease process, and metabolic status of the horse.  Steroids are contraindicated in horses with metabolic disorders which then has us reaching for an alternative – autogenous intraarticular therapies also termed “regenerative medicine.”

Regenerative Medicine Therapies

For those horses with metabolic issues or who no longer respond well to intraarticular steroids, we now have a variety of options for use in their place.  IRAP (interleukin-1 receptor antagonist protein), PRP (platelet rich plasma) and Prostride are all newer, autogenous technologies available to the veterinary industry.  While PRP and ProStride have applications in horses with arthritis, IRAP is far and away the most commonly used.

IRAP is processed directly from your horse’s blood and it works to counteract the interleukin-1 (IL-1) inflammatory protein.  The blood is collected into a special tube that is then incubated for several hours.  During the incubation process, the IRAP molecule is amplified within the sample.  After incubation, the sample is spun in a centrifuge which then separates the red blood cells from the IRAP rich plasma.  The plasma is then divided up into small aliquots to be used during the joint injection process.  Unlike steroids, which usually only require one injection to have a beneficial response, IRAP requires 2-3 injections, separated by 2 weeks in order to deliver similar results.  The IRAP injections usually last an average of 6-8 months, but the duration of efficacy is dependent upon a multitude of factors and is different for every horse.

While arthritis can be a difficult condition to overcome, rest assured that we do have a large variety of therapeutic options to pursue.  Please don’t hesitate to reach out with additional questions or concerns the next time you see one of us at your barn.  We’re always happy to help you and your horse!