Equine Preventative Medicine Checklist

Along with spring comes vaccinations and preventative care appointments for our equine friends. We all understand the importance of preventative medicine, but it’s easy to miss things, so we’ve prepared a list of what you should be doing with your horse to make sure they’re healthy and prepared for summer riding season.

Vaccinations

We will start with the easiest – vaccinations. Vaccine protocol for the spring varies depending on your geography and your individual horse’s exposure potential and travel schedule. Always consult with your veterinarian if you are going to travel somewhere new with your horse. Here on the Front Range, we typically recommend a 5 way (eastern and western equine encephalitis, tetanus, rhinopneumonitis, and influenza) and a West Nile booster as the basic starting place for spring vaccinations. For a more in depth discussion of the vaccinations we recommended in Colorado and why, see the blog titled Why are the Vaccines we give in Spring So Important Here in Colorado?

Deworming

Deworming used to be easy – give your horse a deworming paste at set intervals and you’re done. But research has shown that deworming is certainly not as straightforward as we once thought it was. There are several options and differing approaches to deworming, and whether you opt to use a classical “rotational” deworming, or a more targeted “Fecal Egg count” approach, spring is a time to think about how to protect your horse from internal parasites. There are pros and cons to different deworming approaches, and we have complete articles on both of these regimes listed below.

Rotational Deworming – What’s the Right Choice?

The Scoop on Fecal Egg Counts

Dentistry

teeth

Although there is nothing tying teeth floating to vaccination, deworming or seasonality, most people (veterinarians included) like the convenience of combining all of the preventative medicine into a single visit. Spring is a critical time to have your horses’ teeth checked comprehensively. Tooth and other mouth issues can have a dramatic impact on your horses’ comfort, performance, and even lameness issues. Dental issues and questions like “Does my horse need a float?” are immense subjects and are covered in detail in previous issues of the blog.

Why is Regular Dentistry so Critical to your Horses’ Health?

How Do I know My Horse Needs a Float?

Why Do I Need to Float my Horses’ Teeth?

Physical Examination

A good general physical exam is a good idea for all horses this time of year so that we (both owner and veterinarian) are assured that there is no need for an alteration to the diet or that some insidious disease process is slowly creeping in unnoticed. It’s also very helpful to have a baseline of your horses’ health so when changes happen they can be noticed, and dealt with, quickly. Summer is riding and show season, and a physical examination will ensure your horse is at the top of their game, making your time together enjoyable for you both. An important aspect of the physical exam that often gets ignored is a very brief (just a few minutes) lameness exam. Whether you have noticed that your horse is tripping a bit more, or he just hasn’t been evaluated, a check of his legs could be invaluable in finding a mild issue before it is a major one. If this is something you are interested in, be sure to let the office know when you schedule your appointment that you would like the veterinarian to spend a bit of time with a lameness evaluation, so that a scheduling issue doesn’t arise.

Spring Preventative Medicine Checklist

Below is a quick reference for when your vet arrives for spring tune ups for the horses. I have had clients use this little outline as a basis for questions they have for the vet when he or she arrives. We all fall victim to “I forgot to ask while you were here” questions! Happy trails and enjoy the beautiful Colorado spring!!

Quick Checklist for Spring:

  • vaccines – 5-way and West Nile Booster
  • deworming or FEC – which is better for your horse?
  • Dental – Does your horse need a teeth float?
  • General Physical including weight evaluation, diet discussion, old age changes (ie cushings), and lameness evaluation

The Problem with “Lay Dentists”

You want the best for your horse, and your horse deserves it. Advances in equine preventative care and sports medicine enable our horses to live longer and healthier lives than ever before. In addition to semi-annual wellness exams, vaccinations, and good hoof care, your horse may receive veterinary chiropractic care, veterinary acupuncture, and massage therapy, all to ensure your horse is as healthy and happy as can be.

Good dental care is a critical piece of this “whole horse” approach, vital for your horse’s health and longevity. Unfortunately, more horse owners are encountering equine tooth floating services provided by what are often referred to as “lay dentists”.  Horses – especially our athletes – benefit from the collaborative efforts of professionals, such as veterinarians and farriers. So you may ask, why not between veterinarians and “lay dentists”?

While these individuals promote themselves as equine dentists, the term ‘dentist’ is inaccurate. These individuals may have had some prior experience “floating teeth.” However, they do not have a medical education in the mechanics, physiology, or pharmacology involved. They are not permitted to diagnose or treat disease, as this is the practice of medicine. Additionally, there is no governing body to certify the education or training that these individuals have (or have not) received. Therefore, if an adverse event occurs, the horse owner is left with little recourse. In the state of Colorado, the practice of dentistry may be delegated to veterinary personnel but only under the direct supervision of a licensed veterinarian.

Equine dentistry is so much more than just floating sharp edges from cheek teeth. A comprehensive understanding of anatomy as well as the ability to perform a complete and thorough oral examination is essential.

There are five requirements to perform a complete oral examination.

  1. Sedation: Even if it is light sedation, your horse/donkey/mule must be sedated (and still!) to facilitate a complete examination of the oral cavity. Ensuring your horse’s cooperation and comfort allows the veterinarian to provide dental care more efficiently, while minimizing the amount of time your horse spends with his mouth open.
  2. Dental speculum:  This device keeps the horse’s mouth open, allowing the veterinarian to examine all the teeth. Without a speculum, the cheek teeth at the back of mouth cannot be evaluated.
  3. Light: Examination, floating, and dental procedures require light- just as your own dentist needs light to see what he/she is doing!
  4. Mirror: A mirror is needed to assess all surfaces of the teeth and gums.
  5. Dental probe and/ or a dental explorer: Like us, horses can suffer from periodontal disease, cavities, fractured teeth, and other conditions where a probe and explorer to assess depth and severity are needed to formulate a treatment plan.

Equine dentistry has evolved so much. Even in the field, complex procedures involving extractions, radiographs, or even restorations are possible. A non-veterinary “float” is a disservice to your horse- at best, incomplete, and at worst, potentially harmful.

If having a non-dentist work on your own teeth is unimaginable, why should the case be any different for your horse?

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

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.


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.

Choke in Horses

In horses, “choke” is an esophageal obstruction, usually due to poorly masticated (chewed) food,  which doesn’t obstruct the passage of air to the lungs.  Thus, in horses, choke is a serious condition but most of the time, not an immediately life-threatening one.  That said, there are complications that can arise secondary to the choke, which can become life-threatening.

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How do I know my horse needs a float?

Spring is the time of year in Colorado that many horse owners look forward to. Large mats of shedding hair wafting about in the breeze, sticking to every square inch of fleece that might be exposed. Getting your tack cleaned up for riding season now that you have hours (plural HOURS!) of daylight after you get out of work or school to ride. Working on some refresher training sessions before the show season, in case there is a little bit of rust.

All of these things are rites of spring for horse owners here in Colorado. But spring is also time to schedule your spring checkup visit with your friendly, neighborhood veterinarian! Vaccine boosters, deworming, an annual checkup, and even discussion on Body Condition Scoring are great reasons to make an appointment for your horse. Spring is also a great time to find out if your horse is due for some dental work.

Just like us, regular maintenance dental work is an important part of your horses’ overall health. Horses have teeth that continue to erupt throughout their lives, and this leads to bad malocclusions, fractured teeth, periodontal disease and even a loss of condition in horses that never have a dental procedure done. Most of us have heard of horses needing a dental “float” before (routine filing of the teeth to correct malocclusions and remove overly sharp enamel points from the horses’ cheek teeth), but do you know what the signs are that your horse may be overdue for a dental procedure? What type of things should trigger the thought that your horse could benefit from a dental equilibration or “floating”? At what age should your horse have their first dentistry performed?

Most horses benefit from having their first dental exam and float between 2 and 3 years of age. While there are some reasons to check them out earlier than this age, horses at 2 to 3 years are often beginning to go into training. Making sure that their “baby teeth” are coming in correctly as well as removing any sharp uncomfortable points can really help a young horse to focus on the training that they are receiving. Young horses have teeth that are softer, and erupt faster, than older horses. This means that they can quickly develop sharp points that cause behavioral problems.

In any horses, odd chewing motions, or problems eating are two signs that we see that could indicate the need for a dental exam. If your horse is a “sloppy eater” with grains and pelleted feeds, and they drop more feed than they eat, they could be having problems with uncomfortable bucchal ulcers (sores on the inside of the cheeks) caused by overly sharp enamel points on the cheek teeth.

Also, problems with the bit or bridle, and head shaking or resisting the rider during training can indicate that a horse is due for a float. Most pieces of tack cross the face at the exact place where horses are most likely to develop these painful bucchal ulcers. So reports of a horse “not liking” a bit or bridle, or reports of changing through different types of bridles or bits can be associated with dental or oral discomfort.

Always touch base with your equine veterinary dental expert and ask questions if it has been more than 2 years since the last procedure was performed. By taking care of this important component of preventative maintenance care, you can make sure that your equine partner has a long, healthy, and comfortable life.