Maintaining Your Horse's Well-Being with a Healthy Mouth

The old adage "straight from the horse's mouth" may seem more meaningful when you consider that a licensed practitioner can learn so much about an animal's health by examining its mouth.

A Broader Look at Health

Equine dentistry is more than just floating teeth.  Floating—the term for rasping or filing the horse's teeth—ensures that the horse maintains an even, properly aligned bite plane.  While floating is a physical or mechanical process, equine dentistry is much broader and examines the horse's health more systemically.

The general goals of equine dentistry include:

•  Improving the chewing of food
•  Relieving pain and treating or curing infection and disease
•  Promoting general health, productivity and longevity

Though most people think dentistry is primarily concerned with the teeth and mouth, it also includes the associated structures of the head – for instance the sinuses – and the effect of dental diseases on the health of the rest of the body.

Beyond the comfort and good health of your horse, there are other benefits to proper dental care.  Your horse will consume feed more efficiently with less spillage or waste and may perform better and live longer.

Schedule Exams Regularly

Dental disease is a source of pain and infection—it can affect the systemic health of your horse, especially if undetected or left untreated.  Routine examination by an experienced, licensed veterinarian will help detect dental disease and other health problems early—before they threaten the well-being of your horse.  These examinations make it much easier to diagnose and treat oral diseases early, preventing more severe and costly problems later.

A juvenile horse should have a dental examination when it is foaled, at three months and then every six months until age five. For healthy adult horses, a yearly dental examination is recommended.  Horses older than 20 or with a history of dental problems should return to a twice yearly schedule.

Trust Your Veterinarian

Certain observations in your horse may be clues to you or your veterinarian that a complete physical examination and a thorough dental exam may be in order.  Has your horse’s general attitude changed? Is the appetite normal? What about the ability to chew? How long does it take to eat? What’s the stool consistency? Is long stem hay present? Are there well-formed fecal balls?

The veterinarian may perform a complete physical examination, and other tests if needed, in order to evaluate the horse for possible risks (i.e., fever, severe anemia, ataxia, etc.) prior to carrying out the dental examination

Veterinary practitioners are best qualified to perform dental care on your animal because they are:

•  Trained in equine dentistry, medicine and surgery
•  Licensed to practice dentistry
•  Equipped with the proper resources to examine, diagnose, and treat dental disease
•  Prepared to refer particularly severe or complicated cases to specialists with extensive experience

To safely perform a thorough oral examination, sedation and adequate restraint is recommended.

Treatment may include antibiotics and anti-inflammatories.  All are things that a veterinarian is licensed to provide but an owner or layperson is not.

An oral exam should be an essential part of an annual examination by a veterinarian.  Every dental exam provides the opportunity to perform routine preventative dental care as well. The end result is a healthier, more comfortable horse.

Reprinted courtesy of the American Association of Equine Practitioners. 

Transitioning the Retired Race Horse

Since there are a lot of race horses in our area being retired from the tracks this time of year we thought it was a good idea to post some helpful guidelines for a smooth transition.

American Association of Equine Practitioners

TRANSITIONING THE RETIRED RACEHORSE

Racehorses can be very useful in other careers after retiring from racing. Many are donated 

to retirement facilities that provide permanent sanctuary or provide retraining and 

adoption to suitable homes. These horses’ uses may range from non‐ridden, companion 

animals to athletic sport horses. As in most equine endeavors, the intended use of the horse 

has a large bearing on its rehoming potential. The equine practitioner can assist, both at the 

track and at the retirement facility, with the potential use of these horses after they retire 

from racing. There are many variables that must be considered in this determination. While 

there are no absolutes, there are conditions associated with physical limitations which will 

likely prevent a horse from future athletic endeavors.  Foremost for the equine practitioner 

are the soundness of the individual animal and the identification of various conditions that 

may affect future usability. 

Based on their professional experience, most veterinarians will have a personal 

perspective regarding which medical conditions can be consistent with various uses. These 

guidelines will outline the common health issues encountered and offer opinions based on 

the committee’s collective expertise. There is minimal scientific data on which to base these 

prognostic decisions and ultimately recommendations may be founded solely on 

professional veterinary opinion.  As improved documentation of experience with injury 

rehabilitation becomes available, more accurate prognostic decisions will be possible.  The 

veterinarian advising or making recommendations as to the future use of a horse should be 

familiar with the demands and health requirements of that use, and it is recommended that 

the veterinarian’s prognosis for athletic ability in a specific horse be conservative in order 

to avoid situations where failed expectations result in a horse becoming unwanted. 

The first step in determining the prognosis for a racehorse to be transitioned to another 

use is a comprehensive evaluation. This should include as detailed a medical history as is 

available and a thorough musculoskeletal, respiratory, cardiac and ophthalmic 

examination.  Because many horses that are to be examined have had recent medication for 

various infirmities, it may be necessary to examine an animal more than once to assess its 

accurate health status.  Arrival exams are standard procedure for most of the major 

retirement organizations. Good records of these exams are necessary. Often these exams 

are the responsibility of the facility to which the animal is donated, at which time a medical 

history is likely unavailable.  The AAEP recommends that responsibility for the horse’s 

evaluation be borne by the horse’s donor, thus saving the facility funds and allowing them

to more effectively triage the animal.

Many retirement facilities have very limited capacity and lack resources to support animals 

for a long period. Therefore, it is in the interest of both the horse and the facility to make 

prudent and efficient decisions regarding individual animals in order to responsibly 

manage financial resources. Humane euthanasia is a legitimate consideration for animals 

that have chronic unsoundness that renders them unsuitable candidates for adoption, or 

for animals that are uncomfortable to the extent they cannot humanely live out their days 

in a field. 

Physical Assessment

For the purpose of these guidelines, the following definitions are used to describe the levels 

of recommended use for the transitioned horse. 

• Level I:  Pasture turnout, non‐ridden. 

• Level II:  Light use, to include trail riding at the walk and occasional trot on good 

footing. 

• Level III: Moderate use such as flat work at the walk, trot, canter and varied terrain. 

Occasional jumping in good conditions generally with fences less than two feet. 

• Level IV:  Full athletic work; no exclusions. 

In addition to physical condition, temperament is a critical factor in determining successful 

placement of these horses. Most retirement facilities are managed by experienced horse 

people whose assessment of a horse’s temperament, demeanor, socialization (human and 

equine) and tractability will be important. Such evaluation requires a good history and 

regular monitoring by experienced observers. While the veterinarian may have input as to 

an animal’s temperament for a specific purpose, such decisions should be made in consultation with management. Stallions and colts should be castrated before transitioning.

The following is a listing of conditions commonly seen in retiring racehorses and the 

prognosis for these animals for various uses. 

Musculoskeletal Conditions:

Fetlock

Lameness due to chronic osteoarthritis is common in retiring racehorses and may 

often be the precipitating cause of the horse’s retirement. The degree of lameness 

can be highly variable, and is not always consistent with radiographic findings.  

However, it is unlikely that a horse demonstrating grade 2/5 lameness due to 

fetlock disease will be serviceable as a performance horse. These horses may be able 

to be used for Level II activities, but should still be expected to require an increased 

level of care to maintain their existing level of soundness. Horses with a significant 

decrease in fetlock flexion even if not exhibiting lameness may be compromised for 

significant athletic use (Level III‐IV).  If the adopting agency or person is willing to 

institute therapy to mediate osteoarthritis of the fetlock, the costs should be 

outlined as well as prognosis. Intra‐articular therapies and / or surgery will render 

a number of these animals useful at lower levels (Level I‐III). In general, if a horse 

cannot be maintained for racing with appropriate therapy, it will be difficult to 

maintain that animal for any use other than very low level work in other capacities. 

In particular, these animals will be unlikely to be able to be sound enough for 

jumping or dressage. 

Small osteochrondral fragments should have minimal impact on future soundness if 

the animal is given appropriate therapy and time to recover. Fractures of the 

proximal sesamoids vary greatly and must be individually assessed. In general, 

small apical fractures and basilar fractures without extensive degenerative joint 

disease and marked suspensory disease will be serviceable for moderate level use 

(Level I‐III). Full body fractures often render an animal unsound for any athletic 

activity.

Carpus

The degree of damage to the carpus can dictate future usefulness. If the damage to 

the joint surfaces is not extensive, the horse will be able to transition to low and 

moderate sport horse use including jumping.  If there is extensive osteoarthritis 

involving any of the joint surfaces, the prognosis is quite guarded. Chip fractures can 

be removed and improve the athletic prognosis in many cases. Palmar fractures 

generally carry a less favorable prognosis for any use other than very light pleasure. 

Foot

“No foot, no horse” is a universal truth that crosses all equine disciplines.  Foot 

conditions are often managed on the racetrack with therapeutic shoeing and 

medication and without a specific diagnosis. 

Poorly conformed feet that have to perform on harder surfaces than the track will 

often lead to lameness. Good farriery over time can remedy many hoof conditions, 

and if the adopting group is willing to invest the time, these horses may transition to 

many uses. Chronic quarter cracks can often be healed and corrected. Horses with 

chronic foot pain are poor candidates for use on hard surfaces.  Animals that have 

had laminitis also may be poor candidates for use over firm surfaces. Such horses 

require detailed examination to assess potential serviceability. Since there are many 

causes of foot pain, establishing a diagnosis is key to identifying reasonable athletic 

expectations.  Animals that have been treated with a palmar digital neurectomy will 

require open documentation and careful placement by the adopting group. Wing 

fractures of the third phalanx (coffin bone) often have a good prognosis for other 

uses but should be documented.  Coffin bone fractures involving the joint surface have a poor prognosis for riding soundness. Solar margin fractures generally have a 

favorable prognosis and feet with chronic inflammatory changes may be able to be managed. 

Tarsus

Hock lameness is common and often manageable in both the racing and sport horse. 

Chronic osteoarthritis of the lower joint spaces of the hock will limit usefulness as a 

jumping or dressage horse but may not be inhibiting for lighter work. Many 

appropriate therapies may extend the usefulness of these horses if the adopting 

group is willing to invest in such. In most of these cases, rest alone is not adequate 

for returning a horse to serviceable soundness. 

Stifle

Chronic stifle lameness will prevent most racehorses from transitioning to moderate 

or intense sport use. Osteochrondral fragments (in the absence of osteoarthritic 

changes) typically respond well to surgery, which coupled with appropriate 

intraarticular therapies, will return many of these horses to usefulness for low or 

moderate level activities.  Meniscal or ligamentous damage will limit use to low 

levels of activity. 

Tendon and Ligamentous Injury

Tendonitis of the superficial flexor tendon is a common cause of retirement from 

racing.  The severity of this injury will determine the prognosis for other uses. The 

majority of “bowed” tendons, if treated appropriately and given enough time, will 

transition to most uses other than racing. Most cases will require 10‐12 months to 

be serviceable. 

Suspensory ligament injuries may range from a mild strain to complete failure.  The 

latter is not amenable to transition, and unless extensive treatment is instituted, is a 

life‐threatening injury with a poor prognosis for survival. Chronic severe 

suspensory desmitis will prevent transition to Level III or IV activity. Horses with 

mild to moderate desmitis, if treated appropriately and given considerable rest, may 

be useful for low‐level activity. 

The external appearance of soft tissue structures (tendons and ligaments) may not 

reveal the extent of an injury and it is advisable that ultrasonography be used as an 

adjunct to physical examination to document the degree of injury in cases where 

soft tissue injury is of concern. 

Respiratory Conditions:

Upper Airway Conditions

Laryngeal hemiplegia (“roaring”) is a common cause for racing retirement. 

Although the degree of obstruction will determine future usefulness for other 

purposes, affected horses are very useful as long as speed isn’t required. Horses 

experiencing soft palate problems while racing may not show the same 

symptoms at slower speeds and may be useful for exercise at Levels I‐III.  

Arytenoid chondritis may severely limit a horse’s athletic potential.  Although 

medical and surgical treatments for each of these respiratory conditions may 

improve airway function, a well documented history and endoscopic 

examination prior to referral to the retirement facility is appropriate to help 

clarify the athletic potential of affected horses. 

Lower Airway Disease

Inflammatory airway disease is not uncommon and must be managed if the 

horse is to be transitioned at all. Many horses with an undiagnosed chronic 

cough may transition to lower level uses but should be properly diagnosed for 

the best prognosis.  Horses with exercise induced pulmonary hemorrhage in 

racing will rarely experience bleeding at other uses unless speed is required 

such as eventing or barrel racing. 

Gastrointestinal Conditions:

Underweight

A thorough physical examination may define the cause of a lower body condition 

score (<2/9).  Adequate nutrition and good general care will reverse most 

underweight conditions.  Horses may also lose condition after leaving the 

racetrack, particularly if managed in groups and fed together.  An aggressive, 

competitive race horse may still end up at the bottom of the social hierarchy 

when transferred to a new facility. Intact males are often a management problem 

and should be castrated. 

Gastric Ulcers

Gastric ulcers are a common cause of a lower body condition score and may 

require gastroscopy for accurate diagnosis. Elimination of the stress of 

competition may improve this condition but some horses will require 

appropriate therapy. Alternatively, the horse may be treated empirically for 

ulcers and its response to therapy evaluated 

Chronic diarrhea is a serious condition and will require extensive workup and 

treatment. 

Costs

The cost of housing, retraining and rehoming retired race horses can be considerable. 

These costs are increased if the horse requires significant veterinary medical care. We have 

discussed many of the common problems associated with this transition. There is little 

national data to reference the costs of veterinary care for these animals.  Many adoption 

facilities enjoy close relationships with veterinary practices that render care at significantly 

reduced costs. These practices see this care as a service to the horse and the facilities 

providing care.  

Osteoarthritis

Osteoarthritis is one of the most common causes of chronic, low grade lameness in the horse, and one of the most common diseases treated by veterinarians. Osteoarthritis is generally seen as bony changes, and/or degeneration of the bone and cartilage of the joint surface (arthritis). As a result, there are many treatment and supportive care options currently marketed to horse owners. A few commonly asked questions are, “What is the difference between Legend and Adequan?” “Between Polyglycan and Pentosan?” “What is shock wave therapy?” This guide is intended to help answer some of those questions, however, a discussion with your veterinarian will help put together the best treatment or management plan for your horse.

Hyaluron, Hyaluronic Acid (HA), and Hyaluronate Sodium all refer to the same component of joint fluid in slightly different forms. Healthy joint (synovial) fluid is viscous, and Hyaluron is the substance that provides the cushion/viscosity to joint fluid. It is produced by the cartilage and cells within the joint fluid, and also helps decrease inflammation.

The effectiveness of an HA product is directly associated to is concentration and molecular weight. In general, products with higher concentrations of heavier weight molecules are more effective and have longer lasting results.

Legend:

Legend is Hyaluronate Sodium, a natural glycosaminoglycan (GAG) component of joint fluid. It can be administered intravenously (IV) or intra-articularly (in the joint). When given IV, treatment consists of a once a week injection for three weeks. When given IV, Legend decreases inflammation in the joint fluid, and helps decrease inflammation in the vessels surrounding the joint.

When injected in a joint to treat inflammation or synovitis, a full label treatment is a series of three joint injections spaced every 3 to 6 weeks. There is no period of rest needed post joint injection with an HA product. HA products injected into the joint act to lubricate the joint cartilage, and support lower quality joint fluid.

The concentration of Hyaluronate sodium in Legend is 10mg/mL.

Hyvisc:

Hyvisc is a Hyaluronate Sodium product labeled for intra articular injection for treating joint inflammation (synovitis) and osteoarthritis. It has a high concentration of a high molecular weight hyaluronate sodium (11mg/ml).

Polyglycan:

Marketed as a joint fluid replacement for use during orthopedic surgery, “Poly” is a combination product that contains Hyaluronic acid and Chondroitin Sulfates A and C. It can be given orally or intra-articularly. Its concentration of HA is 5mg/mL, (significantly less than that of Legend or Hyvisc) and it also contains10mg of sodium chondroitin sulfate and 10mg of N-acetyl-D-glucosamine per mL.

Its efficacy and longevity is considered less than other products, due to lower concentrations of HA, though it is also less expensive than Legend or Hyvisc, and some clients have reported positive results from Polyglycan administration.

Pentosan:

A beech wood derived polymer, Pentosan functions as an anti-clotting agent, as well as an anti-inflammatory. Pentosan can be used intravenously, intra-muscularly, intra-articularly, or orally. Pentosan stimulates new cartilage formation, as well as to block inflammatory mediators and to inhibit degredative enzymes. However research has shown that normal blood clotting time was effected 24hrs post administration, and up to 48hrs with large amounts given. Caution should be excersised in choosing to use Pentosan in horses with documented EIPH or within 48hrs of strenuous excersize.

Some university studies have shown similar effects at the cellular level to Adequan, clinical effects have not been proven.

Adequan:

Adequan is Polysulfated Glycosaminoglycan (PSGAG). It inhibits inflammatory enzymes in joint fluid, which decreases protein levels and increases HA levels. It is administered IM or IA. A full course of intra-muscular Adequan involves 7 treatments given once every 4 days for 28 days. It is often then continued once monthly if necessary. It has been shown to increase the level of HA in joint fluid for 4 days post administration.

Corticosteroids:

Intra-articular corticosteroid injections, in combination with non-steroidal anti inflammatories, are a common treatment for osteoarthritis. Corticosteroids have potent anti-inflammatory actions, however when injected in joints they are also destructive to the cartilage. Due to this corticosteroids are commonly combined with an HA product when injected into a joint, to help counteract the chondro-destructive effects.

Not all corticosteroids are as damaging to the joint surface. Triamcinalone acetonide (Vetalog) is slightly protective to the cartilage and has fewer negative effects on cartilage as other corticosteroids. Methylprednisolone acetate (Depo-Medrol) tends to have a longer period of action than Vetalog, but does degrade cartilage when injected into a joint.

Shock Wave Therapy:

ESWT refers to Extracorporeal Shock Wave Therapy. “Shock Wave” has been used for many years in sports medicine. It uses a hand held wand to deliver high intensity pressure waves to the horse’s body in pulses. Shock wave therapy has been shown to reduce inflammation within the joint, and stimulate new bone growth and soft tissue healing, as well as reducing pain.

Shock wave therapy is intended to be used in addition to a period of rest and healing. Since it provides pain reduction to potentially damaged areas, immediate work/training may cause increased damage. Two to four weeks of rest is required post treatment, depending on the condition being treated and its location.

Shock wave therapy can reduce osteoarthritis associated inflammation and clinical lameness, but it does not change the underlying problem, when utilized on sites of osteoarthritis (specifically joints). Thus chondroprotective treatments (HA product, Adequan, etc) are often added when shock wave therapy is utilized.

Lyme Disease (a Timely Tick Topic)

What is Lyme Disease?

     Lyme disease is a bacterial infection caused by Borrelia burgdorferi, a spirochete transmitted by Ixodes ticks.  Deer and mice are the normal mammals in the Lyme disease cycle, and other species such as horses and humans are "aberrant" or unintentional hosts of the disease.

How does a horse contract Lyme Disease?

     An adult tick that is infected with Borrelia burgdorferi must attach and feed for longer than 24hrs to infect a horse with Lyme disease.  The bacteria lives in the "gut" of the tick and is transferred to the animal as the tick feeds.

What are the Clinical Signs of Lyme Disease?

     Fever, diffuse muscle soreness and generalized joint stiffness are the most commonly seen clinical signs.  The presenting signs can be vague, and many clinical signs can be caused by a combinations of other factors such as age, level of work, orthopedic problems, or other infections.  

How is Lyme Disease Diagnosed?

     Diagnosing lyme disease is complicated by the fact that many horses have been exposed to Lyme disease and will have detectable antibodies to Borrelia burgdorferi but may not actually be infected.  Immunofluorescent Antibody (IFA) testing is the optimal testing method, but only diagnoses exposure as many healthy horses may have antibody titers.  

A new "multi-plex" test available through Cornell Animal Health Diagnostic Lab, identifies antibody titers to three seperate Borrelia antigens, and can be used to distinguish between acute (new infections), chronic (or exposure), and vaccine related titers.

     Response to treatment is often used to diagnose Lyme disease, but is also complicated as the antibiotics used to treat (tetracylcines) also have anti-inflammatory properties which may reduce muscle and joint pain, even without an infection to treat.  

     For a definitive diagnosis of Lyme disease, an IFA test should be performed before and after starting treatment, and a notable decrease in the level of antibodies should be seen.

Is there Treatment for Lyme Disease?

     As mentioned above, Lyme disease can be treated with tetracycline antibiotics (oxytetracycline or doxycycline).  Oxytetracycline is used most commonly in horses and is administered intravenously (IV).  Treatment is typically continued for 3 weeks and titers should be retested to document a decrease below "normal" exposure levels before treatment is stopped.

How can I Prevent Lyme Disease?

     Tick control is key to preventing lyme disease.  Regular grooming and checking under mane/forelock and around the base of tail during tick season (mid spring through late fall), with quick removal of any ticks is the most important form of prevention.  In some areas a topical tick preventative may need to be used, and your veterinarian may be able to recommend what has worked best in that area.

     Although a vaccine is available for Lyme disease, it is not commonly used in horses, and vaccination will create elevated antibody levels, which can create difficulties in diagnosing infection.  This is less of a concern with the new "multi-plex" test through Cornell.

Helping Your Foal Grow

A healthy foal will grow rapidly, gaining in height, weight and strength almost before your eyes.  From birth to age two, a young horse can achieve 90 percent or more of its full adult size, sometimes putting on as many as three pounds per day.  Feeding young horses is a balancing act, as the nutritional start a foal gets can have a profound affect on its health and soundness for the rest of its life.

At eight to ten weeks of age, mare’s milk alone may not adequately meet the foal’s nutritional needs, depending on the desired growth rate and owner wants for a foal.  As the foal’s dietary requirements shift from milk to feed and forage, your role in providing the proper nutrition gains in importance.  Following are guidelines from the American Association of Equine Practitioners (AAEP) to help you meet the young horse’s nutritional needs:

1. Provide high quality roughage (hay and pasture) free choice.
2. Supplement with a high quality, properly balanced grain concentrate at weaning, or earlier if more rapid rates of gain are desired.
3. Start by feeding one percent on a foal’s body weight per day (i.e., one pound of feed for each 100 pounds of body weight), or one pound of feed per month of age.
4. Weigh and adjust the feed ration based on growth and fitness.  A weight tape can help you approximate a foal’s size.
5. Foals have small stomachs so divide the daily ration into two to three feedings.
6. Make sure feeds contain the proper balance of vitamins, minerals, energy and protein.
7. Use a creep feeder or feed the foal separate from the mare so it can eat its own ration.  Try

to avoid group creep feeding situations.

1. Remove uneaten portions between feedings.
2. Do not overfeed.  Overweight foals are more prone to developmental orthopedic disease (DOD).
3. Provide unlimited fresh, clean water.
4. Provide opportunity for abundant exercise.

The reward for providing excellent nutrition and conscientious care will be a healthy foal that grows into a sound and useful horse.  For more information about providing proper nutrition for your foal, talk with your equine veterinarian.  Additional information about foal nutrition can also be found on the AAEP’s website www.aaep.org/horseowner.

Reprinted with permission from the American Association of Equine Practitioners.