Kissing spines explained

Kissing spines is a painful condition for those suffering from it. Here, vet David Rutherford from Fellowes Farm Equine Clinic explains more about the condition and the different treatment options available.

The term ‘Kissing spines’ is a term used to describe a condition where the pieces of bone that project upwards from a horse’s back bone (the dorsal spinous processes, or DSPs) become too close together and start to grate on each other, causing pain.

It’s most commonly found in the middle of a horse’s back under the saddle region, but can occur anywhere along the spine. It’s a progressive condition that usually affects horses aged between seven and 14 and is quite common in larger breeds, particularly Thoroughbreds, but rare in ponies.

Bucking can be an early indicator of a problem in your horse's back

Bucking can be an early indicator of a problem in your horse's back

Horses with kissing spines will struggle to perform well under saddle, and show signs of pain in their back – though this discomfort can present itself in different ways. The first thing you may notice is a lack of forward movement, especially in canter. Bucking, refusing jumps or reacting when the girth is tightened or the rider mounts are other signs.

To diagnose kissing spines, the first step is usually to take radiographs of the DSPs. Kissing spines is suspected when the gap between the DSPs narrows and, in some cases, the bones are touching. Often the bony margins will have areas of increased density (which shows as white on an x-ray) and areas where the bone has partly dissolved (black on an x-ray).

In very severe cases the diagnosis may be based on x-rays alone, but this can be problematic as some horses with quite nasty radiographic abnormalities can in fact be completely pain-free in this area. Therefore either bone scanning, or nerve blocking the area and observing an improvement in ridden performance, is usually necessary to confirm the problem.

Can you prevent it?
As kissing spines is a naturally occurring, progressive condition, prevention isn’t possible. There are, however, some things that can be done to help reduce the risk. Experts believe there’s likely to be a genetic component to kissing spines, so breeding from known sufferers should be considered very carefully. In addition, it’s wise to avoid any ridden exercise until a horse is approaching his or her skeletal maturity at three to four years of age. This will give his bones the best chance to develop as they should.

Before you buy a horse, ask your vet to take survey radiographs of his back as part of the pre-purchase exam. Sadly, if a defect is found, this won’t mean the horse will avoid developing kissing spines in the future, but it will at least minimise your risk as a potential buyer.

Finally, bear in mind that the condition is worsened by the action of riding your horse, so symptoms will develop quicker the more work you do with him.

How is it treated?
Once a diagnosis of kissing spines has been confirmed one of three routes can be taken:

1. Medical
While it won’t cure the problem, medical treatment will allow the horse to continue working. Treatment consists of a combination of oral painkillers, anti-inflammatory cortisone injections into the affected part of the back, physiotherapy and altered training methods. This will improve the situation, but rarely resolves it and, as the condition worsens, it becomes less effective.

Surgery can be used to create a larger gap between the impinging bones in cases of Kissing Spines

Surgery can be used to create a larger gap between the impinging bones in cases of Kissing Spines

 2. Surgical treatment
Surgery can be used to create a larger gap between the impinging bones. In some situations wedges of bone are removed, and in others splitting the ligament between the bones is sufficient. Often the procedure is carried out under standing sedation with local anaesthetic, rather than under full general anaesthesia. The exact method of treatment will depend on how severe the impingement is, and on the preferences of surgeon and owner.

3. No treatment
No treatment will ultimately result in retirement or euthanasia. 

To learn more about Fellowes Farm Equine Clinic visit


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Spot the signs of Gastric Ulcers

Zoetis image of ulcer

Equine Gastric Ulceration Syndrome (EGUS) can affect any type of horse or foal in any environment. If your horse is displaying any unusual signs such as poor appetite, body condition and performance, changes in attitude or acute, recurrent colic it’s important to speak to your vet immediately, advises Zoetis vet Dr Wendy Talbot.

Equine Gastric Ulceration Syndrome (EGUS) is a serious and common condition,1,2 with approximately 93%of racehorses, 65% of performance horses, 54% of leisure horses and 50% of foals shown to be affected.2,3,4 The condition is associated with injury to the inner lining of the oesophagus, stomach and upper part of the intestine.2

Horses produce a steady flow of stomach acid to help digestion.1 As a protective mechanism their naturally acidic stomach contents are buffered by alkaline saliva produced in response to regular eating and by the food itself.2 Our domestication of horses, particularly stabling and restriction of grazing, has reduced the time our horses spend eating, resulting in prolonged periods when the stomach is empty, causing reduced production of saliva. In addition feeding grain (rather than fibre) can produce types of acid which contribute to the already acidic environment of the stomach.1

The usual signs of EGUS may include poor appetite, poor body condition, poor performance, changes in attitude and acute and recurrent colic.  In adult horses clinical signs may appear or progress as training intensity, speed and workload increase.2 However, in some horses the signs may be vague. In foals the signs may be very subtle and progress rapidly so it is important to contact your vet immediately if you have any concerns.2

There are many risk factors that may cause your horse or foal to suffer from gastric ulcers. These include stress, intense exercise, a high-grain diet, intermittent feeding, inappropriate management and other illnesses.1,2,4 The only accurate way to definitively diagnose or monitor EGUS is by gastroscopy,1 which involves a vet examining your horse’s oesophagus, stomach and upper part of the intestine using a gastroscope.

Wendy Talbot, vet at Zoetis, said: “EGUS is a serious condition but once diagnosed it can usually be treated very effectively with management changes and orally administered therapy to help the ulcers heal. If you think your horse could be suffering from EGUS you must contact your vet immediately.”

References
1 Bell RJ, et al. Equine gastric ulcer syndrome in adult horses: a review. NZ Vet J 2007; 55 (1): 1-12. 2 Picavet M-Th. EQUINE GASTRIC ULCER SYNDROME. Proceedings of the First European Equine Nutrition & Health Congress. February 9 2002. Antwerp Zoo, Belgium.. 3. Murray MJ, et al. Prevalence of gastric lesions in foals without signs of gastric disease: an endoscopic survey. Equine Vet J 1990; 22(1): 6-8. 4. Sykes BW, et al. European College of Equine Internal Medicine Consensus Statement—Equine Gastric Ulcer Syndrome in Adult Horses. J Vet Intern Med 2015;29:1288–1299

About Zoetis
Zoetis is the leading animal health company, dedicated to supporting its customers and their businesses. Building on more than 60 years of experience in animal health, Zoetis discovers, develops, manufactures and markets veterinary vaccines and medicines, complemented by diagnostic products and genetic tests and supported by a range of services. In 2014, the company generated annual revenue of $4.8 billion. With approximately 10,000 employees worldwide at the beginning of 2015, Zoetis serves veterinarians, livestock producers and people who raise and care for farm and companion animals with sales of its products in 120 countries. For more information, visit www.zoetis.com.

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Common Leg Problems: Tendonitis

See a swelling on your horse’s leg and your first reaction might be to panic - will it take ages to mend, cost me a fortune and potentially affect his future? But don’t panic. With good management, most leg problems can be prevented and early intervention from your vet will more often than not lead to successful treatment.

What is it? 

This is a broad term referring to the inflammation of a tendon. Tendon injuries are one of the most common musculoskeletal problems. The superficial digital flexor tendon (SDFT) is the most frequently affected tendon, with the injury usually occurring at the mid-canon level. Tendonitis can be caused by both intrinsic (strain or displacement) and extrinsic (bruising, penetration, laceration) factors. Intrinsic problems are common in equine athletes, but rare in ponies.


Diagnosis and treatment

In most cases, heat, pain and swelling of the SDFT can be felt over the back of the canon bone. Severe cases will have a ‘bowed’ appearance and may also show over-extension of the fetlock joint when the horse puts his weight on the leg. The degree of lameness is related to the degree of inflammation and not necessarily the extent of the actual tendon damage, so investigation is important. Ultrasonographic examination of the tendons is the best way to confirm the type and extent of the injury. The best time for the first ultrasound scan is between four and seven days after the injury.

The leg should then be scanned at regular intervals to monitor healing. Numerous treatments have been described for tendonitis. During the acute stage (up to three days after injury), cold therapy, support bandages, rest and anti-inflammatories are recommended. There are also a variety of medications for direct administration into the tendon.

Recently, the use of stem cells has received particular interest. These cells are the precursors to all the cells in the body. The benefit of their use in tendon injuries is related to the method of tendon repair. Tendons are unable to regenerate new fibres following injury and instead heal through the formation of scar tissue. Stem cells are stimulated to become new tendon cells (tenocytes), which means the tendon heals through regeneration of normal fibres instead of scar tissue. Scar tissue is prone to injury again, so the use of stem cells could help the horse stay sound. However, the mainstay of treatment for tendonitis remains the controlled return to exercise. The timing and intensity of this should be dictated by the ultrasonographic appearance of the affected tendon.


Prevention

Appropriate early conditioning of young horses will improve the quality of the growing tendon tissue, making them more resistant to subsequent injury. Careful attention should also be paid to speed, ground surface, fatigue, shoeing and weight of rider. Protective boots will help prevent extrinsic causes of tendonitis.

Navicular Syndrome

An MRI image - Magnetic resonance imaging (MRI) allow vets to take a closer, detailed look at all the structures in the foot - bone, cartilage, tendons and ligaments.  

An MRI image - Magnetic resonance imaging (MRI) allow vets to take a closer, detailed look at all the structures in the foot - bone, cartilage, tendons and ligaments.  

Navicular syndrome is a debilitating condition responsible for over a third of chronic lameness in horses. If your horse is diagnosed with the condition it must feel like a crushing blow, but do not despair! Nowadays there’s so much you can do to manage a horse with navicular syndrome and research into this troublesome condition is progressing at a rate of knots. 

The more we understand about the underlying processes, the more able we will be to treat navicular successfully, giving afflicted horses the best quality of life possible.  Here is all the information you need to fight the battle, along with some encouraging advice from owners with first-hand knowledge of the condition.

Here our expert, vet Charlie Tomlison breaks the condition down.

What is navicular syndrome?

Navicular is not a single disease per se, but more of a “syndrome” where multiple structures may be implicated. The navicular bone is a small boat-shaped bone, sitting at the back of the foot and tucked behind the larger pedal bone.  It’s held in place by a number of ligaments. The navicular bursa is a sac filled with lubricating synovial fluid positioned at the back of the bone to cushion the deep digital flexor tendon as it passes over the navicular bone. Pain associated with navicular syndrome can come from damage to any of these structures supporting the navicular bone, as well as direct damage to the bone itself. Historically, navicular disease was attributed to interruption to the blood supply to the navicular bone, “the vascular theory”.  This has gone out of favour as a major factor in navicular syndrome but treatments geared towards restoring the blood flow do have some effect, so opinion is still divided. The navicular bone takes a lot of biomechanical strain when the horse moves.  As the deep digital flexor muscle contracts, the tendon tightens and pushes on the navicular bone.  To help prevent damage to the tendon or navicular bone, a thick layer of fibrous cartilage protects the bone, and this is may be worn down in cases of navicular syndrome.

To make some generalisations, it’s more commonly found in horses with a certain foot conformation - overlong toes and collapsed heels.  There is believed to be a genetic component as navicular syndrome is more common in certain breeds such as warmbloods, thoroughbreds and quarter horses.  It rarely affects ponies.   A susceptible conformation subjected to repetitive concussion can lead to a degenerative processs within the foot.

The average age for a horse to develop signs of navicular disease is 7-11 years, and this perhaps reflects the degenerative nature of the problem caused by wear and tear.  However, it can be seen in horses as young as 3 years old occasionally.

Symptoms

Navicular syndrome can creep up on owners unawares.  It may start as an intermittent low-level lameness that resolves quickly with a couple of days off.  In the early stages, some horses may “warm out” of the lameness, appearing stiff as they leave the stable, then improving with a bit of exercise. 

The lameness is most commonly seen in the front feet.  Usually both front feet are affected, which can sometimes make it difficult for the owner to identify.   This is because, if both feet are affected equally, there will be no obvious head-nod when the horse is trotted up in a straight line.  The stride may look short and choppy.  Lameness may be more noticeable if lunged on a circle, however, as the inside leg takes a greater strain. In some cases, the horse may stumble frequently or point one foot.

A keen eye may notice that the horse subtly puts its toe to the ground slightly before the heel lands when walked on a flat surface and viewed from the side.   This “toe-heel” action occurs because horses with navicular syndrome feel pain in their heel region.

Precise diagnosis is based on the characteristic signs, together with a lameness work-up by your vet.  Your vet may employ a number of techniques in locating the source of pain, including injecting local anaesthetic around nerves supplying the foot or into joints within the foot.  These nerve blocks can narrow down the region the pain is coming from, but recent research has shown that they must be interpreted with care as the anaesthetic can diffuse and affect areas other than those it was intended for.

If navicular syndrome is suspected, X-rays can be taken of the foot.  These focus on two things: 

The shape and balance of the foot,  i.e. how the external appearance of the hoof relates to the internal positioning of the bones within the hoof.  Here vets look at the angles of various structures in the foot to determine what biomechanical forces are applied to the hoof. 
Secondly, the appearance of the navicular bone itself is evaluated.  A number of changes seen on the bone, such as new bone formation, or loss of bone density, can indicate potential navicular syndrome.  It is worth noting, however, that some horses have x-ray changes on their navicular bones and aren’t lame, whilst others have proven navicular syndrome with no evidence of this on x-ray.

Diagnosis

Diagnostic techniques taken from human medicine have been adapted for horses.  This has taken the diagnosis of navicular syndrome to a new dimension. Magnetic resonance imaging (MRI) and Computed Tomography (CT) allow the vet to take a closer, detailed look at ALL the structures in the foot - bone, cartilage, tendons and ligaments.  This has enabled vets to diagnose soft-tissue injuries previously unseen on X-ray. 

MRI scanning is restricted to referral hospitals.  Conditions that may once have been put down to navicular disease can now be more accurately diagnosed, such as fraying of the deep digital flexor tendon within the hoof or damage to the supporting ligaments of the navicular bone. 

These ways of viewing the foot are very useful but also expensive.  Some insurance companies don’t cover their cost fully, so it’s worth bearing this in mind beforehand.

Prevention

In many cases it can be hard to see how you prevent a condition from developing when so many factors contribute to it!   However, some simple rules do apply.  Good, regular routine farriery every 4-6 weeks will help reduce the load on the heels and over the navicular bone.  

If your horse historically “feels” the ground, it is common sense to avoid riding at speed or jumping on hard ground. The repetitive concussion of riding on hard ground is inflicted on the heels and navicular region and can be enough to encourage the onset of this degenerative condition.  Avoid tight circle work unless on a soft, level surface.

Be sensible if the ground is unsuitable.  If you turn up at a competition and the going is too hard, be wise enough to put your horse back in the lorry, no matter how far you’ve driven, and curse the good weather on the way home!

Treatment

Treatment options for navicular sydrome have come a long way.  Firstly, the treatment should be geared towards the actual structures identified as involved in each individual case.   For example, a soft tissue injury may require an extended period of box rest  (over 6 months in some cases).

Corrective farriery is a vital part of, if not the main piece, in the treatment jigsaw!  Teamwork between you, your vet and your farrier can assist in keeping your horse sound and comfortable. 

The aim is to re-establish the best foot shape possible to cope with the demands of work and to fine-tune the forces placed on the foot to avoid over-loading the vulnerable areas, namely the rear third of the hoof. The feet should never be allowed to grow overlong and so make a date in your diary for shoeing every 4-6 weeks, The foot should be balanced from side to side, the toes shortened and good heel support provided.  This may take the form of a rolled toe or four point shoe, bar shoes or 10° heel wedges.  Some farriers like to use silicon pads for their anti-concussive effects.

Careful use of oral anti-inflammatories may help, such as phenylbutazone (bute).  It’s important not to make the horse so comfortable that it worsens an existing injury.

Vets often inject an anti-inflammatory, such as steroid, directly into either the coffin joint or the navicular bursa.  Injecting into the navicular bursa is the trickier but more effective option. In one study, 60% of horses were still sound after 2 months following bursa injection, compared to 34% that had their coffin joints medicated.

A newer treatment to the UK is the anti-arthritic drug, tiludronate, (Tildren™). It helps to switch off cells involved in arthritic processes.  It is given as an intravenous drip and has been quite effective in treating some forms of navicular disease where bony remodelling is a feature.  

In some cases, the vasodilator, isoxuprine has been used successfully on the basis of the restoring good blood flow to the feet, part of the vascular theory of navicular disease.

As a last resort, some owners opt for neurectomy (de-nerving operation).  This is a surgical procedure to numb the foot by cutting the nerves that supply it.  It is often used as a last resort as there are many risky consequences associated with de-nerving, such as dangerous stumbling or development of severe foot abscesses.  Sometimes the nerve grows back or forms a painful lump called a neuroma.  Many governing bodies, such as the FEI, do not allow de-nerved horses to compete.  Despite this, for some horses and owners it proves to be a valid option and they continue a happy, pain-free life for many years. 

 

More about our expert

Charlie Tomlinson (Briggs) is an equine vet working for Hale Equine Vets in Wiltshire.  She’s worked at various large equine referral centres and is a keen horse woman having owned and competed horses all her life. Her main areas of interest are equine orthopaedics and breeding. Find out more at www.haleveterinaryhospital.co.uk/equine

Antimicrobial Resistance explained

The issue of parasite resistance in relation to worming horses has been well publicised in recent years, leading to a greater understanding of the problem. However, another threat
– Antimicrobial Resistance (AMR) – is in urgent need of attention.

Norodine Granules can be effective in treating general infections in horses

Norodine Granules can be effective in treating general infections in horses

“While we’ve certainly not got parasite resistance under control yet, worming is something owners do regularly with their horses, which means it’s become better publicised and understood,” says Dr Kirstie Pickles, a European specialist in equine internal medicine at Scarsdale Vets (part of the XLEquine group) in Derby.

“On the other hand, most horse owners won’t often have to give their horses antibiotics. It’s far more unusual and the issues surrounding AMR are therefore less well understood, despite the related risk factors being much greater.”

What is AMR?
AMR refers to resistance developed by bacteria to antibiotics – something that’s recently been classified as a disease in its own right. It’s now a clinical problem on an international scale and one of the largest threats to equine and human health.

So why is it only being flagged up with such urgency now? As Kirstie explains, antibiotics have been used for a long time, however they’ve been used extensively and not always appropriately. “If people are given five days’ worth of antibiotics for their horse, they’ll often only use three days’ worth, until the clinical signs of an infection have gone, then save the remaining antibiotics to give to their horse at a later date, without the guidance of a vet.” Not finishing a full course of antibiotics means not all offending bacteria will be killed, increasing the likelihood of resistance developing. But it’s not always our fault. Under-dosing can also be the result of horses refusing to eat feed containing the antibiotics they need. Kirstie’s advice? Mix antibiotics with water to create a paste, which can then be administered to your horse via syringe, much like when worming.

Time for action
To tackle the problem of resistance, the British Equine Veterinary Association (BEVA) has advised vets to self-regulate, only giving antibiotics when cases absolutely require them and being more selective about the types of antibiotic they use. “Particular antibiotics used in human medicine are the same as those used in animal medicine,” says Kirstie. “New antibiotics are only licensed infrequently, which means we have to be strict on our use of the antibiotics we have. Added to this, very few are licensed for use in horses,” says Kirstie. “In fact, there’s only one antibiotic licensed for oral use in horses. Others can be injected, but this is much harder for owners to do themselves.”

What can you do?
Aside from always following the advice of your vet, only ever give antibiotics when they’ve been prescribed, and do your best to ensure your horse gets the dosage he needs.

Ultimately, prevention is the best chance we have of slowing down resistance. “Prevention is always better than treatment,” says Kirstie. “This means better biosecurity to prevent infections in the first place.” 

Imogen Johns, Senior Lecturer in Equine Medicine at the Royal Veterinary College, says it’s time we took responsibility: “Resistance to antimicrobials, including bacteria that are resistant to all commonly used antibiotics, does appear to be an increasing problem in horses. These resistant bacteria can be part of the normal bacterial population of the horse, such as on their skin or the intestinal tract, but they can also cause infections, which become very difficult to treat. At present, the best way we know of minimising the development of resistance is to use antibiotics responsibly – that is, only use them when there is a true bacterial infection (not a virus!), and reserving so-called ‘powerful’ antibiotics only for severe and life-threatening infections.”

Shivers

If there’s one thing you can say for certain about shivers, it’s that nothing’s for certain.

It’s a nervous abnormality, or dysfunction of the nerve, that manifests largely in the hindlegs, which twitch and ‘shiver’ when lifted. There’s no definitive known cause, no known cure or treatment, and while draught-type breeds tend to be most commonly affected, finer Thoroughbred types can suffer, too.

While it’s a progressive condition, with symptoms usually worsening over time, the severity and rate of progression varies – some horses are able to lead a full and active life for several years while others deteriorate fast.

When the horse is on all four legs he may appear perfectly normal, but each case is different and it’s the vet’s job to work with the owner to develop ways to manage the condition.

We speak to vet Charlie Briggs and farrier Gil Riley and get their advice on how to spot the signs and how to manage it...


About Shivers

Most common in heavier-set horses, from cobs and Irish Draught cross-types through to Shires, shivers is thought to be a nervous abnormality, possibly with a genetic link, hence its predomination in draughttype breeds.

“It seems to be that when the hindleg is lifted up there’s an interaction between the sensory nerves and the motor nerves controlling the muscle, and this results in an involuntary trembling of the nerve in the leg – or shivering,” says Gil.

Shivers manifests largely in the hind legs

Shivers manifests largely in the hind legs

While there’s no definitive known cause, several possible theories abound. These include abnormalities in the horse’s neurotransmitters (the chemicals that help transmit nerve signals), infectious disease creating toxins in the body that have an adverse effect on the horse’s nervous system, abnormalities within the muscle cells themselves (known as myopathy) and trauma from a heavy fall causing osteoarthritis, which impinges on the nerves leavingthe spinal column.

“Signs include the horse snatching his leg up high in an exaggerated fashion when he’s asked to pick it up, and snatching his leg up when asked to back up,” says Gil.

The leg will tremble or shiver while in the air and though it’s usually the hindlegs that are affected, shivers can affect the forelegs and, in rare cases, other parts of the horse’s body too – including the head – with the eye twitching rapidly or shivering of the neck muscles.

As with most things shiversrelated, there’s no set pattern regarding its onset, and symptoms can strike at any age.

“I’ve read a report of it happening in a Clydesdale yearling,” adds Charlie. “So while the majority of horses are diagnosed between the ages of seven and 11, you can’t rule it out in a youngster.

“As well as the leg trembling, in severe cases there may be muscle wastage related to the shivering, with the horse losing his power behind, eventually becoming incapacitated.”

“A couple of the tests we do routinely as part of a vetting will help detect a shiverer,” says Charlie. “One is that we pick up all four legs, the other test involves asking the horse to back up.Ask a horse with shivers to do either of these things and the classic symptoms of snatching up the leg and trembling will become apparent.

“The problem is that in its very early stages shivers can be extremely difficult to detect, and it can be mistaken for other conditions that mimic shivers’ symptoms.

“These include stringhalt, as this results in a similar action in the hindlegs, but as the horse is moving; upward fixation of the patella, where the patella (stifle) locks; fibrotic myopathy, which is where scar tissue forms in the muscles after an injury; and equine motor neurone disease.”

“Shivers is a progressive condition and in severe cases can progress to the point where the horse refuses to have his hindlegs picked up at all,” says Gil.

“While the condition per se doesn’t make a horse unsound, if it reaches the stage where he won’t pick his hind feet up, this can lead to problems with thrush, which in turn could lead to unsoundness, and how the farrier is going to shoe him. Sadly there’s no treatment, though sedatives can be tried in order to dampen down the reaction of nerves short-term and allow the horse to be shod.”

Obviously you need to be guided by your vet, but plenty of turnout to allow your horse gentle daily exercise is a good idea, while many horses can carry on being ridden as normal if the condition remains mild. Your farrier may suggest your horse goes without shoes behind so he doesn’t have to keep his hindlegs in the air for as long, and you’ll need to be sympathetic in how you handle and pick up the legs.

“Sadly, if the condition is the progressive kind, it can reach the stage where the horse is completely unmanageable and euthanasia is the only answer,” adds Charlie.

Thrush explained

Thrush is an infection of a horse’s frog, frog grooves and heel region caused by a variety of bacteria and fungi, with one particularly aggressive species of bacteria called Fusobacterium necrophorum being commonly involved. It may affect one or more feet and is more common, found in hind feet, or if you horse has deep narrow frog clefts and in the hind legs. Here vet David Rutherford explains the condition in more detail.

Symptoms and diagnosis

Thrush is usually (but not always) the result of horses being kept in wet dirty ground conditions

Thrush is usually (but not always) the result of horses being kept in wet dirty ground conditions

A horse with thrush may well be lame with a foul smelling, slimy, dark discharge around the frog. Pressing on the frog with your thumb often causes pain. The frog itself may be growing abnormally with loose rubbery flaps. In severe cases the bacteria may have eaten away at the frog to cause open sores into the deeper sensitive tissues. Occasionally swelling extends up the lower part of the leg to the knee or hock. The condition is usually recognised by your vet or farrier on signs alone, but occasionally biopsies are taken of the frog tissue.

Prevention

Picking out your horse’s feet properly twice a day and maintaining clean dry bedding in his stable is essential in preventing thrush 

Picking out your horse’s feet properly twice a day and maintaining clean dry bedding in his stable is essential in preventing thrush 

Thrush is usually (but not always) the result of horses being kept in wet dirty ground conditions, which make maintaining good hoof hygiene very difficult. The hoof and frog become soft and crumbly allowing the bacteria and fungi to penetrate and establish themselves leading to infection. Wet and muddy fields or soiled damp bedding are particular culprits with deep litter style bedding being amongst the worst. For this reason thrush is much more common in winter than summer.

Prevention is of course better than cure so picking out your horse’s feet properly twice a day and maintaining clean dry bedding is essential. It can be difficult during the wetter months but avoiding having your horse standing in a badly poached field for long periods is important. In addition, regular trimming of hooves and frog by a farrier or hoof care practitioner is important to maintain good hoof conformation and frog health. Intermittent use of a disinfectant such as iodine to scrub out the hooves about once a month would also be a good idea. It can be difficult to adequately clean the frog and clefts under and around bar shoes and impossible under sole pads putting horses who wear these shoes for other foot problems at increased risk of suffering from thrush.

Treatment

If left untreated a thrush infection will progress and may affect the deeper structures within the foot causing serious distortion of the frog and ongoing lameness. Bar shoes and pads should be removed and the frog, its grooves and the sole trimmed and paired back to visually healthy tissue by a vet or farrier allowing air to reach the affected tissue. The foot should then be picked out carefully twice daily before scrubbing the frog and sole with dilute iodine solution. Once washed the horse should be stood on a clean dry concrete area for about an hour to allow it to dry. Finally disinfectant and antibiotic spray may be applied to the frog and sole. It is very important that the horse is kept in a clean dry stable where immaculate hygiene is maintained during the treatment period. Painkillers may be given by mouth if the horse is lame, but antibiotic powders are rarely required. Tetanus cover must be given to an unvaccinated horse. This regime should be maintained until the feet are back to normal – probably two-three weeks, but sometimes longer.

 

More about our expert

David Rutherford is a vet at Fellowes Farm Equine Clinic in Cambridgeshire for their help with this feature. Part of the XL Equine group, visit www.fellowesfarm.com

 

Ringworm explained

Vet Nick Graham of Severn Edge Equine Vets gives you the lowdown on the common fungal skin infection known as ringworm.

The condition

Not caused by a worm – as its name suggests – but rather a type of fungus, ringworm is a highly contagious condition that can be easily spread from horse to human. Largely to blame are the microsporum and trichophyton species of fungi, which are expert in spreading their spores via direct horse-to-horse contact, or through shared tack, grooming brushes, bedding and other surfaces including stable doors and fencing.

As with most diseases of this type, very young and very old horses are more likely to develop ringworm as their immune systems are generally less effective, though if a horse does catch it he’ll develop a natural immunity that will protect him. This doesn’t mean he’s necessarily protected for life, but he will be less likely to get it again in future.

Mildly affected horses will usually be well in themselves, though some may attempt to rub the ringworm patches and the condition can make them sore and itchy. Left untreated it can start to damage the coat, can take up to several months to ‘self-cure’ and occasionally develop into a serious health problem.

However most cases soon recover with correct treatment and good stable management, and the hair will grow back within a month or so.

As the disease is often spread via infected tack, it’s common to see ringworm patches in the saddle or girth region, though it can affect any part of the horse’s body.

Symptoms and diagnosis

Ringworm patches can be any shape and size, often starting as a raised tuft of hair. It’s common to see the spots in a cluster, with the affected skin becoming scurfy and scabby, leading to patchy hair loss.jpg

Ringworm patches can be any shape and size, often starting as a raised tuft of hair. It’s common to see the spots in a cluster, with the affected skin becoming scurfy and scabby, leading to patchy hair loss.jpg

The condition may develop in a characteristic ‘ring’, but ringworm patches can be any shape and size, often starting as a raised tuft of hair. It’s common to see the spots in a cluster, with the affected skin becoming scurfy and scabby, leading to patchy hair loss. The area may be sore and itchy, and if left untreated it can spread to cover quite a wide area.

Just to confuse matters ringworm symptoms can mimic other skin conditions and your vet may suggest a skin scrape to confirm the diagnosis. This can then be examined under a microscope to look for any ringworm spores, and cultured (which is more sensitive in picking up the disease).

However, as the fungi that cause ringworm are slow-growing, treatment is usually started on suspicion before the results are available.

Prevention

As the condition is so easily passed between horses and people, good stable management is the key to both preventing ringworm, and limiting its spread.

The funghi responsible are hugely resistant to heat, cold and other environmental factors, which means they can stick to stable doors, fencing, tack and grooming brushes for weeks or even months. Added to this is the fact that they can survive on a horse’s skin for up to three weeks before signs of ringworm start to show, allowing the disease quite a lengthy period of time to spread its wings ­– or at least its spores.

Disinfecting a new stable before your horse moves in is a wise precaution to help prevent ringworm.

Disinfecting a new stable before your horse moves in is a wise precaution to help prevent ringworm.

Disinfecting a new stable before your horse moves in is a wise precaution. Look for a product that specifically targets ringworm, such as Virkon S, which is available in tablet, sachet or powder form, priced around £19.99 for 1kg from amazon.co.uk

It’s also a sensible precaution to isolate any new horses that come on to the yard for a sensible amount of time – between two and three weeks – and avoid sharing your grooming equipment and rugs, etc with other horses, especially if you don’t know their history.

Treatment

If your horse is diagnosed with ringworm, your vet will prescribe treatment in the form of an antifungal wash and/or as an oral medication (grieiofulvin).

They may also suggest you use one of a number of fungicidal shampoos on the market, such as Aqueos’ range of horse shampoos and disinfectant tack cleaners (see www.aqueos.co.uk). Whatever is prescribed, areas covered in thick scabs will need removing gently with a nylon brush that will need disinfecting afterwards. Some vets will advise clipping affected areas, but blades must be carefully disinfected afterwards.

As the fungus loves moist areas of skin, it’s wise to towel your horse dry where necessary and help prevent the condition taking hold further. Everything he touches, and all of his gear, must be kept well disinfected.

Your horse should be kept in a paddock or stable where he can’t make direct contact with other horses. Anyone who handles him should wear gloves, and they should change their clothes before handling any other horses on the yard. If you become itchy or have any red sore patches, go and see your GP and tell them your horse is being treated for ringworm.

Common Leg Problems: Bursae

See a swelling on your horse’s leg and your first reaction might be to panic - will it take ages to mend, cost me a fortune and potentially affect his future? But don’t panic. With good management, most leg problems can be prevented and early intervention from your vet will more often than not lead to successful treatment.


What are they?

A bursa is a small fluid-filled sac. The body contains lots of bursae – they minimise friction between tissues and help the gliding action of skin, muscle or tendons over bony surfaces. Direct trauma to these structures will result in painful swelling (bursitis). Similarly, a wound that punctures a bursa will cause an infection and result in a septic bursitis. The bursae most commonly associated with clinical problems are those in the knee (carpal bursa), hock (calcanean bursa), shoulder (bicipital bursa), elbow (olecranon bursa) and foot (navicular bursa). Wounds over the front of the knee and shoulder and the point of the hock should be carefully checked. The navicular bursa is contained within the hoof capsule and the most common cause of septic navicular bursitis is a penetrating foreign body, such as a nail.

Diagnosis and treatment

Radiography and ultrasonography are extremely useful in the early detection of septic bursitis and you need to call the vet urgently if it looks infected. Direct trauma to a bursal region can result in a soft, painful swelling. The most common traumatic bursitis cases are those seen over the knee and the point of the hock and elbow. These are referred to as hygromas and capped hocks/elbows. After the initial inflammation has subsided, these swellings rarely cause lasting problems, apart from cosmetic blemishes. Swellings that remain painful when touched or cause lameness should be examined radiographically and ultrasonographically. In the early stages, treatment consists of cold therapy, rest and topical anti-inflammatories. Sterile drainage of the swelling may be needed if the bursa is grossly enlarged. Prompt surgery is needed for all cases of septic bursitis.


Prevention

Adequate stable bedding must be used as bursal trauma often results from lying on hard surfaces, or injury when the horse gets up. Padded knee and hock boots should be worn during travelling, and protective knee boots are available for exercising on hard surfaces.

Common Leg Problems: Curbs

See a swelling on your horse’s leg and your first reaction might be to panic - will it take ages to mend, cost me a fortune and potentially affect his future? But don’t panic. With good management, most leg problems can be prevented and early intervention from your vet will more often than not lead to successful treatment.


What are they?

This term has been colloquially used to describe a swelling over the back of the hock, just above the tendons that run down the canon bone. Traditionally the swelling was thought to be due to inflammation of the long plantar ligament located in this position. However, the advances in ultrasonographic imaging have now identified a number of additional soft tissue structures, which can produce this type of swelling. The term ‘curb’ now refers to a range of different inflammatory conditions in this region of the limb. As with splints, conformational defects can make horses more likely to develop problems. Those with sickle hock and ‘in at the hock’ conformation are most at risk. Direct trauma in the region at the back of the hock can result in curb formation as can a straininduced injury to any of the tendons or ligaments in that area.


Diagnosis and treatment

The appearance of a curb swelling is best seen from the side – the bowing will show at the back below the point of the hock. The degree of associated lameness is variable, from none to severe, depending on the soft tissue structure involved and the extent of the injury. Ultrasonographic examination is, therefore, crucial to decide on the most appropriate treatment and an accurate prognosis. Horses with curb swellings may also have associated hock problems such as osteoarthritis and it’s important that the source of pain is accurately identified. In the early, acute stages, there may be obvious signs of inflammation and lameness. In more long standing cases, however, the swelling may be hard and fibrous without heat or pain and only a subtle lameness or reduction in performance. Curbs arising from direct trauma usually result in swelling around, rather than within, the tendons or ligament. These cases can usually be managed with local injection of corticosteroids to reduce the swelling and prolonged rest is not normally required. Infection of the area may result from traumatic injury and antibiotics may be needed. Spread of infection into the tendons or ligament in that region is a serious complication requiring long-term therapy. Inflammation of the tendons or ligament in the curb region requires strict rest to prevent further tendon fibre damage. Local cold therapy and antiinflammatories are also useful.

 

Videos and Advice

Bandaging can be seen as a lost art - but not anymore! With our fantastic advice and video, you'll be bandaging in the stable, out travelling, for support ... whenever your horse needs a bit of extra cushioning. Safe, warm, protected legs start with a great set of bandages, so let’s unravel the myths with our guide to choosing, using and applying them

TYPES OF BANDAGES

Exercise bandages

These stretchy bandages are applied over padding to protect the legs from bruising and brushing-type injuries.

First Aid bandages

If your horse has suffered a leg wound, your vet may advise you to apply an elasticated bandage over a dressing to create a clean environment for healing.

Stable bandages

Legs that are tired, old or injured may need a little warmth and support from a set of stable bandages. These bandages are used over padding.


APPLYING BANDAGES

Applying exercise bandages

Many riders favour the support and protection offered by leg bandages for travel and competition.

Applying first aid bandages

Even if your horse rarely gets out and about to shows and events, you may need a little bandaging know-how if he sustains an injury or needs a period of box rest.

Applying stable bandages

There may be a pair of boots available for almost every equestrian activity nowadays, but when it comes to your horse’s legs, it pays to be handy with a bandage.


ADVICE

Bandaging Dos and Don'ts

Make sure you're doing the best for your horse by reading our guide to the dos and don'ts of bandaging your horse.

How to bandage a fidgety horse

These stretchy bandages are applied over padding to protect the legs from bruising and brushing-type injuries. Protective boots may be easier to use, but bandages mould more closely to the leg.


VIDEO

How to bandage your horse correctly

Find out all about bandages and their uses in our great advice section, then watch this video to find out how to apply them.

You’ll soon be bandaging in the stable, out travelling, for support …whenever your horse needs a bit of extra cushioning.