It’s Shedding Time Again

If dealing with shedding was the worst problem we had to face with horses we would be blessed indeed – but it’s still a pain. Getting to that glorious new coat underneath will always be predominantly a matter of time, patience and elbow grease but there are a few things you can do to hasten things along.

Image by Gabriele M Reinhart from Pixabay

Horses in work shed out quicker. This probably has to do with more blood flow to the skin, with more sebum and sweat production easing the hairs out. Exercise can also save grooming time. Give the horse a good curry before you lunge and watch the hair fly off as he works.

Other than exercise and investing in a good horse vacuum (which makes a huge difference!) there’s no way to influence the normal process. However, there is a check list for skin and coat health which will help everything go as quickly and smoothly as possible.

Delayed shedding or failure to shed, especially if the coat is unusually long or curly, is a hallmark of Cushing’s Disease (PPID). This will only respond to treatment that restores normal dopamine levels in the brain. If your horse has held onto a coat that has turned a stark straw to rust color, that’s not normal. A heavy parasite burden can do this too, especially in foals and older horses. Otherwise, look for areas where important aspects of nutrition may be subpar.

Vitamin A is a key nutrient for skin and coat. Hay begins to lose vitamin A activity 6 months after baling.  By 1 year it is often too low to meet requirements.  This starts to become an issue in late winter/early spring, before the grass has come in well or that year’s hay has been baled.  The more faded from bright green the hay has become, the more A loss there has been.  Target supplementation until the horse goes on pasture or that year’s hay is available is 20,000 to 40,000 IU/day.  If the horse is not already getting this much from supplements or grains, add it separately.

Zinc is the most common deficiency in pasture and hays. It plays a key role in antioxidnt functions and pigment production but zinc is also needed for the normal production of new hair from the follicles.

The amount of fat a horse requires in the diet to support life is considerably less than what will give you optimal skin and coat health.  A shiny smooth coat, supple moist skin and good local immune defenses result from supplementation of as little as 4 to 6 oz/day.

Biotin is also extremely important for skin health and skin cell division.  Dry, flaking skin can signal suboptimal biotin intake.  No specific daily requirement has been established but research into the effects of biotin on hoof quality have repeatedly demonstrated an intake of 20 to 30 mg/day provides best results. [Note: The hoof wall, sole and frog are specialized forms of skin.]

Finally, inadequate intake of protein in general or specific amino acids will adversely affect hair growth.  If your hay is of poor quality or cut at a very late growth stage you may need more protein from high quality sources. Otherwise, it may only be lysine and methionine you need to supplement.  Give 10 g/day of lysine and 5 of methionine.

Don’t let shedding be a bigger pain than it needs to be. Plug any nutritional holes now for a smooth transition to that new coat.

Eleanor Kellon, VMD

Vitamin C and the Horse

Vitamin C [ascorbate/ascorbic acid] is a water soluble vitamin which functions as an important antioxidant and is needed for the synthesis of L-carnitine, catecholamines like epinephrine and dopamine, as well as collagen, the major protein in all connective tissues, including tendons and ligaments, even blood vessels.  Deficiency causes a disease called scurvy, beginning as weakness and muscle pain, progressing to bleeding gums, loose teeth, poor healing and eventually mental changes and death.

Fresh, live grass in an excellent source of Vitamin C.

Unlike humans, the horse can synthesize enough vitamin C in its body to prevent the development of a full blown deficiency state (scurvy). However, the ability of this synthesis to maintain normal vitamin C levels and the role of dietary C is poorly understood.

We do know that heavy exercise and chronic disease, especially lung disease, lead to decreased vitamin C blood levels in unsupplemented horses, as does stabling versus pasture access. Low blood levels have also been linked to poor wound healing in horses.

Although information is limited, a “conditionally essential” status may best describe the need for additional vitamin C in the diet of horses that are recovering from illness or surgery, or exercising heavily, when requirements may exceed the body’s ability to make it. The NRC states that information about vitamin C levels in common feedstuffs is lacking but a study from 1938 measured ascorbic acid in many common feeds, hays and references levels in grasses.

The figures are presumably on a dry matter basis and they report 20 to 136 mg/100 gram in fresh pasture; 1.3 mg/100 g in 50:50 alfalfa/grass hay; 0.9 mg/100 g in grass hay; 1.3 to 1.8 mg/100 g in alfalfa; 0.7 mg/100 g in beet pulp; about 0.6 mg/100 g in grains (this would only apply to whole grains). A stabled horse on a grass hay based diet would be taking in less than 1 gram of C from its diet daily while an average horse on pasture is getting a minimum of 20 grams/day (quite possibly part of the value of “Dr. Green”!).

In the early 1970s, Dr. Linus Pauling was recommending megadoses of vitamin C for maximum health and disease prevention. As usually happens, many of these claims were debunked and the pendulum actually swung so far to the other side that megadosing was proposed to be toxic. Once again, the truth is somewhere in between.

With specific reference to the horse, toxicity in the form of diarrhea usually begins with dosages of 20 grams/day and above. This may be more of a local irritation than a toxicity. There are two other properties of vitamin C that would dictate caution in horses known or suspected to be iron overloaded. One is that vitamin C increases iron absorption in the intestine. It also can act as a pro-oxidant rather than anti-oxidant in the presence of excess iron in the circulation or tissues.

A reasonable level of supplementation is 3 to 10 grams/day for an average size adult horse, keeping to the lower levels with iron overload.  For additional antioxidant support vitamin C can be combined with other antioxidants such as resveratrol from grapeseed, citrus bioflavonoids, MSM, herbals with good antioxidant activity such as Jiaogulan or Spirulina and vitamin E for fat soluble coverage.

Eleanor Kellon, VMD

Supplementing for Health

Why is sound nutrition such a hard sell?

Image by Dorota Kudyba from Pixabay

If you are reading this, odds are you already know the clear benefits of optimizing nutrition, but maybe you have run across one or more people who are adamant that all the horse needs is hay, oats and water (or some variation on that theme).

Nutrition and supplementation isn’t a scam. It’s a science. The problem is that not many people, including veterinarians, are really familiar with the science.

Like physicians, vets are trained in dealing with disease, not promoting health. There’s a difference. Health is more than just the absence of disease and death. Living and breathing doesn’t mean healthy, but when thinking about nutrients many people are inclined to believe that if there isn’t a flat out obvious deficiency state that is threatening to kill the horse, there is no deficiency.

Suboptimal nutrition can have two major effects. One is to predispose the horse to developing disease. The other is to keep them from reaching their optimal potential – from coat and hoof quality, to infection resistance, reproduction, athletic potential and many other things.

To complicate things, published requirements are only minimums and apply to horses that are not under any stress from performance, illness, environment, etc.

Vitamin E is a good example. There are no clearly defined symptoms of vitamin E deficiency in horses. We do know that low vitamin E levels predispose horses to several disorders, including EMND, equine motor neuron disease which strikes the nerves supplying muscle. It’s not as simple as E deficiency though.

EMND cases are clustered primarily in the Northeastern United States while unsupplemented horses not on pasture occur all over the country – and the world. EMND has also been diagnosed in horses that are on pasture and getting plenty of vitamin E from fresh grass. Whatever it is that causes EMND, it increases the requirement for vitamin E to fight its effects.

A study in pregnant mares that were already consuming what should have been adequate vitamin E showed that those supplemented with vitamin E had significantly higher levels of antibodies (immunoglobulins) in their colostrum and higher levels in their foals.

Selenium is another nutrient often in short supply. As with vitamin E, research has shown that supplementation can improve function of the immune system.

The point here is that none of the horses in these studies had any obvious deficiency symptoms but their nutrient levels were suboptimal for peak health. That’s why we supplement.

Eleanor M Kellon, VMD

Iron, Insulin and Laminitis

Since this article appeared, and indeed long before it, the idea that too much iron could be harmful and that there is a connection between iron and insulin has generated an enormous push-back.

Most of the objections begin with statements to the effect that iron uptake from the intestinal tract is well regulated and iron is not toxic to horses. However, dietary iron overload is well documented in humans, lab animals and many zoo species when taken out of their native habitat https://tinyurl.com/y9t7c6vn . Severe iron toxicity has also been demonstrated in foals https://tinyurl.com/yc9ebwm8 and adult horses https://tinyurl.com/yckzy9pn .

The point here is that it is indeed possible for iron to be overabsorbed and be toxic, even fatal, to the horse.

The connection between iron and metabolic syndrome is so strong in humans that a paper representing an international consensus statement was recently published https://tinyurl.com/2s3ssc5u . If you want to delve deeper, start with the Recommendations section which describes in part:

“In a large prospective cohort of middle-age healthy men conducted in South Korea, elevated serum levels of ferritin were independently associated with development of the metabolic syndrome during the 5-year follow-up period³². Furthermore, in a large prospective study on European cases of incident type 2 diabetes mellitus, increased serum levels of ferritin were associated with an increased risk of type 2 diabetes mellitus, even among individuals with no overt inflammation, liver disease, high alcohol consumption or obesity³³.”

Getting back to the horse paper linked above, rabid criticism centers around the themes iron does not cause laminitis and does not cause metabolic syndrome. There was even a paper published recently that stated Thoroughbreds fed high levels of iron do not develop metabolic syndrome so there must be no connection between the two, completely ignoring that there is strong evidence for a root genetic predisposition to metabolic syndrome.

The problem is that nowhere in our paper was it ever stated that iron caused metabolic syndrome or laminitis. What we said was 100% of the hyperinsulinemic horses from the ECIR group tested for iron were overloaded and when results from another study were reexamined we found significantly elevated ferritin (p = 0.05) in horses considered hyperinsulinemic by dynamic insulin testing compared to horses with a normal response. Our conclusion was simply:

“These results suggest the potential for iron overload in hyperinsulinemic horses, a feature documented in other species and should stimulate further study into the relationship between insulin and iron dysregulation in the horse.”

Both hyperinsulinemia and iron overload are multifactorial conditions. It’s not as simple as Strep causes Strep throat. You can’t expect x units of change in insulin correlates to y levels of iron, or vice versa. What we do know is there is good evidence of a connection.

Eleanor M. Kellon, VMD

Impaction Season

It can happen any time, but fall and winter are peak seasons for colic, especially impactions.

Image by Joe from Pixabay

There are many reasons for this, including change in diet when coming off pasture, lower water intake when switching off fresh pasture and in winter when water can be frozen or too cold, failure to supplement adequate salt and less exercise because of less riding, stall confinement or bad weather and ground conditions causing even turned out horses not to move much. This very short term study showed dramatic changes moving from pasture to stabled even with exercise https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303976/ .

Reducing the risk comes from efforts to modify these risk factors.  Make dietary changes slowly, including transition from grass to hay.  Make sure the average size horse gets at least 1 oz of salt added to meals daily.  If necessary, dissolve in water and spray over the hay.  Water intake needs to be a bare minimum of 5 to 7 gallons/day.  Heated water is best.  Consider wet meals that contain beet pulp, which can hold 4 times its weight in water.  Make an effort to ride or lunge as much as possible plus plenty of turnout.

Pay close attention to water intake and manure characteristics.  A drop in water consumption is dangerous.  Decrease in manure volume or size of fecal balls is a red flag for impaction developing, as is the appearance of a mucus coating on the manure.

If your horse does develop an impaction, take heart knowing that 90% of horses recover with medical treatment.  The down side is that it can sometimes take a week or even a bit more to resolve an impaction.

Until impaction resolves, the horse will be depressed with periods of colic pain and have little appetite.  If he does attempt to eat, pain will worsen.  Intravenous phenylbutazone or flunixin meglumine are usually used for pain. A once daily visit from the vet to assess your horse, give pain medication, intravenous fluids if necessary and tubing with oral fluids, electrolytes and stool softeners or laxatives is the usual routine.  As with eating, it is to be expected that pain will worsen temporarily after the horse is tubed with fluids.  This is because it triggers the intestine to move but there is still a blockage.

There’s a tendency to get discouraged or give up when the problem lingers 2 or 3 days.  Hang in there.  Good mucus membrane color and rectal examination findings can help reassure you there is nothing more life-threatening going on.  If there’s one good thing to come from riding out the course of an impaction it’s a strong determination to do everything you can to never have to go through it again.

Eleanor Kellon, VMD

Weight and Topline in Cushing’s Horses

Holding weight can be an issue for any horse but especially those with PPID (Cushing’s disease).

Image from Pixabay by ivabalk

All seniors have a variety of factors that can contribute to weight loss. These include:

• Wear of teeth.
  • Alteration in the angle of the occlusal surface of the teeth that reduces the forces generated during chewing.
    • Sarcopenia of aging which is a loss of muscle mass accompanying aging, especially in horses no longer being exercised.
      • Reduced number and diversity of organisms in the large intestine.
        • Possible reduction in the efficiency of enzymatic digestion in the small intestine.

Except for sarcopenia of aging, these changes can be efficiently addressed by feeding the horse a diet of soaked pelleted or cubed feed and hay, possibly with the addition of a supplement with both high digestive enzyme and probiotic ingredients. It is also wise to guarantee adequate intake of essential amino acids.

With PPID, there are also hormonal effects. PPID is a very catabolic state, meaning there is breakdown of protein. This frequently causes unexplained tendon or ligament breakdown/injury and also affects muscle.

Muscle loses both bulk and strength when PPID is not controlled. This leads to the loss of topline and slack abdomen so typical of PPID but also contributes to weight loss is general because the horse cannot hold a normal weight when protein metabolism is disrupted.

The solution here is not dietary, although you do still need to guarantee adequate essential amino acids. The first thing to do is ask your veterinarian to check ACTH to make sure your dose of pergolide is adequate to control the PPID and if not, increase it. Contrary to popular belief, 2 mg is not the maximum dose that can be used.

In a poll conducted on the Equine Cushing’s and Insulin Resistance Group , only approximately 1/3 of the members’ horses were controlled on 2 mg or less of pergolide.

Horses under borderline control may do well through early Summer then start to lose weight as Fall approaches. Other changes you may see at this time and into September are increased water consumption and urination. These are strong indicators that the horse needs more pergolide.

Eleanor Kellon, VMD

Feeding Yearlings

Whether you are prepping for sales and halter classes or trying your best to raise a healthy and sound youngster, careful attention to nutritional needs is a key component.  Yearlings should not be fed like little adults.

This handsome devil is a Beneteau colt that was selling at the 2015 Australia Magic Millions Perth Yearling sale

An easy way to see this is to compare their calorie needs on a Mcal/kg of body weight basis and their protein and mineral needs as grams or milligrams/Mcal of diet.  Those second numbers show you how nutrient dense the diet needs to be.

Compared to the adult maintenance, the yearling needs 113% more calories, 186% calcium, 134% crude protein, and 134% L-lysine.  Although the NRC has not gotten around to recognizing it officially yet, formal research such as vanWeeren et al 2003 shows an effect of copper on healing of osteochondrotic lesions, as did Dr. Knight’s original work in 1990. Feeding three times the current NRC minimum requirement is safe and cheap insurance. Other trace minerals are increased proportionately to keep them in balance.

If you have a properly formulated weanling diet in place this will also meet all the needs of the yearling simply by adjusting calories.  If the horse starts to get too fat, cut back the diet but add 1/2 to 1 lb of a 25% protein and balanced mineral supplement to keep up the nutrient density.

The usual advice for feeding weanlings is a 50:50 diet of pasture or high quality hay and a  commercial concentrate, by weight of each.  The first thing I check is the fat content.  In a 1999 study by Hoffman et al, young horses fed as little as 1 to 1.4 kg (2.2 to 3 lbs) of an average 10.4% fat concentrate twice a day, with pasture, had reduced bone mineral density despite mineral intakes that were at least 200% of requirements.

Fats form insoluble complexes with calcium and magnesium. Fiber binding some minerals was also mentioned but is far less likely as a cause since horses raised on pasture get more fiber than this. Added fat in the supplement from the study above amounts to about 10 oz of oil. Unfortunately, many feeds labeled for use in yearlings have too much fat. This also increases calories and results in just the concentrate providing all calories required, if not more, and a fat youngster. This leaves no room for hay and sets the stage for wide hormonal swings, digestive upset and impaired development of the GI tract and its microbes.

Commercial growth feeds do a good job with minerals but don’t correct imbalance issues in the hay or pasture. Protein provided is 60 to 65 % of minimum requirement with most or all lysine being met, depending on the product.  If hay is at least 8.5% protein, it will fill in the additional protein.  All of this assumes you feed the full recommended amount, typically as much as 7.5 lbs/day for a 650 lb yearling.  If he backs off the recommended minimum 1% of body weight in hay or gets too heavy (and they will with those high fat feeds) you will have to reduce it – and with that the protein and minerals also go down and will have to be added back in.

An alternative approach is a simple concentrate you mix yourself instead of the commercial feeds, adding a separate concentrated mineral mix and protein as needed. For example, by weight, 1 lb beet pulp and 2 lbs high grade oats with 1 oz of flaxseed per pound of mixture is balanced for calcium and phosphorus, about 12% protein and contains about 65 to 70% of the calories of high fat yearling feeds.  Ingredients also meet or exceed the % lysine required in protein for yearlings.  Other combinations of high calcium (alfalfa, clover, beet pulp) and high phosphorus (grains, brans, seeds) can be used to get a balanced Ca:P ratio.

For a 650 lb yearling, combine 7.5 lbs of good quality grass hay with 7.5 lbs of oats/beet pulp mixture, 2 cups of ground flaxseed (all daily totals) and 1 lb/day of a high quality 25% protein and balanced concentrated mineral supplement. Look for a blend of milk and vegetable protein, 4.5 to 5% calcium, at least 350 ppm copper and 875 ppm zinc with lower manganese.

If needed, an additional 2 to 4 oz of oil can be added for coat conditioning. Boost protein for low protein hays or pastures using a protein supplement without the added high levels of minerals.  When more calories are needed, increase all elements of the diet proportionately – e.g. pound each of concentrate and hay, 1 oz flax, 2 oz protein/mineral supplement.

Attention to detail will get you the well developed, muscular rather than fat, shining and structurally sound young horse you are wanting.

Eleanor Kellon, VMD

Understanding Fatty Acids

Fatty acids are the building blocks of fats in the same way that amino acids are the basic unit of proteins. When picking a fat for your horse, you should be guided by the fatty acid levels.

The fatty acids from ground flax seed are the richest source of omega-3 fatty acids

The fat content of the horse’s natural diet is quite low – about 4% during peak grazing season and much lower when grass is not growing or forage has been cut and dried. The fat in grasses contains less than 20% saturated fatty acids, primarily palmitic. Of the unsaturated fatty acids, 60+ percent is alpha-linolenic aka C18:3 omega-3 fatty acids and the remainder a mixture of omega-9 C18:1 oleic acid and omega-6 C18:2 linoleic acid.

You have probably heard that omega-6 fatty acids are inflammatory and omega-3 antiinflammatory but it’s not really quite that simple. Both are needed for healthy and balanced immune activity.

Omega-6 linoleic acid [LA] is converted to arachidonic acid [AA]. This is found in very high concentrations in the brain and skeletal muscles, and in cell membranes. If an inflammatory reaction has been triggered, AA can be a source of immune system inflammatory chemicals but it cannot trigger inflammation by itself. AA is also essential for muscle growth in response to exercise. Training athletes supplemented with AA actually have lower levels of inflammatory markers.  LA is especially important for skin and coat health.

Omega-3 alpha-linolenic [ALA] is also converted into the phospholipids of cell membranes and its derivative DHA is as abundant in the brain as AA [above]. Other derivatives of ALA participate in the homeostasis of inflammatory responses and support the activity of the sophisticated arm of the immune system which in turn makes the nonspecific inflammatory reactions less necessary.

Omega-9 oleic acid is incorporated into phospholipids of cell membranes. Like all the unsaturated fatty acids it help keep membranes supple. It is the most common fatty acid in the popular human Mediterranean diet and associated with healthy lipid profiles in the blood.

Although it hasn’t been formally studied in horses, it is assumed horses can manufacture all the fatty acids they need with the exception of the essential fatty acids alpha-linolenic omega-3, and linoleic, omega-6. Grasses typically have about 4 times as much omega-3 as omega-6 fatty acids.

Horses are fed supplemental fat to boost calorie intake, improve skin and coat health and shine, and provide the essential omega-3 and omega-6 fatty acids. Omega-6 fat may be of additional benefit in active horses, for promoting muscle growth. Good sources include:

Coconut oil: Extremely palatable. Also rich in medium chain triglycerides which are the easiest to metabolize for energy. Low essential fatty acids.

Flaxseed oil: Very high in omega-3 fatty acids.  Omega-3:omega-6 ratio similar to grass. Low saturated fat.

Soybean oil: High omega-6, moderate omega-9 and omega-3, low saturated fat.

High oleic sunflower oil: This specialty type of sunflower oil is high in omega-9 oleic acid (like olive oil) and low in essential fatty acids. This makes it a great way to promote weight gain and coat condition without upsetting the balance of essential fatty acids.

Eleanor Kellon, VMD

Feeding Alfalfa to Horses with EMS

The horse hasn’t been born that doesn’t love alfalfa.  Although it poses some balancing challenges, alfalfa can be a valuable addition to the diet.  However, for reasons that are not yet explained alfalfa can cause flares of laminitis pain in some IR horses.

from USDA National Institute of Food and Agriculture

I have been asked about some information floating around the internet that claims to explain why this happens.  The statements were that the carbon skeletons of amino acids and/or propionate used as a preservative on alfalfa would be converted to glucose and cause a blood sugar spike, just like feeding something that is too high in sugar or starch. Creative theory but it doesn’t hold up to scrutiny.

Gluconeogenesis is the process of creating glucose from precursors such as lactate, pyruvate, other derivatives of some amino acids and other substances like propionate.  It occurs primarily in the liver, to a small extent in the kidney, and is a normal function.  This is how all animals maintain blood sugar levels when glucose is not being absorbed from the intestinal tract.

The fault with the theory that high protein or propionate preservatives in alfalfa cause a blood sugar spike from gluconeogenesis is quite simply that they don’t.  The carbon backbones of amino acids can themselves be directly burned for energy.  If they, or propionate, are converted to glucose that glucose is not necessarily released into the blood.  It can be stored as glycogen or fat if blood sugar is already normal.  This process is under the control of the hormone glucagon.

Drs. Rodiek and Stull published a study on the glycemic index of common feeds in 1988.  Glycemic index refers to how high blood sugar goes after eating.  Oats is assigned a value of 100 and other feeds described as a % of the blood glucose level seen after feeding oats. They studied blood glucose levels for 5 hours after feeding 10 different foods to horses, including alfalfa.  That study, and five others since, have clearly shown the blood sugar response to feeding alfalfa is extremely low.

from Research Gate

As for propionate, a 1971 study by Drs. Argenzio and Hintz, two of the premier equine nutritionists in the last century, found that administering a load of propionate to ponies causes no rise in blood glucose in animals that had not been fasted.  No change in blood glucose was seen in the horses which were not fasted. When fasted before the propionate was given, there was an increase in glucose from lower than normal levels to a low normal glucose level (70 mg/dL to 83.8 mg/dL on average).  This is consistent with gluconeogenesis from the propionate but release of glucose regulated by glucagon to keep glucose well within the normal range – no spike.

There is some evidence that high protein “balancers” may cause an insulin spike but in that study they were fed in much larger amounts than normal and the sugar and starch content of the balancers was also high enough to influence insulin in an EMS horse.

So, while it remains true that alfalfa is problematic for some IR horses, the reason for this is still unknown.

Eleanor Kellon, VMD

Chronic Lower Leg Issues

It’s difficult enough to support the mass of a horse on a tiny column like the leg if it is a rigid structure.  When it also has a moving part (the fetlock), the problem becomes much more complicated.

Exaggerated flexion of the fetlock is an easily seen outward indicator of the force being applied to the leg.  This occurs when speed is added to the mass of the horse, as in racing,

Image by Rebecca Scholz from Pixabay

also in dressage movements requiring suspension, cutting/roping, takeoff and landing from jumps, negotiating hills or uneven ground and sometimes plain old horseplay.

It is the soft tissue structures of tendon, ligament and dense investing fascia that allow the horse’s lower leg to function as it does.  Damage to the extensor tendons, suspensory ligament or any of the myriad other supporting and reinforcing structures is very common.

Once damaged, they never completely regain their normal strength and flexibility but with a little extra care many horses can continue to be athletically active, even at their preinjury level.

Once the healing period from an acute injury has been successfully completed, you need a strategy for reducing the risk of reinjury.  Passive stretching as part of warm up is a good idea.  The flexor tendons are attached to muscle bellies.  Increased tension is common when injury has occurred and can be gently relaxed by stretching.  Even pure connective tissue/ligament injuries can show contraction that may respond to gentle stretching and massage.

Absolutely meticulous attention to hoof balance, regardless of barefoot, shod or type of shoes, is an absolute must.  Every effort must be made to ensure that the leg is loaded evenly.

Physical fitness and good balance (neuromuscular conditioning) are two of the best guardians against reinjury.  Introduce work slowly but with steadily increasing increments.  Avoid unfavorable ground conditions whenever possible.  Do not ask for sudden, sharp movements or speed changes but introduce elements that challenge control and balance, like ground poles.

Finally, use the best and cheapest therapy there is – heat and cold.

Image by Hans from Pixabay

Like massage and stretching, warmth encourages tissue relaxation.  Standard wraps, sweat wraps and neoprene can all be used to advantage when the horse is stalled.

It’s impossible to overemphasize how important ice can be to the horse coming back from an injury.  Apply ice to the previously injured area as soon as possible after exercise stops and maintain it for a 30 minute cooling period.  Ice slows excessive blood flow and/or inflammatory enzyme activity that often result in annoying periods of intermittent heat and edema as you bring the horse back into work.  I use it faithfully after every work regardless of intensity.

Investing these few extra minutes can mean a smooth uneventful rehab and maximize your chances of avoiding reinjury.

Eleanor Kellon, VMD