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What type of sedation can I use on the farm?
by Dr. Kathleen Giguere
The following are options for sedating a horse. Many of these sedatives have more than one route in which it can be administered, but the safest method for an owner on the farm is the oral route. Reasons to give sedation include transportation, working with fractious horses or to help take the edge off after surgery.
Acepromazine oral powder packet
Acepromazine may be prescribed as a pre-anesthetic or as a mild tranquilizer. Acepromazine is a rapid-acting tranquilizer used as an aid for controlling fractious horses during examination, treatment, trailer loading, and transportation. The mechanism of action is a depression effect on the central nervous system causing sedation, muscular relaxation and activity reduction. This sedative can be given in various forms: by mouth, intramuscular and intravenous. The most common form used on the farm is the oral powder packet made by Wedgewood. This is dispensed in pre-measured, individual packets that can be used to top-dress feed. Packets are available from 10mg/10mg to 75mg/10mg.
Method / Dosage / Concentration / Period / Duration
Oral / 0.25-1.0 mg/lb / 10 mg/tablet / Treatment / NA
Oral / 0.25-1.0 mg/lb / 25 mg/tablet / Treatment / NA
Intramuscular / injection / 2-4 mg/100lb / 10 mg/ml / Treatment / NA
Intravenous injection / 2-4 mg/100lb / 10 mg/ml / Treatment / NA
This oral form is not FDA approved and is used extra-label for horses. Animals that are exhibiting symptoms of stress, debilitation, cardiac disease, or shock require additional care and attention when treated with tranquilizers.
Dormosedan Gel or detomidine hydrochloride, is a safe and effective mild standing sedative for use prior to routine horse care procedures. This is an FDA approved oral sedative that owners can safely administer using a dosing syringe. This sedative is administered by mouth, under the tongue for absorption through the horse’s mucous membranes. The syringe delivers the product in 0.25ml increments and is intended for a one time use and should be properly discarded after use. The following table shows the dose volume to be given according to the body weight of the horse:
BODY WEIGHT (lb) / DOSE VOLUME (mL)
330-439 / 1.00
440-549 / 1.25
550-659 / 1.50
660-769 / 1.75
770-879 / 2.00
880-989 / 2.25
990-1,099 / 2.50
1,100-1,209 / 2.75
1,210-1,320 / 3.00
It is important not to use Dormosedan Gel in horses that have pre-existing atrioventricular (AV) or sinoatrial (SA) block, with severe coronary insufficiency, cerebrovascular disease, respiratory disease, or chronic renal failure. Handle gel-dosing syringes with caution to avoid direct exposure to skin, eyes or mouth. It is best to give the sedative 45 minutes before the stressful event. Duration and level of sedation are dose-dependent but usually range from 90 to 180 minutes.
Reserpine is an indole alkaloid anti-hypertensive and anti-psychotic drug. The most common legitimate use in horses is for long-term sedation for enforced rest when recovering from injury, and for this purpose it is very helpful. Reserpine binds to the storage vesicles of neurotransmitters, particularly norepinephrine, serotonin and dopamine. It takes many hours or days to reach full effect and continues to have some subtle sedative effects for many days after the last dose. This sedation can be given intramuscularly or orally. Use caution when administering reserpine in show horses, as the recommended FEI withdrawal is 90 days. The most common adverse effect is diarrhea, which we see regularly. The diarrhea usually resolves with a lower dose of the drug. Different horses vary greatly in their sensitivity to the drug, and other side effects may include colic, sweating, depression, droopy eyes and a dropped penis.
Method / Dosage / Concentration / Period / Duration
Oral / 0.002-0.008 mg/kg 1 0.1 mg/tablet / Daily NA
Oral / 0.002-0.008 mg/kg 1 0.25 mg/tablet / Daily NA
Intramuscular injection / 0.002-0.008 mg/kg / 1 0.5 mg/ml / Daily / NA
Intramuscular injection / 0.002-0.008 mg/kg / 1 2.5 mg/ml / Daily / NA
While the horse is sedated, it is important to keep the animal in a quiet, comfortable environment before, during and after treatment. If the horse is stressed while giving the sedative, you may not reach the proper level of sedation as intended. The horse should also be held off of food until the sedative has worn off. Before administering any of these sedatives, make sure that your horse has had a recent exam performed by a veterinarian to ensure that the chosen sedative will be safe and effective for your horse.
The Mane Event
Famed Lipizzan Stallions to be featured in fund raiser for the
UpReach Therapeutic Equestrian Center
Goffstown, NH: The “Royals” are making a visit to Goffstown in late summer and the public is invited!
The centerpiece of a special fund-raiser, the Royal Lipizzan stallions of Austria will be performing a series of performances at UpReach Therapeutic Equestrian Center August 31 through September 3.
“We’re thrilled to bring these amazing horses to the area this summer,” said Karen Kersting, Executive Director at the UpReach Therapeutic Equestrian Center. “It will truly be a one of a kind experience that directly benefits our programs and services.”
Founded in the 16th century for the exclusive use of the Hapsburg Royal family of Austria, the Royal Lipizzans are unquestionably the rarest, most aristocratic breed of horses in the world. The breed was first established by Archduke Charles at Lipizza (now part of Yugoslavia) and only a few hundred have ever existed at any one time.
In the first half of the 20th century, the breed was threatened a number of times as wars and other conflicts swept Europe. Many credit U.S. General George S. Patton for saving the horses during World War II from the Russian advance. The Lipizzans' celebrated escape was recounted in the Walt Disney movie, "Miracle of the White Stallions".
According to historical accounts, General Patton granted protection to locals who smuggled the horses out from far behind enemy lines, riding at night and hiding by day.
The 2018 performance of the Lipizzan Stallions will be held rain or shine Friday August 31 thru Monday September 3, 2018 at UpReach Therapeutic Equestrian Center in Goffstown, NH.
August 31 – 6:00 pm
September 1 – 4:00 pm
September 2 – 4:00 pm
September 3 – 4:00 pm
GENERAL ADMISSION TICKETS
ADVANCE: $15 CHILD (6-12) $20 ADULT
DOOR: $20 CHILD (6-12) $25 ADULT
To purchase tickets or for more information call (603) 497-2343 or go to www.upreachtec.org
About UpReach Therapeutic Equestrian Center
UpReach is a non-profit organization dedicated to inspiring hope, fostering independence, and improving the physical, emotional, and psychological well-being of individuals with and without disabilities by partnering with the power of the horse. Participants range in age from as young as three years of age to those who are young at heart well into his or her 90's. Most participants have varying degrees of cognitive, physical, behavior, psychological, and sensory challenges. Some of these include autism spectrum disorders, Down syndrome, Cerebral Palsy, intellectual and learning disabilities, multiple sclerosis, muscular dystrophy, PTSD, traumatic brain injury, and sensory integration processing disorders. For 25 years, our organization continues to serve the greater Manchester, Concord, and Nashua areas of New Hampshire delivering excellence in programming with the very best staff, horses and volunteers.
For more information, performance schedule and to purchase your tickets visit call (603) 497-2353 or visit us at www.upreachtec.org
Ella Pittman, DVM www.newenglandequine.com
Laminitis, commonly called founder (founder is when actual rotation occurs due to the inflammation), is inflammation of the lamina. But to understand what that definition means for you and your horse, it’s important to appreciate hoof anatomy. The wedge-shaped bone that sits within the hoof, called the coffin bone, is suspended from the hoof wall by finger-like projections known as the laminae. Inflammation and disruption of blood flow to the hooves damage the laminae, causing the bonds between the finger-like projections to break down. As a result, the coffin bones loses its attachment to the hoof wall, enabling the bone and the wall to separate. In chronic cases, this separation allows the coffin bone to “sink” or “rotate” therefore affecting the structures within the foot.
Laminitis can affect all four feet but most commonly is seen in the forelimbs. Laminitic horses may stand in a sawhorse posture to alleviate pressure on their feet or lie down more frequently to avoid bearing any weight. They most often are lame on tight circles, walk with a stilted gait or be reluctant to lift up their feet when asked. Often, the hooves are warm and bounding digital pulses are present. Digital pulses are the pulses that can be felt along the sides of the sesamoid bones on palpation.
Diagnosis is usually based on x-rays where measurements are taken to determine whether the coffin bone has rotated or sunk within the foot. You can also determine if there is increased gas opacity along the laminar line indicating active inflammation present. Unfortunately, changes on x-rays lag behind what is actually going on in the foot and damage can occur without evidence of rotation or sinking. Therefore, treatment is usually initiated as soon as laminitis is suspected.
Often, the inflammation and disruption of blood flow to the feet result from a problem elsewhere in the horse’s body. Several causes of laminitis include excess grain or lush green grass, severe fever or illness such as colic or Potomac Horse Fever, retained placenta after foaling, endocrine conditions such as Cushing’s or Equine Metabolic Syndrome, or excessive weight-bearing on one limb (contralateral limb laminitis). The exact link between these conditions and laminar damage is still unknown. It is generally agreed upon that the laminar damage results from decreased blood flow to the feet. But how does a disease in one part of the body cause decreased blood flow in another?
One thought is called the circulation theory. This states that inflammation in another part of the body causes constriction of the blood vessels in the foot, decreasing blood flow in the smallest blood vessels in the lamina. As a result, the cells making up the lamina die. The finger-like projections disintegrate as the cells die and nothing is left to suspend the coffin bone. In addition, because the smallest vessels are constricted, blood is rerouted through the larger vessels, which produces the bounding digital pulses seen in acute laminitis. Another theory focuses on primary destruction of the lamina. One of the ways the body repairs itself is by producing enzymes called matrix metalloproteinases (MMPs). MMPs are involved in breaking down tissue at the molecular level to promote the growth of new tissue. In the normal environment, tissue repair is a delicate balance between breakdown by MMPs and restoration by other enzymes and cells. In this theory, severe systemic inflammation causes excessive release of MMPs, which in turn destroy cellular components of the lamina and enables the coffin bone to shift.
Despite disagreement about the exact mechanism of laminitis, treatment is generally the same regardless of cause. If laminitis is a consequence of a systemic disease, first and foremost is to treat the disease. Restriction of grains and lush hay, corrective shoeing, anti-inflammatory medications such as phenylbutazone (Bute), banamine or equioxx, soft bedding, and keeping the feet cool with ice baths or ice boots are mainstays of treatment. More debated therapies include the use of vasodilators such as acepromazine or isoxsuprine and rheological agents such as pentoxyfylline to improve blood flow to the feet. Rheological agents cause the membrane of red blood cells to be more flexible, reportedly enabling them to better sneak through the constricted capillaries.
Prognosis depends on cause, whether the laminitis is acute or chronic, severity of rotation or sinking of the coffin bone, and how quickly steps are taken to reduce the continued destruction of the lamina. Managing a laminitic horse will require good communication between you, your veterinarian, and your farrier. If you suspect your horse is developing laminitis, it is important to contact your veterinarian as soon as possible.
Parks, A. H. (2016). Horse Health. Retrieved from American Association of Equine Practioners : https://aaep.org/horsehealth/laminitis
Pollitt, C. C. (2018). Horse Health . Retrieved from American Association of Equine Practitioners: https://aaep.org/horsehealth/equine-laminitis-update-its-causes#
Reed, S. M., Bayly, W. M., & Sellon, D. C. (2010). Equine Internal Medicine . Saunders Elsevier .
EOTRH: What Does it Mean?
Equine odontoclastic tooth resorption and hypercementosis, or “EOTRH”, is a painful disease of the incisor teeth most often seen in older horses. The disease begins by the body resorbing the bone and soft tissue around the roots of the incisors (and sometimes the canines). This resorption leads to spacing between the gum line and tooth, allowing food and debris to become trapped which leads to infection within the gum pockets. Infections here can destroy parts of the tooth root and soft tissue structures, which hold the teeth in place. This underlying infection and increased inflammation of the gum leads to the proliferation of the tooth cementum (or enamel) along the gum line in attempts to stabilize the tooth. Unfortunately, once this process has started it only progresses, leading to the teeth falling out or fracturing, and continues to be painful for the horse.
This disease is typically seen in older horses over the age of 15 years old. EOTRH is believed to have some risk factors such as horses that chew less often (not able to have constant grazing access) and horses that concurrently suffer from Endocrine diseases such as Equine Metabolic Syndrome or Cushing’s disease. This is due to a decreased immune system and higher concentration of circulating Insulin and ACTH.
Clinic signs of this disease are often hard to detect in the early stages due to the low-grade level of pain compared to when the disease is advanced. Some early signs of incisor discomfort are the unwillingness to grab hard treats with their front teeth. These horses may also try to use their lips for grasping food or grazing to help avoid contact with the incisors. A “smiling” face (when a horse lifts if upper lip at work and rest) can be a common sign in EOTRH as well to try and help alleviate pressure on the teeth. In more advanced disease, head shaking, unwillingness to take a bit and weight loss due to decreased eating can be seen due to the level of pain these horses are experiencing.
The inflamed gums and the hypercemetosis along the gum line can be seen surrounding the infected incisors as EOTRH progresses. These teeth may also become loose and sensitive to oral examination. These signs along with a complete dental exam and possible dental radiographs are the definitive way to diagnose EOTRH. Unfortunately, this disease is not reversible and once there is radiographic evidence or changes to the integrity of the teeth, there is not much that can be done to slow the process.
The recommendation for advanced EOTRH is to have the affected incisors removed. Removing the diseased incisors allows for pain relief and it may also help prevent the disease from affecting the neighboring teeth if removed soon enough. These horses that lack incisors can cope extremely well with only a diet change to help manage them after surgery. After surgery, soaked grain meals followed by either hay stretcher pellets or a complete pelleted feed are recommended to ensure a rationed diet is available. Most of these horses learn to use their lips and tongue to help grasp grass and hay while grazing. Some even, can also go back to being ridden though their tongue often sticks out through their gums. It has shown however, that horses with advanced EOTRH who have their incisors removed live a happier good quality life.
A good way to help identify the clinical signs early in EOTRH is by having your horse receive regular, yearly dental examinations by your veterinarian. Regular dental maintenance can help not only keep your horses mouth comfortable but also help monitor for any signs of disease presence progression.
Equine Dental Pathology: Dixon, Toit, Dacre
Getting to Know EOTRH: Norton
Osteochondrosis and Subchondral Bone Cysts
Dr. Taylor Mahren
New England Equine Medical and Surgical Center
15 members way
Dover NH 03820
Osteochondrosis (OC) is a developmental disorder that leads to failure of bone and cartilage formation (endochondral ossification). Failure of normal bone and cartilage formation results in irregularities in the thickness of cartilage at joint surfaces. This creates areas of weakness and affects the nutrition of the deeper layers of cartilage and bone and can lead to necrosis (decay). Biomechanical influences, mainly shearing forces, lead to the formation of fissures (tiny fractures) and produce cartilage flaps, or detachment of cartilage or fragments of cartilage and bone.
The typical OC patient is a yearling with effusion (swelling) of the upper hock joint or stifle joint. The horse is typically not lame, and radiographs reveal a fragment on part of the tibia called the distal intermediate ridge of the tibia or irregularities of the femur at what is called the lateral trochlear ridge. However, there are many variations on this scenario and age, lameness, effusion, and the joint affected can vary. Most OC patients are juvenile with the most severe cases being seen in foals as young as 6 months of age. OC can also only manifest itself when the horse is put into training and the joint becomes challenged by activity which varies with discipline. Radiography is the gold standard for diagnosing OC but it is not capable of detecting subtle lesions.
DISTRIBUTION OF LESIONS:
OC is most commonly diagnosed in the tarsus (hock), femoropatellar joint (stifle), and the fetlock, but it has been described in almost every synovial joint.
CAUSE OF THE DISORDER (PATHOGENESIS):
OC is a complex disease and multiple factors are involved in the progression and development of the disorder. Biomechanical influences, exercise, failure of vascularization, nutrition imbalances, and genetics have all been linked to the disease.
Treatment of lesions depends on size, clinical signs, location, and severity. Small OC lesions in very young horses where there is still good capacity for regeneration or in very mild OC cases, nonsurgical management consisting of rest, controlled exercise, systemic anti-inflammatories, and intra-articular (within the joint) medications can be successful. Surgical management is the treatment of choice in most cases. This involves removal and debridement of the fragments from the joint via a small incision and use of an arthroscope (surgical instrument with camera).
The prognosis after surgical intervention varies among joints and the severity of the lesion. However, prognosis for return to athletic activity is fair to good for the majority of joints involved.
Things to consider when trying to prevent osteochondrosis would be to avoid feeding high energy feeds to growing animals which can lead to excessive rapid growth and secondary osteochondrosis development. Breeders should monitor sires and mares suspect of yielding offspring with osteochondrosis. Any young horse with persistent joint effusion should be evaluated with radiography. Horses with OCD that are identified and treated early may be athletic; however , if left unrecognized osteoarthritis (degenerative joint changes) and lameness can develop.
SUBCHONDRAL BONE CYSTS:
Subchondral bone cysts, also known as subchondral cystic lesions (SCLs), are a serious cause of lameness and difficult to treat. They are characterized by radiolucent (darker than normal) areas of bone often accompanied by sclerosis (boney remodeling) at a joint surface. In the past, they were considered to be part of the osteochondrosis complex, however, the location of OC lesions differs from SCLs. SCLs are found underneath the cartilage in a weight-bearing area of the joint.
CAUSE OF THE DISORDER (PATHOGENESIS):
Many mechanisms have been proposed for the development of SCLs. However, only two hypotheses have been supported experimentally. The first hypothesis is based on the hydraulic theory in which there is primary cartilage damage followed by secondary intrusion of synovial fluid. The fluid is thought to place mechanical pressure on the subchondral bone through its hydraulic action during weight bearing, resulting in necrosis of the subchondral bone plate. The second hypothesis is the inflammatory theory in which various inflammatory mediators become upregulated (increased) leading to the development of cysts.
DISTRIBUTION OF LESIONS:
SCLs occur mainly in the stifle (medial femoral condyle) and the phalanges (fetlock, pastern, coffin bone, and navicular bone) and less commonly in the carpus (knee), cannon bones, tibia, radius, talus (hock), proximal sesamoid bones, humerus, patella, scapula, and mandible. 62 % of lesions occur in males and Thoroughbreds represent the majority of affected animals.
Horses often present with lameness in the affected limb with or without joint effusion (swelling). SCLs occur mostly in young horses between the ages of 1 and three years and lameness commonly occurs at the onset of training.
Diagnosis is made via lameness examinations and radiographs. In rare cases, computed tomography, CT, has been of great value when SCLs cannot be visualized radiographically.
Nonsurgical management of SCLs involves rest and the use of non-steroidal anti-inflammatory drugs; however, success rate is variable. Intralesional corticosteroid injections do have better success rates but this is generally performed under arthroscopic guidance under general anesthesia. Surgical management is the treatment of choice and involves debridement of the cyst and a combination of intralesional corticosteroid injection, bone grafts, and other modalities.
The healing of treated SCL normally is slow and can take several months to years if just surgical debridement is used, but the use of bone replacements and growth factors to enhance bone healing shortens the healing time considerably. Younger horses have a better prognosis for complete recovery compared to older horses. If the SCLs are associated with osteoarthritis in older patients a cautious prognosis is given.
1.) Auer and Stick. Equine Surgery, 4th edition. Chapters 88 and 89.
First Aid Kit
Katy Raynor, DVM
Equine injuries can be just as common whether your horse is stalled or turned out to pasture. The best way to treat any injury, however, is to be prepared with a well-stocked, easily accessible first aid kit. In fact, keeping even a few of the below first aid essentials could help save a severely injured horse's life while you wait for your veterinarian to arrive.
Vital first aid supplies
Every horse owner needs a few basic first aid essentials. These items will help you dress wounds, reduce swelling and inflammation until your veterinarian arrives. Depending on your preference, pre-made first aid kits are available at our clinic. Or, you can make your own kit with the following items:
- Bandages - protect wounds, support muscles, and hold ice packs with horse leg wraps or self-adhesive bandages.
- Blunt-Tipped Scissors - safely cut away and remove bandages and wraps.
- Buckets - soak hooves and more with a few buckets kept specifically for first aid use.
- Flashlight/Head lamp - view wounds and injuries in darkness or poor light conditions.
- Hoof Pick
- Ice Packs - prevent and reduce swelling.
- Rubbing Alcohol - used as a disinfectant as well as good for cooling horses rapidly if febrile.
- Sheet or Roll Cotton - help apply pressure bandages or offer support to injured muscles or bones.
- Sterile Gauze - clean and cover minor cuts and wounds with sterile gauze or Telfa (non-stick) pads of various sizes. Use gauze rolls to hold dressings and pressure wraps in place.
- Exam Gloves- keep your hands clean and help prevent wound contamination.
- Thermometer - measure your horse's temperature (normal range is 99.0°F to 101.5°F) whenever you have a concern before you call the vet. EVERY FARM SHOULD HAVE ATLEAST 1 WORKING THERMOMETER!
- Stethoscope- Know how to take your horses heart rate! Great information to help your vet!
- Wound Antiseptic
- Wound Cleaner
Easy access to your veterinarian's and farrier's contact information is also vital. In addition, a complete record of all your horse's medications, vaccinations, and wormers is essential - especially in an emergency.
Helpful first aid extras
The best first aid kit holds a range of products to deal with a wide variety of injuries or accidents. In addition to the basics, however, having the following products accessible will help you further prepare for almost any mishap:
- Probiotics- (good quality)
- Eye Cleanser/Saline
- Hoof Boot
- nSAIDS (phenylbutazone, banamine, Equioxx) - Only used after consulting a veterinarian Always take temperature before administration.
- Trailering and Barn additional tip!
Always have a fire extinguisher available in your barn and trailer/truck at all times!