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Causes of Nose Bleeds (Epistaxis) in Equines
Epistaxis is defined as the presence of blood in the external nares. The amount of blood present may range from small flecks in the normal nasal discharge to large volumes flowing from both nostrils. Blood in the external nares can originate from one or more of a variety of structures. These can include the nasal cavity, paranasal sinuses, guttural pouch, oral cavity, pharynx, larynx, trachea, or lungs. Bleeding in these structures can be caused by a primary disease or mucosal damage.
Bleeding associated with the nasal cavity or paranasal sinuses usually has blood coming from only one nostril and is spontaneous in nature. The mucosa in the nasal cavity is highly vascularized and can bleed easily due to foreign bodies, fungal infections, or cancer. Theses disease processes usually cause only a small amount of bleeding that occurs intermittently. Trauma is another common reason for mucosal bleeding in the nasal cavity. This can be caused by veterinarians when a nasogastric tube or endoscope is placed in the horses nasal passage. This at times can cause mild to profuse hemorrhage. Erosive diseases that affect the paranasal sinuses of horses commonly cause a unilateral, blood tinged nasal discharge. An ethmoid hematoma is an example of this.
Another source of bleeding while the horse is at rest is the guttural pouch. The horse has a guttural pouch on each side of its pharynx. The guttural pouch is a diverticulum of the Eustachian tube that runs from the horses inner ear to its pharynx. Many important nerves and the internal carotid artery run through this anatomic structure. Infections can occur in this area especially those fungal in nature. Fungal plaques may cause erosion of the carotid artery. The horse will initially experience several episodes of minor hemorrhage with fresh blood coming from one nostril that ultimately leads to large volumes of blood gushing from both nostrils.
Most commonly epistaxis occurs bilaterally immediately after strenuous exercise in horses. This is cause by Exercise Induced Pulmonary Hemorrhage (EIPH). This is most commonly recognized in Thoroughbred and Standardbred racehorses. This is likely caused by rupture of small capillaries in the lung alveoli. With normal breathing the blood will travel up the trachea where some may be swallowed and some may drain out the nasal passage resulting in epistaxis. Other less common causes of post exercise pulmonary hemorrhage in horses include a pulmonary abscess or pleuropneumonia.
There are many other uncommon causes of epistaxis in horses including lesions in the oral cavity, pharynx or larynx caused by infectious disease or foreign bodies. Also uncommon are a variety of inherited and acquired coagulation disorders manifesting in epistaxis.
If your horse exhibits signs of epistaxis it is important to have him evaluated by your veterinarian. This is especially true if the bleeding is persistent, severe in nature, or your horse is displaying signs of respiratory distress. Evaluation of your horse will include a careful physical exam including auscultation of the lungs and trachea. An oral exam may also be warranted. Most often an endoscopy of the upper airway is performed when available to visualize all structures in the nasal cavity, larynx, pharynx, guttural pouch, and trachea.
If you have any further questions or would like more information about epistaxis in horses, contact your veterinarian or one of the veterinarians at New England Equine Medical & Surgical Center.
Ashley Taylor, DVM
Jacqueline Bartol, DVM, DACVIM
If you or your horse has been outside in the tall grass lately, you've likely seen some ticks on you or your pets. If you have been lucky enough not to see any yet - the season is here and you should know what the latest news is on Lyme Disease.
Lyme Disease is caused by the bacteria Borrelia burgdorferi that completes it's life cycle through ixodid ticks (I. scapularis in the eastern U.S. and I. pacificus in the western U.S.). These ticks transmit the bacteria while taking a blood meal and require prolonged attachment (>24 hours). New research has determined that the prolonged time may be needed to down regulate surface proteins (OspA) on the bacteria which will allow for infection to take place. Other identified surface proteins have been helpful in determining infection and levels of infection (ex: C6 protein, OspC, Osp F).
SIGNALMENT / SYMPTOMS:
The signs of clinical Lyme Disease are often difficult to identify and the high prevalence of antibodies against B. burgdorferi makes test results difficult to interpret and definitive diagnosis complicated. Typical signs can include shifting limb lameness, mild fevers, sensitivity to touch or "hypersensitivity", muscle soreness, attitude changes, decreased appetite and lethargy. Affected horses may show some, all or none of these symptoms. In humans, joint effusion has been noted, but this symptom does not appear to affect horses commonly. In horses with especially high titers, neurologic signs may also be present, including muscle wasting, lumbar pain and/or ataxia.
Diagnosis of Lyme Disease can be a difficult task and should be discussed in depth with your veterinarian. Both a combination of signs and serology (bloodwork) can help in differentiating chronic exposure with acute infection. Previously, Western Blot and ELISA performed together have been the testing of choice. There is a newer test called the Lyme Multiplex that tests for antibodies to the surface proteins OspA, OspC and OspF and gives a quantitative number. This is helpful in monitoring changes over time as well as determining acute vs. chronic infection. These testing methods are minimally invasive and only require an evaluation of your horse by a veterinarian and a blood draw. The blood test is submitted to a laboratory and results are typically available in 5-7 days.
The most commonly used drugs for treatment of Lyme disease have been doxycycline, (an oral formulation) and oxytetracycline (an intravenous formulation). Both of these drugs are in the tetracycline family. A newer, more expensive, but potentially more effective oral antibiotic is minocycline. The ability for this tetracycline to be absorbed through the gastrointestinal tract and the availability of the drug have made it grow in popularity. The oral forms of tetracycline are easily administered at home, but often require longer treatment durations (1-2 months). The intravenous form of tetracycline must be administered by a veterinarian and often through an IV catheter for prolonged treatment. Oxytetracycline is given twice a day for 1-3 weeks. Horses treated with intravenous therapy should have their kidney values monitored due to the drug's uncommon, but potential side effect of kidney damage. Treated horses should be re-evaluated and re-tested 1-2 months after completing antibiotics to assess degree of improvement and if additional or more aggressive treatment is needed.
Prevention consists of environmental control, early antibiotic treatment and potentially, vaccination. Environmental control consists of limiting tick exposure. Horses is high risk areas should be checked every 24 hours and any ticks present should be removed. Paddocks should be groomed and mowed regularly to prevent overgrowth and long grasses (prime tick living area). Several insecticidal spays are available, but can be costly in horses and effectiveness is varied. Tick exposure is most common in the late summer, fall, and early winter. The only available vaccination is currently only approved for use in dogs, but can be used off-label in horses on a case-by-case basis. Efficacy is unknown at this time, but may be beneficial in horses with high risk. Prevention techniques should be discussed with a veterinarian in your area that is knowledgeable of your geographical Lyme Disease prevalence.
If you have any questions regarding Lyme disease please contact your veterinarian or the veterinarians at New England Equine Medical & Surgical Center.
Kimberly Brothwell, DVM
Jacqueline Bartol, DVM, DACVIM
New England Equine Medical and Surgical Center
Silver Oak Jumper Tournament Gearing Up for August Debut
For Immediate Release for Phelps Media Group, Inc. International
Releases and High-Res Photos Available at PhelpsMediaGroup.com
Media Contact: Mason Phelps
Phelps Media Group, Inc. International
phone 561.753.3389 fax 561.753.3386
The "Rider's Horse Show" Returns on
Hampton Falls, NH - May 20, 2013 - Excitement is building for the inaugural Silver Oak Jumper Tournament as the electrifying sport of show jumping is set to make a return to the Silver Oak Equestrian Center at 340 Exeter Road in Hampton Falls, NH on August 7-11, 2013.
The all jumper show is expected to draw a world-class line-up of stars from the United States and Canada and entries from across the globe. The event will offer divisions for children, adults, juniors and amateurs in addition to a big money international open jumper division.
The Prize List for the Silver Oak Jumper Tournament is available here:
The Children's Wish Foundation International takes center stage as the show's much loved charity.
"We have heard from many of the nation's best riders who have told us that they intend to be here and we're also delighted that a number of international competitors, some from as far away as Greece, are also making the trip to New Hampshire," said Show Chairman, Jeffery Papows.
"We are focusing on a number of exciting entertainment attractions too. We know that the large crowds of enthusiastic supporters that come to Silver Oak will get to see a great show."Silver Oak Equestrian Center, located right off Route 95 less than 50 miles from Boston, has built a reputation as one of the leading equestrian sports venues in New England. Its 150-acre facility is dedicated to providing a first-class experience for equestrian competitors and spectators alike. Silver Oak's unique grounds offer one of the country s largest grass Grand Prix and Derby fields along with four all-weather rings featuring world-class GGT footing."This is going to be a first-class event and a great facility and we're going to showcase the sport of show jumping the way it should be," Papows added.
The show is managed by Mike Belisle, whose resume includes the Winter Equestrian Festival, the Washington International Horse Show, Ox Ridge, the Boston Jumper Classic and the Angelstone Tournament in Ontario, Canada.
Germany's Olaf Petersen, Jr., has been named to design the courses for the Silver Oak Tournament. Petersen, one of the world's most popular and respected builders, has worked the world's best shows, including the 2004 Athens Olympic Games and the North American Junior and Young Rider Championships.
The Silver Oak Jumper Tournament is proud to align itself with the Children's Wish Foundation International as our feature charity. Show management is thrilled to bring world class competition and at the same time, play some small part in making the wishes of unfortunate children fighting serious illness dreams a reality.
SILVER OAK JUMPER TOURNAMENT 2013 FAST FACTS
Now under new management, Olympic caliber Show Jumping is set to return to Hampton Falls, NH from August 7 - August 11, 2013 for the Silver Oak Jumper Tournament. We look forward to beginning a new era as we bring world-class competition and exciting entertainment to Hampton Falls. Equestrian Estate Planning Group will be title sponsor of the $75,000 Grand Prix. The show benefits the Children's Wish Foundation International
Silver Oak Equestrian Center
340 Exeter Road
Hampton Falls, NH 02844
Take Exit Route 101 West, pay toll
Follow 101W and take Exit 12
Turn left of the exit and follow to the end of the road
Turn right onto Route 27/111 W-Hampton Road
Travel one mile and turn left on Route 88, Hampton Falls Road
Follow for two miles
Silver Oak Equestrian Center is on the right
Take Exit 7, Route 101E
Take Exit 11, Route 108S
Merge onto Route 108, Portsmouth Avenue
Turn left onto Route 88-Holland Way
Turn right onto Route 27/111, High Street
Turn left onto Route 88, Hampton Falls Road
Follow for two miles
Silver Oak Equestrian Center is on the right
Silver Oak Equestrian Center
340 Exeter Road Hampton Falls, New Hampshire
Vendors offering equestrian equipment, apparel, jewelry and home furnishings will be located on the grounds at the Silver Oak Jumper Tournament
Caren Bayne, Director of Sponsorship
Telephone: (617) 678-3677
VIP Table Sales and Ticket Information:
Telephone: (203) 605-1935
Horse Show Secretary:
John & Pam Rush
Rush Management, Inc.
2344 Laurel Road
Jacksonville, FL 32207-4139
Caren Bayne, Director of Sponsorship
Telephone: (617) 678-3677
The Exeter Inn and Epoch Restaurant
90 Front Street
Exeter, New Hampshire 03833
(603) 778-8757 fax
Fairfield Inn & Suites Portsmouth Exeter
138 Portsmouth Avenue
Exeter, NH 03833
Book King at Fairfield Inn & Suites Portsmouth Exeter for 174 per night
Book dbdb at Fairfield Inn & Suites Portsmouth Exeter for 189 per night
Hampton Inn & Suites Exeter
59 Portsmouth Avenue
Exeter, New Hampshire
Silver Oak Jumper Tournament Media Contact:
Phelps Media Group, Inc.
12230 Forest Hill Blvd.
Wellington, FL 33414
Happenings at Hillside Meadows
May 10, 2013
We have a lot of exciting things going on Hillside Meadows this summer! First off, we have had a lot of changes at our facility. After acquiring another stable on property we now have two boarder barns and one school barn stocked with great mentors and show horses. We have openings for boarding and we are offering a summer promotion. Sign a contract with us this summer and receive your first month of weekly lessons free. Refer a friend to our stable and receive 4 lessons free, regardless if you are a current client or a new customer. All barns are under the same management, and the care of our wonderful staff. We offer beautiful new stalls, quality bedding, beautiful hay four times a day, all day or half day turnout on grass or sand, two attached indoors and two large outdoors, also we have access to miles of trails right off our property. Come see why we are Grafton’s hidden gem, tucked away on top of George Hill.
We are hosting a series of cow sorting and versatility events all summer, dates and sign ups on our website! The popular RFD-TV host of Horse Master, Julie Goodnight is coming to host a clinic June 29th-30th , check online to buy spectator tickets. We are very excited now to wish our Western IEA team the best of luck at Zones this upcoming weekend, following what has been an almost undefeated season. Signups for our championship Huntseat and Western IEA teams begin this summer! We are also proud to be working with the Grafton Recreation department this summer for our Horse Lovers Program for children.
All and all we are growing more and more each day. The group of people at our barn are vivacious and down to earth, versatile and most of all, happy! We are proud to offer a family environment for huntseat and western riders a like, as most of us ride multiple disciplines. Whether you’re a beginner or advanced rider, our team of instructors can get you where you want to go. Our relationship with the wonderful trainers and owner of Grazing Fields out of Buzzards Bay means that we can offer you the training and showing experience that you want, without the big price tag. You’d be surprised what we have to offer in your own backyard. On behalf of all the staff, the owner, Ron Ernenwien and my two assistant managers, Leah Shedd and Amanda Dorherty we hope you’ll come check us out soon!
Hillside Meadows Equestrian Center
RELAXATION IS BOTH A MENTAL AND PHYSICAL GAME
By Nancy Wesolek-Sterrett
Dressage Department Head, Meredith Manor International Equestrian Centre
“Drop the reins. Trust me, JUST DO IT!” I addressed this command to a more advanced student mounted on a 17-hand Thoroughbred known around the barns for his sensitivity. It was the student’s first ride on the gelding and she later admitted that, between the horse’s reputation and his size, she was terrified.
It showed. She held her breath. She held the reins in a death grip with tensed shoulders and rigid forearms. Grippy thighs, locked hip joints and her tight lower back made the horse uncomfortable. Searching for relief, he inverted his neck and back, started stargazing, and began to chase a bit. As he went above the bit and became less responsive to the rider’s aids, her tension increased.
I try to give advanced students time to work problems out on their own. That approach clearly was not working this time. I tried talking to the rider about how her locked joints and shallow breathing affected the horse. I was still looking at a very unhappy horse and rider combination. Because I trusted the horse not to take advantage of relief from the pressures he felt by running off, I issued THE COMMAND.
The horse proved an excellent teacher. As soon as the rider released the reins and went to the buckle, the horse dropped his head to the ground, blew through his nostrils, stretched his back and began moving in a swingy, rhythmic stride. His generous response was a big lesson for this otherwise confident rider who was anticipating what ‘might’ happen instead of staying with what WAS happening and dealing with that.
This incident is a classic example of how relaxation is both a physical and mental game. Relaxation is basic to everything we do with our horses either from the ground or in the saddle. Without it, things go poorly at best and very, very badly at worst. In a previous article on relaxation, I talked about how to build rider confidence so that a fearful rider’s tension does not create tension in the horse. I also discussed how physical pain can affect a horse’s ability to relax. I want to explore relaxation a bit more because it is such a complex topic.
A rider’s muscular tension may be rooted in emotional or physical causes. An anxious, fearful, frustrated, or angry rider will hold her breath, tense her muscles and lock her joints. Riders who lack fitness, balance, or sufficient flexibility in their joints to follow the horse’s motion tense their muscles and joints to compensate. Either way, that tension transmits itself from the rider’s body to the horse’s body.
Muscle tension tends to raise a horse’s emotional level and trigger his fight-or-flight instincts. It makes no difference whether the tension the horse feels comes from his rider, or from stiff muscles due to cold weather, or from the wind that’s howling today, or from the flapping plastic bag that just caught his attention. Muscle tension says ‘go’ not ‘relax.’
There are some horses that will have the opposite reaction to a rider’s muscle tension, though. They mirror a rider’s tense, locked joints by locking their own joints until they are just shuffling along. Either way, the good news is that just as a tense rider makes a tense horse, a relaxed rider can make a relaxed horse.
Whether a tense horse makes the rider tense or whether a tense rider makes the horse tense makes no difference. Either way, a feedback loop begins that will never lead to good results. Someone has to be the grownup. Goldie oldies take the ‘grownup’ role for beginning riders, staying relaxed through all of the mistakes an inexperienced rider makes. Most horses, however, are not goldie oldies. As riders progress and begin riding all types of horses, they become responsible for establishing and maintaining relaxation.
Riders often use tense muscles to make up for their lack of sufficient balance, fitness, or flexibility. It takes strong, flexible muscles (think of a professional dancer gliding across the stage) to support a rider without gripping or excess pressure. Riders with weak muscles and poor balance hang on the reins for support, lock their elbows, grip with their thighs, jam stiff ankles against the stirrups, lock their lower back and have difficulty staying balanced over the horse’s center of gravity without wobbling in front or behind the vertical. A rider also needs good balance and an ability to follow the horse’s motion at every gait in order to ride the horse with complete physical relaxation. Put all of these physical elements together and we say that the rider has an independent seat.
It may seem like a contradiction to say that relaxation is at the base of our riding tree when we often need skills that are much higher up to master it. Rethink mastering riding skills as a spiral learning process rather than a simple linear one. The rider first masters a skill such as circling at the walk. Then she masters it at the trot, then the canter. At each stage she revisits something she already knows while adding something new. As a rider continually revisits and adds, she circles incrementally up the riding tree. So the basic relaxation level that a rider masters when first starting lessons will improve and increase as his or her balance improves. It becomes easier still to stay relaxed when he or she is able to follow the horse’s motion at the walk, then the trot, then the canter. And when the rider achieves an independent seat, relaxation becomes easier to achieve and maintain under more circumstances that challenge her mentally as well as physically.
Even advanced riders with a completely independent seat have anxious moments when a hot or spooky or otherwise highly reactive horse makes it difficult to stay relaxed and focused on the moment. It takes conscious effort for riders to keep their minds off ‘what if’ scenarios when riding green or sensitive or otherwise challenging horses. Focusing on the ‘future possible scary’ creates rider tension that just creates or feeds horse tension. Instead, riders must learn to focus on now and now and now and now. They must ride the horse stride by stride by stride without anticipating any future stride. As my mentor has always said, “ride every stride.”
Watching a confident, competent rider working with an emotionally challenging horse ride through a tough situation can be a revelation. The rider almost seems to be doing nothing. He or she is so focused on the horse that you can imagine they do not even see the boogey man running at their horse (or the mare in heat over by the rail, or the woman whose funky hat is flapping over by the in gate, or whatever it is that is raising the horse’s excitement level). The rider just keeps on keeping on without changing the rhythm of the asking with the aids, quietly reminding the horse to return its attention to this stride, then the next and the next, all without tensing their own body or changing the rhythm of their breathing.
When a rider finds herself tensing and gripping to keep her balance or unable to soften her lower back to follow the horse’s canter, she needs to make a commitment to work on fitness, balance and body awareness on the ground as well as in the saddle. If she notices fears and ‘what ifs’ creeping into her mind and her muscles as she rides, she needs to mentally erase them from her brain blackboard and substitute a picture of that totally focused, totally relaxed rider we talked about. She needs to feel that picture in her own body. We know that horses will mirror any tension a rider holds in her body. We also need to trust they will mirror our relaxation just as easily.
© 2013 Meredith Manor International Equestrian Centre. Nancy Wesolek-Sterrett has earned numerous United States Dressage Federation horse awards including Bronze and Silver Medals on horses she has trained. She competes her horses at Training through FEI levels. As a Certified Riding Instructor she brings over 20 years of experience to her position as Head of the Dressage Department at Meredith Manor International Equestrian Centre (147 Saddle Lane, Waverly, WV 26184; 800-679-2603; www.meredithmanor.com), an ACCET accredited equestrian educational institution.
Equine Dentistry with Sedation
The use of sedation with dentistry has been a long standing practice in both human and veterinary medicine, and for good reason. After seeing numerous message board chats regarding sedation and equine dentistry, I think it is important to discuss why it is often recommended by veterinarians:
Quality of work. After the oral exam has been done and the floating has begun, it is important that it is done right and to completion. A fighting horse may end up with a traumatized oral cavity, or an incomplete procedure. Sedation also allows for excellent visualization and manual palpation of the oral cavity.
Safety. Horses are big, and even some of the smaller ones can do a lot of damage, even if it is unintentional. Having a calm patient helps keep the three participants (patient, handler/owner, veterinarian) involved in the procedure safer.
Bad experiences. Floating is meant to benefit the patient and make them feel better - not stressed or scared. Just like you may feel anxiety when you go to the dentist, so might a horse when someone suddenly shows up at her stall door to perform dental work. Sedation helps reduce this anxiety.
Sedation can best be thought of as mild anesthesia and is similar to the pre-medication you may have once received prior to surgery. While our equine patients are still somewhat aware of their surroundings, they become more tolerant of the work being done on and around them.
Here are some FAQs that I often receive regarding sedation:
“Will my horse lie down?”
This is probably the most common question I am asked. If done properly, then a sedated horse will hang his head, but not fall over or lie down. Horses evolved to sleep on their feet, and proper sedation will keep them upright and put them, as many like to say, “in la la land”. Horses may be laid down intentionally for certain procedures, but this is very rare in routine dental work.
“How long does sedation last?”
If done properly, sedation will allow for about 20-30 minutes of comfortable work. However I always recommend two hours without food to prevent any choke or the small chance of colic.
“How is the sedative given?”
Most commonly it is given intravenously in the jugular vein, but can be given intramuscularly. The benefits of intravenous administration are quick onset (2-3 minutes) and less medication that needs to be used.
“What medications are used?”
Most commonly I use a cocktail composed of xylazine (Rompun), detomidine, and butorphanol. Each patient is different and the amounts are varied depending on factors such as size, age, temperament, and amount of work to be done. Some veterinarians like to use acepromazine, but I do not.
“What side effects are there to sedation?”
Other than general sedation, there are few. The most common ones are increased sweating, increased urination, salivation, and penile prolapse. These are all transient and generally resolve after a few hours.
The idea of having your horse sedated for dental work may be concerning, but when done properly is safe and certainly has its benefits. As always, it is important that you discuss any concerns with your veterinarian prior to the sedation so that you may feel at ease with the procedure.
Michael Marshall, DVM