Senior Wellness Exams

1. I have an 18-year-old donkey that continues to drop chewed up hay instead of swallowing. She has had her teeth examined by both an equine dentist and veterinarian. She seemed better after first done about four years ago but now doesn't seem to get lasting benefits. I suspect a molar has abscessed as radiographs are being taken soon. I am afraid to let anyone pull her tooth and don't want it done unnecessarily. Should I get a second opinion after the radiographs? Also, who should best pull her tooth? An equine dentist or an equine veterinarian? One veterinarian told me she would have to be under anesthesia for a molar extraction. (View Answer)

   You’re on the right track with X-rays and perhaps a second opinion by a veterinarian with advanced training in dentistry. This is especially important since you have a non-traditional equine with some age, clinical signs, and a possible issue that may have complications. If a tooth root infection or abscess is confirmed, its location (upper or lower cheek tooth), the involvement of other structures, the general health of your donkey, and other factors help determine if removal (extraction) is necessary and how best to do it, that is, standing sedation or general anesthesia.

    

   Even though the removal of a cheek tooth in equine is a serious step with long-term consequences, loose or infected teeth can be very painful for horses and she will thank you for helping restore her mouth to health! You’ll want to follow your veterinarian’s instructions for aftercare closely, which may include antibiotics, oral rinsing, and other treatments. It will also be important to have your donkey’s mouth examined twice yearly from now on since equine teeth continue to grow throughout their lives and removing one can affect the others.

    

   Good luck getting to the “root” of her quidding issue and the professional dentistry she needs! Lydia Gray, DVM, MA, SmartPak Equine

2. I have a 17-year old Morgan gelding that is sound and in good health. Should I get a wellness exam to establish a baseline for later use should he have issues? I am particularly concerned about metabolic problems that may occur as he ages as I understand the Morgan breed can be prone to have such problems. What would you recommend a wellness exam include for such a horse, e.g., what type of blood tests? (View Answer)

   You sound like the kind of conscientious horse owner that every veterinarian would love to have as a client! You clearly understand that “prevention is the best medicine” and that breed, age, and other factors can predispose a horse to certain problems.

    

   Morgans are indeed one of the breeds in which Equine Metabolic Syndrome and Cushing’s Disease (PPID or Pituitary Pars Intermedia Dysfunction) do seem to be more prevalent, and the earlier these conditions are diagnosed, the sooner treatment and management can be started to delay progression and prevent complications such as laminitis.

    

   The best place to start is with an annual physical examination by your regular veterinarian. This visit should include not just a hands-on assessment of your gelding’s current overall health, but also a dental exam, a discussion about parasite control, and body condition scoring as part of an overall nutritional evaluation. Administration of vaccines appropriate for your horse’s lifestyle and lifestage may also be a component.

    

   This wellness visit would be a great time to bring up your concerns about your horse’s predisposing factors (age and breed) for two common metabolic and endocrine conditions and ask what specific tests would be appropriate at this time. While general bloodwork such as a CBC (complete blood cell count) and serum chemistry can be useful, certain protocols have been specially developed to identify horses in the early stages of metabolic and endocrine disease, when standard testing is typically unable to detect a difference.

    

   I encourage you and your veterinarian to read and discuss the latest diagnostic and treatment recommendations for EMS and PPID set forth by The Equine Endocrinology Group, a group of clinicians and researchers that are working together to advance our understanding of endocrine disorders in horses: https://sites.tufts.edu/equineendogroup/. Lydia Gray, DVM, MA, SmartPak Equine

3. When should you treat cataracts. What is/are the most effective methods of treatment? (View Answer)

   Cataracts are an opacity or cloudiness of the lens inside the eye. They can be present at birth in foals or develop later in life due to age, trauma, inflammatory eye conditions such as equine recurrent uveitis (moon blindness), or other events.

    

   Owners may notice some of the following signs as their horse’s vision progressively worsens:

   • The normally black pupil (not the cornea) becoming cloudy white
   • Walking into objects
   • Stumbling and tripping
   • An increased amount of head injuries
   • Increased shying, anxiety, and jumpiness
   • A change in head carriage

   Note that these observations are not specific to cataracts but could indicate other conditions, and so it is always a good idea to have a veterinarian perform an examination for an accurate diagnosis and treatment plan when you notice things out of the ordinary.

    

   The only treatment for cataracts is surgical removal, and the decision to go this route depends on what you do with your horse, how healthy he is, what caused the cataracts in the first place, and how well you will both tolerate the rather long and intensive aftercare regimen.

    

   Cataracts themselves are generally not painful but the underlying cause may be so it sounds like a visit from your vet is in order to see what’s going on and to discuss your options.  Lydia Gray, DVM, MA, SmartPak Equine

4. I recently adopted an 18-year-old companion Thoroughbred from a rescue. I was told that the rescue's veterinarian diagnosed him with stifle issues but I do not know specifically what the issues are. He seems very sore and will pick up his hind legs frequently standing with his hind legs slightly extended behind him. Upon backing you can see it really bothers him. My question is what can I do to keep him comfortable? I just started him on "Buteless" and 1 scoop per day, but have not yet noticed any improvement. (View Answer)

   It’s hard to provide any specific recommendations without seeing your horse, so I would ask your regular veterinarian (since it sounds like you have another horse) to come out and look him over. Getting an accurate diagnosis is the first step towards developing a treatment plan and relieving his discomfort and will be faster and more economical in the long run.

    

   Pictures, videos, and the medical report from the rescue veterinarian will help your own vet reach that diagnosis as some musculoskeletal issues don’t always show up the day that you need them to or only occur under certain conditions. If you can capture some images on your phone to share with your vet, that -- along with his medical history including any treatments given -- will greatly assist your veterinarian in narrowing down the list of possible conditions.

    

   I hope that you get to the bottom of this quickly so you and your new guy can start enjoying each other! Lydia Gray, DVM, MA, SmartPak Equine

5. I have an older gelding that recently tested positive for insulin resistance and now has alopecia. What can I do to help alleviate the symptoms of the alopecia as well as a diet for the insulin resistance? Low carbohydrates, low starch, low sugar grain and not placing on pasture with dewy grass? (View Answer)

   I can share the usual advice regarding the nutrition and management of a horse with insulin resistance (insulin dysregulation), but since alopecia or hair loss is not typically associated with IR, I suggest you go back to your veterinarian with this new and likely separate problem for a diagnosis and treatment plan.

    

   So as far as what to feed the horse that doesn’t metabolize sugars and starches well, here’s what is commonly recommended:

    

   Hay

   • Have your hay analyzed to see what the non-structural carbohydrate (NSC) percent is. If about 12% or lower, you’re in good shape. But if it’s higher, either seek a lower NSC hay or soak the hay you have. Studies have shown that soaking in cold water for 60 minutes or hot water for 30 minutes can leach out 20-30% of the sugars and starches without much loss of other nutrients
   • Restrict your horse to 1.5% of his body weight each day in grass hay (gradually!) and use a small hole hay net or other type of slow feeder to limit the rate of intake. For a 1000lb horse, that would be about 15 pounds of hay – ask your vet to help you guesstimate your horse’s weight if you’re not sure.

   Grass

   • Your vet may or may not want your horse to have any grass at all depending on your horse’s degree of IR, risk of laminitis, body condition and cresty neck score, as well as the fall/winter high risk season, where you live, the species of grass available, and other factors. If grass is still an option, a grazing muzzle is a must!

   Grain

   • Grain (oats, corn, sweet feed, pelleted concentrate, etc) is a no-no for most IR horses, but he still needs protein, vitamins, and minerals. Consider a ration balancer or multi-vitamin/mineral supplement to complete and balance the diet.

   Other

   • Ask your vet what treats are off the table, such as sugar cubes, peppermints, and products with lots of molasses or grain. A few slices of apple or a couple of baby carrots are probably okay, and many companies make “healthy” treats that are low in sugars and starches so you can still reward your horse for a job well done!

   While this advice may seem restrictive at first, your horse will thank you in the long run for being a conscientious caregiver and feeding to prevent some serious health problems associated with high sugar and starch feedstuffs! Lydia Gray, DVM, MA, SmartPak Equine