Category Archives: Equine Medicine

Lisa’s diary: Spotlight on Strangles

Brian’s owner requested a call-out when the five-year-old Warmblood seemed under the weather.

He had arrived on his new yard 10 days before and seemed fine until yesterday, when he was a bit lethargic.

On examination his head was hanging low and he looked very sad. He had a thick nasal discharge and a high temperature (39.1C) He also had a mild swelling around the throat.

To start with, I prescribed some anti-inflammatory drugs. In this case, no antibiotics were given as it can prolong the formation of abscesses. Strangles was a concern so I recommended a nasopharyngeal swab to determine the cause of the nasal discharge.

A blood sample was taken to check the level of strangles antibodies.

Until the results were back, it was advised that the horse was kept isolated and that it was best that only his owner would care for and handle Brian, using strict biosecurity. This meant following a routine of changing clothes, as well as washing and disinfecting hands and boots.

The lab contacted us 48 hours later and confirmed a strangles infection. Strangles is an infection caused by Streptococcus equi equi and can affect any horse, at any age.

It is highly contagious and in one per cent of cases, proves fatal. It is spread via direct and indirect contact so on equipment, clothing and hands. The yard was asked to refrain from moving horses off the yard as a precaution. The horses were split into groups 1) affected horses 2) in contact horses and 3) horses that have had no contact. Owners were advised to monitor their horses’ temperature and if increased then to isolate them also.

In 10 per cent of cases, horses will become carriers. This means they look well but may still harbour bacteria in the guttural pouches. Horses can incubate the infection for three to 14 days and abscesses can take up to two weeks to form.

We monitored Brian closely and he recovered well. We carried out further swabs and blood samples to determine he was free from infection.

Plea for horse owners to worm wisely

Ref: Horse & Hound; 12 March 2015 Horse & Hound

“Routine testing, not routine worming” is the message industry experts are trying to put across after a recent study found that 81% of owners are not conducting frequent faecal egg counts (FECs).

Nearly 1,000 owners were questioned on their current worming procedure and knowledge by equestrian supplier Countrywide. The results showed worrying trends.

“The survey has brought out the disparities in current practice against best practice and how this is leading to the rise in resistance to wormers,” said Countrywide’s Sara Blackshaw.

Only 31% of owners said they conduct regular FEC tests while nearly 60% of owners said that they routinely worm — interval dosing at set times of the year.

In 2010 the British Veterinary Association (BVA) launched a campaign telling owners that, in order to slow resistance, all worming treatments should be based on veterinary diagnosis.

The owner of Westgate Laboratories, Gillian Booth, is concerned the results show that owners have still not updated “their worming practice to match the increase in resistance and improvement in testing technology”.

“Previous worming practices have led to the resistance problems we now have, so it is vital that there is change,” she said.

Countrywide’s Mark Hawkins added: “Without testing there is no way of knowing if a wormer is being effective. The implications of not worming if it is required, or ineffective worming, can be severe.”

Lack of knowledge

The research also found that a worrying number of owners do not know the accurate weight of the horse they are worming — nearly 40% of people questioned were unclear.

Director of BW Equine Vets, Chris Shepherd, said this figure was “very concerning” as “dosing plays a large role in the increase in resistance”.

“If you do need to treat, accurate dosing is essential. Under-dosing promotes resistance and is similar to giving the worms a vaccine allowing resistance to build up to that particular wormer,”
Mr Shepherd added.

Industry experts want owners to take an active role in preserving wormers that are currently effective.

European veterinary advisor at Norbrook Pharmaceuticals, Rebekah Dudek, warned: “If we continue to worm simply ‘as we always have’, there is a chance we will eventually be left with no efficacious wormers in our arsenal, meaning we would have to rely on management strategies as the only option to control worm burdens.”

Lisa’s diary: The mysterious missing haynet

By Lisa Paterson

On my rounds I get reassigned to an emergency call. Molly, a 4-year-old cob, has started to show signs of colic.

Her owner Mike is concerned as there is a small portion of fluorescent green haynet that has gone missing overnight.

On examination, Molly’s vitals are normal. She has passed some normal faeces and seems to be keen to eat. I give her some pain relief and buscopan, an antispasmodic drug, to settle her abdominal discomfort.

We hunt the area for the haynet – has it been eaten or blown away?

I chat to Mike about the options. We could do endoscopy to see if it is in Molly’s stomach. If the colic signs don’t settle then the worst case scenario would be surgery. We decide to monitor Molly closely for the next 24 hours.

Luckily, on the follow up call, Molly is settled and shows no further signs of colic.

Mystery of the missing haynet…UNSOLVED!


Vaccine amnesty following tetanus death

Over the New Year, our vet Lisa treated a horse found with the early stages of tetanus. Unfortunately, he went downhill very quickly and was put to sleep. It is simply horrible for all involved when this happens and our thoughts are with the owners.

Vet injecting horse in neck

Just a small wound can allow tetanus to enter the horse’s body, and the mortality rate is extremely high, meaning many horses cannot survive this serious infection.

Spurred into action, our head vet tech Lynne has organised another tetanus vaccine amnesty with the backing of drug company Elanco. From February 1, clients can pay for a first vaccination and get the second a month later, free of charge. Visit charges will still apply.

Call the clinic to book your horse in. Be safe, not sorry.


Lisa’s Diary: wounds and wonky feet

By Lisa Paterson MRCVS

Keeping up to date with new developments in veterinary care is an essential part of our job and the Simply Horses staff often attend Continuing Professional Development events. In November I was invited to a BEVA event at Matfen Hall, where Patrick Pollock and Jim Ferrie gave talks on remedial shoeing and wound management in horses. Patrick is a vet based at Glasgow university and specialises in equine surgery, and Jim is one of Scotland’s best known farriers, so together they had a lot of good cases to talk about.

Patrick had brought along summaries of some of his most challenging and technical patients, including one poor horse with a stake stuck in its head. He discussed cases that hadn’t responded to traditional treatment and why they wouldn’t, because of complications with infection and foreign bodies. He also talked about the use of medicinal honeys.
Jim then stepped up to talk about his shoeing work and his use of spiral shoes and spiral trimming, which he finds are making a great improvement with horses that have a foot imbalance. Some horses, as they move forward, have an outward rotation between the knee and the canon bone and will place the hoof outside the middle of the leg to land flat. This causes excess load on the inside of the leg and hoof.

To address this problem, especially in a young horse in which the growth plates have not yet closed, Jim trims the hoof on a spiral which would see the outside lowered to allow normal footfall. In cases where the horse is older and already lame, this spiral can be made with a shoe. Jim also showed us photos of a horse that had been diagnosed and treated for a keratoma, which is a kind of benign tumour that grows through the horse’s foot.
Matfen Hall provided a delicious evening meal and it was good to chat with fellow equine vets from around the North East. The evening continued with Merial, a veterinary drugs company, talking about changes to their proteq flu/ tet vaccination. There is now a more advanced form of vaccine that protects against the Clade 2 strain of equine flu, which we are already using at Simply Horses.
Patrick then resumed his talk about wounds and there were some photo examples of equine limbs with wounds to evaluate. Answers were submitted and a prize was given for the best answer. The competition was fierce as the prize was a 10-year-old Scottish whiskey! I really enjoyed the evening and it has given me a lot of food for thought and some new information when it comes to dealing with complicated cases.

Another skin cancer commonly seen in the horse is squamous cell carcinoma (abbreviated as SCC). It is usually found at the muco-cutaneous junctions e.g. the corner of the eye/eyelids, vulva and penile sheath; Basically areas were skin is less pigmented. The condition has been associated with equine papilloma virus 2 with transition from warts into skin cancer and sunlight. Initial  skin abnormalities can appear as warts but later become more irregular with a tendency to bleed.  In more advanced stages they tend to infiltrate the local surrounding tissue and cause problems due to interfering with mechanical function (eyelids, penile sheath) and local lymph flow. A variety of treatments is available but depends on the stage (early vs. late, extend, infiltration in the region and location). Treatments can include surgery, cryotherapy (freezing), injection as well topical application with cytostatic drugs). Obviously early treatment will likely be more successful.


Picture of two early stage penile SCC.  The primary complaints were failure to drop the  penis (picture one with a “wartlike growth on the penile shaft) and bloody spots on the hind legs (picture 2 from a bleeding SCC on the tip of the penis).

Penile squomous carcinoma Penile squomous carcinoma2



A skin disorder that quite commonly is seen is the  equine sarcoid. It probably is best to classify a sarcoid as a  tumour like skin condition although the exact cause is still unclear. There is some support for possible viral involvement by an aberrant  bovine fibropapilloma infection and possibly some underlying genetic predisposition. Sarcoids are often found on certain locations on the body such as close to the eye, under the abdomen and chest as well inguinal area and the axilla but other locations are possible too. Potential spread by insects has been implicated partly based on these locations (there were flies like to bite) and small predisposing wounds could also be a risk factor.  Six different presentation forms are generally recognized but intermediate forms exists.  A large percentage of sarcoids can be treated by “immune-stimulating creams” which basically blister the sarcoid off (and it does look ugly when this happens). However the best approach and success depends eventually on the type of sarcoid, it’s location, size etc. Success is not always guaranteed and treatment will take time as it often is taken in stages.  Also while sarcoids may successfully be treated it is not a guarantee either that new ones will occur in the future. That is of course not a reasons for not treating them as over time they eventually become more aggressive and can cause problems and at that stage will be harder and more costly to treat.

Picture 1: Example of a occult sarcoid type in the lower flank area.

occult sarcoid


Picture 2: Example of a nodular sarcoid type near the (medial) corner of the eye.

nodular ocular sarcoid

Grass Sickness

By KC: Speaking to a few colleagues last week there have been some cases of Grass Sickness around again. A change to more wet and windy weather appears to be one of the triggers for certain pastures that are affected. Signs can vary depending on the dose of toxin ingested. This can include (impaction) colic or reduced faecal output, muscle fasciculations, sweating, a droopy eyelid (see picture) while cases that are more chronic will rapidly waste and become weak. Many cases are fatal but chronic cases may with a lot of TLC (and time and expenses) recover.

Pic: Notice the droopy upper right eye lid (left on the photo) compared to the left upper eyelid (right on the photo) which had it reversed after topical application of  phenylephrine eye drops.

Grass Sickness_Phenylephrine eye  Test

Tetanus in Horses

By KC: Yesterday I saw a horse with early signs of tetanus. The horse was not vaccinated and had started to show signs of  a stiff gait, hyper-excitability (i.e. exaggerated response to noise and movement),  a slightly elevated tail carriage and easily visible 3rd eyelids (see pics.). Luckily it was still able to eat but as it was early stage things can potentially change to real “lock jaw”.  The condition is caused by a bacterial toxin that overstimulates the nerve ends and hence cause muscle rigidity.   The toxin is produced by a bacterium called Clostridium tetani which normally lives in the soil as it does not like oxygen.  The usual cause of clinical tetanus is when this bacterium gets in a wound which favours bacterial growth and production of the toxin. Another and less documented source for the toxin is entrance to the body via the gastro-intestinal tract as the bacteria can be found as part of the bacterial flora in the gut,  likely from soil ingestion. Treatment focuses on stopping the bacteria to grow  and produce more toxin (antibiotics), inactivate new toxin (with a specific antiserum) were possible and supportive treatment (sedation, force feeding if needed).  Success is not guaranteed and thus prevention by vaccination is much better than relying on a cure.

Simply Horses Vets , Equine Education

Working for a certificate

Having been out of University for just over 4 years now, I decided it was time to go back to the books and study. I enrolled on a certificate in advanced veterinary practice (certAVP), that I could do from home while continuing to work. So I am now once again a student at the University of Liverpool.

eq9vet vets study Loenardo horse and rider

The aim of the certAVP is to provide more in depth knowledge in a specific field of veterinary practice. As I am still in the early stages, I am learning more general information before going into a more in depth area of interest. Eventually I will be doing more specific work on medicine subjects, including hearts and lungs, colics, liver problems and several others.

I am sent weekly reading lists, along with weekly assignments. These vary from short responses, to longer case reports. I am also required to attend online meetings and online discussion boards with other vets enrolled on the certificate. These give me the opportunity to discuss alternative diagnoses and treatments with vets from this country and also those outside the UK working for the same certAVP.

I have been very lucky to have the help of my colleague, Keesjan, who started working for us a few months ago. He has done a lot of work in medicine (already holding certificates) and provides a lot of support for me when working up cases.

I hope that this certAVP will bring more to our clients and allow us to provide a better service to you all. In the mean time, it is back to the study for me as I have deadlines to meet!

Charlotte Stedman MRCVS

Education is a progressive discovery of our ignorance.Will Durant (1885-1981) U.S. author and historian.