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Kaydence Sports Medicine & Rehab, 12635 County Road 130, Carthage, MO (2026)

08/03/2026

SUMMER SORES "BUG" HORSES

Ahhh summertime approaches--- that wonderful time of long days and warm weather where you can spend even more time with your horses! After months of trying to race against daylight to ride your horses and get all the barn chores done, the long warm days of summer can hold a lot of promise of equine fun.

Pretty much everywhere though- summertime can bring with it extra work to keep your horses safe from diseases borne by insects, which are much more prevalent in warm weather. In particular, rising temperatures and increasing humidity can mean more fly activity and an increase in the prevalence of summer sores.

I have owned and cared for horses since 1991, and the vast majority of that time has been in subtropical and tropical climates (Florida and Hawaii) where insect pests can be active nearly the entire year. While in Hawaii we are blessed enough to not have many nasty insect-driven infections (yet…), we do have summer sores!

When my grey mare Tess was moved from the mainland to Hawaii, she was stuck in a holding facility in California for an extra week while her trans-oceanic flight was on hold due to a hurricane. In that short time, she developed a summer sore and the first thing I noticed when she got off the plane in Hawaii was that she looked like she had intense black eyeliner around her eyes from rubbing them so much that all the hair came off (see photo of us on the airport runway below!). That led to a two-month daily ordeal of trying to heal up her eyes, stop the rubbing, stop the immune response causing the intense itch, etc. She would flee from me as soon as I showed up at the barn because she knew I was going to mess with her eyes. We came very close to having to put her in an equine hospital and sew a catheter to her eyelid to be able to medicate her! In the long run, it all worked out but I would never wish this on anyone!

Many horse owners have had to deal with summer sores- which can cause cycles of chronic wound outbreaks in really hard-to-manage places, such as eyes, lips, ge****ls, and the lower limbs of horses.

So what are summer sores exactly? Well- it’s fascinating and disturbing all at the same time. Summer sores are officially known as habronemiasis or granular dermatitis. They are caused by the larvae of Habronema spp worms that cause parasitic infections in horses' stomachs. Normally, stable flies buzzing around manure will pick up larvae that hatched in manure and deposit them in moist areas (typically near the mouths) of horses, which then swallow them and continue the lifecycle in the stomach. These internal infections are usually controlled with the deworming medication Ivermectin/ Moxidectin. The trouble arises when these Habronema larvae are deposited in other moist areas like the p***s sheath, the corner of the eyes, wounds, or any moist skin of the horse. Then, the larva burrows about, creating a lot of allergic and inflammatory processes to happen, including intense itching that causes the horse to rub and bite the area, further increasing the risk of trauma to the area and increasing this process. The larvae actually die, because they cannot complete their life cycle, and often be seen as small “grains of rice” looking objects. A hallmark of summer sores are slow or non-healing lesions that are weepy with greasy exudate, and, depending on the area, can form proud flesh, or are frequently re-traumatized because the horse is biting or rubbing the area.

Even after the larvae are dead in the initial infection, the allergic-inflammatory type response of the body often perpetuates this whole cycle, because before the wound can heal, more flies are drawn to it, potentially creating further infection or re-seeding with more Habronema larvae. In subtropical and tropical areas, the wounds may heal up briefly, only to break back open when the weather gets wetter and the ambient humidity keeps moist areas even moister! As stated before, flies tend to be drawn to moister areas where dirt, old food, excrement, and body fluids collect, such as nostrils, lips, corners of the eye, lower limbs (especially the fetlock down), and ge***al regions. The nature of these moist areas also makes it difficult to keep clean and bandage (if you can at all).

So how do you treat such a nasty thing?

First-line treatment is prevention! Doing whatever you can to reduce fly load at your barn is key, especially if you live in a warm, humid area or in a high-density area where manure is piled/collected anywhere close to the barn. This involves a number of controls, from fly predator use, stringent hygiene in stalls/barns, and on the horses themselves, sprays, consistent deworming protocols- especially in boarding facilities or places where there are a high number of horses in nearby farms.

Once the horse already has a summer sore, treatment is usually done with Ivermectin to kill any Habronema larvae living in the body. Then, wound management takes over. Unfortunately, this is where the vicious cycle gets going, because the dewormer doesn’t last in perpetuity in the body, and it doesn’t do anything for the inflammatory response that is triggered in the wound-- and the little dead larvae, if they are not removed from the wound, can make the immune response even more severe. Reinfections can quickly reoccur if there is a heavy existing parasite load in your barn situation along with flies. Fly control must be implemented, along with stringent wound care procedures and the barn environment should be kept as clean and dry as possible.

Fly masks, leg guards and sheets, along with strong fans to keep flies from landing, can be helpful, along with good bandaging. For over 12 years I have worked as an equine fascial therapist across the country in all sorts of high-end barns, with fly control misting systems, owners using every imaginable spray- and what I can say is that with the chemical spray on controls, I have timed it as I am working on horses and the longest any single spray worked was for about 20 minutes, and most worked less than 10. Physical barrier creams like SWAT on wounds do work well, but obviously cannot be pasted across the horse’s entire body or even near sensitive areas like the inner canthus of the eye. Veterinarians can prescribe drugs for wound infections, but the take-home message is that summer sores can be notoriously challenging to treat.

SUMMER SORE CASE STUDY --- INCLUDES PHOTOS NOT FOR THE FAINT OF HEART!

This last year, Dr. Clabaugh called me to ask if I would modify a TCM (Traditional Chinese Medicine) wound salve that I had already created the prior year to deal with a particularly nasty summer sore on gelding’s sheath. I jumped at such an interesting opportunity.

I am in my last 7 months of training of 4 years of training as a (human) Acupuncture and Oriental Medicine practitioner and am a fully trained Chinese medicine herbalist. While TCM (Traditional Chinese Medicine) is often frowned upon because of its association with endangered species, the vast majority of medicinal herbs-- like 440 out of the 460 TCM “herbs” I learned-- are NOT animal products (also, I am a vegetarian, a former professional environmental research scientist and STAUNCH animal rights advocate, so I refuse to use animal products anyway!)

True Chinese herbalism has a history of over 3,000 years and is a carefully developed and elegant system of herbal combinations that can be highly individualized for maximum effect. Appropriate application of Chinese herbal medications requires a masters to doctoral level of training. Aside from my Oriental Medicine program which has a comprehensive herbal program, I also completed an externship two medical universities in China and a year long internship with a Master Chinese herbalist here in the US.

In this case, I used my base wound formula, which promotes wound healing via micro-circulation and rapid epithelialization while also providing antimicrobial activity, pain relief and providing a lubricating,thick barrier to outside pathogens. I gleefully went to my favorite TCM herb shop in Honolulu’s Chinatown and ordered several batches of herbs that have been used since antiquity to remove parasites- internal worms and external parasites have been a problem for man and beast for far longer than we have had ivermectin! I got some pretty strange looks at the herb order, since these issues aren’t such a big problem in our modern times and are not used a lot, but the pharmacist didn’t ask. (He probably thought I had nasty cooties, though….)

I added these herbs into my wound salve. The horse was treated with dewormer to kill all parasites and my wound salve was meant to help speed up the healing process and stop re-infection. This owner lives in a very wet part of our state, so reinfection was a high risk. The owner-who told me she had dealt with this thing for months- sent Dr Clabaugh and I a steady supply of semi-shocking photos of horse ge****ls, and she was thrilled to note that the salve was doing its work. The wound was on the prepuce of the p***s, so it could not be bandaged, and was impossible to keep completely clean and dry. About 10 days into treatment, I spoke with the owner and we decided to add infrared laser therapy to the treatment to speed up the whole process even more. The original wound in shown below.

Within two more weeks, the wound was significantly better, with clean new skin regenerating where the ulceration had been previously and no evidence of re-infection. While not perfect, you can see from the photo the massive improvement.

To conclude, treating summer sores is best done through prevention, which requires a multi-phase approach: barn/manure management, fly control, good barn/horse hygiene and proven deworming protocols. Summer sore infections can still occur despite these efforts, and often require veterinary intervention to help develop a treatment and wound management strategy. Physical barriers to flies such as masks, wraps, and thick ointments may help, and specialized applications of medicated salves and laser therapy have proven useful in our experience.

The Equine Institute

07/31/2026

Back to Basics: Dental Anatomy

People have been warning others not to look a gift horse in the mouth since the 1500s, and maybe even earlier. The adage was borne out of the fact that horses’ teeth change continuously over time and are often used to approximate their age. So, looking at a gift horse’s teeth is, essentially, indicative of distrust toward the giver.

But at the 2016 American Association of Equine Practitioners’ Convention, held Dec. 3-7 in Orlando, Florida, Bruce Whittle, DVM, encouraged attendees to look inside horses’ mouths, as there’s substantial information hiding there. Not only can a veterinarian estimate the animal’s age, as we’ve already ascertained, but these important structures can also help guide treatment or even become injured or diseased themselves, he said.

Whittle, a practitioner at Honey Creek Veterinary Hospital, in Trenton, Missouri, reviewed basic dental anatomy and function with attendees during the convention.

Tooth Structure
The equine tooth—like that of other animal and human species—is comprised of four layers: pulp, dentin, enamel, and cementum.

The innermost layer, the pulp is “basically the heart and brain of the tooth,” Whittle said. It contains vital structures including nerves, the blood supply, lymphatics (which play a part in immune responses), and odontoblasts (cells that produce dentin).

This important, but soft, structure is protected by the outer layers. Pulp damage can result in tooth disease or death, but it can also take years to become clinically apparent, he said.

The average horse has 140 or more pulp horns, ranging from one to six or seven in each tooth, depending on the type of tooth. The challenge, Whittle said, is that it’s almost impossible to tell where in a tooth the pulp is located; it can be as close as 1 millimeter under the chewing surface, or up to 36 millimeters below it. As such, it’s crucial for veterinarians to use extreme caution when floating teeth. Not only can they inadvertently directly damage the pulp with the floating device but they can also damage it indirectly.

“Thermal damage is a concern,” he said. “Only 20 seconds of grinding can increase the tooth temperature by 4.6 degrees Celsius (40 degrees Fahrenheit), and it takes 5 to 10 minutes to cool down” to normal.

Veterinarians can image pulp using radiographs (this is most useful for incisors, he said, which are located at the front of the mouth) and CT or MRI, although it’s uncommon to place a horse under general anesthesia to image their heads for dental issues, he added.

The next layer is dentin, which makes up the bulk of the tooth, Whittle said.

“Dentin is more mineralized (about 70%) than cementum (65%) but less than enamel (96-98%),” he said. “Dentin, therefore, wears more quickly than enamel, contributing to the ‘rough’ occlusal surface important for grinding fibrous feed material.”

There are four subtypes of dentin—primary, regular secondary, irregular secondary, and tertiary—all of which aid in protecting the pulp.

Enamel is the tooth’s hardest substance and forms the ridges on the horse’s rough occlusal (or chewing) surface. However, enamel doesn’t have the capacity to heal itself if it’s damaged like the other tissues in the tooth can—once it’s gone, it’s gone. As such, it’s located between the dentin and cementum to stay protected from damage as much as possible.

Finally, cementum is the outermost layer of the tooth. Whittle said it’s a tissue similar to bone and serves as an attachment between the tooth and the periodontal ligament, which secures the tooth in the socket (or alveolar bone) and provides support as the horse chews.

Cementum fills the infundibulum (a crescent-shaped depression in a tooth’s crown) formed by the enamel on the occlusal surface, but Whittle said it might not be filled completely in the incisors and upper cheek teeth. In fact, one study revealed that only 11% of infundibula were completely cementum-filled, he said.

Tooth Eruption
Whittle said horses have a hypsodont tooth structure, meaning they continue to erupt throughout the horse’s lifetime; the only teeth that do not continue erupting are the first premolars, or the wolf teeth, he said. Horses wear their teeth down about 2.5 millimeters per year, on average, he said.

Young horses develop and erupt 24 deciduous (or baby) teeth, including the incisors and premolars. Starting at about 1 year of age and continuing approximately through age 5, horses sequentially erupt 36 to 44 permanent teeth.

Whittle cautioned that if horses’ baby incisors don’t fall out at the right time, their permanent teeth can grow in behind them and cause dental issues. Additionally, he said, the order in which horses’ cheek teeth erupt can lead to malocclusion (abnormal contact between opposing teeth). For example, the last cheek tooth to erupt—the fourth premolar—must grow in straight between two other permanent cheek teeth. Any deviation from this could lead to misaligned teeth and associated problems that require frequent care.

Chewing Cycle
Finally, Whittle reviewed how horses use their teeth during chewing and how their jaw anatomy impacts that movement.

The horse’s lower jaw (the mandible) is narrower than his upper jaw (the maxilla), and the lower teeth are positioned slightly to the inside of the upper teeth. As the horse chews in a triangular pattern, the outside edges of the upper teeth and the insides edges of the lower teeth can develop sharp points. And, because there’s little extra room in a horse’s closed mouth once the tongue and the palate (the top of the mouth) are considered, these sharp points have the potential to damage soft structures they contact. As such, routine dental exams and treatment are crucial to keep horses’ mouths healthy.

Take-Home Message
Whittle wrapped up by highlighting a few important points for attendees to remember. Teeth are living structures, he said, and the pulpar depth beneath the chewing surface varies from horse to horse and tooth to tooth. Because the pulp is vulnerable to damage, it’s important to use caution when floating teeth. On that note, he said, when floating, be sure to leave enough rough surface on the cheek teeth so horses can chew properly. Finally, evaluate young horses’ teeth regularly, catch malocclusions early, and administer treatment to reduce the likelihood of ongoing problems.

The Horse

07/30/2026

Visits from our mini friends are a sure way to bring big smiles to the clinic!!

Foals are the cutest things in the world, and mini foals bring that cuteness to an even more extreme level 🤯

07/29/2026

Kaydence Sports Medicine and Rehab ❤️ ponies!!

The Differences Between Ponies and Horses

There are perceived differences, and then there are actual differences between ponies and horses.

* Perceived differences are that ponies are more stubborn, naughtier, chubbier. Certainly, this is the case for some ponies – but I also know plenty of wonderful, kind, and svelte ponies that counteract this pony stereotype. I also know plenty of horses that are stubborn, naughty, and chubby.

Real differences between ponies and horses may change the way you manage your pony.

* It turns out that ponies are asked to carry a larger percentage of their weight than their horse counterparts. This, in turn, means that your pony is putting more stress and strain on his joints, back, muscles, and hooves. You know, all of the pony parts.

* Ponies are also more prone to skeletal problems, so that the larger percentage of weight they carry may affect their bones, too.

Ponies are also famous for becoming overweight!

* While this makes them adorable, the health consequences are real. Metabolic disorders, such as Cushing’s disease, are common and can contribute to laminitis.

* Ponies can also develop liver problems and have increased blood levels of fats. Overweight ponies also put even more pressure and strain on their legs and joints.

When you are caring for a pony, you will need to step up the care and management routine in a few areas.

* Monitor weight, use grazing muzzles, and have regular blood tests to stay ahead of metabolic disorders.

* Support your pony’s body with properly fitted tack, and use therapeutic measures to pamper his legs.

* Regular grooming, Veterinary care, and a well-balanced diet will help your pony thrive. And stay naughty.

Pro Equine Grooms

07/28/2026

How to Prevent Laminitis in Horses

By the time a horse shows signs of laminitis, damage to the coffin bone’s supporting tissues, called the lamellae, has often already begun. Identifying and managing insulin dysregulation (ID) before clinical signs of laminitis appear offers one of the best opportunities to prevent this painful condition, said Andrew van Eps, BVSc, PhD, Dipl. ACVIM, professor at the University of Pennsylvania’s New Bolton Center, in Kennett Square, during his presentation at the 2026 American College of Veterinary Internal Medicine Forum, held June 11-13, in Seattle, Washington.

Hyperinsulinemia, or persistently high blood insulin concentrations, is the primary driver of endocrinopathic laminitis in horses. While obesity, pituitary pars intermedia dysfunction (PPID), age, stress, pregnancy, certain medications, and high nonstructural carbohydrate (NSC) intake can all contribute, the elevated insulin itself causes damage to the lamellae, said van Eps.

Identifying Insulin Dysregulation in Horses
Horse owners should work closely with their veterinarians to identify ID before lamellar damage occurs. Van Eps recommended annual metabolic screening for most horses younger than 10 years old, except for those in intense aerobic work such as racehorses, endurance horses, and upper-level eventers (who are less likely to be at risk of metabolic disease). He said horses older than 10, as well as breeds or individuals considered at higher risk (i.e., pony breeds, Warmbloods, and gaited horses), should be screened twice yearly—in the spring and fall. Veterinarians should also include PPID screening as a part of routine testing in senior horses.

While insulin remains the cornerstone of equine metabolic screening, newer biomarkers can help identify horses at risk even earlier. “Adiponectin (a hormone that improves insulin sensitivity) is an independent predictor of laminitis risk,” said van Eps. “Horses with normal insulin but low adiponectin may still have an increased likelihood of developing hyperinsulinemia after a feed or sugar challenge and warrant close monitoring and additional testing.”

Managing Horses at Risk for Laminitis
Managing horses at risk focuses on reducing insulin spikes before they damage the lamellae. Horses with ID benefit from diets low in nonstructural carbohydrates (NSCs). In overweight horses and ponies Van Eps recommended restricting forage intake for weight loss when appropriate and feeding hay that either tests below 10% NSC or has been soaked before feeding.

Generally, the safest time for these horses to graze is late at night or early in the morning, before the sun comes up. Avoid afternoon and early evening grazing, lush spring or fall grass, and pasture stressed by frost or drought because these conditions can increase NSC concentrations in grass.

When management changes haven’t controlled a horse’s ID, van Eps said veterinarians might consider medication alongside dietary modifications:
* SGLT2 inhibitors (ertugliflozin, canagliflozin, and bexagliflozin)effectively reduce hyperinsulinemia and can help prevent laminitis in high-risk horses. However, the horse’s insulin concentrations typically rise again after treatment ends unless diet, exercise, and weight management improve insulin sensitivity.
* Pioglitazone increases adiponectin concentrations and can improve insulin sensitivity. Van Eps said it can be useful for horses with mild ID and low adiponectin or in combination with an SGLT2 inhibitor.
* Metformin has inconsistent effects and veterinarians no longer consider it a first-choice treatment for ID in horses.
* Levothyroxine can help horses lose weight when used alongside feed restriction, but veterinarians should only prescribe it as a short-term therapy.

Take-Home Message
Preventing laminitis involves identifying equine metabolic abnormalities early and managing a horse’s insulin levels before lamellar damage occurs inside the hoof. Work with your veterinarian to develop a feed, exercise, and in some cases a medication routine to meet your horse’s needs.

The Horse

07/27/2026

We have last minute appointment availability tomorrow, 7/28, at the clinic in Carthage. All appointment types are available. Please text the clinic at 417-448-0131 to schedule

07/24/2026

Anhidrosis in Horses and Electrolyte Therapy

The sweat glands of most horses toil glitch-free for a lifetime, working tirelessly to moderate body temperature, excrete waste products, and help maintain the ecosystem of the skin. Occasionally, and often inexplicably, a horse will lose its ability to sweat, a condition known as anhidrosis. As with humans, sweating among horses is key to thermoregulation, so anhidrotic horses, sometimes called “non-sweaters,” pose significant challenges for their owners.

“The disease seems to be especially prominent in hot, humid climates, which makes the necessity of sweating all that more important,” said Kathleen Crandell, Ph.D., a nutrition advisor with Kentucky Equine Research (KER), Versailles, Ky. “It can come on suddenly or develop slowly over time and is most often associated with times when the nighttime temperature does not go below 80o F (27o C).”

Researchers estimate that 2-6% of horses suffer from anhidrosis. In one study* of 834 Thoroughbreds on central Florida farms, 6% of horses were affected. Horses in training and nonpregnant broodmares were diagnosed most often in this study, while young horses were infrequently affected. In a more recent, larger study**, one featuring just over 4,600 horses in Florida, researchers found about 2% of horses were anhidrotic.

Not all horses are similarly affected; some anhidrotic horses have decreased sweat production, some have areas of the body that stop sweating, while others completely stop sweating. Anecdotal reports reveal that dark-colored horses are affected more frequently than light horses.

Aside from lack of sweating, an acute episode of anhidrosis is characterized by labored breathing, flared nostrils, increased heart rate, increased body temperature, fatigue and possibly collapse. The greatest risk with anhidrosis is from the onset of heat stroke, which can be fatal if not dealt with immediately. Chronic cases are marked by increased drinking and urination, as well as a poor appetite. Horses with chronic anhidrosis might also have changes to their skin and coat, including dryness, scaling, regional balding, and itching, which is where another term for anhidrosis, “dry coat syndrome,” originates. Impaired performance is a problem among those horses chronically affected. Those that do not sweat at all might be unable to work altogether because of their inability to cool themselves.

Anhidrosis can be diagnosed by a veterinarian. A series of injections of dilutions of terbutaline, designed to stimulate the sweat glands, will help pinpoint non-sweaters. Blood work that includes an electrolyte analysis could be useful in developing a treatment plan.

Some horses that begin electrolyte supplementation are jump-started out of an anhidrotic state. Choose an electrolyte wisely. Restore SR (available as Restore in Australia), developed by the nutrition specialists at Kentucky Equine Research, provides innovative electrolyte therapy. Not only does it contain all of the important electrolytes—sodium, chloride, potassium, and magnesium—but it provides sodium in such a way that releases it slowly into the gastrointestinal tract, and this allows for sustained absorption. Restore Paste is also available and provides both oral and gastrointestinal comfort to sensitive horses that become irritated by traditional electrolytes.

“While electrolyte and salt supplementation are an integral part of a treatment plan for anhidrosis, if the solution was as simple as just adding electrolytes to the diet, then we would not have a problem with anhidrosis. There may not be a cure for the disease, but there are other ways to address the problem that also help the horse deal with the issues caused by anhidrosis,” added Crandell.

Additional management strategies, aside from moving the horse to a cooler climate, include:
* Provide access to a shady environment during the daylight hours, and use fans to keep air moving in stalls or run-in sheds. Air-conditioned stalls are helpful for maintaining a cooler body temperature. Water misters may also be used to keep horses cool in extreme heat.
* Nighttime turnout is helpful because there is more air movement and temperatures can be cooler than in stalls.
* Offer a source of cool, fresh water at all times.
* Exercise horses when temperatures are lower, such as in the early morning or late evening. Dampen the coat with water before starting exercise. Allow for plenty of cooldown time after exercise and monitor respiration rate. Splashing water on the neck, legs, and body will help bring down the body temperature. Watch carefully for any sign of heat distress.
* Aggressive, regular grooming stimulates blood flow to the skin. Keep the hair coat clipped regularly during the hot season.
* Some researchers believe supplementation with vitamin E might help anhidrotic horses.**,*** Natural-source vitamin E is superior to synthetic sources. Nano-E, a natural-source product developed by Kentucky Equine Research (KER), features nanodispersion technology, which ensures rapid bioavailability.
* Consult with a veterinarian to discuss an appropriate treatment plan. Different treatment options are available, many of which depend on severity.

As of today there is no known cure for the disease, so all of the management, supplement, and medications recommended are for treating the symptoms and making the horse more comfortable.

Kentucky Equine Research

07/23/2026

A Whole-Horse Approach to Equine Joint Therapies

When addressing equine joint disease (arthritis), veterinarians must match treatment to the affected tissue type, the horse’s overall health, and the underlying cause of disease to reduce complications and improve outcomes. Kimberly Hallowell, DVM, Dipl. ACVIM (LAIM), a PhD student at North Carolina State University, in Raleigh, and Lauren Schnabel, DVM, PhD, Dipl. ACVS-LA, Dipl. ACVMSR, professor of equine orthopedic surgery and Hallowell’s mentor in the PhD program, presented on the topic at the 2026 American College of Veterinary Internal Medicine Forum, held June 11-13 in Seattle, Washington.

Osteoarthritis affects the structures in the horse’s joint capsule, the synovial membrane lining it, synovial fluid, subchondral bone (which lies beneath the cartilage), and surrounding soft tissues such as tendons and ligaments, contributing to pain and lameness. This means no single therapy works for every horse.

“The goal is to intervene early, treat the underlying injury, restore joint homeostasis, and return the horse to its highest possible level of athletic function,” Schnabel said. In many cases that involves combining therapies rather than relying on a single treatment.

Corticosteroids for Treating Equine Joints
Corticosteroids remain one of the most used intra-articular treatments because they provide powerful anti-inflammatory effects at a relatively low cost. “However, growing evidence suggests veterinarians should carefully consider each horse’s metabolic health before administering these medications,” said Hallowell.

Intra-articular corticosteroids can cause temporary increases in insulin and blood glucose concentrations, raising concerns about corticosteroid-associated laminitis, particularly in horses with insulin dysregulation or equine metabolic syndrome (EMS). For horses with confirmed or suspected EMS, she recommended considering orthobiologics or polyacrylamide hydrogels (PAAGs) instead of corticosteroids.

Orthobiologics and PAAGs for Treating Equine Joints
Orthobiologic joint therapies for horses include autologous conditioned serum (ACS, also known as interleukin-1 receptor antagonist protein ), platelet-rich plasma (PRP), autologous protein solution (APS), alpha-2 macroglobulin (A*M), and stem cell therapies. Because these products originate from the individual horse, however, their composition can vary considerably. “Hydration status, recent exercise, stress, and medications, in addition to blood collection and storage techniques, can all influence the final product’s quality,” said Schnabel. Following standardized collection protocols helps maximize treatment consistency.

“Injectable polyacrylamide hydrogels give veterinarians another option for managing osteoarthritis,” Schnabel added. “These synthetic products integrate into joint tissues or supplement joint lubrication depending on the formulation.” The 2.5% PAAG product acts through integration in the synovial membrane, while the 4% PAAG product provides viscosupplementation and aggregates in areas of damaged cartilage, she explained.

Equine Endocrine Disease and Joint Therapies
Hallowell said veterinarians should test horses with possible endocrine disease before selecting a joint therapy. In fact, she recommended making endocrine screening part of routine preventive care by testing horses over the age of 15 for PPID and evaluating all horses for EMS with a dynamic test such as the oral sugar test.

Although horses with signs of EMS, such as regional fat deposits, generalized obesity, intermittent foot soreness, or divergent hoof growth rings, should be highest priority for testing, Hallowell highlighted that she and her colleagues recently found almost 25% of sport horses have EMS, and even horses without classic clinical signs can be affected.

These screenings can be incorporated into annual wellness exams, and point-of-care insulin tests now make it possible to assess many horses’ metabolic status on the day of treatment. “Identifying endocrine disease before joint therapy can help veterinarians select the most appropriate treatment and better manage potential risks,” said Hallowell.

Take-Home Message
Schnabel and Hallowell emphasized that successful joint therapy depends on accurate diagnosis and individualized treatment. Matching therapy to the injured tissue and the individual horse’s health offers the best opportunity to improve soundness while minimizing treatment-related risks.

The Horse

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